'A caring professional attitude': What service users and carers seek in graduate nurses and the challenge for educators

Care Competencies Training Enhances Adolescents' Well-being: A Randomized Controlled Trial

Objective: This intervention study seeks to assess the impact of a care competencies training program on students' well-being. Method: This randomized controlled trial involved 191 Vietnamese adolescents (65.4% female, Mage = 16 years and 8 months) in a 7-week intervention study that used video vignettes to build their care competencies. Validated scales were used to determine their care competencies (Care Competencies Questionnaire for Adolescents) and well-being (Strengths and Difficulties Questionnaire, Perceived Stress Scale and Satisfaction with Life Scale) at three points in time: before, immediately after, and two months after the intervention. The full-information maximum likelihood approach was applied to latent growth curve modeling (LGM) in Mplus 8.5 to estimate the initial level (i.e., intercept) and the change (i.e., slope) in care competencies and well-being among adolescents over time. Factor scores of LGMs were saved for correlation and multiple linear regression analysis by using SPSS (version 26.0) to explore the relationships between the changes in care competencies/failures and the changes in well-being. Results: Results showed that, next to a significant increase in care competencies and a significant decrease in care failures, other well-being variables also significantly changed in the intervention group. In the intervention group, but not in the control group, changes in care competencies and failures consistently and significantly predicted changes in well-being. Conclusion: The results support the potential of the video vignette-based intervention to promote the development of adolescents' care competencies.

Nursing students' empathic communication: Role in recognizing and treating chronic pain patients

OBJECTIVE

A substantial body of research supports what many nurses know from experience: empathy is at the heart of providing quality care. The major objective of this study was to identify unique mechanisms through which higher empathy translates into greater intentions to treat patients in pain employing novel methodology.

METHODS

Using an ecologically-valid scenario methodology, student nurses (N = 156) reviewed the narrative of a patient in chronic pain. They completed standard, valid measures of empathy toward the patient, perception of the patient's pain, and intention to provide pain-relieving treatment. Nursing student's personality traits were assessed and perception of patients' age and sex were experimentally manipulated.

RESULTS

Empathy was associated with higher intention to treat the patient in chronic pain irrespective of patients' age or sex. A moderated-mediation analysis confirmed that nursing students with higher empathy perceived the patient in the scenario as being in greater pain. This was correspondingly associated with higher intention to provide treatment. Nursing students' trait Extraversion was a moderator.

CONCLUSION

Empathy not only improves rapport between patients and providers but is related to intentions to provide pain-relieving treatment.

PRACTICE IMPLICATIONS

The clinical and educational importance of empathy in patient-provider relationships are discussed.

Meaning of hygiene care for patients as perceived by clinical nurses through an interactive care process: A grounded theory approach

AIM

This study aimed to explore the meaning of hygiene care for patients from the perspective of nurses, who provide them with care through an interactive process.

METHODS

Sixteen registered nurses working in general wards for over 5 years were selected through purposive and snowball sampling. Individual semi-structured interviews were conducted between May and August 2021. Data were analyzed using a grounded theory approach, and the Consolidated Criteria for Reporting Qualitative Research was used to ensure quality and transparency.

RESULTS

The participants recognized the core category "realizing oneself alive here," where hygiene care energized patients and promoted their realization of "feeling alive." Hygiene care created "time of relief, temporarily forgetting the illness," and "restoring a sense of oneself." A situation of care also created an "opportunity to treat each other as unique individuals," "opportunity to face self," and "encouraging the recovery and disease-fighting process."

CONCLUSIONS

This study highlights the value of hygiene care provided by nurses to patients. The meaning of hygiene care conceptualized in this study should help build a conceptual framework for understanding the patient's experience and reaffirming the value of hygiene care.

Correlation between mindfulness, empathy and compassion levels of nursing students: A cross-sectional study

BACKGROUND

The concept of mindfulness does not attract enough attention in the field of health. Despite this, it is thought to be effective on the concept of empathy and compassion, which have an importance in nursing practices.

AIM

The aim of the study was to investigate the correlation between the mindfulness, empathy and compassion levels of nursing students.

METHODS

This is a descriptive-correlational and cross-sectional study which comprised 347 students in the nursing department of a university. As data collection tools, the Mindful Attention Awareness Scale, the Basic Empathy Scale and the Compassion Scale.

