Patient care: Is interpersonal trust missing (original) (raw)

Reciprocal trust in health care relationships

Journal of Advanced Nursing, 1988

Reciprocal trust in health care relationships This paper examines the phenomenon of trust in health care relationships from a new perspective, that ofthe recipients ofcare for chronic illness. The authors argue that reciprocal trust is a necessary component of satisfying, effective health care relationships when the illness is of an ongoing nature. From the patient's perspective, reciprocal trust has a significant impact on the experience of being a receiver of health care and on the development of competency with illness management. Because of this, the authors claim that it is imperative for health care professionals to alter their traditional beliefs with regard to sick role and trust. With a new perspective, they may then develop the specific skills necessary to enact the caring aspect ofthe service they offer. The authors offer a number of suggestions for actualizing this reciprocal trust in clinical practice.

Mental health care: trust and mistrust in different caring contexts

Journal of Clinical Nursing, 2008

Aims and objectives. To identify the factors that make trust within the context of public mental health possible. We also consider the question of patients' trust in the whole caring system. The study is based on individual interviews with 22 psychiatric patients, who were also users of social services. Background. There are theoretical studies concerning trust between human beings in several disciplines within psychiatry and social services but few studies investigate how trust can be created and what makes it possible. The literature reveals that there is need for research concerning trust in psychiatry. In this study we examined two different caring contexts and investigated what makes trust possible in these contexts. The contexts are termed the Integrated Network and Family Model and the Traditional Model. Design. A qualitative method based on the grounded theory approach was used. Methods. The main focus in the analysis was on how the patients had experienced the contexts of the caring systems and how trust was created or not within them. Results. Three categories creating trust were found in the Integrated Network and Family Model and two in the Traditional context. Acceptance of the patient's expertise concerning his/her life situation, openness and joint discussions concerning knowledge are important. Trust is closely connected to autonomy and power: patients feel that trust increases as their experience of autonomy increases and in such situations power is not owned by any one person. Conclusions. Trust between psychiatric patients and personnel can be created in both the Integrated Network and Family Model and traditional context, but in different ways. Relevance to clinical practice. Clinical workers and nursing personnel can use our findings in their practical work with psychiatric patients. Our findings support theoretical considerations concerning trust and can be used as guidelines for nursing personnel in their work.

When people become patients: fluctuations in trust from the cancer patient’s perspective

Chinese Journal of Communication, 2018

This study explores the trust relationships between cancer patients and their physicians by discussing the concept of trust and the collection of patients' medical experiences before and after being diagnosed with cancer. The purpose of the study is to determine changes in patients' trust during this process. This ethnographic study was conducted from 2009 to 2014 on doctor-patient relationships under the coverage of the National Health Insurance (NHI) in Taiwan. Under the NHI, patients may access physicians and acquire treatment at low cost. In this study, the sample comprised 12 female cancer patients. Data were collected in in-depth interviews with six patients. With the bloggers' consent, data were collected from six blogs. These data were analyzed to determine how these cancer patients constructed and altered their opinions during their diagnosis and treatment. The results are discussed according to the calculative trust that was constructed based on information collected and/or impressions developed during their initial visits. The findings showed that relational trust was developed and (dis)evolved through interactions and experiences with medical staff. In addition, calculative trust was generated based on the following: eliminating institutions or physicians with which the patients had negative experiences; feeling and perceiving caring and professional competence; yielding to cancer and respecting professional reputations. Relational trust was derived from the following: the doctors' ability to sooth patients' anxieties and explain uncertainties; the compatibility of expectations in information sharing between physicians and patients. The results showed that in the early stage of developing a doctor-patient relationship, calculative and relational trusts were intertwined. As the doctor-patient relationship developed, the patients' relational trust increased. The findings of this study contribute to the knowledge concerning the coconstruction of patients' trust in physicians in medical systems through communication between patients and medical staff.

Trust and Communication: Cornerstones of Care

North Carolina Medical Journal

In this issue of the North Carolina Medical Journal, authors explore and debate the ways communication can influ­ence how North Carolinians access health care in our state. Articles illustrate the importance of increasing trust in health care providers and systems at a time when care is changing dramatically, and patients have more access to information than they ever have.

