title: Impersonal trust and professional authority: exploring the dynamics.
abstract: OBJECTIVE
  The aim of the study was to explore the relationship between impersonal trust, governmentality and professional activity through an analysis of professional discourse.
  
  
  BACKGROUND
  This study emerged from an earlier paper that described a four-dimensional model based on Luhmann's definition of trust as "reducing complexity and managing expectations". Linking trust with the Foucauldian notion of governmentality develops this further. Governmentality raises the question of how professional authority is constituted through the practice of nurses and other health and welfare professionals.
  
  
  METHODS
  Discourse analysis was used to explore the text from two genres--academic literature and interview material (n = 17)--in the context of community residential services for people with learning disabilities. Findings. The study provided evidence to support claims that trust is produced through impersonal systems. Trust is contested in a dynamic process where there are gains and losses. Professionals in organisations actively promote trust, often through systems of distrust. The study also built on the four-dimensional model of impersonal trust--trust, mistrust, abuse and hope--and re-conceptualized the trust-hope dimension.
  
  
  CONCLUSIONS
  There are theoretical links between governmentality and trust. Similarly, in order to understand trust nurses need to understand the dynamic nature of the systems in which they operate. The proposition that trust could frustrate hope adds an element of controversy to the discussion of hope in the nursing literature.
authors.affiliation: School of Social Work and Primary Care, Faculty of Health and Social Work, University of Plymouth, Portland Square Building, Drake Circus, Plymouth PL4 8AA, Devon, UK. anthony.gilbert@plymouth.ac.uk
authors.forename: Tony P
authors.initials: TP
authors.lastname: Gilbert
mesh_terms: D001291:Attitude of Health Personnel; D001318:Authoritarianism; D002983:Clinical Competence; D003156:Community Mental Health Services / Q000458:organization & administration; D004739:England; D006801:Humans; D007859:Learning Disabilities / Q000451:nursing*; D012947:Social Work; D035502:Trust