Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Psychooncology. 2012 Apr;21(4):392-9. doi: 10.1002/pon.1910. Epub 2011 Jan 30.
Patients' trust in their physician is crucial for an optimal treatment. Yet, among oncology patients, for whom trust might be especially important, research into trust is limited. A qualitative interview study was carried out to investigate (1) to what extent aspects of trust important to cancer patients reflect the aspects described in other patient populations and (2) which additional themes emerge.
In-depth, semi-structured interviews were performed with a purposefully selected heterogeneous sample of 29 cancer patients. Transcribed interviews were analyzed using MAXqda. Data were clustered across interviews to derive common themes related to trust.
Three commonly described aspects, i.e., fidelity, competence and honesty, were strongly reflected in patients' accounts of trust in their oncologist. Confidentiality was irrelevant to many. An additional aspect, labeled 'caring', was distinguished. Central to the accounts of these patients was their need to trust the oncologist, arising from the severe and life-threatening nature of their disease. This necessity to trust led to the quick establishment of a competence-based trust alliance. A deeper, more emotional bond of trust was developed only after repeated interaction and seemed primarily based on the oncologist's interpersonal skills.
The need for trust encountered in this study underscores the power imbalance between cancer patients and their oncologist. Additionally, these results imply that when aiming to measure cancer patients' trust, what we might actually be assessing is patients' intention and determination to trust their oncologist.
患者对医生的信任对于最佳治疗至关重要。然而，在肿瘤患者中，信任可能尤为重要，但对信任的研究却很有限。本研究进行了一项定性访谈研究，旨在调查：（1）对癌症患者重要的信任方面在多大程度上反映了其他患者群体中描述的方面；（2）出现了哪些额外的主题。
对 29 名癌症患者进行了有目的选择的异质样本的深入半结构化访谈。使用 MAXqda 对转录的访谈进行了分析。对数据进行了聚类分析，以得出与信任相关的常见主题。
三个普遍描述的方面，即忠诚、能力和诚实，在患者对肿瘤医生的信任中得到了强烈的体现。许多患者认为保密性并不重要。还区分了一个额外的方面，称为“关怀”。对这些患者而言，信任肿瘤医生是至关重要的，这是由于他们的疾病严重且危及生命。这种对信任的需求导致了以能力为基础的信任联盟的快速建立。更深层次、更情绪化的信任纽带只有在反复互动后才会发展，并且似乎主要基于肿瘤医生的人际交往能力。
本研究中遇到的对信任的需求强调了癌症患者与肿瘤医生之间的权力不平衡。此外，这些结果表明，当我们旨在衡量癌症患者的信任时，我们实际上可能评估的是患者信任其肿瘤医生的意愿和决心。
