Towards a politics of trust (original) (raw)
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Part I Trust in Health and Social Care
1988
In this introductory chapter we address the construct of trust and its discursive realisation from two related perspectives: an ontological perspective in which we focus on how trust has been conceptualised historically and philosophically, and a methodological perspective in which, taking account of this ontology, we highlight a range of inter-relatable methodologies in terms of which discourses of trust have been described, interpreted and explained.
Trust and managerialism: exploring discourses of care
Journal of Advanced Nursing, 2005
Aim. This paper reports a study that explored the relationship between trust and managerialism through an analysis of professional discourse.Background. Managerialism is a distinct set of discourses and practices related to managerial effectiveness, flexibility and consumer responsiveness that have come to characterize debates over the provision of health and welfare services across the developed world. At the same time, trust has attracted increasing academic and political interest. Managerial discourses are critical of healthcare professions and the way they operate. Professional opinions are challenged as representing the interests of professions rather than service users; as a consequence trust is contested. However, where practitioners are both professionals and managers, the boundaries between these discourses become blurred. Moreover, paradoxical development occurs where increasing autonomy for practitioners is accompanied by a strengthening of managerial controls over thei...
Trust, power, and vulnerability: a discourse on helping in nursing
The Nursing clinics of North America, 2009
This article uses philosophical inquiry to present the relationship between the helping role in nursing and the concept of trust essential to it. It characterizes helping as the moral center of the nurse-patient relationship and discusses how patients' expectations of help and caring create obligations of trustworthiness on the part of the nurse. It uses literature from various disciplines to examine different theoretical accounts of trust, each presenting important features of trust relationships that apply to health care professionals, patients, and families. Exploring the concept of trust, and the key leverage points that elicit it, develops a thesis that nurses can improve their understanding of the principal attributes and the conditions that foster or impede trust. The article concludes that trust is the core moral ingredient of helping relationships. Trust as a moral value is even more basic than duties of beneficence, respect, veracity, and autonomy. Trust is the confide...
Trust" and Professional Power: Towards a Social Theory of Self
Human Affairs, 2007
context of health care. Understood in its micro-political terms and conceived as impacting on individual organisational levels and the socio-political; this relationship stands at the interface of competing pressures working to produce the increasing complexity of social life. "Trust" is inextricably linked with uncertainty and complexity while professional authority rests on the specialist knowledge claimed by the range of experts and technologists that inhabit the spaces through which social life is governed and complexity managed.
Various dimensions of trust in the health care system
Emergency Medical Service, 2020
Trust is one of the most important factors in building effective and long-lasting relationships in the entire healthcare sector. Trust becomes a valuable ally in situations of high risk and uncertainty as well as the increasing complexity of tasks that accompany the daily work of all medical professionals, especially paramedics, due to the nature of their work in the medical rescue system. Mutual trust is the basis of social capital thanks to which it is possible to achieve mutual benefits, easier to coordinate activities, create new quality and solutions through cooperation or strong ties. It is a kind of glue that binds various organizational and system links, thanks to which it is easier to plan and introduce necessary improvements and changes within individual medical units or the entire health care system. The high degree of trust increases the quality of clinical communication with the patient and the effectiveness of medical care and strengthens the employees’ motivation and ...
A discourse analysis of managerialism and trust amongst nursing professionals
The Irish Journal of Management, 2019
This study explores the effects of New Public Management (NPM) on trust amongst nursing professionals, nurses and nurse ward managers within the British National Health Service (NHS). Thirty-nine nurses and nurse ward managers, recruited randomly, participated in semi-structured interviews. The original data, collected in 2000-2002, are re-analysed from a discourse analysis perspective. The findings support and extend contemporary research. They show that nurses have a strong professional identity and commitment and that increasing managerialism is eroding trust. Nurses both accommodate and resist managerialist discourses. They conceptualise trust in terms of their own ward environment, line-manager and colleagues. Trust is reciprocal and related to previous experiences and other factors. Trust is beneficial to healthcare organisations, healthcare professionals and their patients. Good communication and openness positively influence the development of trust. Nurse ward managers play...
Background This paper explores the nature and reasoning for (dis)trust in Australian public and private hospitals. Patient trust increases uptake of, engagement with and optimal outcomes from healthcare services and is therefore central to health practice, policy and planning. Methods A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Results ‘Private patients’ made active choices about both their hospital and doctor, playing the role of the ‘consumer’, where trust and choice went hand in hand. The reputation of the doctor and hospital were key drivers of trust, under the assumption that a better reputation equates with higher quality care. However, making a choice to trust a doctor led to personal responsibility and the additional requirement for self-trust. ‘Public patients’ described having no choice in their hospital or doctor. They recognised ‘problems’ in the public healthcare system but accepted and even excused these as ‘part of the system’. In order to justify their trust, they argued that doctors in public hospitals tried to do their best in difficult circumstances, thereby deserving of trust. This ‘resigned trust’ may stem from a lack of alternatives for free health care and thus a dependence on the system. Conclusion These two contrasting models of trust within the same locality point to the way different configurations of healthcare systems, hospital experiences, insurance coverage and related forms of ‘choice’ combine to shape different formats of trust, as patients act to manage their vulnerability within these contexts.
The 'Science of Trust': moving the field forward
Journal of Communication in Healthcare: Strategies, Media, and Engagement in Global Health, 2022
Renata Schiavo (2022) The ‘Science of Trust’: moving the field forward, Journal of Communication in Healthcare: Strategies, Media and Engagement in Global Health 15:2, 75-77, DOI: 10.1080/17538068.2022.2089611 Editorial