THE RELATIONSHIP BETWEEN JEAN WATSON'S THEORY OF HELPING TRUST WITH PATIENT SATISFACTION

Background: Fostering a trusting relationship between nurses and patients is the development of one of the curative caring factors because it is closely related to the acceptance of positive and negative feelings of patients when receiving services from nurses. The quality of a person's relationship with others is an element that determines the caring behavior of a nurse (Sartika, 2011). Nurses must be patient, generous, willing to provide assistance to patients voluntarily and be able to communicate, work and be responsible for their duties and rights when acting (Nursalam, 2013).Objectives: The purpose of this study was to determine Jean Watson's theory of helping trust with patient satisfaction in the inpatient room in The Government Hospital of Tangerang Regency.Methods: The research design used in this study is descriptive correlation using the Cross-Sectional approach. The population used in this study were patients treated in the inpatient rooms of Government Hospital of Tangerang Regency amounting to 80 people. The sampling method used is the non-probability sampling method. The sampling technique in this research is purposive sampling. The sample used in this study were 65 respondents. This research instrument using a questionnaire. The analysis used the Chi square test with a significance level α < 0.05.Results: Jean Watson's helping trust relationship both 13 respondents (34.2%) and those who were not satisfied were 1 respondent (3.7%). the results of the analysis obtained OR = 25.35 means that patients who claim helping trust relationship Jean Watson have a 25.35 times chance expressed satisfied. Chi square test results obtained p value 0.001 so that it can be concluded that there is a significant relationship between Jean Watson’s theory of helping trust relationship with patient satisfaction in class III inpatient room at The Government Hospital of Tangerang Regency.Conclusion: Patient satisfaction depends on the quality of nursing services. Service is said to be good if in fact the nurse provides the needs according to the patient's condition and the patient's response to service can be disappointing or satisfying. Further research is expected that nurses can provide assistance to the relationship of trust to patients so that patients can feel safe and comfortable when nurses take nursing actions to patients. Further researchers can use other research methods either qualitatively or add other variables so that the helping trust relationship between nurses and patients can be well developed. Keywords: Helping Trust Relationship, Patient, Satisfaction, Jean Watson.


INTRODUCTION
In Indonesia, the health services provided by hospitals continue to develop and always provide very rapid changes in line with the globalization era that we face in the health sector (Muninjaya, 2005). Quality hospital services are factors that support the success of services and patient satisfaction. Quality of health services usually refers to the ability of a hospital to provide services that are in accordance with health professional standards and are acceptable to patients. Hospitals must continue to strive to improve the quality of health services so that they can become a reference and source of information and meet patient expectations and satisfaction (Aditama, 2003).
Patients think that only hospitals are able to provide medical services as an effort to cure and recover from the pain they suffer so that patient satisfaction with nurses who care for them in the hospital is important to improve the performance of health workers in the hospital where it can improve quality, quality. from the hospital. Patients expect services that are ready, fast, responsive and comfortable, for complaints of patient illnesses (Widiyatun, 2009).
According to Satrinegara (2014), if a patient is admitted to the hospital with a series of hopes and desires to get hospital services that match expectations, the patient will feel satisfied. Patient dissatisfaction arises because of the gap between cultivated patients and nurses who care for using health services. Nurses must be patient, generous, willing to provide assistance to patients voluntarily and be able to communicate, work and be responsible for their duties and rights when acting (Nursalam, 2013).
The success of a hospital in carrying out its functions is marked by an increase in the quality of service by all actors or workers who work in the hospital and those who interact directly with patients are nurses, so that the quality of service carried out by nurses can be assessed as an indicator of the good and bad quality of service at hospital (Suyanto, 2009). In providing nursing services, caring behavior is the soul of the nursing profession where caring behavior is one of the assertive, supportive, facilitative behaviors for patients with certain needs that can be practiced and demonstrated interpersonal (Kozier, 2014).
The nurse has the main duty to provide caring. nurses who care for clients in this case provide caring for clients. The main aspects of caring include: knowledge, learning from experience, patience, honesty, trust, humility and courage so that nurses are expected to be able to provide total service to their clients (Morrison and Burnard (2009).
Caring according to Watson in Potter & Perry (2011) is the core of nursing practice. Nursing is also a dynamic approach, in which nurses work to further enhance their attention to patients. In the world of caring for nurses it is satisfactory, but there are still some countries with bad caring behavior with a percentage of nurses who have poor quality caring services in Ireland 11%, and Greece 47%, while in Indonesia caring is one of the assessments for health service users (Aiken, 2013) Fostering a trusting relationship between nurses and patients is the development of one of the carative caring factor because it is closely related to the acceptance of positive and negative feelings of patients when receiving services from nurses. The quality of a person's relationship with others is an element that determines the caring behavior of a nurse (Sartika, 2011). Helping trust is a relationship between nurses and patient are honest and open, empathy and warmly accepts other people (Allygood, 2010).
The results of research Yasmini's (2015) show that there is a relationship between nurses who care for patient satisfaction with a P-value of 0.001. Martiningtya's research (2013) shows that there is a relationship between nurses who care for patient satisfaction with a P-value of 0.015. The research of Manurung's (2013) showing that the factors related to the perception of patients undergoing treatment are the need for caring with a P-value of 0.001 and caring behavior of nurses with a P-value of 0.006 so that caring behavior affects patient satisfaction and success in treatment.
The Government Hospital of Tangerang Regency is a class B hospital and is a reference for the Banten province (Profile the Government Hospital of Tangerang Regency, 2016). Based on the results of the documentation of medical and employment records (2016), it shows that customer satisfaction in receiving health services is 71.98% even though it has not reached the 80% value, The Government Hospital of Tangerang Regency always maintains patient trust by continuously improving service quality improvements.
Based on the results of interviews with the Head of Nursing that The Government Hospital of Tangerang Regency always improves caring, especially health workers, in order to improve the trusting relationship between the community and The Government Hospital of Tangerang Regency services. This belief is very important because it will have an impact on patient satisfaction when receiving health services. research related to the relationship of trust with patient satisfaction has never been studied in the Government Hospital of Tangerang Regency because the hospital focuses on increasing employee satisfaction and performance. The hospital only knows from the patient satisfaction questionnaire after the patient will go home without paying attention to the acceptance of positive and negative feelings of the patient while being hospitalized.
The purpose of this study is to determine the relationship Jean Watson's theory of Helping trust with patient satisfaction inpatient room in The Government Hospital of Tangerang Regency.

