Developing reciprocal trust in the caregiving relationship.

A summer camp for ventilator-dependent children provided a natural laboratory in which to explore the development of a caregiver-child relationship. The campers' routine treatments were "downplayed" to create a more "normal" camp experience while ensuring that the children had a safe environment and maintained a stable medical condition. Campers who normally had consistent home caregivers were observed as they were cared for by new caregivers. Using grounded theory methods, a model describing four types of relationships--tentative, familiar, mutually protective, and connected--was developed. Strategies used by caregiver-camper dyads to sustain a relationship or to progress to a more intense relationship were identified. Developing reciprocal trust was the basic social process that enabled the caregiver and child to reach the goal of becoming connected. Previous camp experience and caregiver contact had an impact on the initial degree of trust between camper and caregiver, and subsequently, it influenced the development of the relationship. This study provides important information about the role of trust in establishing effective caregiving relationships.