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Objective: Patient satisfaction reflects the social benefits of hospitals and is an important indicator of hospital performance. This study explores the mechanism through which inpatients' trust in physicians, self-efficacy, and participation in medical decision-making impact their satisfaction with medical services. Methods: A questionnaire was administered to 814 inpatients in 10 randomly selected tertiary hospitals and 10 randomly selected secondary hospitals in Hangzhou, China. A correlation analysis and hierarchical linear regression were conducted to analyze the factors influencing inpatient satisfaction. Results: The outcome measures of trust in physicians and participation in medical decision-making behaviors had significant positive effects on inpatient satisfaction.Trust in physicians was shown to directly influence inpatient satisfaction, while inpatient participation in decision-making partially mediated this relationship. Inpatient participation in medical decision-making fully mediated the relationship between self-efficacy and inpatient satisfaction. Conclusion: While inpatients were relatively satisfied, there is room for improvement. Healthcare providers should improve patient trust by actively listening to their needs and providing feedback, establishing effective communication mechanisms. Patient self-efficacy can be enhanced through health education, special lectures, and case sharing. Patients should also be encouraged to actively participate in medical decision-making. Practical implications: Based on inpatient feedback during a preliminary survey, we refined this study's questionnaire to enhance its feasibility for future research. This article shares key findings for healthcare managers and providers, advising that patient satisfaction can be enhanced through trust, self-efficacy, and participation.

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(1) Introduction: Trust is a cornerstone of the patient-physician relationships. Unforeseen complications in the health care system could jeopardize patients' trust in their physicians. (2) Aim: This article presents a quantitative figure regarding foreseeing the necessity of a three-dimensional quantitative visualization of bone structure and concurrently preparing for an ancillary procedure by a dentist to successfully perform the surgery that could minimize unforeseen complications; (3) Materials and method: This retrospective study has been derived based on an analysis of 1134 patients who had received 4800 dental implants from January 2001 to August 2020, out of which 200 cases were randomly selected for this study. Each procedure during implant treatment was categorized as OPG (Orthopantomography) or OPG with CBCT as per all the procedures which included and were coded as follows, 1: Surgery & Restoration, 2: GBR (Guided Bone Regeneration), 3: GTR (Guided Tissue Regeneration), 4: Block Bone Graft, 5: Spreading, 6: Splitting, 7: Internal Sinus, 8: External Sinus, 9: PRF (Platelet Rich Fibrin). Any of the 200 cases in which implant placement could not have been performed for reasons related to a lack of CBCT were selected for this study. The surgery was aborted halfway through without implant placement in these cases due to a lack of bone quantity and/or lack of primary stability. These cases were registered for re-evaluation and statistical analysis; (4) Results: 7% of the cases that used OPG alone led the surgeon to unexpectedly abort in the middle of the surgery without implant placement. All (100%) of the patients who had CBCT during treatment planning were able to receive implants during the surgery. None of the patients left the surgery without receiving implants if CBCT was used (0%); (5) Discussion: Radiographic image quality is defined as the amount of information within the image that allows the radiologist to make a diagnostic decision with a particular level of certainty (Martin et al., 1999) and hence the importance of CBCT. The unexpected 7% of devastating situations for patients who started surgery but did not have implant placement led to [A] aborting the surgery, [B] procedural difficulties requiring an alternative treatment plan, [C] a negative impact on the patient's behavior, and [D] wanting to change doctor due to a lack of trust; (6) Conclusion: This study indicates that in implant dentistry patients' mistrust could be avoided by 7% if CBCT is obtained. It also shows the significance of cone-beam computed tomography as an adjunct to panoramic radiography during the diagnosis and treatment planning phase. The use of panoramic radiography alone can lead to a 7% likelihood of misdiagnosis. A lack of CBCT during treatment planning negatively affects the outcome of surgical procedures.

