How much does trust really matter? A study of the longitudinal effects of trust and decision-making preferences on diabetic patient outcomes

Patient Educ Couns. 2011 Dec;85(3):406-12. doi: 10.1016/j.pec.2010.12.005. Epub 2011 Jan 26.


Objective: To examine the impact of trust on patient outcomes (satisfaction, HbA(1C), physical and mental health-related quality of life (HRQoL)) and to investigate the role of decision-making preferences in the trust-outcome relationship.

Methods: We conducted a one-year longitudinal analysis of 614 type 2 diabetic patients (mean age: 59.3 years; mean disease duration: 6.7 years). Patients' self-administered questionnaires and medical record were used for the research. Multiple regression analyses were conducted to investigate the relationship among variables during a 12-month follow-up. Further, we used latent growth modeling (LGM) to assess changes in health outcomes and to examine how these changes were related to trust.

Results: Regression analyses revealed that trust was positively related to glycemic control, physical HRQoL, and satisfaction at 12 months. Patients with higher decision-making preferences experienced a greater increase in subsequent satisfaction. The results of LGM showed that higher levels of trust were associated with greater increases in physical HRQoL.

Conclusion: Trust contributes to improvements in health outcomes. The relationship between trust and satisfaction may be stronger among patients with higher decision-making preferences.

Practice implications: For healthcare providers, efforts should be made to cultivate patients' trust and enhance their decision-making preferences to maximize satisfaction and improve outcomes.

MeSH terms

  • Adult
  • Aged
  • Decision Making*
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / metabolism
  • Health Status
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Participation
  • Patient Preference
  • Patient Satisfaction*
  • Physician-Patient Relations*
  • Quality of Life
  • Surveys and Questionnaires
  • Taiwan
  • Treatment Outcome
  • Trust / psychology*


  • Glycated Hemoglobin A