Editorial: Patient-centered care: strengthening trust and communication in healthcare relationships
Year: 2026
Type: editorial
Abstract: The Research Topic, patient-centered care: strengthening trust and communication in healthcare relationships, brings together twenty-three articles spanning diverse settings and populations, illustrating how trust and communication within patient-centered care are shaped across these levels, from individual experiences and interpersonal communication to organizational structures and broader societal conditions, and how improving health requires alignment across them.At the individual level, patient-centered care is shaped by patients' knowledge, beliefs, preferences, prior experiences, and capacity to engage in their care. 20 These studies highlight how these factors influence patients' information needs, decision-making preferences, and how patients interpret, respond to, and participate in healthcare. This work shows that trust and communication begin before any clinical interaction takes place, underscoring the need for communication approaches that are responsive to individual context, capacity.Hendrix et al. leveraged a co-design approach to develop patient education interventions aimed at improving medication safety, identifying knowledge gaps and information asymmetry as key barriers. They found that patients showed greater interest in partnership-focused educational content and that addressing information asymmetry may support more active patient engagement and shared decision-making. Fusiak et al. found that preferences for involvement in care are not fixed and may vary depending on how they are elicited, pointing to the importance of using thoughtful methods to understand what role patients want to play in decision-making. Extending this focus beyond patients alone, the review by Ofosu et al. captured the emotional, ethical, and practical complexity caregivers face when making high-stakes decisions under uncertainty, showing how limited support and power imbalances can shape participation and trust. Finally, Zhang et al. provided a window into the lived realities of managing chronic illness, illustrating how ongoing physical, emotional, and social burdens shape how individuals experience care and interact with healthcare providers.At the interpersonal level, patient-centered care is enacted through relationships between patients, clinicians, and caregivers, where communication serves as the primary vehicle for care delivery. These studies focus on the dynamics of these interactions, including how communication strategies and behaviors of both patients and clinicians, as well as relational cues, influence understanding and engagement. Together, they demonstrate that trust is built through interaction, not intention. Both verbal and nonverbal communication, as well as respect, responsiveness, and inclusion in decision-making (i.e. Shared Decision Making), shape whether patients feel heard, valued, and confident in their care, ultimately influencing satisfaction, adherence, and outcomes.In an opinion piece, Faytong-Haro examined how patients' symptoms and concerns may be dismissed or minimized across clinical contexts such as chronic, poorly understood conditions, mental health, and women's health, contributing to emotional distress, delayed diagnosis, and erosion of trust, particularly among marginalized populations. The author concludes that these patterns are driven by a combination of information asymmetry, bias, and systemic constraints, and emphasizes the need for improved communication, clinician awareness, and system-level changes to rebuild trust and support safer care. The review by Piątkowska et al. highlighted both the promise and challenges of implementing Shared Decision Making in the context of asthma and chronic respiratory disease management, emphasizing the need for approaches that are feasible and responsive to real-world clinical settings. Efforts to better capture and evaluate communication are reflected in the original research by Shao et al., which introduced a structured, patient-reported scale to assess doctorpatient communication quality, including how communication is experienced and its impact on engagement and health behaviors. At the community and organizational level, patient-centered care is shaped by the environments in which care is delivered, including care delivery models, access to services, and the broader social and cultural context. These studies highlight how care delivery structures, continuity, and community-based resources shape the context in which patient-clinician communication occurs. Collectively, this work illustrates that trust and communication are not solely the responsibility of individual clinicians but are enabled or constrained by system design. Access, coordination, and organizational culture shape the conditions under which meaningful communication can occur and ultimately determine whether patient-centered care can be consistently delivered.At the level of care delivery experience shaped by organizational context, Zhang et al. demonstrated that how patients experience and evaluate care strongly influences whether they engage with and consistently use primary care services. Similarly, in a brief research report, Moreno & Cornejo highlighted the importance of sustained relationships in care among older adults in primary care settings, linking continuity not only to patient experience but also to broader well-being, including mental health outcomes. Expanding beyond individual encounters, Mitnik et al. illustrated how community-based oncology centers can improve access to care by bringing services closer to patients' homes, while also highlighting the need for strong coordination between community and hospital teams to