TRUST IN SOURCES OF HEALTHCARE ADVICE: A MULTICENTRE STUDY OF ORTHOPAEDIC CLINIC ATTENDEES IN SOUTHWESTERN NIGERIA
Main Article Content
Abstract
Background:
Trust in sources of healthcare advice plays a pivotal role in healthcare utilisation, treatment adherence, and clinical outcomes. In Nigeria, orthopaedic patients frequently consult a wide range of formal, informal, and digital sources of healthcare advice, which may influence care-seeking behaviour and contribute to delays in presentation. However, empirical data on patients’ trust in these sources, particularly in Southwestern Nigeria, remain limited.
Methods:
Multicentre cross-sectional study conducted across seven orthopaedic outpatient clinics in Southwestern Nigeria between September and October 2025. Adult patients attending orthopaedic clinics were recruited consecutively using a structured, self-administered questionnaire assessing sociodemographic characteristics, clinical diagnoses, sources of healthcare advice, and levels of trust in these sources. Trust was measured on a four-point Likert scale. Data from 478 respondents were analysed using descriptive statistics, ANOVA, and post-hoc tests, with statistical significance set at p < 0.05.
Results:
The mean age of respondents was 42.2 ± 16.5 years, with near-equal gender representation. Fractures (37.7%) and degenerative joint and spine disorders (29.1%) were the most common diagnoses. Healthcare professionals were the most trusted sources of healthcare advice, with doctors having the highest mean trust score (3.8 ± 0.6), while traditional healers had the lowest (1.7 ± 0.8). Trust in AI-based and internet sources was relatively low but increased significantly with higher educational attainment. Male respondents and unmarried individuals demonstrated greater trust in digital sources compared with females and married individuals.
Conclusion:
Orthopaedic patients in Southwestern Nigeria exhibit high trust in orthodox healthcare providers and low trust in traditional and digital healthcare advice sources. Educational level, gender, and marital status significantly influence trust in non-professional sources.
Downloads
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Articles published in the journal are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license permits users to read, download, copy, distribute, print, search, or link to the full texts of the articles, and to use them for any lawful purpose, provided that appropriate credit is given to the original author(s) and the source.
How to Cite
Share
References
Gilson L. Trust and the development of health care as a social institution. Social science & medicine 2003; 56: 1453–1468.
Organization WH. Health systems in Africa: Community perceptions and perspectives: the report of a multi-country study. 2012. https://iris.who.int/bitstream/handle/10665/79711/9789290232018.pdf (accessed 30 Dec2025).
Oluwadiya KS, Esan O, Popoola SO, Alabi EO. Internet use by orthopaedic patients: a survey of patients in three teaching hospitals in Southwestern Nigeria. Afr. J. Med. Med. Sci. 2018;47:155-60.
Esan O, Oluwadiya KS, Popoola SO, Babalola RO, Alabi EO. Attitude of Orthopaedic Surgeons to the E-Patient: Experience from a Developing Country. Nigerian Journal of Orthopaedics and Trauma 2018; 17: 73.
Birkhäuer J, Gaab J, Kossowsky J, Hasler S, Krummenacher P, Werner C et al. Trust in the health care professional and health outcome: A meta-analysis. PloS one 2017; 12: e0170988.
Nápoles‐Springer AM, Santoyo J, Houston K, Pérez‐Stable EJ, Stewart AL. Patients’ perceptions of cultural factors affecting the quality of their medical encounters. Health Expectations 2005; 8: 4–17.
Sofaer S, Firminger K. PATIENT PERCEPTIONS OF THE QUALITY OF HEALTH SERVICES. Annu Rev Public Health 2005; 26: 513–559.
Onuminya JE. The role of the traditional bonesetter in primary fracture care in Nigeria. South African Medical Journal 2004; 94: 652–658.
Dada A, Giwa SO, Yinusa W, Ugbeye M, Gbadegesin S. Complications of treatment of musculoskeletal injuries by bone setters. West African Journal of Medicine 2009; 28. https://www.ajol.info/index.php/wajm/article/view/48426 (accessed 1 Jan2026).
Hall MA, Dugan E, Zheng B, Mishra AK. Trust in Physicians and Medical Institutions: What Is It, Can It Be Measured, and Does It Matter? Milbank Quarterly 2001; 79: 613–639.
Mechanic D, Meyer S. Concepts of trust among patients with serious illness. Social science & medicine 2000; 51: 657–668.
Street Jr RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient education and counseling 2009; 74: 295–301.
Wu D, Lowry PB, Zhang D, Tao Y. Patient trust in physicians matters—Understanding the role of a mobile patient education system and patient-physician communication in improving patient adherence behavior: Field study. Journal of Medical Internet Research 2022; 24: e42941.
Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Archives of orofacial Sciences 2006; 1: 9–14.
Polinski JM, Kesselheim AS, Frolkis JP, Wescott P, Allen-Coleman C, Fischer MA. A matter of trust: patient barriers to primary medication adherence. Health Education Research 2014; 29: 755–763.
Abel WM, Efird JT. The association between trust in health care providers and medication adherence among Black women with hypertension. Frontiers in public health 2013; 1: 66.
Yusuf MB, Ogunlusi JD, Popoola SO, Ogunlayi SO, Babalola WO, Oluwadiya KS. Self-discharge against medical advice from tertiary health institution: A call for concern. Nigerian Postgraduate Medical Journal 2017; 24: 174.
Popoola SO, Onyemaechi NOC, Kortor JN, Oluwadiya KS. Leave against medical advice (LAMA) from in-patient orthopaedic treatment. SA Orthopaedic Journal 2013; 12: 58–61.
Thanni LOA, Kehinde OA. Trauma at a Nigerian teaching hospital: pattern and documentation of presentation. African Health Sciences 2006; 6: 104–107.
Aaron FE, Ijah RFOA, Obene T. Pattern of orthopaedic case presentations at the rivers state university teaching hospital: a ten-year review. International Surgery Journal 2022; 9: 781–789.
Chen X, Hay JL, Waters EA, Kiviniemi MT, Biddle C, Schofield E et al. Health Literacy and Use and Trust in Health Information. Journal of Health Communication 2018; 23: 724–734.
Olaoye A, Onyenankeya K. A systematic review of health communication strategies in Sub-Saharan Africa-2015-2022. Health Promotion Perspectives 2023; 13: 10.
Kim W, Kreps GL, Shin C-N. The role of social support and social networks in health information–seeking behavior among Korean Americans: a qualitative study. Int J Equity Health 2015; 14: 40.
Picchiello M, Rule P, Lu T, Carpenter B. Gender Differences in Online Health-Related Search Behaviors Among Older Adults. Innovation in Aging 2021; 5: 657.
Bickler SW, Sanno-Duanda B. Bone setter’s gangrene. Journal of pediatric surgery 2000; 35: 1431–1433.
Thanni LO. Factors influencing patronage of traditional bone setters. West African journal of medicine 2000; 19: 220–224.
Ogunlusi JD, Okem IC, Oginni LM. Why patients patronize traditional bone setters. Internet J Orthop Surg 2007; 4: 1–7.
Charles Mock MD, Nathan CM. The global burden of musculoskeletal injuries. Clin Orthop Relat Res 2008; 466: 2306–2316.