Females prefer discovering social media or healthcare systems to finding information and presenting their cases with any physician; however, the behavior of physicians tends to be uncontrollable on the healthcare system. Physicians have the capacity to share all of their patients' information with their colleagues without any permission or concern from the patients. For this reason, it is of utmost importance to design a breast self-examination system that can keep monthly track of self-exam data and communication between patient and physician. To develop such a system, identify the ethical values and trustworthiness as an indicator. Then, the survey will provide the details on ethical values and trustworthiness applicable in the system. Therefore, this research objective on the importance of ethical value and trustworthiness in the healthcare system. The survey on 772 respondents leading to the importance of the ethical value being used in the healthcare system is required. The ethical value of interaction, integrity, confidentiality, protection, caring, and fairness have a significant influence on the healthcare system. The path coefficients are answering Hypothesis I in presenting the positive relationship and significant effect between ethical value and BSE system (P<.001). On the other side, trustworthiness has a significant influence on the healthcare system. The path coefficients are answering Hypothesis II in presenting the positive relationship and significant effect between trustworthiness and the BSE system (P<.001). Finally, the relationship in healthcare between trustworthiness and ethical value is on integrity with honesty and belief.

Background Breast cancer is the leading cause of mortality among women worldwide. However, female patients often feel reluctant and embarrassed about meeting physicians in person to discuss their intimate body parts, and prefer to use social media for such interactions. Indeed, the number of patients and physicians interacting and seeking information related to breast cancer on social media has been growing. However, a physician may behave inappropriately on social media by sharing a patient’s personal medical data excessively with colleagues or the public. Such an act would reduce the physician’s trustworthiness from the patient’s perspective. The multifaceted trust model is currently most commonly used for investigating social media interactions, which facilitates its enhanced adoption in the context of breast self-examination. The characteristics of the multifaceted trust model go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. Thus, in this study, we explored and evaluated use of the multifaceted trust model for breast self-examination as a more suitable trust model for patient-physician social media interactions in breast cancer screening. Objective The objectives of this study were: (1) to identify the trustworthiness indicators that are suitable for a breast self-examination system, (2) design and propose a breast self-examination system, and (3) evaluate the multifaceted trustworthiness interaction between patients and physicians. Methods We used a qualitative study design based on open-ended interviews with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the proposed breast self-examination system. The breast self-examination system was then evaluated by asking the patient to rate their trustworthiness with the physician after the consultation. The evaluation was also based on monitoring the activity in the chat room (interactions between physicians and patients) during daily meetings, weekly meetings, and the articles posted by the physician in the forum. Results Based on the interview sessions with 16 physicians and 16 patients on using the breast self-examination system, honesty had a strong positive correlation (r=0.91) with trustworthiness, followed by credibility (r=0.85), confidence (r=0.79), and faith (r=0.79). In addition, belief (r=0.75), competency (r=0.73), and reliability (r=0.73) were strongly correlated with trustworthiness, with the lowest correlation found for reputation (r=0.72). The correlation among trustworthiness indicators was significant (P<.001). Moreover, the trust level of a patient for a particular physician was found to increase after several interactions. Conclusions Multifaceted trustworthiness has a significant impact on a breast self-examination system. Evaluation of trustworthiness indicators helps to ensure a trustworthy system and ethical interaction between a patient and physician. A new patient can obtain a consultation by referring to the best physician according to preference of other patients. Patients can also trust a physician based on another patient’s recommendation regarding the physician’s trust level. The correlation analysis further showed that the most preferred trustworthiness indicator is honesty.

BACKGROUND Breast cancer is the number one cause of mortality among females. Female patients feel reluctant and embarrassed about meeting physicians in person to discuss their intimate parts; as a result, they prefer to use social media for such interactions. The number of patients and physicians interacting and seeking information related to breast cancer on social media is growing. However, a physician may behave inappropriately on social media by sharing a patient’s personal medical data excessively to colleagues or the public. Such an act would reduce the physician’s trustworthiness from the patient’s perspective. Thus, in this study, an exploration of a more suitable trust model is presented. Investigating the multi-faceted trust model that is currently used for social media interaction facilitates enhanced adoption of its usage for breast self-examination (BSE). Multi-faceted trust model characteristics go beyond being personalized, context-dependent, and transitive. This model is more user-centric, which allows any user to evaluate the interaction process. In this study, a BSE using a multi-faceted trust model is proposed and evaluated. OBJECTIVE 1) to identify the trustworthiness indicators that are suitable for the BSE system; 2) to design and propose a BSE system, and 3) to evaluate the multi-faceted trustworthiness interaction between patients and physicians. METHODS We used a qualitative study using an open-ended interview with 32 participants (16 outpatients and 16 physicians). The interview started with an introduction to the research objective and an explanation of the steps on how to use the BSE system. The BSE system was evaluated by asking the patient to rate their trustworthiness with the physician after consultation. The evaluation has monitored the activity in the chat room (interaction between physician and patient) based on the daily meeting, weekly meeting, and the posting article by the physician in the forum. RESULTS Based on the interview session with 16 physicians and 16 patients on using the BSE system reveals honesty as having a strong positive correlation (0.91) followed by credibility (0.85), confidence (0.79), and faith (0.79). Others are belief (0.75), competency (0.73), and reliability (0.73), and the lowest preference is reputation (0.72). On the other hand, the trust level of a patient to a particular physician will increase after several interactions. CONCLUSIONS Multi-faceted trustworthiness brings a significant impact on the BSE system. The trustworthiness indicators provide a trustworthy system and ethical interaction between patient and physician. A new patient can get a consultation by referring to the best physician preference. Patients also trust a physician based on another patient’s recommendation regarding the physician’s trust level. The correlation analysis also shows that the most preferred trustworthiness indicator is honesty.