From confrontation to fragmentation: A discourse analysis on the processual dynamics of institutional trust in healthcare collective bargaining

In this qualitative study, we investigate how institutional trust and distrust are processually constructed during collective bargaining in the Finnish health and social care sector. Focusing on media discourse, the study analyses how stakeholders involved in industrial action interpret and make sense of different phases of the negotiation process, as represented in Finnish mainstream media. The aim is to deepen understanding of the dynamic, multi-level processes through which trust is built, challenged, and transformed within a tense labour market context. Prior literature indicates that institutional trust is a key factor in the cooperation of organisations and the achievement of common goals. Applying discourse analysis and a process perspective, the study deepens our understanding of the processual formation of institutional trust. The empirical data comprises 183 news articles from a 10-month period in 2022. The analysis revealed two main discourses related to the construction of institutional trust and distrust which were denoted as ‘confrontation’ and ‘fragmentation.’ Furthermore, patient safety and the right to industrial action were found to function as sub-discourses within the broader confrontation and fragmentation discourses, respectively. Leverage points – critical moments where the direction of the trust cycle shifted, either strengthening or weakening trust were identified within discourses. The study provides recommendations for labour market parties, political decision makers, media actors, and union leaders to enhance institutional trust development and effectiveness in negotiations.