title: Breast cancer patients' trust in physicians: the impact of patients' perception of physicians' communication behaviors and hospital organizational climate.
abstract: 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.
  
  
  CONCLUSIONS
  With regard to clinical organization, efforts should be put into improving the organizational climate and making physicians more accessible to patients.
authors.affiliation: Department of Medical Sociology, Institute and Polyclinic for Social and Occupational Medicine and Public Health, University of Cologne, Eupener Strasse 129, 50933 Cologne, Germany. christoph.kowalski@uk-koeln.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Kowalski
authors.forename: Anika
authors.initials: A
authors.lastname: Nitzsche
authors.forename: Fueloep
authors.initials: F
authors.lastname: Scheibler
authors.forename: Petra
authors.initials: P
authors.lastname: Steffen
authors.forename: Ute-Susann
authors.initials: US
authors.lastname: Albert
authors.forename: Holger
authors.initials: H
authors.lastname: Pfaff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015279:Organizational Culture; D010817:Physician-Patient Relations; D011594:Psychometrics; D012938:Social Perception; D011795:Surveys and Questionnaires; D035502:Trust; D055815:Young Adult