• Judith E Hupcey and Jamie Miller.
• School of Nursing, College of Health & Human Development, The Pennsylvania State University, Hershey, PA, USA. jxh37@psu.edu
• J Clin Nurs. 2006 Sep 1; 15 (9): 1132-9.

AimsThis study investigated community dwelling adults' definition of trust in health care providers vs. interpersonal trust, description of the attributes of a trustworthy provider, factors that influenced the development and loss of trust.BackgroundTrust is an important part of health care relationships, however, the meaning of trust for patients is not well understood. Health care providers need to understand the meaning of trust in order to build and maintain therapeutic relationships with their patients.DesignA descriptive qualitative research design was used to investigate perceptions of trust.MethodsSemi-structured open-ended interviews were carried out with 32 community dwelling adults. The participants were recruited from church groups, senior health programs and other community programs. The interviews were thematically analysed for: definitions of interpersonal trust vs. trust in a health care provider, attributes of a trustworthy provider and factors that were pivotal in the development and loss of trust in a health care provider.ResultsTrust in health care providers differed from interpersonal trust in the role-specific attributes of the individuals. Trust, although influenced by having confidence in the provider's competence, was strongly tied to the interpersonal caring attributes of the provider. Loss of trust, on the other hand, was more closely allied with the issues of competency.ConclusionsPerceptions of trust varied greatly among this sample, reinforcing the significance of tailoring our approach to patients on an individual basis.Relevance To Clinical PracticeAssuming that we will be trusted based on our role as nurses may not facilitate the development of a therapeutic relationship with some patients. Nurses and other health care providers need to be acutely aware of our patient's trust and clues of pending loss of trust because, as this study and other prior studies have shown, once trust in a provider is lost, it is nearly impossible to rebuild.

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