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Monday, 31 October 2011
Learning Objective 1: The learner will be able to explain the four main categories of Gee's (2005) discourse analysis methodology.
Learning Objective 2: The learner will be able to explain how patients describe trust.
Trust is an important factor in providing quality healthcare. While trust is assumed to have an impact on health related outcomes, the meaning that patients ascribe to the word trust has not been explored. The purpose of this study was to explore patients’ descriptions of feeling trusted by healthcare providers. This research was guided by the following question: How does Audre Lorde (1997) describe her experience of trust in The Cancer Journals? Using the concept analysis of trust developed by Hupcey et al. (2001), passages relevant to healthcare trust were chosen. The analysis of these passages followed Gee’s (2005) discourse analysis process. This analysis indicated Lorde not only established trust based on experience but also extended trust and distrust fluidly between individual providers and the healthcare system as a whole. Lorde’s descriptions demonstrate that trust is a cyclical process where the antecedents of trust are dependent on the outcome of trust. These descriptions of trust are not found in the Lorde’s journal entries but only in her later reflections. Trust may not be as evident to the patient in the moment of crisis, but only truly explored with the luxury of space and time. The word trust is not used in the entire text of The Cancer Journals, though instances discussing trust are evident. No other terms are used in the place of trust; instead it seems to be the unnamed force that holds together and assists in making sense of the narrative.
Gee, J. P. (2005). An introduction to discourse analysis: Theory and method (2nd ed.). London: Routledge.
Hupcey, J. E., Penrod, J., Morse, J. M., & Mitcham, C. (2001). An exploration and advancement of the concept of trust. Journal of Advanced Nursing, 36, 282-293.
Lorde, A. (1997). The cancer journals: Special edition. San Francisco, CA: Aunt Lute Books.