Gerhards Helene, Jongsma Karin, Schicktanz Silke
Institute of Political Science, University of Duisburg-Essen, Lotharstraße 65, 47057, Duisburg, Germany.
Department of Medical Ethics and History of Medicine, University Medical Centre Göttingen, Humboldtallee 36, 37073, Göttingen, Germany.
BMC Health Serv Res. 2017 Jul 11;17(1):474. doi: 10.1186/s12913-017-2368-z.
Trust within organizations is important for ensuring members' acceptance of the organization's activities and to expand their scope of action. Remarkably, Patient Organizations (POs) that often both function as a forum for self-help and represent patients on the health-political level, have been understudied in this respect. This paper analyzes the relation between trust and representation in POs. We distinguish between two models of representation originating from political theory: the trustee and delegate model and between two types of trust: horizontal and vertical trust.
Our theoretical approach is illustrated with an analysis of 13 interviews with representatives of German POs.
We have found that the delegate model requires horizontal trust and the trustee model vertical trust. Both models: horizontal/delegate and vertical/trustee exist within single POs.
The representation process within POs demands a balancing act between inclusion of affected persons and strategically aggregating a clear-cut political claim. Trust plays in that process of coming from individual wishes to collective and political standpoints a major role both in terms of horizontal as well as vertical trust. Horizontal trust serves the communication between affected members, and vertical trust allows representatives to be decisive.
组织内部的信任对于确保成员接受组织活动并扩大其行动范围至关重要。值得注意的是，患者组织（POs）既经常充当自助论坛，又在健康政治层面代表患者，但在这方面的研究却很少。本文分析了患者组织中信任与代表之间的关系。我们区分了源自政治理论的两种代表模式：受托人和代表模式，以及两种信任类型：横向信任和纵向信任。
我们通过对德国患者组织代表的13次访谈分析来说明我们的理论方法。
我们发现代表模式需要横向信任，受托模式需要纵向信任。这两种模式：横向/代表和纵向/受托，都存在于单个患者组织中。
患者组织内部的代表过程需要在纳入受影响人员和战略性地汇总明确的政治主张之间进行平衡。在从个人愿望到集体和政治立场的过程中，信任在横向和纵向信任方面都起着重要作用。横向信任有助于受影响成员之间的沟通，纵向信任使代表能够做出决定性决策。
