Methods: The researcher had previously conducted three separate grounded theory (classic) studies on the development of trust in the nurse-patient relationship from the patient’s perspective with hospitalized patients using three distinct patient populations in the Midwestern United States. These populations were English-speaking, Mexican American adult patients (data collected 2011), Spanish-speaking (monolingual or limited English proficient), Mexican American adult patients (data collected 2014-2015), and English-speaking, non-Hispanic adult patients (data collected 2016-2017). The researcher synthesized these three separate models into an empirically-based middle range theory of how interpersonal trust develops between the hospitalized patient and the bedside nurse.
Results: The process of how the researcher developed the theory is presented as well as the resulting theory. Assumptions of the theory as well as definitions of concepts and explanations of propositions/relationships between concepts to explain the theory are presented. Based on preliminary results, the categories and relationships in the three models were similar across models. The addition of the presence of a language barrier between patient and nurse added a level of complexity to the development of trust but did not prevent trust from forming.
Conclusion: This middle range theory is useful in practice, education and research. Nurses caring for hospitalized patients can apply the theory in their practice to identify areas to assist them in developing trust with patients. Educators can use the theory with students to explore interpersonal communication and the development of interpersonal relationships in the hospital setting. Future research with the middle range theory includes testing the theory using a quantitative approach or expanding the empirical evidence for the theory with additional patient populations in other countries to test the fit of the theory in different settings.