The purpose of this investigation was to determine the relationship of trust to self-esteem for psychiatric patients and the extent that psychiatric nurses' perceptions concurred with patients' perceptions of their trust and self-esteem. The theoretical framework utilized was Erikson's ego development theory supported by Rosenberg's self-esteem theory and Combs and Snygg's perceptual constructs.

The sample consisted of 43 one-to-one nurse-patient diads from a public mental hospital. The patients completed Rosenberg's Self-esteem and Faith in People Scales, and the patient's one-to-one nurse completed the same scales the way he/she thought the patient had. The nurses also assessed their patients' self-esteem and trust on a Likert scale. The data were analyzed with descriptive statistics, the paired t-test, the kappa, correlations and step-wise regressions.

The patients' and nurses' scores for the patients' trust and self-esteem were significantly correlated but not sufficiently to suggest that they were measuring the same variable. In contrast, the nurses' assessments of their patients' trust and self-esteem had such high correlations with each other that, without objective criteria for guidance, nurses seemed to have difficulty distinguishing between the patients' trust and self-esteem. Nurses' perceptions did not concur to a significant degree with the patients' perceptions of their trust and self-esteem.

Patients with paranoia/paranoid schizophrenia showed higher levels of self-esteem, and those with a substance abuse or affective disorder showed lower levels of trust. The longer nurses had worked with the patients the higher they assessed the patients' self-esteem.

Discussion focused on the implications of the findings for the study hypotheses and for several aspects of nursing: theoretical, clinical, administrative, research. Suggestions for further investigations were proposed.