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Degree Type


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Doctor of Philosophy (PhD)




The Hispanic population in the United States is growing and this population experiences health care disparities compared to non-Hispanic Whites. Mexican Americans are the largest sub-group of Hispanics and providing nursing care that is patient-centered and culturally competent is important when caring for this population. Trust is an important component of patient-centered care and culturally competent care as well as a major element , (confianza) in the Hispanic culture. Although nursing researchers have identified the need for trust in culturally competent care with Mexican American patients, none have explored how trust develops between the nurse and the Mexican American patient. The classical grounded theory methodology was used to explore the process of the development of interpersonal trust between the nurse and the hospitalized Mexican American patient. Twenty-two English-speaking Mexican American patients hospitalized at least two days on an obstetric or medical-surgical unit in a hospital in the Midwestern United States were interviewed using a semi-structured interview guide. Through data analysis using constant comparison, a model emerged that explained the development of trust. The core category was Making Me Feel Comfortable and the model had eight categories. These categories reflected stages in the model. The beginning stages of the model included the categories Having Needs and Relying on the Nurse. The middle stages of the model reflecting interaction between the nurse and patient included the categories Coming Across to Me, Taking Care of Me, and Connecting. The final stages were the category Feeling Confianza (Trust) with the outcome categories Confiding in the Nurse and Taking Away the Negative. Of particular importance, anytime there was a negative element while interacting with the nurse during the middle stages, this element halted any further development of trust. Establishment of trust for the hospitalized patient with the nurse was a cyclical process, beginning again with the nurse on the next shift. 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 of this study have implications for nursing care with Mexican American patients that may impact patient safety and quality care.

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