Constructions of competence within dietetics: Trust, professionalism and communications with individual clients

Aim:  Issues of trust are important factors that affect communication in professional–client relationships. This paper aims to explore trust in communication from the viewpoint of both clients (the truster) and dietitians.
Methods:  The qualitative research techniques were based on grounded theory. Purposive samples of 46 dietitians and 34 of their adult outpatients were drawn from health services (hospitals, community services and private clinics) in one state of Australia. Clients from eight centres were aged from 21 to 80+ years. Audio-recorded in-depth interviews and focus groups were used to gather data. Transcribed narratives were open-coded and examined for deviant cases. Themes identified in dietitian and client data sets describing clients' trust were compared.
Results:  The themes identified confirmed a typology of trust (from the perspective of the truster) present in the health care literature. Clients' trust was derived from institutional context or reputation. Interpersonal trust perceived in verbal and non-verbal communications with a dietitian were in evidence. Dietitians' value attributes of integrity and respect were identified as traits that help build trust and demonstrate dietitians' professionalism. The findings were built into a concept model of trust.
Conclusions:  Behaviours shown that convey a sense of acceptance, understanding and individual management may lead to positive communication, and hence help build a client's trust in a professional. The link between trust, performance and dietetics clients' outcomes should be investigated further.