Ward Paul, Coates Anna
Department of Public Health, Flinders University, Adelaide, Australia.
Health (London). 2006 Jul;10(3):283-301. doi: 10.1177/1363459306064481.
This article reports on a qualitative study in a materially deprived locality in northern England, which originally aimed to explore local residents' views of proposed changes to local health care provision. However, participants also quickly moved the research agenda onto widespread discussions of (mis)trust. Unlike much sociological literature that defines trust as operating on two levels (inter-personal and system-based), their narratives of trust were constructed on several inter-connected levels. We explore mistrust in local general practitioners (GPs) as a factor of mistrust of a number of local and national organizations and social systems, rather than solely related to the medical system. Widespread mistrust of 'authority' was narrated through a shared history of disinvestment and loss of services in the locality and 'broken promises' by a range of institutions, which precipitated feelings of social exclusion and disembeddedness.
本文报道了在英格兰北部一个物质匮乏地区开展的一项定性研究，该研究最初旨在探究当地居民对当地医疗服务提议变革的看法。然而，参与者们也很快将研究议程转向了关于（不）信任的广泛讨论。与许多将信任定义为在两个层面（人际层面和基于系统的层面）运作的社会学文献不同，他们关于信任的叙述是在几个相互关联的层面上构建的。我们探讨了对当地全科医生（GP）的不信任是对一些地方和国家组织及社会系统不信任的一个因素，而不仅仅与医疗系统相关。通过当地撤资和服务丧失的共同历史以及一系列机构的“失信承诺”，讲述了对“权威”的广泛不信任，这引发了社会排斥和脱节的感觉。