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Telemedicine is an emerging option to improve patients' medical outcomes and overcome health disparities. The technology is a cost-effective alternative to in-person medical treatments and can supplement medical care to alleviate stress on the medical infrastructure in the upcoming decade. This study uses survey methods to investigate the patient population's intention to use telemedicine and assess the influence of different variables on telemedicine usage choices. Findings show that loss of income, trust in physicians, and time lost reduce intention to use telemedicine. The results carry implications for the healthcare industry, lawmakers, social workers, community activists, and family caregivers who bear the burden of helping loved ones with everyday tasks.

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Background: Trust is a major factor affecting patient-physician relationship and healthcare quality. However, there has been a lack of comprehensive study on the extent of and major factors affecting patient trust in healthcare providers of China, the world's largest developing country. The objective of this study is to elucidate the current status of outpatient trust in physicians in China and its influencing factors, providing empirical evidence to enhance doctor-patient trust and improve doctor-patient relationships. Methods: Between December 2017 and January 2018, 28,760 patients seeking care at the outpatient departments of 136 tertiary hospitals were interviewed, where they were asked to rate their trust in physicians. We applied a multilevel logistic regression model to explore the association between patients trust and characteristics of hospitals, physicians and patient characteristics. We conducted a series of sensitivity analysis to check the robustness of our findings. Results: Among 28,760 participants included in this study, 91.54% expressed trust in their physicians, while 7.52% showed moderate trust. Only 0.94% expressly distrusted or strongly distrusted their physicians. Outpatients of hospitals with convenient payment, volunteer guidance and enough seats available in the rest and waiting area showed higher levels of trust. Physicians who had a senior title, showed patience and protection of the patient's privacy were more likely to be trusted by their patients in the outpatient setting. Compared to their female counterparts, male outpatients showed a higher degree of trust. Conclusion: While this study highlights an overall high level of Trust in physicians (TIP) among patients in China's tertiary hospitals, it is found to vary with patient demographic factors as well as provider's attributes. Hospitals with a more keen sense of protecting patients privacy and better meeting patients' need for efficient and caring service provision process appeared to yield a higher level of trust.

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Objectives: Patient trust in physicians is associated with patient satisfaction with healthcare, patients engaging in follow-up care, and positive health-related outcomes. The current study investigated whether age moderated the relation between trust in physicians and four health outcome variables, including patient satisfaction, doctor visits, emergency room visits, and hospital admissions. Methods: 398 English-speaking, community-dwelling adults completed measures of physician trust and important health outcome variables via Amazon Mechanical Turk. Results: Age significantly moderated relations between trust in physicians and hospital admissions, and trust in physicians and patient satisfaction, with both positive relations becoming stronger with increasing age. Discussion: The results highlight the need for a lifespan approach to the study of physician trust and related health outcomes. They offer an avenue for increasing physician trust, engagement with the healthcare system prior to the need for hospitalization, and the reduction of healthcare costs.

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OBJECTIVE: To evaluate the use of social media (SM) as a source of health information among patients with chronic low back pain (LBP) and to evaluate the factors associated with this use. METHODS: This was a cross-sectional study involving patients with chronic LBP. Information on their sociodemographics, LBP characteristics, and comorbidities was collected. With the use of a questionnaire, we evaluated the use of SM as a source of information, examining the frequency of use, the type of SM used, and degree of confidence and application of information found. Catastrophising, trust in physicians, and concerns regarding medicines were assessed through the Pain Catastrophizing Scale (PCS), Trust in Physician Scale (TPS) and Beliefs about Medicines Questionnaire (BMQ Specific Concerns). A regression analysis was conducted to identify factors associated with the use of SM. RESULTS: A total of 118 patients were included. The mean age was 53.01 ± 14.09 years. Of the sample, 68.6% sought information regarding their LBP on social networks. The main source was YouTube (30%). Eighteen point six percent of patients trusted the information found through SM, and 16.1% have already acted on some of this information. The majority of patients (82%) would prefer to have healthcare professionals in their virtual spaces to answer their questions. In a multivariate analysis, only the degree of trust in the physician was negatively associated with SM use (OR = 0.95 IC 95% [0.91-0.99]; p = 0.03). CONCLUSION: This survey showed that a proportion of patients suffering from chronic LBP use SM, YouTube in particular, as a source of health information. The level of trust in physicians was the strongest factor that impelled people to use SM as a source of health information.

