TY - JOUR

T1 - Developing Interpersonal Trust Between Service Users and Professionals in Integrated Services

T2 - Compensating for Latent Distrust, Vulnerabilities and Uncertainty Shaped by Organisational Context

AU - Poulsen, Rie Mandrup

AU - Pii, Kathrine Hoffmann

AU - Eplov, Lene Falgaard

AU - Meijer, Mathias

AU - Bultmann, Ute

AU - Christensen, Ulla

PY - 2021

Y1 - 2021

N2 - Introduction: Studies show a need for trust between stakeholders in integrated services. However, few studies have investigated how trust develops between stakeholders on a micro-level. In a Danish intersectoral intervention for persons on sick leave due to common mental disorders, we explored why trust is needed and how trust is developed between micro-level stakeholders.Methodology: The qualitative study was based on 12 observations of inter-organisational meetings, 16 interviews with service users, 24 interviews with health care professionals and employment consultants, and 8 interviews with supervisors. The analysis was guided by the theoretical concepts (dis-) trust, vulnerability and uncertainty.Results: Latent distrust between involved organisations, and vulnerabilities and uncertainties related to employment consultants' statutory power over service users caused a perceived need for interpersonal trust. Time to establish knowledge-based relationships, healthcare professionals' caring approach, and creating a feeling of sharing interests were compensating trust-building strategies that were often regarded as positive.Discussion and conclusion: Trust in personal relationships between stakeholders appeared to compensate for contextually shaped distrust, vulnerability and uncertainty. Identifying latent distrust, vulnerabilities, uncertainties, and power structures might be key to improving trust-building strategies in a specific context. The time-consuming process of trust-building between micro-level stakeholders should be supported structurally.

AB - Introduction: Studies show a need for trust between stakeholders in integrated services. However, few studies have investigated how trust develops between stakeholders on a micro-level. In a Danish intersectoral intervention for persons on sick leave due to common mental disorders, we explored why trust is needed and how trust is developed between micro-level stakeholders.Methodology: The qualitative study was based on 12 observations of inter-organisational meetings, 16 interviews with service users, 24 interviews with health care professionals and employment consultants, and 8 interviews with supervisors. The analysis was guided by the theoretical concepts (dis-) trust, vulnerability and uncertainty.Results: Latent distrust between involved organisations, and vulnerabilities and uncertainties related to employment consultants' statutory power over service users caused a perceived need for interpersonal trust. Time to establish knowledge-based relationships, healthcare professionals' caring approach, and creating a feeling of sharing interests were compensating trust-building strategies that were often regarded as positive.Discussion and conclusion: Trust in personal relationships between stakeholders appeared to compensate for contextually shaped distrust, vulnerability and uncertainty. Identifying latent distrust, vulnerabilities, uncertainties, and power structures might be key to improving trust-building strategies in a specific context. The time-consuming process of trust-building between micro-level stakeholders should be supported structurally.

KW - trust

KW - integrated services

KW - common mental disorders

KW - organisational context

KW - person-centred services

KW - process evaluation

KW - COMMON MENTAL-DISORDERS

KW - QUALITATIVE RESEARCH

KW - SECONDARY ANALYSIS

KW - WORK

KW - RETURN

KW - EXPERIENCES

KW - HEALTH

KW - PERCEPTIONS

KW - GOVERNANCE

KW - EMPLOYEES

U2 - 10.5334/ijic.5599

DO - 10.5334/ijic.5599

M3 - Journal article

C2 - 34248445

VL - 21

JO - International Journal of Integrated Care

JF - International Journal of Integrated Care

SN - 1568-4156

IS - 3

M1 - 1

ER -