A major-risk environment can impact nurses' expectations moderated by medical institutional trust and communication

Nurses' positive expectations of patients in medical interactions constitute an important component of nurse-patient trust and can foster good nurse-patient relationships; therefore, it is critical to investigate factors that influence nurses' expectations. This study aims to examine the relationship between nurses' institutional trust, nurse-patient communication, and nurses' expectations of patients before and after the outbreak of the COVID-19 pandemic.

Self-reported questionnaires were administered to 1752 nurses (M_age = 32.14 years, SD = 7.62) before the COVID-19 outbreak and 768 nurses (M_age = 29.48 years, SD = 5.51) after the COVID-19 outbreak to assess their medical institutional trust, communication skills, and expectations of patients. Mediational models were constructed to examine the relationship between these variables.

Before the outbreak of the COVID-19 pandemic, there was a significant positive correlation between nurses' medical institutional trust and their expectations of patients, with nurse-patient communication serving as a mediator. During the COVID-19 pandemic, the association between nurses' medical institutional trust and expectations of patients was nonsignificant; however, a significant mediating effect of nurse-patient communication remained between nurses' medical institutional trust and expectations of patients.

Improving nurses' trust in medical institutions may enhance their positive expectations of patients. Healthcare managers should make efforts to foster nurses' trust in healthcare institutions. Furthermore, nurse-patient communication plays a critical mediating role between nurses' medical institutional trust and their expectations of patients, highlighting the importance of interventions and training programs that improve nurses' communication skills, especially when encountering high-risk circumstances.