Exploring trust in the provider - patient DYAD : capturing the mother's voice in her own words
Cline, Elize Marie
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In 2013, Montana was ranked 50th, or the lowest ranking state, for child health status according to the Annie E. Casey Foundation. The Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) was created when the Patient Protection and Affordable Care Act was signed into law. Several counties within Montana adopted the evidence-based Nurse-Family Partnership (NFP) home visiting program under the direction of MIECHV. The NFP program delivers care to at-risk pregnant mothers and their children. The purpose of this paper was to conduct a review of the literature to investigate communication approaches that the NFP nurse uses or could use during a home visit with the mother, that strengthens the ability of the nurse to capture and empower the mother's voice as customer. Three databases were utilized with a total of ten search terms. A total of five qualitative articles were found that directly examined the voice of the mother receiving home visiting services. Trust was the key term used to examine components of the dyad relationship. Trust within the provider-patient relationship is important as it is tied directly to program engagement and positive outcomes. After analysis of the articles, six themes surfaced that the mothers expressed and included personality, friendship, availability, empowerment, reducing vulnerability, and testing. Additional sub themes included emotional support, knowing, control, verbal praise, advocacy, and respect. Little research exists that directly examines and seeks to garner the experiences of at-risk mothers participating in home visiting programs. Complicating the literature search was the finding that trust is poorly defined in nursing literature and the health science literature as a whole. Further research and inquiry is needed to understand, according to the patient perspective, how trust is built, maintained, broken, and repaired. Understanding the concept of trust according to the patient perspective is imperative as home visiting programs are implemented within the state of Montana. Capturing the voice of the customer is not only a mandate but is imperative to improve the health status of our State.