Developing Interpersonal Trust Between Service Users and Professionals in Integrated Services: Compensating for Latent Distrust, Vulnerabilities and Uncertainty Shaped by Organisational Context
Abstract: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, … Show more
“…Trust has also a context-specific cognitive dimension, meaning that people have beliefs and make decisions about whom to trust and when. For example, the specific actions that people believe contribute to trust in the context of authorities are different from those in the community or in the context of personal relationships [ 41 ]. Accordingly, the same trust-building strategies do not apply to both.…”
Understanding the risk perceptions of the public is central for risk communications and infodemic management during emergency and preparedness planning as people’s behavior depends on how they perceive the related risks. This qualitative study aimed to identify and describe factors related to COVID-19 risk perceptions of the public in Finland and to make this information readily available to those who communicate with the public during crises. The study is part of a larger project exploring crisis narratives through a mixed-methods approach. The study was based on a dataset of over 10,000 comments on the Facebook and Twitter posts of the Finnish Institute of Health and Welfare (THL) between March-May 2021. The data were analyzed qualitatively using thematic analysis. The study identified concepts linked with the pandemic risk perception that included knowledge, perceptions, personal experiences, trust, attitudes, and cultural values. The findings resulted in a framework of risk perceptions that can be used as taxonomy and a set of key concepts and keywords in social listening to monitor risk perception during future epidemics and pandemics.
“…Trust has also a context-specific cognitive dimension, meaning that people have beliefs and make decisions about whom to trust and when. For example, the specific actions that people believe contribute to trust in the context of authorities are different from those in the community or in the context of personal relationships [ 41 ]. Accordingly, the same trust-building strategies do not apply to both.…”
Understanding the risk perceptions of the public is central for risk communications and infodemic management during emergency and preparedness planning as people’s behavior depends on how they perceive the related risks. This qualitative study aimed to identify and describe factors related to COVID-19 risk perceptions of the public in Finland and to make this information readily available to those who communicate with the public during crises. The study is part of a larger project exploring crisis narratives through a mixed-methods approach. The study was based on a dataset of over 10,000 comments on the Facebook and Twitter posts of the Finnish Institute of Health and Welfare (THL) between March-May 2021. The data were analyzed qualitatively using thematic analysis. The study identified concepts linked with the pandemic risk perception that included knowledge, perceptions, personal experiences, trust, attitudes, and cultural values. The findings resulted in a framework of risk perceptions that can be used as taxonomy and a set of key concepts and keywords in social listening to monitor risk perception during future epidemics and pandemics.
“…As these two parts of the intervention were only part of INT, we can conclude that only interventions in the MHC group were implemented with high fidelity. True integration of the intervention components in INT was challenged by lack of trust and diverging norms and goals between the different sectors, as described elsewhere (12,13). In other studies, VR services similar to IBBIS-VR have shown positive effect.…”
Not only at one-year follow-up, but also at two-year follow-up, integrating vocational rehabilitation and mental healthcare yielded negative effects on vocational outcomes during sick leave with common mental disorders.
Integration of vocational rehabilitation and mental healthcare has shown some effect on work participation at 1-year follow-up after sick leave with depression and anxiety. We aimed to study the effect on work and health outcomes at 2-year follow-up, why we performed a randomized trial was conducted to study the effectiveness of integrated intervention (INT) compared to service as usual (SAU) and best practice mental healthcare (MHC). We included 631 participants, and at 24-month follow-up, we detected no differences in effect between INT and SAU. Compared to MHC, INT showed faster return-to-work (RTW) rates (p = 0.044) and a higher number of weeks in work (p = 0.024). No symptom differences were observed between the groups at 24 months. In conclusion, compared to SAU, INT was associated with a slightly higher work rate reaching borderline statistical significance at 12-month follow-up and lower stress levels at 6-month follow-up. The disappearance of relative effect between 12 and 24 months may be explained by the fact that the intervention lasted less than 12 months or by delayed spontaneous remission in the SAU group after 12 months. Despite the lack of effect at long-term follow-up, INT still performed slightly better than SAU overall. Moderate implementation difficulties, may partly explain the absence of the hypothesized effect. Integrated intervention, as implemented in this trial, showed some positive effects on mid-term vocational status and short-term stress symptom levels. However, these effects were not sustained beyond the duration of the intervention.
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