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Use of the emergency medical services by patients with suspected acute primary healthcare problems: developing a questionnaire to measure patient trust in healthcare

Gabriella Norberg-Boysen, Lennart Christensson, Birgitta Wireklint-Sundström, Johan Herlitz, Maria Nyström, Göran Jutengren


Rationale, aims and objectives The objective of this study is to develop a questionnaire measuring the level of trust and its constituents in patients calling the Emergency Medical Services for suspected acute primary healthcare problems. Four different frontline service providers were involved: the Dispatch Centre (DC), the Emergency Medical Services (EMS), the Emergency Department (ED) and the Healthcare Centre (HCC).

Method The questionnaire was called the Patient Trust Questionnaire (PTQ). Repeated cross-sectional data collections were made and redundant items were gradually discarded. Finally, the constituents of trust were sought. Based on a literature review, the PTQ was developed as a psychometric instrument in four steps, as follows: 1) Item construction, 2) Face-to-face evaluation of items, 3) Item reduction, 4) Test of factor structure. The inclusion criteria for participating were that the patient must be 18 years of age or older and suspected having an acute primary healthcare problem when calling the EMS. In developing the questionnaire, 427 patients were included.

Results Eight items remained for each frontline service provider in the PTQ, and two constituents of trust were found: credibility and accessibility.

Conclusion A new measuring instrument has been developed for this particular healthcare chain, for patients with suspected acute primary healthcare problems calling the EMS. The two constituents of trust, credibility and accessibility, are assumed to be specific for this particular healthcare chain.


Acute primary healthcare, Emergency Department, Emergency Medical Services, Healthcare Centre, patient dependence, patient vulnerability, patient mistrust, patient trust, person-centered healthcare, questionnaire

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