Lemmers Anne Lotte, van der Voort Peter H J
Department of Intensive Care, OLVG Hospital, P.O. Box 95500, 1090HM Amsterdam, The Netherlands.
Department of Critical Care, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Healthcare (Basel). 2021 Feb 15;9(2):208. doi: 10.3390/healthcare9020208.
Intensive care patients experience anxiety, pain, uncertainty, and total dependency. In general, it is important to develop trust between the healthcare professionals (HCPs), patients, and their family. Trust building in the ICU setting is challenging because of the time sensitivity of decision making and the dependency of patients on health care professionals. The objectives of this study are the development of a trust framework and then to use this framework in a case study in the intensive care. In three steps we developed a comprehensive trust framework from the literature concerning trust. First, we identified the elements of trust. Second, we adapted and integrated the dimensions to six concepts to construct the trust framework. Third, these concepts are incorporated into a comprehensive trust framework. In a case study we explored the facilitators and barriers within this framework in eight semi-open interviews with healthcare professionals and eight patients or partners. Trust was first explored inductively and then deductively. We showed that HCPs, patients, and family have largely the same perspective regarding the facilitators of trust, in which communication emerged as the most important one. Other facilitators are maintaining an open feedback culture for HCPs and being aware of patients' physical and informational privacy. Patients want to be approached as an individual with individual needs. Dishonesty and differences in values and norms were the most important barriers. To contribute to a positive perception of health delivery and to avoid conflicts between HCP and patients or their family we formulated five practical recommendations.
重症监护患者会经历焦虑、疼痛、不确定性和完全的依赖。一般来说，在医护人员、患者及其家属之间建立信任很重要。在重症监护环境中建立信任具有挑战性，因为决策具有时间敏感性，且患者依赖医护人员。本研究的目的是制定一个信任框架，然后在重症监护的案例研究中使用该框架。我们通过三个步骤从有关信任的文献中制定了一个全面的信任框架。首先，我们确定了信任的要素。其次，我们将这些维度调整并整合为六个概念以构建信任框架。第三，将这些概念纳入一个全面的信任框架。在一个案例研究中，我们通过对医护人员和八名患者或其家属进行八次半开放式访谈，探索了该框架内的促进因素和障碍。信任首先通过归纳法进行探索，然后通过演绎法进行探索。我们发现，医护人员、患者和家属在信任促进因素方面的看法基本相同，其中沟通是最重要的因素。其他促进因素包括为医护人员保持开放的反馈文化以及意识到患者的身体和信息隐私。患者希望被视为有个人需求的个体。不诚实以及价值观和规范的差异是最重要的障碍。为了促进对医疗服务的积极认知并避免医护人员与患者或其家属之间的冲突，我们提出了五条实用建议。