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Objective: The present study aimed to probe the intergenerational transmission of intolerance of uncertainty (IU) and trust in physicians. Besides, through the actor-partner interdependence model (APIM), the predictive effect of parents' IU on their own and their spouses' trust in physicians was examined. A mediation model was further constructed to probe the mechanisms by which parents' IU affects children's trust in physicians. Methods: The Intolerance of Uncertainty Scale-12 (IUS-12) and the Wake Forest Physician Trust Scale (WFPTS) were employed to conduct the questionnaire survey among 384 families (each family with a father, mother, and one child). Results: IU and trust in physicians were found to be intergenerationally transmitted. The results of the APIM analyses showed that fathers' total IUS-12 scores negatively predicted their own (ß = -0.419, p < 0.01) and mothers' (ß = -0.235, p < 0.01) total WFPTS scores. Mothers' total IUS-12 scores negatively predicted their own (ß = -0.353, p < 0.01) and fathers' (ß = -0.138, p = 0.017) total WFPTS scores. The results of mediation analyses indicated that parents' total WFPTS scores and children's total IUS-12 scores mediated the effect of parents' total IUS-12 scores on children's total WFPTS scores. Conclusion: The public's IU is a crucial influencing factor of their trust in physicians. Besides, the IU between couples and between parents and children could be mutually affected. On the one hand, husbands' IU could affect their own and their wives' trust in physicians, and vice versa. On the other hand, parents' IU and trust in physicians could affect their children's IU and trust in physicians, respectively.

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OBJECTIVES: To investigate the effects of media reports of medical outcomes and connection-based medicine on trust in physicians. In "connection-based medicine," people use personal connections to obtain better medical resources. METHODS: Vignette experiments were used to investigate attitudes toward physicians among 230 cancer patients and their families (Sample 1) and a cross-validated sample of 280 employees from various industries (Sample 2). RESULTS: For both samples, negative media reports were associated with lower trust in physicians; when the reports were positive, the participants generally perceived physicians as more competent and trustworthy. However, with negative reports, patients and families perceived connection-based physicians as less right and professional than non-connection-based physicians; the public (represented by the employee sample) perceived connection-based physicians as less right than non-connection-based physicians and negative outcomes to be caused more by connection-based physicians than non-connection-based physicians. CONCLUSIONS: Medical reports can influence the perception of a physician's traits, which are important for trust. Positive reports promote evaluation of Rightness, Attribution, and Professionalism, whereas negative results may elicit the opposite effect, especially for connection-based physicians. PRACTICAL IMPLICATIONS: Positive media images of physicians can help facilitate trust. Connection-based medical treatment should be reduced to improve access to medical resources in China.

