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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. General Pediatrics and Pediatric Emergency Care
Volume 12 - 2024 | doi: 10.3389/fped.2024.1443869

Trust of Inpatient Physicians Among Parents of Children with Medical Complexity: A Qualitative Study

Provisionally accepted
Tammie Dewan Tammie Dewan 1,2*Andrea Whiteley Andrea Whiteley 1Lyndsay J. Mackay Lyndsay J. Mackay 3Rachel Martens Rachel Martens 1,4Melanie Noel Melanie Noel 1Chantelle Barnard Chantelle Barnard 1,2Isabel Jordan Isabel Jordan 5Annie Janvier Annie Janvier 6,7Sally Thorne Sally Thorne 8
  • 1 University of Calgary, Calgary, Canada
  • 2 Alberta Children's Hospital, Calgary, Alberta, Canada
  • 3 Trinity Western University, Langley Township, British Columbia, Canada
  • 4 McMaster University, Hamilton, Ontario, Canada
  • 5 Other, Squamish, Canada
  • 6 CHU Sainte-Justine, Montreal, Quebec, Canada
  • 7 Montreal University, Montreal, Quebec, Canada
  • 8 University of British Columbia, Vancouver, British Columbia, Canada

The final, formatted version of the article will be published soon.

    Trust is a foundation of the therapeutic relationship and is associated with important patient outcomes. Building trust between parents of children with medical complexity (CMC) and physicians during inpatient care is complicated by lack of relational continuity, cumulative (sometimes negative) parent experiences and the need to adjust roles and expectations to accommodate parental expertise. This study’s objective was to describe how parents of CMC conceptualize trust with physicians within the pediatric inpatient setting and to provide recommendations for building trust in these relationships. Qualitative semi-structured research interviews with parents of CMC were analyzed using interpretive description methodology. Researchers interviewed 16 parents of CMC. The research team identified one overarching meta theme regarding factors that influence trust development: situational awareness is needed to inform personalized care of children and families. There were also six major themes: 1) ensuring that the focus is on the child and family, 2) respecting both parent and physician expertise, 3) collaborating effectively, 4) maintaining a flow of communication, 5) acknowledging the impact of personal attributes, and 6) recognizing issues related to the healthcare system. Many elements that facilitated trust development were also components of patient- and family-centered care. Parents in this study approached trust with inpatient physicians as something that needs to be earned and reciprocated. To gain the trust of parents of CMC, inpatient physicians should personalize medical care to address the needs of each child and should explore the perceptions, expertise, and previous experiences of their parents.

    Keywords: Trust, medical complexity, Parents, relationship, Patient-and family-centered care, physician, Hospital, Pediatrics

    Received: 04 Jun 2024; Accepted: 30 Aug 2024.

    Copyright: © 2024 Dewan, Whiteley, Mackay, Martens, Noel, Barnard, Jordan, Janvier and Thorne. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tammie Dewan, University of Calgary, Calgary, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.