Health disparities related to the provision of, and access to, healthcare in the United States are well documented across racial and ethnic groups. One area of particular interest to health disparities researchers has been solid organ transplantation. Both provider and patient behaviors are implicated as contributing to ethnic variance of medical care in kidney transplantation. Research evidence suggests that an important target for improvement is the patient-provider relationship. Trust is central to this relationship, yet trust has been described as the scarcest of medical resources. ? ? This pilot study explored the perceptions of trust among patients in the kidney transplant process at the National Institutes of Health (NIH) Clinical Center and the Walter Reed Army Medical Center (WRAMC).Face-to-face interviews were conducted that included questions related to demographic variables, the Trust in Physician Scale, the Trust in Nurse Scale and the Patient Trust Scale. Study accrual was closed in 2006. Total accrual is 113 subjects; sixty-eight subjects were enrolled at the NIH site and forty-five subjects were enrolled at the WRAMC site. ? ? Data analysis is currently ongoing. Data analysis reveals the emergence of confidence as a sixth dimension of trust in addition to the following five dimensions previously described in the literature: competence, compassion, control, communication and confidentiality. Data analysis also reveals lower Physician Trust scores and lower Nurse Trust scores among females and individuals with less than a high school diploma. The identification of confidence as a sixth dimension of trust contributes to the understanding of the dynamics of trust and the patient-provider relationship. This new information has the potential to facilitate the development of specific interventions designed to improve patient-provider relationships.
