'I've just got to take that risk and have faith . . .': The challenge of gaining and maintaining trust in patients undergoing knee surgery with a regional anaesthetic.
Luke Ewart
PMID 38605479WHAT IT FOUND
Patients having knee surgery under regional anaesthetic often trusted the hospital and profession more than the surgeon they had not met.
That trust helped them consent. Standard protocols and mismatched explanations could weaken it.
Key findings
01Trust was the key theme across interviews and participant observation in patients having knee surgery while conscious with regional anaesthesia.
02Patients often placed trust in the hospital or profession rather than in a surgeon they had not met, and this helped them proceed with consent.
03When care followed a standardised protocol that did not fit a patient's circumstances, or when information did not match expectations, trust could be undermined.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only patients scheduled for knee arthroscopy or arthroplasty under local or spinal anaesthesia were interviewed, so it says little about other surgeries or patients who did not take part. The study was done in an acute UK NHS hospital, so its trust findings may not transfer to other health systems. The researcher was a former operating department practitioner and current university lecturer, and used his own reflexivity; this can shape what was observed and interpreted. No clinical outcomes were measured, so the study cannot show that any communication strategy improves trust, consent or recovery.
Declared interests
The author declared no potential conflicts of interest and received no financial support.
The easy way to misread this
Do not conclude that meeting the surgeon beforehand improves consent or surgical outcomes. This was a small qualitative study of patients' experiences, and it did not measure clinical outcomes or test any communication intervention.