ED Services: The Impact of Caring Behaviors on Patient Loyalty

The Effect of Education Based on Human Care Theory on Caring Behaviors and Job Involvement of Nurses in Intensive Care Units

Background

Caring is the essence of nursing, and nurses who are dissatisfied with their job are not able to perform optimal patient care. This study was conducted with the aim to determine the effect of education based on human care theory on nurses' caring behaviors and job involvement.

Materials and Methods

In this clinical trial, a total of 110 intensive care unit nurses from Nemazee Hospital, Shiraz, Iran, were randomly allocated to control and intervention groups. The intervention group received a 6-h workshop based on Watson's human care theory using a collaborative and role-playing approach and 1-month follow-up period through presenting weekly preplanned care and caregiving scenarios. The control group received routine hospital trainings. The data collection tools used were included in a demographic information form, and the Larson Caring Assessment Questionnaire, and Kanungo Job Involvement Questionnaire. Data were analyzed using Chi-square test, and independent and paired t-test in SPSS software.

Results

Majority of the participants were married women and had Bachelor of Science degree in Nursing. The participants' age ranged from 21 to 52 years. After the education, caring behaviors and job involvement scores significantly increased in the intervention group compared to the control group (p < 0.001).

Conclusions

The findings suggest that a care workshop can be effective in improving care behaviors and job involvement. Therefore, we recommend more extensive research to determine the effectiveness of long-term intervention on nursing care behaviors.

Investigating the relationship between workplace stressors and caring behaviours of nursing staff in inpatient wards: A cross-sectional study

AIM

The present study aimed to investigate the effects of various job stressors on caring behaviours of nursing staff.

DESIGN

A cross-sectional nationwide study.

METHODS

This cross-sectional, descriptive-correlational study was conducted on 260 nurses employed in the inpatient wards of seven teaching hospitals in Tehran, Iran during December 2019-February 2020. The participants were selected via convenience sampling. Data were collected using a demographic questionnaire, the nursing stress scale and the caring behaviours inventory. Data analysis was performed in SPSS version 20 using descriptive statistics and linear regression analysis.

RESULTS

The results of regression analysis indicated that job stress is correlated with nurses' caring behaviours (β = -.36; p = .001). Factors such as workload (β = -.27; p = .001), uncertainty about patient treatment (β = -.26; p = .017) and lack of emotional preparation (β = -.20; p = .017) were the important stressors associated with nurses' caring behaviours.

CONCLUSIONS

According to the results, high levels of perceived job stress due to workload, uncertainty about patient treatment and lack of emotional preparation are associated with lower levels of nurses' caring behaviours.

IMPACTS

The findings of this study showed that to provide patients with optimal caring behaviours, hospital and nursing managers should design interventions to reduce nurses' job stressors, especially in terms of their interactions with their colleagues and physicians.

Physicians' empathy levels in a primary care setting: perceptions of patients and their physicians, a qualitative study

BACKGROUND

The physician-patient relationship is a crucial element in successful medical care. Empathy is the ability to understand an individual's subjective experience yet remain as an observer. It plays a major role in establishing a good physician-patient relationship.

OBJECTIVE

The aim of this study was to evaluate the perspectives of patients and their corresponding emergency physicians regarding physicians' empathy levels and to extract themes that both patients and their doctors considered as important for an empathic encounter.

METHODS

This is a qualitative study conducted at a Middle Eastern tertiary care centre Emergency Department (ED) using in-depth semi-structured interviews administered to each participating patient and his/her corresponding ED physician. Empathy-related themes were identified using inductive thematic analysis.

RESULTS

This study shows that both patients and physicians believe in the importance of empathy in the ED based on four major themes: emotions, interpersonal skills, time and chief complaint. Time and the chief complaint were perceived as barriers by physicians, but not by their patients.

CONCLUSIONS

A gap lies in the expressive communication phase of empathy between the two groups. The four major themes retrieved could form the basis of an empathy measure in the medical encounter in Lebanese and similar settings.