Study Design
The research design used in this study is descriptive correlation using the Cross-Sectional approach.

Setting
This research was conducted in May-June 2017 in the class III inpatient Room of the Government Hospital of Tangerang Regency. In the class III inpatient room consist Soka, Cempaka, and Kenanga Rooms. The three inpatient rooms were selected because they were in accordance with the inclusion and exclusion criteria by the researcher

Research Subject
The population used in this study were patients treated in the inpatient rooms of Government Hospital of Tangerang Regency amounting to 80 people. The sampling method used is the non-probability sampling method. The sampling technique in this research is purposive sampling. The sample used in this study were 65 respondents to determine samples using the Slovin formula. In this study the sample criteria are determined by the researcher. The inclusion criteria in this study are as follows: (1) patients aged 20-60 years, (2) patients who are willing to be respondents and have approved informed consent sheets, (3) adult patients who can communicate well, can read and write, (4) mentally healthy patients. While the exclusion criteria in this study are as follows: (1) pediatric, teenagers, and patients less than 20 years of age (2) patients who are not willing to be respondents (3) patients who cannot read and write (4) patients who are mentally unwell

Instruments
The instrument in this study is a questionnaire consisting of helping trust and patient satisfaction questionnaires. The helping trust questionnaire was made by the researcher with 20 items. The patient satisfaction questionnaire uses a questionnaire from Nursalam (2013) with 15 items. The helping trust questionnaire was categorized as less and good while the patient satisfaction questionnaire was satisfied and dissatisfied.
Validity and reliability tests were carried out in the class II inpatient room of The Government Hospital of Tangerang Regency with 30 respondents. The inpatient room of Seruni and Mawar is only used to test the validity and reliability.
The result of helping trust questionnaire validity test showed that out of 20 items only 2 items were invalid so the researcher did not use these 2 items. The reliability test results showed and alpha value of > 0.930, which means the helping trust questionnaire is reliable. The result of patient satisfaction questionnaire validity test showed that out of 15 items only 1 item were invalid so the researcher did not use this 1 item. The reliability test results showed and alpha value of > 0.920, which means the patient satisfaction questionnaire is reliable.

Data Analysis
The analysis used the Chi square test with a significance level α < 0.05. This Chi Square test is used to analyze categoric relationships with categoric. The research was analyzed by univariate analysis and sufficient analysis using SPSS version 23 statistic program.

Ethical Consideration
The ethical problem in nursing research is a very important issue, considering the nursing research relates to human beings directly. The ethics that must be considered are as follows: Inform consent, autonomy, confidentiality, beneficent, non-maleficence, justice, veracity.
Ethics test has been conducted at the Government Hospital of Tangerang Regency. This research implemented based by permit letter number 445/036/KEP. Based on table 1, it is known that the majority of patients are in the range of 36-45 years with 34 respondents (53.8%). The sex of the patients was more female, amounting to 34 respondents (52.3%). Most of the ethnic groups come from Sundanese, with 39 respondents (60.0%). The most recent education of patients was junior high school graduates totaling 25 respondents (38.5%). The most jobs are traders, with 20 respondents (30.8%). The length of stay of patients was in the range of 8-14 days with 32 respondents (49.2%). The frequency distribution for statements of helping trust relationships is good at 38 respondents (58.8%) while helping trust relationships are less at 27 respondents (57.5%). The frequency distribution for the satisfaction statement of patients was 31 respondents were satisfied (42.5%) while 34 patients were dissatisfied (57.5%).

