Trustful relationships between healthcare professionals and children: a concept analysis using Rodgers' evolutionary...

Despite the recognized importance of trust in pediatric healthcare, the concept of "trustful relationships" between children and healthcare professionals (HCPs) remains poorly defined, leading to inconsistencies in clinical practice and education. This study aims to define and clarify the concept of "trustful relationships" between pediatric patients aged 2 to 12 years and HCPs. It seeks to identify key attributes, antecedents, and consequences of these relationships and to develop a conceptual framework for future research and practice. An evolutionary concept analysis (ECA) following Rodgers' (2000) framework was conducted to explore the dynamic nature of trust in pediatric care. A comprehensive literature search was performed using PubMed, Embase, CINAHL, and PsychINFO databases, covering publications from 1936 until 2024. Forty articles meeting inclusion criteria were analyzed. The analysis identified surrogate terms such as "trusting relationship" and "established rapport." Fifty-six attributes of trustful relationships emerged, including HCP characteristics, time, language, and non-verbal communication. Twenty-three antecedents were identified, such as preparation, parental presence, and environmental factors. Additionally, 22 consequences were recognized, encompassing both emotional outcomes (e.g., reduced anxiety, increased comfort) and medical outcomes (e.g., improved adherence to treatment plans).

This study highlights the complexity of trustful relationships between children and HCPs, emphasizing the importance of empathy, effective communication, and a child-centered environment. Integrating these findings into healthcare education and clinical practice can improve pediatric care by fostering stronger provider-patient relationships, reducing patient anxiety, and enhancing health outcomes.

• Trust between children and HCPs in pediatric medicine has come to play a much larger role in recent years. However, the concept of "trustful relationships" between children and HCPs has not been systematically and empirically analyzed before, leaving it ill-defined and confusing.

• This is, to our knowledge, the first time this concept has been analyzed in a systematic and empirical way, and it provides a preliminary theoretical framework for better understanding the character of trustful relationships between children and HCPs. • Based on our findings, we propose a definition of trustful relationships between children and HCPs as "dynamic, reciprocal connections characterized by mutual curiosity, respect, and confidence. These relationships form the foundation of effective clinical care and develop through the interplay of contextual factors and professional behaviors intended to establish trust."