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1 Journal of Preventive Medicine and Public Health September 2010, Vol. 43, No. 5, doi: /jpmph A Study of Factors Related to Korean Physicians Trust in the Government: On the Target for Board Members of Physicians Associations Sunhee Lee 1, Gunmo Yang 2, Juhyun Seo 3, Juhye Kim 3 1 Department of Preventive Medicine, School of Medicine, Ewha Womans University; 2 Department of Public Administration, Graduate School of Ewha Womans University; 3 Department of Medicine, Graduate School of Ewha Womans University Objectives: This study aims to investigate the factors related to Korean physicians trust in the government. Methods: We used structured questionnaires that were composed of multidimensional scales for each of the various categories. Results: The recognition levels of trust of the government by Korean physicians were not high, and they ranged from 3.6 to 4.8 for ten scales. The factors related to trust in the government were categorized into seven factors on the basis of a factor analysis. On the regression analysis, a positive relationship was found between the individual propensity to trust and trust in the government, while a negative relationship was found between the recognition level regarding the government as an authoritarian power and trust in the government. Confidence about participation in the policy process as internal efficacy and belief in governmental ability and motivation toward public demand as external efficacy also showed a strong positive relationship with trust in the government. Conclusions: From these results, we can draw the conclusion that making efforts to improve the recognition level of trust in the government among physicians is an important policy task. To increase the trust level, participation of physicians in the policy process in various ways and open communication between the physiciansassociations and the government should be facilitated. Key words: Trust in the government, Policy making, Physicians J Prev Med Public Health 2010;43(5):

3 Figure 1. Analytical framework of factors to related to physician s trust in the government.

5 Table 1. Comparison in trust levels toward government by sociodemographic characteristics unit : mean(sd), n (%) Characterstics n (%) Trust level Gender Male Female Age (y) < >50 Occupation Intern/Resident Independent practitioner Professor Practitioner Regions Seoul Others Total *p<0.05, p< (76.1) 082 (23.9) 134 (39.0) 161 (46.8) 048 (14.0) 078 (22.7) 083 (24.1) 062 (18.0) 120 (34.9) 095 (27.7) 248 (72.3) 343 (100) * ,, meant that there were significant differences between the group with same mark tagging.

6 Table 2. The results of factor analysis for factors related to trust in government Variable Propensity to trust Internal efficacy External efficacy (Incumbent) Authoritarian power participation (Non-Governnment) Participation (Governnment) External efficacy (Institution) n A1 A2 A3 A4 A5 A6 B1 B2 B3 B4 B5 C1 C2 C3 C4 D1 D2 D3 D4 D5 D6 E1 E2 E3 F1 F2 F3 F4 G1 G2 Component A B C D E F G Eigenvalue % of Cronbach's

7 Table 3. Comparison of trust propensity and the recognition toward government's authoritarian power by sociodemographic characteristics unit : mean(sd) Characteristics Gender Male Female Age (y) < >50 Occupation Intern/Resident Independent practitioner Professor Practitioner Regions Seoul Others Propensity to trust** Authoritarian power** * Total *p<0.05, p<0.01, ** Likert scale is ranged from 1 to 10.,,, meant that there were significant differences between the group with same mark tagging. Table 4. Comparison of participation types of policy process by sociodemographic characteristics unit : mean(sd) Characteristics Gender Male Female Age (y) < >50 Occupation Intern/Resident Independent practitioner Professor Practitioner Regions Seoul Others Participation led by nongovernment** * Participation led by government** * * * * Total *p<0.05, p<0.01,** Likert scale is ranged from 1 (absolutely disagree) to 5 (absolutely agree).,,, meant that there were significant differences between the group with same mark tagging.

8 Table 5. Comparison of efficacy in policy participation by sociodemographic characteristics Characteristics Internal efficacy** External efficacy** (incumbent) unit : mean(sd) External efficacy** (Institution) Gender Male Female Age (y) < >50 Occupation Intern/Resident Independent practitioner Professor Practitioner Regions Seoul Others * * Total *p<0.05, p<0.01, ** Likert scale is ranged from 1 (absolutely disagree) to 5 (absolutely agree).,, meant that there were significant differences between the group with same mark tagging. Table 6. Factors related to the trust in government Variables Model1 t Model2 t Model3 t VIF Propensity to trust Authoritarian power Internal efficacy External efficacy (Institution) External efficacy (Incumbent) Participation led by non government Participation led by government F-test Adj. R Adjusted for age, gender, occupation and regions, VIF: variation inflation factor. *p<0.05, p<0.01.

