title: Fostering trusting relationships with older immigrants hospitalised for end-of-life care.
abstract: BACKGROUND
  Trust has been identified as a vital value in the nurse-patient relationship. Although increasingly the subject of empirical inquiries, the specific processes used by nurses to foster trust in nurse-patient relationships with older immigrants of non-English speaking backgrounds hospitalised for end-of-life care have not been investigated.
  
  
  OBJECTIVE
  To explore and describe the specific processes that nurses use to foster trust and overcome possible cultural mistrust when caring for older immigrants of non-English speaking backgrounds hospitalised for end-of-life care.
  
  
  METHODS
  A qualitative descriptive approach was used. Twenty-two registered nurses were recruited from four metropolitan health services in Melbourne, Australia. Ethical considerations: Research approval was granted by the Human Research Ethics Committees of the host institution and four participating health services.
  
  
  RESULTS
  Thematic analysis revealed that fostering trust encompassed the following three commensurate stages: establishing trust, strengthening trust and sustaining trust. Underpinning the successful achievement of these stages was the nurses' moral commitment (reflected in their intentional, conscious and conscientious approach) to fostering trust as an essential ingredient of quality end-of-life care.
  
  
  CONCLUSIONS
  This study has shown that while professional competencies are important to providing quality end-of-life care to older immigrant patients of non-English speaking backgrounds, it is a nurse's moral commitment to fostering trust that may ultimately lay the foundations for a trusting quality care relationship to be established and sustained.
  
  
  CONCLUSIONS
  This study has captured the processes used by nurses to foster trust as an essential element of quality end-of-life care in older immigrants. The characteristics of trust and the different factors influencing its expression in diverse cultural contexts are, however, under-researched. Accordingly, gaps remain in the knowledge and understanding of the specific cultural nuances and manifestations of trust across and within different cultures. This is an area that is germane to further cross-cultural and international collaborative scholarly inquiry and research.
authors.affiliation: Deakin University, Australia.
authors.forename: Megan-Jane
authors.initials: MJ
authors.lastname: Johnstone
authors.affiliation: Deakin University, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Rawson
authors.affiliation: Deakin University, Australia.
authors.forename: Alison Margaret
authors.initials: AM
authors.lastname: Hutchinson
authors.affiliation: Deakin University, Australia.
authors.forename: Bernice
authors.initials: B
authors.lastname: Redley
mesh_terms: D000368:Aged; D001315:Australia; D003144:Communication Barriers; D018864:Cultural Diversity; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D004993:Ethics, Nursing; D005260:Female; D006760:Hospitalization; D006801:Humans; D007802:Language; D008297:Male; D009723:Nurse-Patient Relations; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D011787:Quality of Health Care; D013727:Terminal Care; D035502:Trust / Q000523:psychology*
keywords: Aged; Australia; cultural diversity; immigrants; nurse–patient relationship; terminal care; trust