| Popis: |
Background Patients’ trust in physicians has been identified as essential to establishing relationship, receiving reliable information and treatment adherence. Less is known about physicians’ trust in their patients. Physicians’ trust may play an important role especially during complex, long-term relationships with patients dealing with a chronic illness such as Diabetes. Aim To learn about physicians’ perceptions of trust in their patients and understand how these perceptions impact their patient-physician communication. Methods A qualitative study using an Immersion/Crystallization thematic analysis of 23 semi-structured interviews with physicians, specializing in Diabetes. Analysis included both horizontal (focusing on each interview separately) and vertical (comparing different interviews) analysis to learn how different physicians perceive their relationship with Diabetes patients and the communication skills they use. Results Physicians discussed the complexity in Diabetes care, including the need to rely on their patients to manage their disease and adhere to the challenging treatment plan. They mentioned their feeling of limited control over this adherence. Some have come to terms with this limited ‘control’ and accepted their reliance on the patient. These physicians invested in building a relationship and mutual trust with the patient, accepting his involvement as a key partner in treatment decision-making. Others, found relying on the patient challenging. They were concerned with their responsibility and felt frustrated and intimidated by the limited control. They invested in preserving and enhancing control over the decision-making, including using tactics and persuasion or intimidation, to increase adherence. Conclusions Physicians’ trust in their patients, and their perceptions and acceptance of the limited control, play a significant role in the way they communicate and share decisions. Providing them tools to reflect and deal with their perceptions, accepting the limited control, and enhancing their trust in their patients, can help them cope with these challenges and communicate in a more patient-centered manner. |
