Patient dissatisfaction and institutional betrayal in the Canadian medical system: A qualitative study

J Trauma Dissociation. 2017 Jan-Feb;18(1):38-57. doi: 10.1080/15299732.2016.1181134. Epub 2016 Apr 26.

Abstract

Individuals who struggle with chronic medical conditions frequently use medical services and may depend on the medical system to ensure their overall well-being. As a result, they may be at a greater risk of feeling betrayed by the medical system when their needs are not being met. The current study aimed to qualitatively assess patients' negative experiences with the medical system that may lead to feelings of institutional betrayal. A total of 14 Canadian adults struggling with various chronic conditions completed an online open-ended questionnaire. Results indicated that institutional betrayal is composed of doctor-level betrayal (inadequate medical care and lack of psychological support) as well as system-level betrayal. The findings are discussed in the context of betrayal trauma theory; specifically, patients' appraisals of their negative health care experiences may play a vital role when one is considering the impact of institutional betrayal on an individual's overall well-being.

Keywords: Betrayal trauma; chronic medical illness; medical system; qualitative methods.

MeSH terms

  • Adult
  • Canada
  • Chronic Disease / therapy*
  • Delivery of Health Care / standards*
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Mental Health
  • Middle Aged
  • Patient Satisfaction*
  • Physician-Patient Relations*
  • Qualitative Research
  • Risk Factors
  • Surveys and Questionnaires