Patient Knowledge and Trust in Health Care. A Theoretical Discussion on the Relationship Between Patients' Knowledge and Their Trust in Health Care Personnel in High Modernity.

In this paper we aim to discuss a theoretical explanation for the positive relationship between patients' knowledge and their trust in healthcare personnel. Our approach is based on John Dewey's notion of continuity. This notion entails that the individual's experiences are interpreted as interrelated to each other, and that knowledge is related to future experience, not merely a record of the past. Furthermore, we apply Niklas Luhmann's theory on trust as a way of reducing complexity and enabling action. Anthony Giddens' description and analysis of the high modern society provides a frame for discussing the preconditions for patient-healthcare personnel interaction. High modernity is dominated by expert systems and demands trust in these. We conclude that patient knowledge and trust in healthcare personnel is related because both knowledge and trust are future- and action-oriented concepts. The traits of high modernity provides opportunities and challenges as the personnel can and must perform discretion. This discretion must be made in a context where knowledge is considered uncertain and preliminary.

Trust in healthcare before and during the COVID-19 pandemic.

BACKGROUND: Public trust is often advantageous for health authorities during crises such as the COVID-19 pandemic. Norwegian health authorities used the public´s high trust to control the pandemic, resulting in relatively few casualties. METHODS: We wanted to describe and compare the Norwegian public trust in GPs, public healthcare, information and treatment in hospitals before and during the early phases of the COVID-19 pandemic. Further, we wanted to investigate the relationship between somatic or mental illness, and trust in GPs and public health information, and to develop a theoretical understanding of the relationship between trust in healthcare institutions, generalised trust and the societal situation caused by the COVID-19 pandemic. We performed two surveys, the first in December 2019; the second in May 2020, thus providing two snapshots of the Norwegian public's trust in healthcare and healthcare actors before and during the COVID-19 pandemic. RESULTS: There was statistically significant increased trust in public healthcare, in treatment at hospital and in information at hospital after the outbreak of the COVID-19 pandemic. There was a non-significant rise in trust in GPs. We found that trust in public health information was not related to mental health nor having a chronic, somatic disease. CONCLUSION: The findings confirm that the Norwegian public's trust in healthcare and healthcare actors is high. The trust levels are also relatively stable, and even show an increase during the early phases of the pandemic. We suggest that there is a dynamic relationship between trust in public health information, healthcare institutions, generalised trust and a societal crisis situation such as the COVID-19 pandemic. However, the GP-patient trust seems less affected by a crisis situation, than the public´s trust in healthcare institutions. This difference may be explained by the relative stability caused by mandates of trust obtained from the patient.

Patients' experiences from an education programme ahead of orthopaedic surgery - a qualitative study.

AIMS AND OBJECTIVES: The objective of this study was to investigate how patient education in a surgical department was experienced by patients who had undergone total knee arthroplasty or total hip arthroplasty. BACKGROUND: Total knee arthroplasty and total hip arthroplasty are two of the most common and clinically effective surgical treatments performed in the Western world. Patient education efforts related to these procedures have been studied, but usually only to evaluate clinical outcome and little in a patient perspective. DESIGN: The empirics consist of qualitative in-depth interviews with 11 patients admitted to the surgical department at a Norwegian hospital. The interviews were carried out in 2011. METHODS: The study has a qualitative design with a phenomenological approach. The data have been analysed through meaning condensation, in accordance with Amadeo Giorgi's four-step method. N = 11. RESULTS: The education programme made the patients feel mentally prepared for surgery and the postsurgical situation. Three themes were identified: (1) realistic information preparing for surgery, (2) involvement and sense of control and (3) trust in staff. CONCLUSION: A relationship seems to exist between how informed patients feel and how much they trust the department in which they are undergoing treatment. There may also be a relationship between a sense of control and trust. RELEVANCE TO CLINICAL PRACTICE: To build a trustful relationship between healthcare providers and patients, patient education both in groups and individually should be implemented, and be designed in a way that supports trust. Information should be realistic and accurate.