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OBJECTIVE: Physicians' low adoption of diagnostic decision aids (DDAs) may be partially due to concerns about patient/public perceptions. We investigated how the UK public views DDA use and factors affecting perceptions. MATERIALS AND METHODS: In this online experiment, 730 UK adults were asked to imagine attending a medical appointment where the doctor used a computerized DDA. The DDA recommended a test to rule out serious disease. We varied the test's invasiveness, the doctor's adherence to DDA advice, and the severity of the patient's disease. Before disease severity was revealed, respondents indicated how worried they felt. Both before [t1] and after [t2] severity was revealed, we measured satisfaction with the consultation, likelihood of recommending the doctor, and suggested frequency of DDA use. RESULTS: At both timepoints, satisfaction and likelihood of recommending the doctor increased when the doctor adhered to DDA advice (P ≤ .01), and when the DDA suggested an invasive versus noninvasive test (P ≤ .05). The effect of adherence to DDA advice was stronger when participants were worried (P ≤ .05), and the disease turned out to be serious (P ≤ .01). Most respondents felt that DDAs should be used by doctors "sparingly" (34%[t1]/29%[t2]), "frequently," (43%[t1]/43%[t2]) or "always" (17%[t1]/21%[t2]). DISCUSSION: People are more satisfied when doctors adhere to DDA advice, especially when worried, and when it helps to spot serious disease. Having to undergo an invasive test does not appear to dampen satisfaction. CONCLUSION: Positive attitudes regarding DDA use and satisfaction with doctors adhering to DDA advice could encourage greater use of DDAs in consultations.

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RATIONALE: Public trust in physicians had declined in China for decades before the COVID-19 pandemic. During the COVID-19 pandemic, frontline physicians have experienced high work volume despite a high risk of COVID-19 infection. The willingness of physicians to treat COVID patients with a high risk of exposure to the infection may have improved public trust in physicians. OBJECTIVE: This study analyzes how public trust in physicians has changed since the pandemic started using a nationally representative survey. METHODS: We used the China Family Panel Studies (CFPS), with 179,123 respondents 10 years or older who were eligible to answer the question on public trust in physicians from 2012 to 2020. Public trust has been measured by an 11-point Likert scale. A quasi pre-post study design using a segmented regression impact model was used to evaluate the impact of the COVID-19 pandemic on public trust in physicians. RESULTS: At the start of the observation period, the average public trust score was 6.86 out of 10.00. The immediate unadjusted change of mean score for public trust during COVID-19 was significantly higher (Coef. = 0.361; 95% CI = 0.359, 0.364). Moreover, a significant increase in the unadjusted trend during the COVID-19 pandemic was observed in the mean score for public trust (Coef. = 0.005; 95% CI = 0.004, 0.006). The results were similar to the estimates obtained when we adjusted for demographic characteristics and health status. CONCLUSIONS: The mean score for public trust increased during the COVID-19 pandemic. This study provides a new perspective on restoring public trust in physicians, a significant concern of the Chinese healthcare system. During the COVID-19 pandemic, social and mainstream media helped to establish the "good doctor" image, which may have improved patients' trust in physicians. Improving health literacy through effective communication and education may help increase public trust in physicians.

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OBJECTIVE: Trust in physicians (TIP) plays a critical role in the health care utilization (HCU) of minority older adults and older immigrants. Although previous studies suggested that TIP was positively associated with primary care visits, negatively associated with Emergency Room (ER) visits and hospitalization among African Americans in the United States (U.S.), it is unclear whether and how TIP influences various types of HCU among Chinese older immigrants, a fast-growing group of minority older immigrants in the U.S. Furthermore, despite the important role insurance plays in HCU and health disparities, few studies have tested whether TIP influences the HCU of the insured and uninsured Chinese older immigrants differently. Therefore, this study aims to examine the role of TIP in three types of HCU (physician visits, ER visits, and hospitalization) among Chinese older immigrants and whether the associations differ by insurance status. DESIGN: The data were derived from the Population Study of ChINese Elderly in Chicago (PINE), N = 3,157. The sample is representative of Chinese older immigrants (60+ years) in Chicago. Guided by Andersen's behavioral model, hierarchical regression analyses examined the role of TIP in physician visits, ER visits, and hospitalization among Chinese older immigrants. An interaction term was added to examine whether the aforementioned associations differed by insurance status. RESULTS: TIP was positively associated with the likelihood of physician visits (Odds Ratio [OR] = 1.07, p < 0.001) but not with ER (OR = 1.02, p = 0.054) or hospitalization (OR = 1.01, p = 0.13). The results of the moderation analyses further showed that TIP was more positively associated with ER visits (OR=0.94, p=0.006) and hospitalization (OR = 0.93, p = 0.004) among the uninsured population, compared to those insured. CONCLUSIONS: TIP played an important role in facilitating primary care visits among Chinese older immigrants regardless of insurance status. Additionally, TIP facilitated the ER visit and hospitalization among uninsured Chinese older immigrants.