Ambient versus traditional environment in pediatric emergency department

OBJECTIVE

We sought to examine the effect of exposure to an ambient environment in a pediatric emergency department. We hypothesized that passive distraction from ambient lighting in an emergency department would lead to reduction in patient pain and anxiety and increased caregiver satisfaction with services.

BACKGROUND

Passive distraction has been associated with lower anxiety and pain in patients and affects perception of wait time. A pediatric ED was designed that optimized passive distraction techniques using colorful ambient lighting.

METHODS

Participants were nonrandomly assigned to either an ambient ED environment or a traditional ED environment. Entry and exit questionnaires assessed caregiver expectations and experiences. Pain ratings were obtained with age-appropriate scales, and wait times were recorded.

RESULTS

A total of 70 participants were assessed across conditions, that is, 40 in the ambient ED group and 30 in the traditional ED group. Caregivers in the traditional ED group expected a longer wait, had higher anxiety pretreatment, and felt more scared than those in the ambient ED group. Caregivers in the ambient ED group felt more included in the care of their child and rated quality of care higher than caregivers in the traditional ED group. Pain ratings and administrations of pain medication were lower in the ambient ED group.

CONCLUSIONS

Mean scores for the ambient ED group were in the expected direction on several items measuring satisfaction with ED experiences. Results were suggestive of less stress in caregivers, less pain in patients, and higher satisfaction levels in the ambient ED group.

The relationship between organizational commitment and nursing care behavior

Introduction

Nursing care encompasses physical, emotional, mental and social needs, in order to improve a patient’s health and wellbeing. Caring is the central core and the essence of nursing. The important issue of care is access to proper care and increasing patients’ satisfaction. Job performance of nurses is affected by many factors including organizational commitment. This study aimed to determine the relationship between organizational commitment and nurses caring behavior.

Methods

In this cross-sectional study, 322 nurses from selected Hospitals of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected and enrolled in the study in 2015. The self-reported data by nurses were collected through demographic characteristics questionnaire, Meyer & Allen organizational commitment model and Caring Behavior Inventory (CBI). Data were analyzed with SPSS statistical software version 20, using t-test and ANOVA.

Findings

The majority of nurses (63%) were female. The mean score and standard deviation of organizational commitment and caring behavior of nurses were 74.12±9.61 and 203.1±22.46, respectively. The results showed a significantly positive correlation between organizational commitment and caring behavior (p=0.001).

Conclusion

In this study the caring behavior of nurses with higher organizational commitment were significantly better than the others. Managers and nurse leaders should pay more attention to improve organizational commitment of nurses, in order to improve nurses’ performance.

Understanding the perspectives of health service staff on the Friends and Family Test

Objectives The present study was designed to determine what staff consider when asked to respond to the Friends and Family Test question. Methods Over 300 health service staff responded to an online questionnaire exploring whether they would recommend treatment at their organisation to friends and family (Friends and Family Test). Results Staff identified staff attitudes and behaviours, the busyness of the health service and quality of care as themes that affected their recommendation. A considerable number of staff also identified factors largely outside the control of the health service as influencing their response. Conclusions Majority of respondents based their perceptions on personal expectations, with smaller numbers citing personal experience and hearsay. Staff would need to see changes both in the quality of care and management practice to amend their recommendation on the Friends and Family Test. What is known about the topic? The Friends and Family Test is seen as a useful tool to gather the opinions of patients and staff on the patient experience, yet there has been little validation of this question. What does this paper add? The present study suggests that, as currently worded, the question does not reliably report staff perceptions regarding patient experience. The study illustrates that the relationship with the organisation and perceptions of effective management are linked to staff responses. What are the implications for practitioners? The Family and Friends Test question may need to be more clearly focused to gather the desired information. Improvement on this indicator is only likely to be seen when management teams are meeting the expectations of staff for good management practice.

