title: Perceptions of adults with hearing impairment regarding the promotion of trust in hearing healthcare service delivery.
abstract: OBJECTIVE
  This paper describes how trust is promoted in adults with hearing impairment within the context of hearing healthcare (HHC) service delivery.
  
  
  METHODS
  Data were analysed from a previously published descriptive qualitative study that explored perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation.
  
  
  METHODS
  Interview transcripts from 29 adults from four countries with different levels of hearing impairment and different experience with the HHC system were analysed thematically.
  
  
  RESULTS
  Patients enter into the HHC system with service expectations resulting in a preconceived level of trust that can vary from low to high. Relational competence, technical competence, commercialized approach, and clinical environment (relevant to both the clinician and the clinic) influence a patient's resulting level of trust.
  
  
  CONCLUSIONS
  Trust is evolving rather than static in HHC: Both clinicians and clinics can promote trust. The characteristics of HHC that engender trust are: practicing good communication, supporting shared decision making, displaying technical competence, offering comprehensive hearing rehabilitation, promoting self-management, avoiding a focus on hearing-aid sales, and offering a professional clinic setting.
authors.affiliation: * Program in Audiology, University of Louisville School of Medicine , Louisville , USA.
authors.forename: Jill E
authors.initials: JE
authors.lastname: Preminger
authors.forename: Maria
authors.initials: M
authors.lastname: Oxenbøll
authors.forename: Margaret B
authors.initials: MB
authors.lastname: Barnett
authors.forename: Lisbeth D
authors.initials: LD
authors.lastname: Jensen
authors.forename: Ariane
authors.initials: A
authors.lastname: Laplante-Lévesque
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D012048:Correction of Hearing Impairment / Q000523:psychology*; D003657:Decision Making; D003718:Denmark; D004645:Empathy; D005260:Female; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D010465:Perception; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D010817:Physician-Patient Relations; D011361:Professional Competence; D036301:Qualitative Research; D011793:Queensland; D035502:Trust / Q000523:psychology*; D006113:United Kingdom
keywords: Trust; clinician patient relationship; hearing healthcare