An integrative review of adolescent trust in the healthcare provider relationship.
Heather K Hardin, Anna E Bender, Carla P Hermann and 1 others
PMID 33249644WHAT IT FOUND
Adolescents most often defined trust in a healthcare provider as confidentiality, then honesty, respect and empathy.
Trust varied by service: mental health care often drew distrust, while chronic care studies associated trust with disclosure and adherence.
Key findings
01Confidentiality was the most frequently reported characteristic of adolescent trust in healthcare providers.
02In one survey, nearly 43% of adolescents reported distrust of mental healthcare providers, and more than half of those were unwilling to use mental health services.
03Among adolescents with chronic conditions, lack of trust was associated with withholding information, and trusting relationships were reported to support treatment adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included 17 studies, not all relevant studies, and the authors noted more eligible studies likely exist. Most studies, 82%, had small samples of fewer than 500 participants, and study quality varied. No studies were excluded based on quality appraisal, so weak studies could influence the themes. The search was limited to English-language publications from 2004 to 2019 in five databases. Included studies came from the Netherlands, New Zealand, United Kingdom and the United States, and participant diversity was limited. Only two of nine quantitative studies used a valid and reliable trust measure, and neither was designed for adolescents. No included study measured gender identity or sexual orientation. Evidence about age and sex was conflicting, so the review cannot say how trust changes across adolescence.
The easy way to misread this
Do not read this as evidence that explaining confidentiality will improve adolescent trust or treatment outcomes. The review reports what adolescents said and what small, varied studies found; it did not test an intervention.