FINDINGS

The results of the study show that no significant correlation was found between the mindfulness, total empathy levels and cognitive empathy levels of the students, and that there was a significant negative correlation between their emotional empathy levels. There was found to be a significant positive correlation between their mindfulness and total compassion levels.

DISCUSSION

The findings of this study contribute to the literature that the mindfulness of nursing students is not related to total empathy levels, but is closely related to compassion levels. Some studies in the literature support these findings.

CONCLUSION

It is thought that knowing, teaching and developing the concepts of empathy and compassion in nursing education is important for raising nurses who can provide compassionate care with a high level of empathy. The practice of mindfulness should always have a prominent role in nursing education. Its correlation with empathy and compassion should be consistently highlighted.

Calling an Oncological Emergency Telephone to Seek Advice: An Interview Study

BACKGROUND

Cancer treatment is increasingly provided on an outpatient basis, which may challenge patients and caregivers coping with illness and adverse effects at home. A telephone consultation is an accepted type of healthcare provision to support patients and prevent adverse outcomes when their capacity to self-manage is inadequate. Whether this option for help sufficiently supports patients needs further investigation.

OBJECTIVES

The aim of this study was to explore patients' and caregivers' experience of calling an oncological emergency telephone.

METHODS

The study applies a phenomenological hermeneutic approach with 12 semistructured interviews. Patients and caregivers who had called the oncological emergency telephone within the last 2 months were included. The interview texts were analyzed by content analysis.

RESULTS

Patients and caregivers perceive the emergency telephone as a lifeline that they consider calling when the patient's condition changes from what they understand as normal to what they perceive as abnormal. They would rather call "one time too many than one time too few" if their resources are inadequate to ensure their safety. The tone, attitude, and professional competency of healthcare providers affect patients' experience of the call.

CONCLUSIONS

The value of calling the oncological emergency telephone depends on the healthcare providers' professional competences and skills to establish a relationship that makes patients feeling accommodated and taken care of.

IMPLICATIONS FOR PRACTICE

Patients' and caregivers' perceptions of what constitutes a good telephone consultation represent significant knowledge that contributes to a more comprehensive and practice-based understanding of what is required to advise patients and caregivers in an oncological emergency telephone.

Co-production in nursing and midwifery education: A systematic review of the literature

OBJECTIVES

Co-producing aspects of nursing and midwifery education is increasingly being used in higher education to try to improve student learning and meet standards set by some professional accreditation bodies. This review aims to identify and synthesise evidence on this pedagogical approach.

DESIGN

Systematic review.

DATA SOURCES

Searches were conducted in CINAHL, ERIC, MEDLINE, and PubMed.

REVIEW METHODS

Four bibliographical databases were searched using relevant search terms between 2009 and 2019. Titles, abstracts, and full text papers were screened. Pertinent data were extracted and critical appraisal undertaken. Data were analysed using the framework approach and findings presented in a narrative summary.

RESULTS

Twenty-three studies were included. Two overarching themes emerged. The first focused on the impact of co-production on nursing and midwifery students, service users, and carers which had five subthemes; 1) acquiring new knowledge and skills, 2) gaining confidence and awareness, 3) building better relationships, 4) feeling vulnerable, and 5) attaining a sense of pride or enjoyment. The second theme centred on factors affecting how co-production was delivered which had three subthemes; 1) human interactional approach, 2) pedagogic quality, and 3) organisational environment.

CONCLUSION

This review provides a comprehensive update of the literature on co-production in nursing and midwifery education. Tentative evidence exists that participatory approaches could improve learning and positively impact on nursing and midwifery students, service users, and carers. Educators should consider adopting co-production and including students, service users, carers, practice staff, and other relevant stakeholders in this pedagogical process. However, more rigorous research examining how effective co-production is in improving learning over traditional methods is warranted given the additional resources required to deliver it.

A caring model for nursing education

With the many changes occurring within the health system and nursing education, ongoing shortages in the number of nurses and nursing faculty, increased incidences of incivility, and the charge to transform nursing education while upholding and transmitting the core professional values, a better understanding of the climate within nursing education is warranted. Caring is a core value of the profession of nursing and has received much attention and study, primarily in the practice setting. In nursing education much of this work has centered on the structure and processes of nursing education and the nursing student’s development of caring behaviors. This article proposes a caring model for nursing education that integrates the key concepts of organizational climate, leadership, and caring theories. The intent of the model is to provide a framework that can be used for professional nursing education that incorporates the core value of caring and develops graduates prepared to provide relationship-based, patient-centered care.