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Motivated by current debates over the relationship between epidemic and trust, this paper estimates the short-term effects of the Covid-19 pandemic on general trust, political trust, and trust in physicians in China. Using an individual-level national longitude dataset, results from the Difference-in-Difference estimation show that greater exposure to Covid-19 risks significantly decreased general and political trust among the Chinese population, except for the younger generation (age 8-22). Higher exposure to Covid-19 in malleable ages of trust formation (age 8-22) may worsen individuals' general trust but improve their trust in local officials and physicians. Results from heterogeneity tests reveal that Covid-19 exacerbated general trust among the vulnerable groups, whereas their political trust was stable.

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BACKGROUND: Trust between the parties is essential for the efficient functioning of the healthcare market. Physician-patient relationship represents an asymmetric information situation and trust in physicians is critical for improving health and wellbeing of patients. In China, trust in physicians appears to be quite low creating conflicts between physicians and patients. This study aims to identify some general factors associated with trust in physicians in general using a nationally representative survey. METHODS: A cross-sectional analysis using data from 2018 China Family Panel Study (CFPS). Survey responses of individuals aged 16 years or above were extracted from CFPS and the final sample consisted of 29,192 individuals. An ordered probit model was used to identify factors causing heterogeneity in the levels of trust in physicians. RESULTS: Higher educational attainment and having medical insurance coverage are associated with higher likelihood of trusting physicians. Older adults (> = 30 years), males, urban residents, wage-earners, and self-employed persons are less likely to trust physicians. People who are diagnosed as chronic diseases or current smokers indicate lower level of trust in physicians. Higher perceived quality of services improves trust. CONCLUSION: Socioeconomically disadvantaged population groups and uninsured individuals are less likely to trust physicians. Health care delivery system needs to address the concerns of these specific population groups to reduce tensions between physicians and patients. Increasing health insurance coverage and offering insurance with low out-of-pocket expenses should reduce the perception that physicians are more guided by their income rather than the wellbeing of patients. The system should also develop a comprehensive bill of rights of patients to improve patient-physician relationship.

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Purpose: Interventions that are tailored to the specific psychosocial needs of people with diabetes may be more effective than a "one size fits all" approach. The purpose of this study is to identify patient profiles with distinct characteristics to inform the development of tailored interventions. Methods: A latent class cluster analysis was conducted with data from the ENCOURAGE trial based on participant responses to 6 baseline psychosocial measures, including trust in physicians, perceived discrimination, perceived efficacy in patient-physician interactions, social support, patient activation, and diabetes distress. The trial's primary outcomes were hemoglobin A1c, body mass index, systolic blood pressure, low-density lipoprotein cholesterol, and quality of life; secondary outcomes were diabetes distress and patient engagement. Results: Three classes of participants were identified: Class 1 (n = 72) had high trust, activation, perceived efficacy and social support; low diabetes distress; and good glycemic control (7.1 ± 1.3%). Class 2 (n = 178) had moderate values in all measures with higher baseline A1c (8.1 ± 2.1%). Class 3 (n = 155) had high diabetes distress; low trust, patient engagement, and perceived efficacy; with similar baseline A1c (8.2 ± 2.1%) as Class 2. Intervention effects differed for these 3 classes. Conclusion: Three distinct subpopulations, which exhibited different responses to the ENCOURAGE intervention, were identified based on baseline characteristics. These groups could be used as intervention targets. Future studies can determine whether these approaches can be used to target scarce resources efficiently and effectively in real-world settings to maximize the impact of interventions on population health, especially in impoverished communities.

