Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Services Research & Administration

First Committee Member

Jungyoon Kim

Second Committee Member

Shinobu Watanabe-Galloway

Third Committee Member

Lynn Harland


Background: The intangible concept of trust is critical in the patient-provider relationship. Cancer patients may experience positive and negative impacts of trust in this relationship to a higher degree due to the inherently serious nature of their disease and the level of dependence upon treatment providers.

Objective: The goal of this study was to compare colorectal cancer patients’ levels of trust in their primary care physician and oncologist, along with examining trust differences associated with demographics and other characteristics.

Methods: Colorectal cancer patients (n=158) treated at Nebraska Medicine and consented into the Integrated Cancer Repository for Cancer Research IRB 253-13-EP (iCaRe2) database were surveyed. The TiOS instrument measures five domains of trust using a 5-point Likert scale. Possible rural and urban differences, as well as other data characteristic patterns, were examined using descriptive statistics, frequency analysis, and t-tests.

Results: There was a measurable difference observed between oncologist and primary care provider (PCP) trust levels for all domains (except Competence), with trust in the oncologist reported higher. The overall Global domain measured a higher level of patient trust in the oncologist (3.65) compared to the PCP (2.96) with a P-value of 0.003. Due to the small sample size, statistical tests were not conducted comparing mean trust between oncologist and PCP within the sociodemographic and geographic variables.

Conclusion: The higher levels of trust reported for four out of five domains suggest that cancer patients feel more trust toward their oncologist than toward their PCP. The difference in trust in the Global domain suggests that cancer patients feel a deeper trust in their oncologist that includes aspects of Fidelity, Honesty, and Caring. Future studies should seek to further understand the impact of trust in the patient-provider relationship as well as the factors that influence trust. The findings from this study contribute to the current knowledge of patient-provider trust in the cancer patient population and provide valuable information for future studies.

REV-REV_tios questionnaire (2)_01.10.18.docx (25 kB)
Trust in Oncologist Scale Questionnaire

GACCaRE Affected_Krista Brown_1-24-17_CLEAN (1).docx (97 kB)
iCaRe2 GACCare Questionnaire

iCare2 Core Data Elements_v10 1-7-17 clean (3).docx (45 kB)
iCaRe2 Core Data Questionnaire