Nursing student-patient relationship - a 10-year comparison study in Finland

Objective This study aimed to describe and compare the group-level findings from 2005-2006 and 2015-2016 regarding students' and patients' views of the nursing student-patient relationship and associated factors. Methods The data were in both cases collected using Student-Patient Relationship Scales. The data were analysed statistically. Results In both student cohorts, authoritative and facilitative student-patient relationships were reported by the students more frequently than mechanistic relationships. Authoritative relationships were most common in both patient cohorts, whereas facilitative relationships had become more frequent than mechanistic relationships. A positive change of views in the student and patient cohorts was found in factors associated with the relationship. Conclusion In order to strengthen a clinical learning culture that reflects a facilitative student-patient relationship, further research is needed on the processes and outcomes of that relationship.

Hospital Nurses in Comparison to Community Nurses: Motivation, Empathy, and the Mediating Role of Burnout

Background

Hospital nurses’ experience of their profession differs from that of community clinic nurses due to different working conditions and settings.

Purpose

To compare hospital nurses and community clinic nurses as to the mediating role of burnout on motivation and empathy.

Methods

In this cross-sectional study, 457 nurses completed four questionnaires: Demographic, Motivation Questionnaire, the Maslach Burnout Inventory, and the Toronto Empathy Questionnaire.

Results

Emotional exhaustion and depersonalization among hospital nurses were significantly higher than among community nurses. No significant differences were found in personal accomplishment, empathy, and motivation between the groups. Empathy and motivation were more strongly correlated among hospital nurses than among community nurses. Burnout was found to be a significant mediator between empathy and motivation in both groups but in each group by different burnout subscales.

Conclusions

To reduce burnout, leaders in the nursing field must enhance conditions in the hospital nurses’ work environment to lower levels of emotional exhaustion and depersonalization; community nurses should be guided to improve their attitudes toward their on-the-job performance to promote their personal accomplishment. Understanding the differences could direct policy makers’ desire toward enacting policies that accommodate these differences and focus on the needs of both groups of professionals.

Perceived caring attributes and priorities of preregistration nursing students throughout a nursing curriculum underpinned by person-centredness

AIM AND OBJECTIVE

To explore preregistration nursing students' caring attributes development through a person-centred focused curriculum.

BACKGROUND

Developing caring attributes in student nurses to the point of registration has historically been challenging. Globally, curricula have not yet demonstrated the ability to sustain and develop caring attributes in this population, despite its centrality to practice.

DESIGN AND METHODS

This longitudinal cohort study tracked how University preregistration nursing students (N = 212) developed their caring attributes over the 3 years of their programme using repeated measures at the end of each year with the same cohort. The Caring Dimensions Inventory (35 item version with 25 caring items under three constructs (technical, intimacy and supporting) and 10 inappropriate or unnecessary construct items) was used and data analysed using Mokken scale analysis to create a hierarchy of actions that students deemed as caring. Repeated measures of analysis of variance enabled evaluation of changes in responses over time.

RESULTS

Students developed their caring attributes throughout their programme, ranking 22 of 25 items as caring (with statistical significance) at the end of year 1, 18 at the end of year 2 and all 25 caring items at the end of their final year. No unnecessary or inappropriate construct items were ranked as caring at any data collection point. Participants consistently ranked assisting a person with an activity of living, listening to a patient and involving them in their care as the most caring actions.

CONCLUSION

This study found caring attributes can not only be sustained, but can also be developed throughout a preregistration nursing education programme grounded in person-centredness.

RELEVANCE TO CLINICAL PRACTICE

Internationally, caring attributes are challenging to develop and sustain throughout preregistration education, largely being diminished over time. Little published evidence evidences how person-centred frameworks are successfully integrated into preregistration nursing curricula to develop person-centred nurses.

Introducing nursing practice to student nurses: How can we promote care compassion and empathy

To the population nursing and caring are synonymous. Empathy and using therapeutic relationships are ways that nurses can utilise care and compassion in their practice. However health care delivery needs to be led by evidence and one way to ensure evidence-based care is delivered compassionately and with empathy is to utilise the principles of nursing therapeutics. Nursing therapeutics allows a nurse to understand how care should be delivered as well as why. This discussion paper explores the use of therapeutic relationship building, nursing therapeutics and compassionate nursing and how neophyte student nurses can be introduced into these concepts during their first practice exposure. Using clinical case-studies, role-play and reflective discussion, student nurses explore and re-evaluate assumptions, to apprise and consider their beliefs and their impulse to care. Educational dialogue encourages a connection with the patient, to the person and their humanity. The implementation of this approach is facilitated by the use of newly devised learning resources which have been formulated to frame the encounter and to enable the student to look at their interaction and develop their therapeutic approach.

