The fragility of trust between patients and oncologists: A multiple case study

Abstract

Objectives. This study aimed to explore in a naturalistic, real-life setting the dynamics of trust in oncological consultations. Methods. Cases to study were purposively selected from a data set of audio-recorded and transcribed consultations between oncology physicians and patients with advanced cancer, and analyzed qualitatively. The analytical approach was deductive, relying on a thematic framework of dimensions of trust, and inductive, not restricted by this framework. Results. The multiple case study approach allowed to identify factors, which play a role in the dynamics of trust. These factors are the number of treating physicians and how they communicate, continuity of care and the capital of trust, the hierarchical position of the physician and the physician’s self-trust, and the patient’s personality. Significance of results. The findings illustrate the importance to contextualize trust in the flow of oncological consultations and to conceive it comprehensively for each singular encounter between patients and clinicians.