23 What can be learned from ethnographic research on trust between physicians and parents and between physicians and children with cancer

Abstract

Despite theoretical and empirical support for the importance of trust in the physician-patient relationship, there are few studies focusing on the construction of trust among physicians, parents, and children. The purpose of the proposed lecture is to introduce verbal and nonverbal behaviors, that may shape and establish trust between physicians and parents, and between physicians and children with cancer. An ethnographic study, examining the work of all physicians in one oncology ward, in a hospital, and a sample of 27 parents and 27 children with lymphoblastic leukemia. Triangulation was conducted in the study: 1) Observations in various discourse arenas, documenting a year of the physicians’ work. 2) Semi-structured interviews with all doctors, children and parents 3) Collection of documents. Data analysis included: exact transcriptions of all research materials as well as content analysis. Findings All parents and children, the conditions for establishing trust with a physician were: the duration of their acquaintance with that physician, frequency of the child’s treatments, that physician being the child’s regular doctor, and the physician’s attitude toward the child and the parent. In addition, the study findings revealed two common themes for parents and children that form trust between physician-parent, and physician-child, these two main themes are: physician’s attitude and professionalism. The proposed lecture will focus on the first theme – the physician-parent and physician-child relationships, this theme includes four categories that shape trust, which were reported, with high frequency, by parents and children, and these are: patience, humanity, sharing information and respect, in each of the categories, both verbal and nonverbal characteristics behaviors were found, which I will present in the lecture. The findings of this study could have important implications for physician training, and the quality of care that physicians provide.