Increasing a patient's sense of security in the hospital: A theory of trust and nursing action

Abstract

Having a decreased sense of security leads to unnecessary suffering and distress for patients. Establishing trust is critical for nurses to promote a patient's sense of security, consistent with trauma‐informed care. Research regarding nursing action, trust, and sense of security is wide‐ranging but fragmented. We used theory synthesis to organize the disparate existing knowledge into a testable middle‐range theory encompassing these concepts in hospitals. The resulting model illustrates how individuals are admitted to the hospital with some predisposition to trust or mistrust the healthcare system and/or personnel. Patients encounter circumstances increasing their emotional and/or physical vulnerability to harm, leading to experiences of fear and anxiety. Without intervention, fear and anxiety lead to a decreased sense of security, increased distress, and suffering. Nurse action can ameliorate these effects by increasing a hospitalized person's sense of security or by promoting the development of interpersonal trust, also leading to an increased sense of security. Increased sense of security results in diminished anxiety and fear, and increased hopefulness, confidence, calm, sense of value, and sense of control. The consequences of a decreased sense of security are harmful to patients and nurses should know that they can intervene in ways that both increase interpersonal trust and sense of security.

Nurse-patient Relationships and Expatiate Nurse in Saudi Arabia: Challenges and Implications

“…For example, caring interactions require nurses to demonstrate unique perspectives they have of their patients, creating opportunities to want to get to know them while providing a sense of security and comfort in the patient's care setting. To convey this sense, nurses need to use strategies that create an atmosphere to help patients 'open up' and share their thoughts, feelings, and concerns [6,7] . It is suggested that such sharing has the potential for patients to feel their own worth through reaffirming their intrinsic value [7] .…”