title: Understanding physical health of older adults with schizophrenia: building and eroding trust.
abstract: Adults with schizophrenia are living longer, and data suggest they face health care disparities contributing to poor physical health. This article presents findings from a study that explored the understanding of physical health among older adults with schizophrenia. One goal was to understand factors that influence experienced health care disparities. This grounded theory study used semi-structured interviews and participant observation and was conducted among 28 older adults with schizophrenia living in a variety of settings. Trust evolved as a dynamic process that was built with factors of respect, caring, advocacy, and consistency and eroded through factors of disrespect, not being heard, lack of time and provider inaction, and stigmatization. When trust is given and received between providers, the health care system, and the older adult with schizophrenia, the adult's physical health outcomes may improve and health care disparities may decline. These findings provide insights to promote optimal physical health outcomes.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, California 94143-0610, USA. Heather.Leutwyler@ucsf.edu
authors.forename: Heather C
authors.initials: HC
authors.lastname: Leutwyler
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Wallhagen
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003299:Cooperative Behavior; D004645:Empathy; D005260:Female; D005851:Geriatric Nursing / Q000458:organization & administration; D006293:Health Promotion; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D011369:Professional-Patient Relations; D012559:Schizophrenia / Q000517:prevention & control*; D012565:Schizophrenic Psychology; D013240:Stereotyping; D035502:Trust