Exploring Patient–Clinician Trust During Pregnancy Care

Abstract

OBJECTIVE: To explore patient experiences and perspectives regarding trust in clinicians during pregnancy care among Latine patients, focusing on those with Spanish as their preferred language. METHODS: We conducted a qualitative focus group study to explore trust in pregnancy care clinicians. Eligible participants self-identified as Hispanic/Latine, reported Spanish or English as their preferred language, were pregnant or had given birth in the previous year, and were at least 18 years old. Participants completed a brief demographic survey. We report descriptive statistics for survey responses. A semistructured discussion guide was developed from a literature review and feedback from a patient advisory panel. We report emerging themes using a modified grounded theory approach with an analysis of focus group transcripts. We mapped themes to the five dimensions of trust according to the Building Trust Initiative—communication, caring, comfort, cost, and competency—and barriers to trust. RESULTS: We conducted eight focus groups (five in Spanish, three in English) through Zoom between July and September 2023. Cost was not discussed in any of the focus groups. Rather, there was an emerging theme around acompañamiento (accompaniment is a distinct form of companionship in which there is shared power during a shared journey), particularly in the Spanish focus groups. Barriers to building trust exist at the interpersonal and health system levels, including miscommunication, lack of continuity, and brevity of appointments. CONCLUSION: This study explores how trust is conceptualized in pregnancy care according to the perspectives of Latine patients. We found that acompañamiento is a unique and crucial dimension of trust among Spanish-speaking patients.