Goudge Jane, Gilson Lucy
Centre for Health Policy, School of Public Health, University of Witwatersrand, SA.
Soc Sci Med. 2005 Oct;61(7):1439-51. doi: 10.1016/j.socscimed.2004.11.071. Epub 2005 Jan 28.
Although the concept of trust has gained popularity in public debate and academic analysis over recent years, it continues to be regarded by many as difficult to define and so to investigate. In this paper we provide guidance on how to conduct future work on trust in the health sector, by reviewing the methods used in earlier studies. The paper draws on a range of the available literature which investigates trust in different settings from a variety of disciplinary perspectives. The review suggests that appropriate definitions of trust are highly context dependent. Where little is known about how trust functions, qualitative research to explore how respondents view trust and 'trusted' behaviour is important in advance of quantitative investigation. The results of qualitative inquiry facilitate the development and refinement of hypotheses about how trust functions and can be used to generate questions for use in structured questionnaires. Quantitative inquiry is valuable because it allows larger scale investigation and generates data that can be used, for example, to assess the statistical significance of different determinants to overall levels of trust. The review indicates that trying to use existing data to answer a new research question, without ensuring that respondents' answers refer to the form of trust under investigation, may lead to the generation of use of inappropriate data. In this respect, it highlights the need to test pre-existing research tools to ensure that they remain valid and relevant and retain their reliability in different settings. Although there may appear to be common structural features of specific relationships that might allow international measurement tools to be developed for use in the same type setting across geographical locations, cultural differences might invalidate such tools. Specific investigation of such differences is, therefore, needed to explore the potential validity of international tools for investigating trust.
尽管近年来信任的概念在公众辩论和学术分析中越来越流行，但许多人仍然认为它难以定义，因此也难以进行研究。在本文中，我们通过回顾早期研究中使用的方法，为如何在卫生部门开展未来关于信任的研究提供指导。本文借鉴了一系列现有文献，这些文献从不同学科角度研究了不同背景下的信任。综述表明，对信任的恰当定义高度依赖于具体情境。在对信任的运作方式了解甚少的情况下，在进行定量调查之前，通过定性研究来探索受访者如何看待信任和“可信任”行为非常重要。定性探究的结果有助于形成和完善关于信任如何运作的假设，并可用于生成结构化问卷中的问题。定量探究很有价值，因为它允许进行更大规模的调查，并生成可用于评估不同决定因素对总体信任水平的统计显著性的数据。综述指出，试图使用现有数据来回答新的研究问题，而不确保受访者的回答涉及所研究的信任形式，可能会导致产生和使用不适当的数据。在这方面，它强调需要测试现有的研究工具，以确保它们仍然有效且相关，并在不同情境下保持其可靠性。尽管特定关系可能存在一些共同的结构特征，这或许能使国际测量工具得以开发，用于跨地理位置的同一类型情境，但文化差异可能会使这些工具失效。因此，需要对这些差异进行具体研究，以探索用于调查信任的国际工具的潜在有效性。