Service user involvement in preregistration child nursing programmes

Service user involvement is a fundamental part of preregistration nursing education programmes, however achieving this for child nursing students is challenging. Service user involvement can be achieved through online forums but this method can lack the emotional interaction and opportunity for deep reflection. This article reviews the background and challenges of service user involvement in preregistration child nursing programmes, further exploring the evaluation of a group of final year child nursing students' experience of appreciating the journey of two service users. The input from service users provided the opportunity for reflection, empathy and improved student self-awareness in nursing practice. Students gained perspective of the holistic needs of the service user, which empowered them to have confidence in their communication skills to ensure the voice of the child is heard and their rights are upheld. This article concludes that service user involvement is crucial in preregistration nursing programmes for the development of child nursing students, not only affecting their training but also the future workforce.

Assessing the Consultation and Relational Empathy (CARE) Measure in sexual health nurses' consultations

Background

Increasingly healthcare policies emphasise the importance of person-centred, empathic care. Consequently, healthcare professionals are expected to demonstrate the ‘human’ aspects of care in training and in practice. The Consultation and Relational Empathy (CARE) Measure is a patient-rated measure of the interpersonal skills of healthcare practitioners. It has been widely validated for use by healthcare professionals in both primary and secondary care. This paper reports on the validity and reliability of the CARE Measure with sexual health nurses.

Methods

Patient questionnaires were collected for 943 consultations with 20 sexual health nurses. Participating patients self-completed the questionnaire immediately after the encounter with the nurse. The questionnaire included the ten item CARE Measure, the Patient Enablement Index, and overall satisfaction instruments. Construct validity was assessed through Spearman’s correlation and principal component analysis. Internal consistence was assessed through Cronbach’s alpha and the inter-rater reliability through Generalisability Theory. Data were collected in 2013 in Scotland.

Results

Female patients completed 68% of the questionnaires. The mean patient age was 28.8 years (standard deviation 9.8 years). Two of the 20 participating nurses withdrew from the study. Most patients (71.7%) regarded the CARE Measure items as very important to their consultation and the number of ‘not applicable’ and missing responses’ were low (2.6% and 0.1% respectively). The participating nurses had high CARE Measure scores; out of a maximum possible score of 50, the overall mean CARE measure score was 47.8 (standard deviation 4.4). The scores were moderately correlated with patient enablement (rho = 0.232, p = 0.001) and overall satisfaction (rho = 0.377, p = 0.001. Cronbach’s alpha showed the measure’s high internal consistency (Cronbach’s alpha coefficient = 0.95), but the inter-rater reliability could not be calculated due to the high achieved CARE Measure scores that varied little between nurses.

Conclusions

Within this clinical context the CARE Measure has high perceived relevance and face validity. The findings support construct validity and some evidence of reliability. The high CARE Measure scores may have been due to sample bias. A future study which ensures a representative sample of patients on a larger group of nurses is required to determine whether the measure can discriminate between nurses.

A research-based mantra for compassionate caring

BACKGROUND

The United Kingdom introduced the Six C's strategy to help address deficits in approaching nursing care in a compassionate and caring manner.

OBJECTIVE

To identify the book, article, poem, film or play that most influenced nurse educators' understanding of care and compassion and to articulate a clearer understanding of compassionate caring.

DESIGN

A qualitative study applying discourse analysis to respondents' questionnaires and their nominated narrative.

SETTINGS AND PARTICIPANTS

41 nurse educators working in 5 universities in the UK (n=3), Republic of Ireland and Canada participated. 39 items (10 books, 2 journal articles, 10 poems, 15 films and 2 plays) were nominated.

FINDINGS

The desire to understand others and how to care compassionately characterised choices. Three main themes emerged. Abandonment of, and failure to see, the suffering person was evident in 25 narratives. Connecting with others was shown in 25 narratives as being able to truly seeing the other person. Comforting others was supported by 37 narratives with examples of kindness and compassion.

