Doctor-patient communication and trust in doctors during COVID 19 times - A cross sectional study in Chennai, India

Abstract

Background: The COVID 19 pandemic created a global public health crisis. Physical distancing, masks, personal protective equipment worn by the doctors created difficulties in effective doctorpatient communication. Objectives: This study was conducted to assess the difficulties faced by patients in communicating with their doctors due to the COVID 19 preventive measures, and its impact on the trust on their doctors. Methods: A cross sectional study of 359 persons attending a tertiary care center in Chennai, sampled in a non-probabilistic manner selected from the outpatient department, wards, and isolation facilities, was conducted using a questionnaire containing items covering three dimensions namely difficulties faced in accessing the health facility, difficulties in doctor-patient communication and trust in the doctors. The data were collected using Google Forms and analyzed using GNU PSPP open-source statistical software version 1.4.0. Results: More than 60% of the participants complained of difficulty in accessing the health facility. More than 60% had difficulties in communicating with the doctors. There was a high level of trust in doctors among more than 80% of the participants. Comparison of the mean scores revealed that accessibility was a problem across ages, sexes, education and occupation groups. Communication barriers decreased with age and increased with education, but trust increased with age, but reduced with increasing education. Multivariable linear regression analysis revealed that difficulties in communication had a negative impact on trust (β = -0.63, p<0.001) and increasing education had a negative impact on trust (β = -0.42, p = 0.034). Conclusions: The COVID 19 pandemic and the preventive strategies such as lock-down, physical distancing, face mask and personal protective equipment created barriers to effective doctor patient communication and led to some compromise in trust in doctors during this time.