First, public trust in health care was measured by means of three items: trust in present health care, trust in future health care and trust in existing medical possibilities (the ability of medicine to treat problems effectively).
The ZAPA is a German scale measuring satisfaction in outpatient care with a focus on patient participation ('Zufriedenheit in der ambulanten Versorgung – Schwerpunkt Patientenbeteiligung', [ 39]. Three items (trust in the clinician, satisfaction with information given, and quality of the treatment) are rated on a 4-point Likert scale.
"Being accessible" (6 items), "Explains and facilitates" (6 items), "Comforts" (9 items), "Anticipates" (5 items), "Trusting relationship" (16 items), "Monitors and follows through" (8 items).
As a result, the Care-Q consists of 57 caring behaviors that were ordered in the following 6 subscales: "Being accessible" (6 items), "Explains and facilitates" (9 items), "Comforts" (11 items), "Anticipates" (5 items), "Trusting relationship" (18 items), "Monitors and follows through" (8 items).
The final 12 item trust in physician scale has a good construct validity and internal consistency.
Cronbach alpha of this 4 item trust and solidarity index was 0.63 in this sample.
Trust in the observed oncologist was assessed with the 18-item Trust in Oncologist Scale [ 47, 48].
After a series of classical and item response approaches, a final 12-item trust in physician scale was developed.
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A decision was made to assess the construct validity of the scale using the following methods: assessment of dimensionality using CFA and item information provided by each item about trust using item response analysis.
Psychosocial functioning was further assessed in terms of four sub-domains: social functioning (four items on trust, confidence, and interactions), activity (seven items on energy, ability to conduct daily tasks), cognitive (seven items on clarity, concentration, and communication), and dysphoria (six items on happiness, future, and self-esteem).
