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改善公共卫生项目的可及性、利用率及成果:与患者/客户建立并维持信任的重要性。

Improving Access to, Use of, and Outcomes from Public Health Programs: The Importance of Building and Maintaining Trust with Patients/Clients.

作者信息

Ward Paul Russell

机构信息

Discipline of Public Health, Flinders University , Adelaide, SA , Australia.

出版信息

Front Public Health. 2017 Mar 8;5:22. doi: 10.3389/fpubh.2017.00022. eCollection 2017.

Abstract

The central argument in this paper is that "public trust" is critical for developing and maintaining the health and wellbeing of individuals, communities, and societies. I argue that public health practitioners and policy makers need to take "public trust" seriously if they intend to improve both the public's health and the engagement between members of the public and public health systems. Public health practitioners implement a range of services and interventions aimed at improving health but implicit a requirement for individuals to trust the practitioners and the services/interventions, before they engage with them. I then go on to provide an overview of the theory of trust within sociology and show why it is important to understand this theory in order to promote trust in public health services. I then draw on literature in three classic areas of public health-hospitals, cancer screening, and childhood immunization-to show why trust is vital in terms of understanding and potentially improving uptake of services. The case studies in this paper reveal that public health practitioners need to understand the centrality of building and maintaining trusting relationships with patients/clients because people who distrust public health services are less likely to use them, less likely to follow advice or recommendations, and more likely to have poorer health outcomes.

摘要

本文的核心观点是,“公众信任”对于个人、社区和社会的健康发展与福祉维护至关重要。我认为,如果公共卫生从业者和政策制定者想要改善公众健康以及公众与公共卫生系统之间的互动,就需要认真对待“公众信任”。公共卫生从业者实施一系列旨在改善健康的服务和干预措施,但在个人参与这些服务和干预措施之前,隐含着要求他们信任从业者以及这些服务/干预措施。接着,我概述了社会学中的信任理论,并说明为何理解这一理论对于促进对公共卫生服务的信任很重要。然后,我借鉴公共卫生三个经典领域——医院、癌症筛查和儿童免疫——的文献,来阐述为何信任对于理解并潜在地提高服务利用率至关重要。本文的案例研究表明,公共卫生从业者需要理解与患者/客户建立和维持信任关系的核心地位,因为不信任公共卫生服务的人使用这些服务的可能性较小,遵循建议或推荐的可能性较小,而且健康结果更可能较差。

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