Abstract
Intensive care patients experience anxiety, pain, uncertainty, and total dependency. In general, it is important to develop trust between the healthcare professionals (HCPs), patients, and their family. Trust building in the ICU setting is challenging because of the time sensitivity of decision making and the dependency of patients on health care professionals. The objectives of this study are the development of a trust framework and then to use this framework in a case study in the intensive care. In three steps we developed a comprehensive trust framework from the literature concerning trust. First, we identified the elements of trust. Second, we adapted and integrated the dimensions to six concepts to construct the trust framework. Third, these concepts are incorporated into a comprehensive trust framework. In a case study we explored the facilitators and barriers within this framework in eight semi-open interviews with healthcare professionals and eight patients or partners. Trust was first explored inductively and then deductively. We showed that HCPs, patients, and family have largely the same perspective regarding the facilitators of trust, in which communication emerged as the most important one. Other facilitators are maintaining an open feedback culture for HCPs and being aware of patients’ physical and informational privacy. Patients want to be approached as an individual with individual needs. Dishonesty and differences in values and norms were the most important barriers. To contribute to a positive perception of health delivery and to avoid conflicts between HCP and patients or their family we formulated five practical recommendations.
Highlights
The objectives of this study are twofold: first, based on the current literature, we developed a conceptual framework of trust between healthcare professionals (HCPs) and patients with their families which can be applied to the intensive care setting
Sixteen interviews were performed (Table 3). It appeared that all the characteristics described for the trust concepts in the framework, if executed as explained, increase the probability that patients trust or increase their trust in HCPs
This result is in line with earlier research in which it was found that the course of action of HCPs regarding mistakes influences how patients feel after an adverse event or complication
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The intensive care is a unique location in the hospital where patients are extremely vulnerable and life-threatening risks are frequently, if not constantly, present. In this setting, patients experience anxiety, fear, pain, and complete dependency on care providers. Family members are emotionally challenged as they fear for the life of their relative and are uncertain about the future
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