The following is a summary of “Indicators of the dimensions of trust (and mistrust) in early primary care practice: a qualitative study,” published in the July 2023 issue of Primary Care by Shaughnessy, et al.
Trust is a significant aspect of interpersonal relationships, where individuals feel safe and open to vulnerability due to perceived sincerity, benevolence, truthfulness, and sometimes competence. For a study, researchers sought to explore the different types of trust expressed in written reflections of developing healthcare clinicians. The goal was to comprehend the roles trust plays in residents’ self-examination and use insights from relationship science to enhance teaching and clinical practices, ultimately fostering better trust in healthcare.
767 reflective writings from 33 residents, submitted anonymously, were analyzed to identify explicit or implicit indicators of attention to trust or relationship development. Two authors independently coded the entries based on inductively identified dimensions, and three authors developed and validated a final coding structure.
114 written reflections were found to contain indicators of trust, which were categorized into five code categories: Trust of self/trust as the basis for confidence in decision-making; Trust of others in the medical community; Trust of the patient and its effect on the clinician; Assessment of the trust exhibited by the patient towards the resident; and Assessment of the effect of the patient’s trust on their behavior.
Trust was observed to be relationship-centered and institutionally situated, relying on reciprocity. The interplay among actions that benefit the patient, the resident, and the medical institution was tacitly acknowledged. Focusing solely on moments of trust or its absence or only on specific types of trust overlooked the phenomenon’s complexity.
Developing a deeper awareness of the presence or absence of trust can lead to a better understanding and improved healthcare education, positively affecting clinicians’ performance, personal and professional satisfaction, and enhanced quality in patient interactions.