Jean Watson's Helping Trust Relationship in Class III Inpatient Rooms
Based on the results of the study showed that helping trust relationships were not good category as many as 27 respondents (57.5%) and helping trust relationships were good as many as 38 respondents (58.5%). According to Yusuf (2004) nurses caring assessment is an ongoing process to assess the quality of work of personnel and efforts to improve the work of personnel in the organization. nurses are a profession that is humanitarian based on a sense of responsibility and dedication so that nursing services always involve humanitarian efforts whose implementation requires sincerity, mutual respect and wisdom towards humans. nurses' attention when organizing nursing services is on the fulfillment of basic human beings.

Patient Satisfaction in Class III Inpatient Rooms
Based on the results of the study showed that patient satisfaction in class III inpatient rooms is known that most respondents were dissatisfied as many as 34 respondents (57.5%) and satisfied patients as many as 31 respondents (42.5%). According to Hafid (2014) states patient satisfaction depends on the quality of nurse services. services are all efforts made by nurses as a profession or professional to meet the wishes of patients with the services provided. a service can be said to be good is determined based on the fact whether the services provided by nurses can meet the needs of patients by using patient perceptions about the services received (satisfying or disappointing).

Relationship of Jean Watson's Theory of Helping Trust with Patient Satisfaction in Class III Inpatients Room in Government Hospital of Tangerang Regency
Based on the results of research Jean Watson's helping trust relationship yesterday 65 respondents stated helping trust relationship Jean Watson was not as good as 27 respondents, stated well as many as 38 respondents, patients were not satisfied as many as 26 respondents (40.0), and patients were satisfied as many as 39 respondents (60.0). Statistical test results obtained p value of 0.001 where the value of p value <0.05 then there is a relationship between helping trust relationship Jean Watson with patient satisfaction in class III inpatients in Tangerang Regency General Hospital.
As for the proportion that expressed satisfaction was obtained from respondents who answered Jean Watson's helping trust relationship both 13 respondents (34.2%) and those who were not satisfied were 1 respondent (3.7%). the results of the analysis obtained OR = 25.35 means that patients who claim helping trust relationship Jean Watson have a 25.35 times chance expressed satisfied. Chi square test results obtained p value 0.001 so that it can be concluded that there is a significant relationship between Jean Watson's helping trust relationship with patient satisfaction in class III inpatients at RSU Regency Tangerang.
Patient satisfaction or dissatisfaction is the patient's response to the evaluation of the perceived discrepancy between previous expectations and performance (Nursalam, 2013). According to Satrinegara (2014) if patients enter the hospital with a series of hopes and desires, in fact, as long as they get better service at the hospital as expected, the patient will be satisfied. The results of this study are Yasmini's (2015) study stating that there is a significant relationship between caring nurses and patient satisfaction with a p value of 0.003. the results of this study are supported by Asrini's research (2012). 68% of patients are satisfied with the caring behavior of nurses.
Nurses who are caring in building relationships with people others must also show empathy and easy to approach and want listen to other people. The nurse more sensitive, sociable, polite and able to communicate well with others (Morison & Burnard, 2009). Caring is an attitude and behavior nurses to patients in doing Nursing care, Caring is the way maintaining a related relationship with value, commitment and responsibility answer yourself and others, Watson in (Tomey & Alligood, 2006). The quality of health services usually refers to the ability of hospitals to provide services that are in accordance with the standards of the health profession and can be accepted by their patients (Simamora, 2012).
Nurse caring behaviors are mostly performed on inpatients because inpatient services are the center of the most frequent activities of interactions between nurses and clients. This unit provides the most services compared to the others. Nursing is one of the factors that play a role in determining patient satisfaction (Muninjaya, 2005).
Executing nurse in the inpatient room Dr. H Soewondo Kendal has partly behaved caring towards patients but this does not guarantee that nurses who care for patients will feel satisfied. That is because the patient is not satisfied with the completeness of the facilities in the room and the lack of care (empathy) of nurses towards the help of the road, sitting, and standing for patients who have limited physical mobility. On the contrary, from nurses' noncaring behavior, there are patients who are satisfied because these patients get reduced costs from facilities provided by the government to underprivileged patients (Martiningtyas, 2013).

CONCLUSION
Based on the results of the study found that helping trust relationships affect patient satisfaction. more patients are satisfied with helping a good trust relationship than patients are not satisfied with a helping trust relationship is not good.
Helping trust relationships play a role in determining patient satisfaction. Patient satisfaction depends on the quality of nursing services. Service is said to be good if in reality the nurse provides needs according to the patient's condition and the patient responding to the service can be disappointing or satisfying. .

SUGGESTIONS
Patient satisfaction depends on the quality of nursing services. Service is said to be good if in fact the nurse provides the needs according to the patient's condition and the patient's response to service can be disappointing or satisfying. Further research is expected that nurses can provide assistance to the relationship of trust to patients so that patients can feel safe and comfortable when nurses take nursing actions to patients. Further researchers can use other research methods either qualitatively or add other variables so that the helping trust relationship between nurses and patients can be well developed.