CONCLUSION

Published narratives are valuable in developing compassionate responses. An annotated list is provided with suggestions for educational uses to help develop compassionate caring in student nurses. Compassionate, caring nurses recognise that patients need them to: "See who I am; Be present with me; Do not abandon me."

Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study

BACKGROUND

Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments.

OBJECTIVES

To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum.

DESIGN

Five case studies using mixed data collection methods.

SETTINGS

British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media.

PARTICIPANTS

Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum.

METHODS

We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum.

RESULTS

Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services.

CONCLUSIONS

Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the nursing curriculum.

Nursing students' perceptions of soft skills training in Ghana

Background

The quality of nursing care rendered today is markedly reducing and the amount of time spent with patients listening to and explaining issues concerning their conditions is gradually diminishing. The therapeutic touch and the listening ear of the nurse are no longer accessible to the patient. Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of consideration. Although recent literature has highlighted the necessity of introducing soft skills training and assessment within medical education, nursing education is yet to fully embrace this skills training.

Objectives

The aim of this study was to explore nursing students’ understanding of the concept of soft skills and to acquire their perception on the need for soft skills training to promote quality nursing care.

Methods

A quantitative research design with descriptive and explorative strategies was used. One hundred and ten nursing students were sampled after permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee.

Results

The results indicated that a majority (68.8%) of respondents understood the concept of soft skills and agreed with the definition of ‘soft skills’. They furthermore agreed that soft skills should be part of the training that student nurses receive during their professional training.

Conclusion

The study revealed that there is a need for nursing students to be educated in soft skills and that this will enhance their job performances in the clinical environment and improve the way in which they communicate with their clients.

Explicating Filipino student nurses' preferences of clinical instructors' attributes: A conjoint analysis

The role of clinical instructor in student nurses' preparation for the professional nursing practice cannot be underestimated. The extent to which such role is achieved depends highly on the instructors' ability to realize the desired qualities expected of them. While a number of empirical studies have qualitatively explored the attributes of an effective clinical instructor, no attempt has ventured yet on the power of experimental vignettes for conjoint analysis in explicating the preferences of a select group of Filipino student nurses relative to their clinical instructors' attributes. Junior and senior nursing students (n=227), recruited from one of the comprehensive universities in the Philippines, were asked to sort out orthogonal cards generated by Sawtooth Software. As shown, the full-profile conjoint analysis was considerably fit for this study: Pearson's R=0.988, (p<0.05) and Kendall's t=0.944, (p<0.05). Results indicated that the student nurses are one in terms of their most preferred clinical instructor attribute, which was clinical teaching capacity (38.14%) followed by interpersonal relationship and caring behavior (33.17%). In regard to the clinical teaching capability, a clinical instructor who parallels clinical teaching skills with the students' understanding and experience (0.089) was the highest part-worth. As for the interpersonal relationship and caring behavior, the highest part-worth was a clinical instructor who respects a student nurse as an individual and cares about him/her as a person (0.114). Findings of this study can be a basis for clinical instructors as to which qualities to cultivate best to facilitate a first-rate clinical nursing instruction. Likewise, the results of this study can inform current practices of clinical instructors by making them aware of how they can nurture a pedagogical approach consistent with the student nurses' preferences.

Mindfulness predicts student nurses' communication self-efficacy: A cross-national comparative study

OBJECTIVES

The aim of this study was to compare student nurses' communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities.

METHODS

The study had a cross-sectional design. Data was collected from final year student nurses in Norway and Sweden. Communication self-efficacy, empathy, and mindfulness were reported by questionnaires; Clear-cut communication with patients, Jefferson Scale of Empathy, and Langer 14 items mindfulness scale.

RESULTS

The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116-122), empathy score 115 (95% CI 113-117) and mindfulness score 79 (95% CI 78-81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy.

CONCLUSION

The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher.

PRACTICE IMPLICATIONS

A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training.

A role for virtue in unifying the 'knowledge' and 'caring' discourses in nursing theory

A critical examination of contemporary nursing theory suggests that two distinct discourses coexist within this field. On the one hand, proponents of the 'knowledge discourse' argue that nurses should drop the 'virtue script' and focus on the scientific and technical aspects of their work. On the other hand, proponents of the 'caring discourse' promote a view of nursing that embodies humanistic qualities such as compassion, empathy and mutuality. In view of this, we suggest a way to reconcile both discourses despite the fact that they appear to be at odds theoretically and practically. To that end, we argue that nursing theory must give a prominent role to the Aristotelian conception of virtue, and we offer an account that includes both character and intellectual virtues. This account allows for a focus on moral competence but also accommodates the demands for discipline-specific knowledge. Our account incorporates the caring discourse by suggesting a way for individuals to cultivate the conditions within themselves that make 'caring in nursing' possible, while the knowledge discourse is accommodated via the acquisition of the intellectual virtues. The process for achieving both these ends is the same: an intention to consistently develop, hone and exercise certain character traits over time.

