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The Trust-Link Relational Transition Model: A Unitary Caring Framework for Youth With HIV Transitioning to Adult
Emily Anne Barr1,2, Sara Horton-Deutsch3
1Cizik School of Nursing at University of Texas Health Science Center at Houston, Houston, Texas, USA.
Aims:
To develop a conceptual model integrating Robinson's Theory of Trust and Watson's Caritas Processes to guide trust-building approaches and caring practices that support adolescents and young adults with HIV during the healthcare transition from paediatric to adult care.
Design:
This is a discursive, theory synthesis paper that integrates theoretical frameworks and conceptually relevant literature to inform model development. The paper emphasises the importance of trust and caring science in the context of long-term engagement in care.
Methods:
An inductive theory-building approach was used to identify key themes related to trust, stigma and the patient-provider relationship. Using Pound and Campbell's guidelines for theory synthesis, we developed a conceptual model reflecting the intersection of trust theory and caring science. The synthesis was further grounded in Robinson's concept of theoretical coalescence, supporting the development of a relational framework to guide future research and practice.
Data Sources:
A structured literature review was conducted across PubMed, CINAHL, EBSCOhost and Google Scholar. Peer-reviewed articles published between 1987 and 2022 were included to capture the historical and contemporary perspectives on paediatric HIV care and healthcare transition. A snowballing method was also used to identify additional conceptually relevant sources.
Results:
The Trust-Link Relational Transition Model highlights trust as a protective factor during transition for adolescents and young adults with HIV and its close links to medication adherence, care engagement and viral suppression. Fostering trust through caring science practices, such as Watson's 10 Caritas Processes, enhances patient-provider relationships, promotes reciprocal trust and empowers patients while addressing stigma, fear of new providers and loss of familiar teams, while promoting autonomy.
Conclusion:
The Trust-Link Model, integrating trust theory and caring science, provides a framework for improving healthcare transition. By emphasising trust-building and caring interventions, this model aims to promote autonomy, support adherence and improve health outcomes for youth with HIV transitioning to adult care.
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