Communicating in times of uncertainty: The need for trust
Communicating in times of uncertainty: The need for trust
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DOI：
10.1080/10810730390224839
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发表时间：
2003-06-01
影响因子：
4.4
通讯作者：
Shore, DA
中科院分区：
文献类型：
--
作者：
Shore, DA
当被众议员帕特里克肯尼迪（D-RI）问及公共卫生系统是否会被对严重急性呼吸系统综合症和生物恐怖主义感到恐慌的人所淹没时，疾病控制和预防中心主任朱莉·格伯丁回答说，“如果人们信任你，你可以管理他们.我们在改善州和地方的沟通方面投入了大量的努力，并扩大了我们自己的公共事务能力。我们正在建立信誉、能力和信任“（Gerberding，2003）。当前卫生与公众服务部部长Donna Shalala反思保护研究对象所需的关键因素时，她也将注意力集中在信任上：“如果我们要继续测试治疗疾病的新药和新方法，我们就不能损害患者参与临床试验的信任和意愿。美国医学会断言，医患关系是一种“基于信任契约的道德企业”（AMA，1995）。信任在决策过程和依从率中扮演的核心角色，也许最好的总结是我在一个基于信仰的医疗保健系统中进行信任诊断审计时收到的一位前病人的评论：“看起来很简单，真实的。如果你不相信你的医生，你就不会好起来。这种情绪已经多次得到回应，通常包括“医院”，“诊所”和“护士”以及或代替“医生”。在人们对公共和私人机构的信任已经削弱的时候，加强对医疗保健的信任将要求我们不仅仅是强调其重要性。
When asked by Rep. Patrick Kennedy (D-RI) whether the public health system could be overrun by people panicked about Severe Acute Respiratory Syndrome and bioterrorism, Centers for Disease Control and Prevention Director Julie Gerberding replied,‘‘You can manage people if they trust you... we’ve put a great deal of effort into improving state and local communication and scaled up our own public affairs capacity... we’re building credibility, competence, trust’’(Gerberding, 2003). When former Health and Human Services Secretary Donna Shalala reflected on the key ingredient necessary to protect research subjects, she, too, zeroed in on trust:‘‘If we are to keep testing new medicines and new approaches to curing disease, we cannot compromise the trust and willingness of patients to participate in clinical trials’’(Shalala, 2000). The American Medical Association asserts that the patient-physician relationship is a ‘‘moral enterprise grounded in a covenant of trust’’(AMA, 1995).The central role trust plays in decision-making processes and compliance rates is perhaps best summed up in a comment I received from a former patient while conducting a Trust Diagnostic Audit in a faith-based health care system:‘‘Look—it’s real simple. If you don’t trust your doctor, you just ain’t gonna get well.’’This sentiment has been echoed many times, often including ‘‘hospital,’’‘‘clinic,’’and ‘‘nurse’’along with or in lieu of ‘‘doctor.’’At a time when trust in public and private institutions has eroded, enhancing trust in health care will require that we move beyond simply asserting its importance.