F E A T U R E A R T I C L E Enhancing Patients’ Trust in the Virtual Home Healthcare Nurse KIMBERLY SHEA, MS, RN JUDITH A. EFFKEN, PhD, RN, FACMI, FAAN Home visits by professional nurses can reduce the length and cost of hospitalizations, alleviate patients’ symptoms, promote healing, and relieve stress. Because nurses have always worked closely with patients and have typically had considerable physical contact, patients learn to trust their nurses. Perhaps that is why nurses are the most trusted professionals in the United States. Today, a growing number of nurses are practicing telehome care. Telehome care is defined as ‘‘the trans- mission of digital audio and video data during an interactive healthcare encounter between participants in different locations.’’ 1(p289) In addition to interactive video, data are provided by a variety of monitoring de- vices, such as stethoscope, oximeter, glucometer, blood pressure cuff, and thermometer. Telehome care technol- ogy can improve patient accessibility to nursing care, while maximizing nurses’ availability. Research has shown a link between patients’ trust in providers and quality care. 2,3 However, in telehome care, nurses are physically separated from direct patient contact. Build- ing a trusting relationship in a telehome care setting requires different strategies. The purpose of this article is to explore the nature of trust and the way it develops and suggest strategies that can be used by telehome care nurses to counter any barriers to trust imposed by the technology. WHY IS TRUST IMPORTANT? Patient-provider trust can ease the burden of health- care. When patients are experiencing illness, disability, and/or recuperation, the ability to trust healthcare professionals reduces the stress of uncertainty. Patients and family members who place their confidence in a healthcare professional can then expend their efforts on the often-daunting task of living with illness or disability. Trust in the home healthcare professional opens up information exchange so the nurse knows which resources will best support the individual needs that enable patients to remain in their homes. In addition, trust in providers has been found to correlate positively with adherence to treatment, provider con- tinuity, and perceived effectiveness of care. 3 Trusting a nurse with sensitive patient information indicates that the relationship has more depth than a casual acquain- tance. Depth, more than the length of a relationship, affects the ability of the nurse to readily recognize and respond to impending problems. 4 Conversely, patient- provider relationships that lack trust have been found to have lower rates of care seeking, preventive services, and surgical treatment. 5 Studies have found that provider behaviors associ- ated with increased trust include (1) greater perceived CIN: Computers, Informatics, Nursing & May/June 2008 135 CIN: Computers, Informatics, Nursing & Vol. 26, No. 3, 135–141 & Copyright B 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Typically, patients develop trusting relation- ships with their nurses through a variety of face-to-face, often hands-on, interpersonal interactions that convey the nurse’s ability, integrity, and benevolence. However, in tele- home care, face-to-face interaction is limited, so nurses must learn to use different strategies to convey those professional characteristics that promote patients’ trust. This study explores the nature of trust and the way it develops, and suggests strategies that can be used by tele- home care nurses to counter any barriers to trust imposed by the technology. KEY WORDS Home healthcare & Telehealth & Trust & User computer interface Author Affiliation: University of Arizona, Tucson. Funding/Support: This study was funded by NIH/NINR National Research Student Award 1F31NR008825-01-A1. Corresponding author: Kimberly Shea, MS, RN, University of Arizona, 8 Tucson Terrace, Tucson, AZ 85745 (kshea@nursing. arizona.edu). Copyright @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.