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BACKGROUND: Interest in various forms of complementary and alternative medicine (CAM) (e.g., naturopathy, homeopathy, traditional Chinese medicine, osteopathy, and chiropractic) is continuing to grow throughout Europe. Very little is known as to whether the prevalence and patterns of CAM usage are another cross-cutting phenomenon, dividing Europe, or whether they indicate homogenous healthcare settings throughout the continent. By examining data from the general population, the main objective of the study is to conduct a cross-country comparison of medical pluralism in Eastern and Western European countries. METHODS: The cross-country comparison was conducted using data obtained through the International Social Survey Programme (ISSP). Data addressing healthcare issues were last collected for the ISSP in 2011. By analysing existing similarities and/or differences in the prevalence of sociodemographic and socioeconomic determinants, which could encourage visits to complementary and alternative practitioners, data from 21 European societies only were included. In addition, the aim was to investigate whether individuals' scarcity of trust in physicians, as well as a lack of confidence in healthcare systems, may explain visits to CAM practitioners across Europe. RESULTS: While in Eastern countries, a total of 531 (5.5%) respondents reported a visit to/by a CAM healthcare practitioner during the preceding 12 months, in Western Europe, a visit to/by a CAM healthcare practitioner was reported by 11.6% of individuals. In Western Europe, the use of CAM is most prevalent among younger generations of women, those of a lower socioeconomic position and/or with a low level of trust in conventional doctors. In Eastern Europe, CAM practitioners are mainly visited by older generations, city dwellers of a higher socioeconomic position and with a relatively high level of trust in physicians. CONCLUSION: After collating data from 21 societies, the study concludes that more than three decades after the collapse of the socialist experiment in Eastern Europe, there is evidence that the European continent remains divided in relation to the alternative healthcare sector. The field of non-conventional healthcare represents an indicator supporting the existence of a dividing line between Eastern and Western Europe.

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The Crimson Care Collaborative (CCC) is a network of seven student-faculty clinics in the Greater Boston area that provides primary care services to underserved patient populations and social services to address social determinants of health. Promoting healthy behaviors and health-seeking habits are among the most important focuses in the field of public health and medicine. The main objective of this study is to understand the influence that the student-faculty collaborative clinic in Chelsea has on where patients seek out medical information and if that influence changes with time. To study this phenomenon, a retrospective analysis was conducted for six years of data (2013-2019). The CCC Chelsea patient survey database included 349 surveys for 229 patients. McNemar's test for paired patient survey data showed no significant difference between health information seeking preferences before and after a CCC visit ([2.783], p = 0.093). Chi-square comparing these three visit types is associated with a significant p-value of 0.025 ([Formula: see text] = 7.374). Patients who are at their second visit at CCC are more likely to report favoring reliable sources of medical information, and patients at their third visit are increasingly more likely to report first consulting reliable sources of medical information, including doctors and other healthcare providers. Fisher's test showed no significant difference between health information seeking preferences for patients who last saw a health professional less than 6 months prior to survey administration and greater than 6 months prior to survey administration at a significance level of 0.05 (p = 0.06). Our results suggest that clinic attendance may have an impact on patients' use of reputable sources of medical information in CCC Chelsea, and the positive impact that clinic attendance has on health information seeking habits may be long-standing.

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Objective: To assess parental decision-making preferences when caring for a child with serious illness and to evaluate for an association between preferences and parental trust in physicians, and potential modification of this association by parental anxiety or depression. Methods: We analyzed cross-sectional data from 200 parents of 158 children in the United States who had life-threatening illnesses and whose attending physicians thought that the parents would have to make major medical decision in the next 12 to 24 months. Parents completed measures of decision-making preferences, trust in physicians, anxiety, and depression. Results: Higher reported levels of trust were associated with lower preferences for autonomous decision making (Spearman correlation = -0.24; 95% confidence interval [CI] = -0.36 to -0.01; p < 0.008). Among parents with higher levels of trust, increasing anxiety scores were associated with decreasing preference for autonomy, whereas among parents with lower levels of trust, increasing anxiety scores showed an increasing preference for autonomy (regression coefficient = -0.01; 95% CI = -0.02 to -0.001; p ≤ 0.03). Conclusions: Decreasing trust in physicians is associated with a higher preference for autonomous decision making. Parents who have higher levels of anxiety exhibit this association more strongly. Decision support for parents of children with serious illness should use strategies to respect parental decision-making preferences, address potential distrust, and provide mental health support to parents who are anxious or depressed.