One Size Does Not Fit All: Pediatric Patient Satisfaction Within an Integrated Health Network

It is unknown how differently a factor influences pediatric patient satisfaction across multiple service areas. The objective of the study was to assess relative impacts of factors across 4 health service areas. In this retrospective study of 27 028 responses from patient satisfaction surveys, the multiple-group structural equation modeling was used to assess factor effects. "Physician care" has the largest impact on overall pediatric patient satisfaction in outpatient specialty care with a 1.4-fold, 1.7-fold, and 3-fold reduction in effect in primary care, emergency department, and inpatient care, respectively. "Nursing care" has the largest impact in inpatient care with a 3-fold effect reduction in emergency care. "Personal concern" is an impacting factor in all areas with the largest effect in emergency care. The influence of factors on pediatric patient satisfaction varies significantly across service areas. These findings help health care leaders design customized patient experience models to achieve optimal outcomes across the health system.

The emergency department: experiences of patients, families, and their nurses

Research regarding the triad of nurses, patients, and family members looking at the lived emergency department experiences and their perspective of each from the other is notably absent. In this study, M. van Manen's (1990) hermeneutic phenomenological approach was used to explore, understand, and describe the lived experiences of nurses, patients, and family members during critical illness in the emergency department. Data were collected over a 6-month period by means of in-depth interviews. While nurses perceived that addressing the patient's physiological deficit promptly is paramount in the emergency department, they also indicated that including family members as coparticipants in the care is equally important. Patients and family members perceived that communication, critical thinking, sensitivity, and caring are necessary for emergency department nurses. The study supports recognizing the patient and family as active participants in the patient's medical care, encouraging family member presence, and creating institutional policies for patient- and family-centered care.

Using the synergy model of patient care in understanding the lived emergency department experiences of patients, family members and their nurses during critical illness: a phenomenological study

Despite many studies conducted aimed to understand and improve emergency care, research on the triad of nurses, patients, and family members looking at the lived emergency department experiences and their perspective of each from the other is notably absent. In a hermeneutic phenomenological study using van Manen's method, a sample of 10 patients, 5 family members, and 8 nurses of a nonprofit community hospital was recruited and interviewed in 2010 to 2011 to explore, understand, and describe their lived experiences during critical illness in the emergency department. The nurses perceived that addressing the patient's physiologic deficit promptly is vital in the emergency department as well as including family members as coparticipants in the care. Patients and family members perceived that communication, critical thinking, sensitivity, and caring are essential for emergency department nurses. The American Association of Critical-Care Nurses' Synergy Model for Patient Care was applied in conceptualizing the findings and served as a framework in recommending practices and interventions geared toward improving competencies required in caring for critically ill patients and their families in the emergency department. The study supports recognizing the patient and family as active participants in the patient's medical care; encouraging family-member presence and creating institutional policies for patient- and family-centered care, as well as encouraging the development of ongoing programs that will recognize, enhance, and support the psychological and emotional well-being of emergency department nurses.

Patient satisfaction with nursing care in an urban and suburban emergency department

REVIEW OF LITERATURE

Patient satisfaction is an important outcome measurement in the emergency department (ED). When unavoidable, the negative effect of patient wait time may be lessened by communicating expected wait time, affective support, health information, decisional control, and competent providers.

METHODS

This controlled quasi-experimental design used a convenience sample. The patient questionnaire included demographics, expected and perceived wait time, receiving of comfort items, information and engaging activities and their perceived helpfulness for coping with waiting, and the Consumer Emergency Care Satisfaction Scale measure of patient satisfaction with nursing. Systematic offering of comfort items, clinical information, and engaging activities were statistically analyzed for impact on perceived wait times, helpfulness in waiting, and satisfaction with nursing care.

RESULTS

Interventions were supported by the data as helpful for coping with waiting and were significantly related to nursing care satisfaction. Interventions were less helpful for suburban patients who were also less satisfied.

CONCLUSION

Nurses can influence patient satisfaction in the ED through communication and caring behaviors.