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Image J Nurs Sch. 1989 Fall;21(3):153-7.

Guarded alliance: health care relationships in chronic illness.


A multiphase, qualitative study of ongoing health care relationships from the perspective of the chronically ill patient and family confirmed that such relationships evolve over time through three predictable stages: naïve trust, disenchantment and guarded alliance. In the final stage, four patterns of health care relationships were identified: hero worship, resignation, consumerism and team playing. The configuration of these relationships in guarded alliance is explained by dimensions of the core variable of reconstructed trust--patients' trust in a health care professional and their trust in their own competence.

[Indexed for MEDLINE]

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