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Objective: Public trust in physicians and public health literacy (HL) are important factors that ensure the effectiveness of health-care delivery, particularly that provided during the SARS-CoV-2 pandemic. This study investigates HL as a predictor of public trust in physicians in China's ongoing efforts to control COVID-19. Methods: Data were gathered in February 2020 during the peak of the disease in China. Based on Nutbeam's conceptualization of HL, we measure HL vis-à-vis COVID-19 by using a six-item scale that includes two items each for functional, interactive, and critical HL. Trust in physicians was measured by assessing physicians' capability to diagnose COVID-19. A rank-sum test and ordinal logit regression modeling were used to analyze the data. Results: Two key findings: (a) trust in physician handling of treatment for COVID-19 is reported by about 74% of respondents; and (b) five of the six HL measures are positive predictors of public trust in physician treatment of the disease, with functional HL1 having the highest level of such association (coefficient 0.285, odds ratio 1.33%, p < 0.01). Conclusions: Improving public HL is important for better public-physician relationships, as well as for nations' efforts to contain the pandemic, serving as a possible behavioral, non-clinical antidote to COVID-19. Being confronted with the unprecedented virus, humans need trust. Health education and risk communication can improve public compliance with physicians' requirements and build a solid foundation for collective responses.

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Patient participation in care decisions is facilitated by shared-decision-making (SDM). This study, therefore, aims to explore the impact of patient's trust in physicians, emotional support, informational support, and tendency to excuse on SDM. A cross-sectional study was conducted at the medical-surgical wards of 6 similar-sized public hospitals in Tabriz, northwest Iran, using a self-administered questionnaire, with 321 cases collected from October to December 2019. The structural equation modeling (SEM) analysis was used to test the hypothetical model. Using the SEM approach, the findings fully confirmed the study hypothesis, and patients' trust in physician (Beta = -0.44), emotional support (Beta = 0.29), tendency to excuse (Beta = 0.18), and informational support (Beta = 0.58) predicted the inpatient's SDM behavior (R 2 = 0.65, goodness-of-fit index = 0.902). To improve patient outcomes, physicians might advise incorporating techniques such as improving patient trust, informational and emotional supports to improve SDM. Improving the psychosocial skills of physicians also seems to be essential to help patients express their concerns.

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BACKGROUND: The research focused on the relationships between attitudes towards vaccination and the trust placed in different sources of information (science, experts and the information available on the Internet) before and during COVID-19. METHOD: A longitudinal design was applied with the first measurement in February 2018 (N = 1039). The second measurement (N = 400) was carried out in December 2020 to test if the pandemic influenced the trust in different sources of information. RESULTS: The final analyses carried out on final sample of 400 participants showed that there has been no change in trust in the Internet as a source of knowledge about health during the pandemic. However, the trust in science, physicians, subjective health knowledge, as well as the attitude towards the vaccination has declined. Regression analysis also showed that changes in the level of trust in physicians and science were associated with analogous (in the same direction) changes in attitudes toward vaccination. The study was also focused on the trust in different sources of health knowledge as possible predictors of willingness to be vaccinated against SARS-nCoV-2. However, it appeared that the selected predictors explained a small part of the variance. This suggests that attitudes toward the new COVID vaccines may have different sources than attitudes toward vaccines that have been known to the public for a long time.