title: Disentangling cancer patients' trust in their oncologist: a qualitative study.
abstract: OBJECTIVE
  Patients' trust in their physician is crucial for an optimal treatment. Yet, among oncology patients, for whom trust might be especially important, research into trust is limited. A qualitative interview study was carried out to investigate (1) to what extent aspects of trust important to cancer patients reflect the aspects described in other patient populations and (2) which additional themes emerge.
  
  
  METHODS
  In-depth, semi-structured interviews were performed with a purposefully selected heterogeneous sample of 29 cancer patients. Transcribed interviews were analyzed using MAXqda. Data were clustered across interviews to derive common themes related to trust.
  
  
  RESULTS
  Three commonly described aspects, i.e., fidelity, competence and honesty, were strongly reflected in patients' accounts of trust in their oncologist. Confidentiality was irrelevant to many. An additional aspect, labeled 'caring', was distinguished. Central to the accounts of these patients was their need to trust the oncologist, arising from the severe and life-threatening nature of their disease. This necessity to trust led to the quick establishment of a competence-based trust alliance. A deeper, more emotional bond of trust was developed only after repeated interaction and seemed primarily based on the oncologist's interpersonal skills.
  
  
  CONCLUSIONS
  The need for trust encountered in this study underscores the power imbalance between cancer patients and their oncologist. Additionally, these results imply that when aiming to measure cancer patients' trust, what we might actually be assessing is patients' intention and determination to trust their oncologist.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. M.A.Hillen@amc.uva.nl
authors.forename: Marij A
authors.initials: MA
authors.lastname: Hillen
authors.forename: Astrid T
authors.initials: AT
authors.lastname: Onderwater
authors.forename: Myra C B
authors.initials: MC
authors.lastname: van Zwieten
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
authors.forename: Ellen M A
authors.initials: EM
authors.lastname: Smets
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003142:Communication; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010817:Physician-Patient Relations; D036301:Qualitative Research; D035502:Trust / Q000523:psychology*