Breast cancer patients' trust in physicians: The impact of patients' perception of physicians' communication behaviors and hospital organizational climate

Objective: To examine whether patients' perception of a hospital's organizational climate has an impact on their trust in physicians after accounting for physicians' communication behaviors as perceived by the patients and patient characteristics. Methods: Patients undergoing treatment in breast centers in the German state of North Rhein-Westphalia in 2006 were asked to complete a standardized postal questionnaire. Disease characteristics were then added by the medical personnel. Multiple linear regressions were performed. Results: 80.5% of the patients responded to the survey. 37% of the variance in patients' trust in physicians can be explained by the variables included in our final model (N = 2226; R-2 adj. = 0.372; p < 0.001). Breast cancer patients' trust in their physicians is strongly associated with their perception of a hospital's organizational climate. The impact of their perception of physicians' communication behaviors persists after introducing hospital organizational characteristics. Perceived physician accessibility shows the strongest association with trust. Conclusions: A trusting physician-patient relationship among breast cancer patients is associated with both the perceived quality of the hospital organizational climate and perceived physicians' communication behaviors. Practice implications: With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients. (C) 2009 Elsevier Ireland Ltd. All rights reserved.