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11 work relationships. In: Kramer RM, Tyler TR, editors. Trust in Organizations: Frontiers of Theory and Research, CA: Sage Publications, Inc; 1996, p Zucker LG. Production of trust; institutional sources of economic structure In Staw BM, Cumming LL, editors. Research In Organizational Behavior, Greenwich; JAI Press; 1986, pp Debra LS, Blair HS, Lisa C. Business on a handshake. Negot J 1992; 8(4): Richard JT, David PL. Effective support an empirical examiniation. Comp Polit Stud 1975;7(4): Yamagishi T, Yamagishi M. Trust and commitment in the United States and Japan. Motiv Emot 1994; 18(2): Muller EN, Godwin RK. Democratic and aggressive political participation: estimation of a nonrecursive model. Polit Behav 1984; 6(2): Cole RL. Toward a model of political traust: a causual analysis. Am J Polit Sci 1973; 17(4): Chun JS. The study on policy change of prescription/ pharmacy separation through the application of advocacy coalition framework. Korean Policy Stud Rev 2003; 12(2): (Korean) 15. Song SK. The gap between medical community and government. Dong-A Newspaper; Seoul, [cited 2010 Sep 8]; Available from: URL: fbin/output?n= (Korean) 16. Dasgupta, Partha. Trust as a commodity. In: Gambetta D, editor. Trust: Making and Breaking Cooperative Relation: New York: Basil Blackwell;1988. p Lee HS. The public trust in civil servants of Korea. Korean Public Admin Rev 1999; 33(2): (Korean) 18. Whitener EN, Brodt SE, Korsgaard MA, Werner JM. Managers as initiators of trust: an exchange relationship framework for understanding managerial trustworthy behavior. Acad Manag Rev 1998; 23(3): Bigley GA, Pearce JL. Straining for shared meaning in organization science: problems of trust and distrust. Acad Manag Rev 1998; 23(3): Craig SC, Niemi RG, Silver GE. Political efficacy and trust: a report on the NES pilot study items. Polit Behav 1990; 12(3): Kim HJ. Trust and organizational commitment. Korean Public Admin Rev 1999; 33(2): (Korean) 22. University of Michigan Institute for Social Research. World Value Survey Methodological questionnaire; USA, [cited 2010 Sep 8]; Available from: URL: Kumar N, Sheer LK, SteenKamp Jan-Benedict EM. The effect of percieved interdependence on dealer attitudes. J Market Res 1995; 32(3): King C, Stivers C. Government is Us: the citizen government connection. PA Times 1998; 21(4): Levi M. A state of trust. In Braithwaie V, Levi M, editors. Trust and Governance. New York: Russell Sage Foundation Publications; Maloney W, Smith G, Stoker G. Social capital and urban governance: adding a more contextualized top- down perspective. Polit Stud 2000; 48(4): American National Election Studies. Annual Pilot Study Reports USA: A Collaboration of Stanford University and the University of Michigan; [cited 2010 Sep 17]; Available from: URL: 28. Jung JK. Theories of Public Administration, Seoul: Dae Myung; (Korean) 29. Stolle D, Rochon TR. Are all associations alike? Member diversity, associatonal type, and the creation of social capital. Am Behav Sci 1998; 42(1): Park HB, Lee HC, Cho YS. An analysis on the properties and determinants of trust in government in Korea. Korean Public Adm Rev 2003; 37(3): (Korean) 31. University of Michigan Institute for Social Research(ISR). The National Political Study USA:center for political studies ; [cited 2010 Sep 17]; Available from: URL: 32. The Washington Post, Kaiser Family Foundation, Harvard University Survey Project. Why don't American trust the government?; USA, [cited 2010 Sep 8]; Available from: URL: kaiserpolls/1110- governs.cfm. 33. Bae BR, Lee HC, Lee SW. The origins and consequences of distrust in government. Korean Public Admin Rev 1998; 22(2): (Korean) 34. Almond GA, Verba S. The Civic Culture: Political Attitudes and Democracy in Five Nations. Princeton: Princeton University Press; Jang SC. The presence of the vicious cycle among civic engagement, social capital (trust), and confidence in political institutions in South Korea. Korean J Polit Sci 2002; 36(1): (Korean) 36. Park CO. Interest group influence on bureaucracy in Korea. Korean Public Admin Rev 1999; 33(1): (Korean)

12 Appendix. Questionnaires and references of main variables Variables Questionnaires References Trust in government (7 items) T1. T2. T3. T4. T5. T6. () T7.()? [31], [33] *Propensity to trust (6 items) A1. A2. A3. [11], [34], [35] *Authoritarian power(6 items) *Participation led by non government (3 items) *Participation led by government (4 items) *Internal efficacy (5 items) *External efficacy (Incumbent) (4 items) *External efficacy (institution) (2 items) A4. A5. A6. D1. D2. D3. D4. D5. D6. E1. E2. E3. F1. F2. F3. F4. ( ) B1. B2. B3. B4. B5. C1. C2. C3. C4. G1. G2. [18], [21] [12], [22], [29], [35], [36] [27] *Questionnaire relating factor analysis (Table 2).

Journal of Educational Innovation Research 2018, Vol. 28, No. 3, pp DOI: * Strenghening the Cap

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