Expectations of information sharing in Primary Care and the role of trust

Samantha Fitch1

1 The University of Auckland, Private Bag 92019, Auckland 1142 s.fitch@auckland.ac.nz

Trust is a defining characteristic that gives the doctor-patient relationship meaning, importance and substance. Trust is said to promote honesty, disclosure and compliance between doctors and their patients. High profile scandals concerning medical competence, malpractice, breach of confidence and data breaches highlight individual and system failures that can undermine patient trust in health care providers and health care organisations more generally. Beitat et al. (2013) propose a dynamic model of trust where a patient’s trust in a practitioner is influenced by expectations, information/knowledge and outcomes/actions, which are all mediated by communication. These factors are seen to influence the building and break down of trust.

In primary care, a call for increased information sharing needs to be balanced with the interests of privacy and confidentiality. Where information is shared beyond the patient-GP dyad this study contends that trust is an important factor. Information sharing and trust were examined in an empirical ethics, multi-method study examining the role of trust in information sharing in Primary Care in New Zealand.  A theoretically driven survey was formulated to evaluate how expectations, information/knowledge, outcomes and communication influence patient trust in GPs concerning information sharing. The multi-format survey of New Zealand Adults, (n=449) was analysed using regression analysis, and thematic analysis of text questions. Qualitative interviews (n=40) with Auckland-based patients, utilised vignettes and follow up questions to ask about trust, information sharing practices and a data breach were analysed using thematic analysis.

Preliminary findings, show differences in general and particularised trust, though overall trust in GPs was high. Expectations of GPs concerning information go beyond privacy and confidentiality. Responses are consistent with the Beitat et al (2013) model outlined earlier. The findings may contribute to our understanding of trust as an aspect of ethical information sharing for GPs and generate recommendations for practice.

References

Beitat, K., Bentele, G., and Iedema, R. (2013). Trust after medical incidents. In Candlin, C. and Crichton, J., editors, Discourses of trust. Palgrave Macmillan, Houndmills, Basingstoke, Hampshire.


Biography

PhD Student at the University of Auckland, supervised by Dr Monique Jonas and Dr Rob McNeill from the School of Population Health. Topic: The role of trust in information sharing between Patients and GPs.