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Health Expect. 2021 Apr;24(2):317-326. doi: 10.1111/hex.13171. Epub 2021 Feb 02.

Trust, medical expertise and humaneness: A qualitative study on people with cancer' satisfaction with medical care.

Health expectations : an international journal of public participation in health care and health policy

Susanne Blödt, Jacqueline Müller-Nordhorn, Georg Seifert, Christine Holmberg

Affiliations

  1. Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany.
  2. Institute of Public Health of the Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
  3. Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
  4. Faculdade de Medicina, Departamento de Pediatria, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil.
  5. Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Potsdam, Germany.

PMID: 33528878 PMCID: PMC8077133 DOI: 10.1111/hex.13171

Abstract

BACKGROUND: Understanding peoples' evaluations of their health care is important to ensure appropriate health-care services.

OBJECTIVES: To understand what factors influence peoples' satisfaction with care and how interpersonal trust is established between doctors and cancer patients in Germany.

DESIGN: A narrative interview study that included women with a diagnosis of breast cancer and men with a diagnosis of prostate cancer. A question-focused analysis was conducted.

SETTING AND PARTICIPANTS: Interviewees were sought across Germany through self-help organizations, clinics, rehabilitation facilities, physicians and other health-care professionals, in order to develop modules on experiencing cancer for the website krankheitserfahrungen.de (illness experiences.de).

RESULTS: Satisfaction was related to the perception of having a knowledgeable and trusted physician. Trust was developed through particular interactions in which 'medical expertise' and 'humaneness' were enacted by physicians. Humaneness represents the ability of physicians to personalize medical expertise and thereby to convey working in the individual's best interest and to treat the patient as an individual and unique human being. This was fostered through contextual and relational factors including among others setting, time, information transfer, respect, availability, profoundness, sensitivity and understanding.

CONCLUSION: It was the ability to make oneself known to and know the patient in particular ways that allowed for satisfying care experiences by establishing interpersonal trust. This suggests the importance of conceptualizing the doctor-patient relationship as a fundamentally reciprocal human interaction of caregiving and care-receiving. At the core of the satisfying care experiences lies a doctor-patient relationship with a profoundly humane quality.

© 2020 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Keywords: breast cancer; good care; patient narratives; prostate cancer; qualitative research

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