The impact of patient-physician alliance on trust following an adverse event

Objective: Adverse events in maternity care have a negative impact on the patient-physician relationship. This study assesses the effects of healthcare institutions, communication, and patient involvement on patient trust following adverse events. Methods: Surveys were distributed online to women across the US who had given birth. Women were asked to recount their experiences during their most recent pregnancy including unexpected procedures, adverse events, support from healthcare institutions, and perceived betrayals by healthcare institutions. Results: Adverse events were negatively correlated with patient trust in their physician. This study's results illustrated that patient involvement and institutional betrayal mediated patient trust following adverse events. Patients who were more involved in decision-making with their physician were found to have more trust in them following adverse events than those who did not. Conclusions: Patient-physician trust is negatively affected by adverse events, but patient-physician alliance in decision-making can decrease this impact. Therefore, physicians can work proactively to lessen the detrimental effects of adverse events on patient trust, but the patient-physician relationship is still impacted by healthcare institutions. Practice implications: This study demonstrates the benefits of encouraging patient alliance with their physician and supports a need for education on the use of these strategies in healthcare. (C) 2019 Elsevier B.V. All rights reserved.