maintain patient confidence, ensure safety, and support continuity of care.At the organizational level, Alshahrani et al. demonstrated that workforce experience directly influences communication quality and patient trust, with supportive work environments enabling more effective and patient-centered interactions. Complementing this systematic review, the brief research report by Reid et al. highlighted how workflow integration, competing demands, and technological fit shape whether new tools can be successfully implemented. Together, these studies reinforce that patient-centered care depends not only on what clinicians do, but on how systems are designed to support consistent, coordinated, and meaningful communication and relationships over time.At the policy and societal level, patient-centered care is influenced by broader structural forces, including socioeconomic conditions, cultural norms, and health system policies that shape access to care and distribution of resources. These studies highlight how disparities and structural barriers impact patient experiences across settings and populations. Taken together, they emphasize that trust in healthcare providers, systems, and the care patients receive is deeply tied to equity and fairness. When patients encounter systemic barriers, discrimination, or inconsistent access, trust can be eroded before any interaction occurs, reinforcing the need to address structural determinants as part of delivering truly patient-centered care.At a global level, Bhatt et al. highlight how cultural and socioeconomic factors shape family satisfaction with care in intensive care unit (ICU) settings through a systematic review, finding that communication quality, support for shared decision-making, and attention to family needs are key drivers of satisfaction, while gaps remain in understanding these dynamics in low-and middle-income countries. Similarly, Kong et al. illustrate how geographic isolation, social context, and resource constraints shape interpersonal health communication among older adults in rural China, demonstrating that communication is often centered on face-to-face interactions with family doctors and influenced by multilevel factors, including health literacy, provider workload, and broader policy and environmental conditions.At the intersection of structural context and patient experience, García-Sáenz et al. explored how patients with HER2+ metastatic breast cancer navigate uncertainty and transitions across care contexts, revealing how health system structures and information delivery practices, rather than individual factors alone, shape communication, expectations, and engagement. As an example of how system-level design can address structural barriers, Cohen et al. demonstrates how proactive, relationship-based outreach models like their novel Boost Team can be embedded within care systems to improve access, connect patients to needed services, and build trust among underserved populations. Together, these studies highlight that improving patient-centered care requires not only better communication in the clinical encounter, but intentional redesign of the structural conditions that shape when, how, and whether communication and trust can occur at all, including efforts to improve access and reduce disparities.Spanning multiple levels of the socioecological model, emerging technologies are increasingly shaping how patients and clinicians communicate and engage in care. These studies explore how tools such as imaging and artificial intelligence can influence understanding, transparency, and interaction. Collectively, this work highlights that technology has the potential to both strengthen and disrupt trust in healthcare providers, systems, and the tools themselves. When thoughtfully implemented, it can enhance communication, identify gaps, and empower patients, but without careful integration, it risks introducing new barriers or reinforcing existing inequities.Through their mini review, Conte et al. demonstrate how visual tools and imaging modalities in inflammatory arthritis care can enhance patient understanding, engagement, and treatment adherence by making disease processes more visible and accessible. Complementing this, Zhou et al. analyzed clinical transcripts from primary care encounters to identify communication gaps, finding that while diagnostic accuracy may remain high, important contextual and patient-specific details are frequently missed, and that empathy and clear explanations are strongly associated with higher patient satisfaction. Together, these studies suggest that technology can not only improve information exchange but also serve as a mechanism for identifying gaps and supporting reflection, advancing more complete, transparent, and patient-centered communication while requiring thoughtful integration to maintain trust in clinicians, systems, and the technologies themselves.Together, the studies in this Research Topic demonstrate that patient-centered care is not a single intervention or approach, but a system-level outcome that emerges from alignment across the socioecological model. Trust and communication are shaped at every level, from patients' knowledge, preferences, and lived experiences, to interpersonal interactions with clinicians, to the design of care environments, and to broader structural conditions that influence access and equity. When these levels are aligned, clinician-patient communication is more effective, relationships are stronger, and patients are better able to engage in their care. When they are not, even well-intentioned efforts can fall short, resulting in fragmented communication and weakened trust across the care experience.
Source: Frontiers in Medicine
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7160506092