Because trust and justice matter: perceptions of health professionals providing palliative care in primary care services

Introduction: Organisations’ true sustainable advantage is its people. Health professionals are key-players in providing quality patient-centered care. Their perceptions of the structure and processes of the workplace may affect their performance and quality of care. Trust and procedural justice are core features in healthcare organisations. Studying these variables is relevant to evaluate micro, meso and macro outcomes in health services research and evaluation. Aim: To analyse the relationship between two organisational contextual factors (trust and procedural justice) and psychological empowerment among professionals providing a palliative care approach in primary care settings. Methods: As part of a larger multicenter survey study, a random sample of 209 professionals (nurses and physicians) providing a palliative care approach in primary care settings in two Spanish regions was drawn. Three pre-validated scales were used to measure trust, procedural justice and professional empowerment: The Trustworthiness, the Procedural Fairness and the Psychological Empowerment Questionnaires. Multiple regression analyses were performed to study the hypothesis of trust and procedural justice being positively associated with psychological empowerment. Results: As hypothesised, both trust (β=.164, p<.05) and procedural justice (β=.229, p<.01) in the workplace were significantly and positively associated with perceptions of psychological empowerment in health professionals providing a palliative care approach in primary care home services. Conclusions: Based on these findings, recommendations can be made to ensure that healthcare managers and professionals leading primary care teams facilitate the implementation and delivery of palliative care by promoting trustworthiness and fairness in their teams. These are critical to create conditions (trust within teams and fairness of formal decision-making policies) that facilitate teamwork and promote empowerment in primary care settings, contributing to the quality of care provided.