A multiperspective interpretative phenomenological analysis of the trust of people with chronic illnesses in healthcare professionals

Introduction. Trust is a cornerstone of the patient-professional relationship. In particular, trust is especially important in the context of chronic diseases due to increased vulnerability, uncertainty, and dependence on healthcare professionals for longer periods of time.

Goals and Methods. The study aims to better understand the trust phenomenon from the perspectives of people with chronic cardiovascular and gastrointestinal disease. A multiperspectival interpretative phenomenological analysis (IPA) design with indirectly related groups of participants was used. Semi-structured interviews were conducted with eleven participants with cardiovascular disease and ten with chronic gastrointestinal disease. Data analysis was performed according to IPA with the support of Atlas.ti 9. The study was approved by the local ethics committee.

Findings. The trust of participants in healthcare professionals was grounded in the tension between respect for their autonomy and a paternalistic approach to them. Trust was strongly supported by the compassionate engagement of healthcare professionals complemented by holistic patient-centred care. Another essential element influencing their trust was their expectation and reality of the expertise of healthcare professionals. Trust was also affected by the way participants perceived the management of health care, especially among participants with gastrointestinal disease. The degree to which participants experienced trust created a dynamic between their sense of security and perceived vulnerability and dependence.

Conclusions. The findings highlighted the complex and relational nature of trust experiences and contribute to a better understanding of how people with chronic diseases experience trust in healthcare professionals. Study is an example of how multiprespective IPA can be used to study trust as a relational phenomenon. The study was supported by VEGA project No. 1/0276/21.