Indicators of the dimensions of trust (and mistrust) in early primary care practice: A qualitative study (original) (raw)
2022, Research Square (Research Square)
Background Trust occurs when a person feels they can be vulnerable to others because of the sincerity, benevolence, truthfulness and sometimes the competence they perceive. This project examines the various types of trust expressed in written re ections of developing healthcare clinicians. Our goal is to understand the roles trust plays in residents' self-examination and to offer insight from relationship science to inform the teaching and clinical work for better trust in healthcare. Methods We analyzed 767 re ective writings of 33 residents submitted anonymously, to identify explicit or implicit indicators attention to trust or relationship development. Two authors independently coded the entries based on inductively identi ed dimensions. Three authors developed a nal coding structure that was checked against the entries. These codes were sorted into nal dimensions. Results We identi ed 114 written re ections that contained one or more indicators of trust. These codes were compiled into ve code categories: Trust of self/trust as the basis for con dence in decision making; Trust of others in the medical community; Trust of the patient and its effect on clinician; Assessment of the trust of them exhibited by the patient; and Assessment of the effect of the patient's trust on the patient's behavior. Discussion Broadly, trust is both relationship-centered and institutionally situated. Trust is a process, built on reciprocity. There is tacit acknowledgement of the interplay among what the residents do is good for the patient, good for themselves, and good for the medical institution. A focus on moments in which trust is experienced or missed, as well as on types of trust, misses this complexity. Conclusion A greater awareness of how trust is present or absent could lead to a greater understanding and healthcare education for bene cial effects on clinicians' performance, personal and professional satisfaction, and improved quality in patients' interactions.
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