The health care relationship (HCR) trust scale: Development and psychometric evaluation

Research in Nursing & Health, 2006

A sequential multi-method approach using focus groups, individual interviews, and quantitative instrument development procedures was used to develop and evaluate a scale to measure patient trust in health care providers (HCPs). The resulting 15-item Health Care Relationship (HCR) Trust Scale was tested for internal consistency, test-retest reliability, and construct validity. The Cronbach alphas were .92 (time 1) and .95 (time 2), respectively. Test-retest reliability was .59 (p < .01). The HCR Trust Scale did not correlate with the Marlowe-Crowne Social Desirability Scale (r ¼ .20, p ¼ .07) or the Rapid Estimate of Adult Literacy in Medicine scale (r ¼ À.21, p ¼ .13). Principal component factor analysis with varimax rotation revealed a three-factor solution that explained 69% of the estimated common variance in the HCR trust scale. Cronbach alphas for the 3 factors ranged from .81 to .89. Findings of this study support the use of the HCR Trust Scale for measuring trust in various HCPs by diverse patient populations. More work is needed to test the usefulness of the scale with a greater number of patients and in other chronic illness populations.

Trust in nurse–patient relationships

Nursing Ethics, 2013

The aim of this study was to report the results of a literature review of empirical studies on trust within the nurse–patient relationship. A search of electronic databases yielded 34 articles published between 1980 and 2011. Twenty-two studies used a qualitative design, and 12 studies used quantitative research methods. The context of most quantitative studies was nurse caring behaviours, whereas most qualitative studies focused on trust in the nurse–patient relationship. Most of the quantitative studies used a descriptive design, while qualitative methods included the phenomenological approach, grounded theory, ethnography and interpretive interactionism. Data collection was mainly by questionnaires or interviews. Evidence from this review suggests that the development of trust is a relational phenomenon, and a process, during which trust could be broken and re-established. Nurses’ professional competencies and interpersonal caring attributes were important in developing trust; ho...

Earning Patient Trust: More Than a Question of Signaling

Hastings Center Report, 2020

Medical providers see themselves as already trustworthy; the challenge is how to signal their trustworthiness to a mistrusting patient. I suggest that providers ought first to consider whether their or their institutions’ agendas are genuinely at odds with those of the patient. . . . .

Generating Oncology Patient Trust in the Nurse: An Integrative Review

Western Journal of Nursing Research, 2020

Establishing trust is the foundation of all interpersonal relationships and is vitally important when developing therapeutic relationships in nursing (Halldorsdottir & Hamrin, 1997; Pask, 1995; Robinson, 2016). Although trust is not readily visible, it is important for the patient-nurse relationship to be successful (Johns, 1996; Murray & McCrone, 2015). Trust in the nurse is influenced by patients' experiences, expectations, and encounters with the health care system (Dinc & Gastmans, 2012; Sellman, 2007). The inclusion or exclusion of family members during encounters with nurses also influences trust in the nurse, as family members are often primary caregivers (Robinson, 2016). As identified by Dinc and Gastmans (2013), trust in the nurse is a process that develops over time during consistent interactions with the nurse and can be either strengthened or diminished. Trust in the nurse is fragile and once it is lost it is not easily regained; thus, patient trust in the nurse, once obtained, must be maintained (Bell & Duffy, 2009). Many definitions regarding trust have been identified. Trust can be categorized as institutional or interpersonal (Gilson, 2006; Radwin & Alster, 1999). Institutional trust is between a patient and health care organization such as a hospital (Gilson, 2006). Interpersonal trust is between two individuals such as a patient and nurse (Radwin & Alster, 1999). The focus of this integrative review is the interpersonal trust between the adult oncology patient and the nurse. Definitions of interpersonal trust share a common viewpoint in that there is reliance upon a person, with the intent of goodwill, during circumstances of uncertainty and risk. Bell and Duffy (2009) defined interpersonal trust as "the optimistic acceptance of a vulnerable situation, following careful assessment, in which the trustor believes that the trustee has his best interests as paramount" (p. 50). A specific definition of interpersonal patient-nurse trust has been conceptualized by Radwin and Alster (1999) as "the confidence that care would be appropriate, reliable and as successful as possible" (p. 332).When patients trust the nurse, they feel emotionally and physically safe, and valued as individuals (Benkert et al., 2008; Langley & Klopper, 2005). The absence of trust in the patient-nurse relationship can produce emotional anguish for the patient, leading to insecurity, vulnerability, and poor outcomes of health and wellness (

Trust in Nurse-Patient Relationships: A Literature Review

Nursing Ethics

The aim of this study was to report the results of a literature review of empirical studies on trust within the nurse-patient relationship. A search of electronic databases yielded 34 articles published between 1980 and 2011. Twenty-two studies used a qualitative design, and 12 studies used quantitative research methods. The context of most quantitative studies was nurse caring behaviours, whereas most qualitative studies focused on trust in the nurse-patient relationship. Most of the quantitative studies used a descriptive design, while qualitative methods included the phenomenological approach, grounded theory, ethnography and interpretive interactionism. Data collection was mainly by questionnaires or interviews. Evidence from this review suggests that the development of trust is a relational phenomenon, and a process, during which trust could be broken and re-established. Nurses' professional competencies and interpersonal caring attributes were important in developing trust...