Development of Trust in the Nurse-Patient Relationship with Hospitalized Mexican-American Patients

Wednesday, 24 July 2013: 3:30 PM

Sharon M. Jones, PhD, RN
School of Nursing, Indiana University South Bend, South Bend, IN

Learning Objective 1: The learner will be able to list three nursing actions that will contribute to the development of interpersonal trust with the hospitalized Mexican American patient.

Learning Objective 2: The learner will be able to identify barriers to the development of trust with the hospitalized Mexican American patient.

Trust is an important component of patient-centered care and culturally competent care and a major element (confianza) in the Hispanic culture throughout the world. Knowing how trust develops with the Mexican American patient is important, yet this process is not empirically known.

Purpose: To conceptualize the process of the development of interpersonal trust between the nurse and the hospitalized Mexican American patient.

Methods: The classical grounded theory method was used to generate a theory related to the development of interpersonal trust. There was no theoretical framework at the outset of this study. English-speaking Mexican American patients (n=22) hospitalized at least two days on an obstetric or medical-surgical unit were interviewed.

Results: Making Me Feel Comfortable emerged as the core category. The process was conceptualized as having beginning, middle and final stages. In the beginning stage, hospitalized patients are Having Needs and Relying on the Nurse to meet those needs during a single work shift. In the middle stage, the nurse interacts with the patient in Coming Across to Me and Taking Care of Me and may establish a mutual connection with the patient (Connecting). In the final stage, the patient is Feeling Confianza (Trust) with the nurse which leads to the outcomes of Confiding in the Nurse and Taking Away the Negative. Anytime there was a negative element while interacting with the nurse during the middle stage, this element halted any further development of trust. The establishment of trust was a cyclical process, beginning again with the next shift and a different nurse.

 Conclusion: Hispanic cultural values of personalismo (friendly relations) and familism impacted the development of trust and contributed to the unique findings in this study. The findings have implications for nursing care with Mexican American patients that may impact patient safety and quality care.