Poulsen Rie Mandrup, Pii Kathrine Hoffmann, Eplov Lene Falgaard, Meijer Mathias, Bültmann Ute, Christensen Ulla
The National Board of Social Services, Center for Data, Analysis and Methods, Edisonsvej 1, 5000 Odense C, Denmark.
University College Copenhagen, Faculty of Health, Institute for Nursing and Nutrition, Tagensvej 86, 2200 Copenhagen N, Denmark.
Int J Integr Care. 2021 Jul 1;21(3):1. doi: 10.5334/ijic.5599. eCollection 2021 Jul-Sep.
INTRODUCTION: Studies show a need for trust between stakeholders in integrated services. However, few studies have investigated how trust develops between stakeholders on a micro-level. In a Danish intersectoral intervention for persons on sick leave due to common mental disorders, we explored why trust is needed and how trust is developed between micro-level stakeholders. METHODOLOGY: The qualitative study was based on 12 observations of inter-organisational meetings, 16 interviews with service users, 24 interviews with health care professionals and employment consultants, and 8 interviews with supervisors. The analysis was guided by the theoretical concepts (dis-) trust, vulnerability and uncertainty. RESULTS: Latent distrust between involved organisations, and vulnerabilities and uncertainties related to employment consultants' statutory power over service users caused a perceived need for interpersonal trust. Time to establish knowledge-based relationships, healthcare professionals' caring approach, and creating a feeling of sharing interests were compensating trust-building strategies that were often regarded as positive. DISCUSSION AND CONCLUSION: Trust in personal relationships between stakeholders appeared to compensate for contextually shaped distrust, vulnerability and uncertainty. Identifying latent distrust, vulnerabilities, uncertainties, and power structures might be key to improving trust-building strategies in a specific context. The time-consuming process of trust-building between micro-level stakeholders should be supported structurally.
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