The role of service-user feedback in undergraduate nursing courses

There is an increasing expectation that service users should contribute in a meaningful way to student nurse education courses. This article describes how service-user feedback on undergraduate student nurses' performance during practice learning opportunities (PLOs) gives an insight into the qualities service users value in student nurses. At Cardiff University, the new Bachelor of Nursing course, launched in September 2012, took into account the Nursing and Midwifery (NMC) standards for preregistration, implementing a mechanism for service users to feed back on students' clinical performance. To facilitate this service, user/carer feedback pages were inserted into the students' bound clinical practice portfolio. A large sample of the clinical portfolios (n=100) from one cohort across adult, child and mental health nursing fields were examined at the end of year 1, year 2 and again at the end of year 3, and service users' comments collated. In considering the words used by service users, the authors propose that they reflected the six fundamental values-or 6Cs-of care, compassion, competence, communication, courage and commitment that underpin the delivery of excellent care. Conclusions drawn from the feedback were that students exhibited the caring and professional qualities that service users value, and indeed showed the dignity and respect for patients and people that the profession demands.

Exploring the meaning of caring amongst student midwives, professional midwives and educators in Tshwane, South Africa

BACKGROUND

In spite of caring being the core of midwifery and nursing, there is a constant public outcry about uncaring behaviours of midwives towards clients. Local media reports and recent discussion in the health system have highlighted the concerns regarding caring behaviours of midwives. Thus, there is a need to compare the meaning of caring from the perspectives of student midwives, midwives and educators.

AIMS

The aim of this article was to determine the meaning of caring from the perspectives of the undergraduate student midwives, the professional midwives, and the educators teaching midwifery in Tshwane.

SETTING

The study was conducted at healthcare institutions which the undergraduate student midwives attended for work integrated learning and at nursing education institutions in Tshwane, South Africa.

METHODS

The strategy was qualitative and exploratory in nature. The population comprised student midwives, professional midwives and educators. Purposive sampling was done. Focus group discussions were held with student midwives and professional midwives, whilst the naïve sketch form was used as data-collection instrument for educators. Content data analysis was done. The total sample realised was 38.

RESULTS

The findings revealed that 'caring' was taken to mean being well conversant, up to-date and proficient in the field of work as well as considerate and respectful to others. The professional midwives indicated that they have seen colleagues demonstrate uncaring behaviour whilst educators emphasised respect as caring.

CONCLUSION

The student midwives, professional midwives and educators described caring as being a competent nurse with compassion and respect for others.

Psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version: An Italian validation study with nursing students

This methodological study was conducted to test the psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version (JSE-HPS), in a convenience sample of 797 Italian nursing students and to describe their empathic engagement. Data were subjected to exploratory and confirmatory factor analysis, test-retest, correlation analysis, t-test, and analysis of variance method. Principal component factor extraction with Oblimin rotation on the first half of the sample was conducted. The analysis suggested a three-factor solution for 14 items: "compassionate care/emotional engagement," "perspective-taking," and "standing in the patient's shoes." Confirmatory factor analysis on the second half of the sample showed good fit indexes for the 14-item solution, indicated by the exploratory factor analysis, and the 20 item solution of the scale, with the exception of one item. Test-retest correlation was 0.50 (P < 0.001) for the overall scale. Results from group comparisons and correlations are also provided and discussed. The Italian version of the JSE-HPS is a psychometrically sound tool. The translated 20-item solution is also suitable to carry out cross-cultural comparisons.

Nursing therapeutics: Teaching student nurses care, compassion and empathy

BACKGROUND

Debate continues regarding whether humanitarian values such as care and compassion can be taught or are innate in individuals who wish to become nurses.

OBJECTIVES

To undertake a discursive review of the literature on caring, compassion and empathy. To understand the teaching and learning issues associated with these concepts. To design and implement an Undergraduate Unit of study which addresses the development of caring, compassion and empathy in student nurses.

METHODS/DATA SOURCES

MEDLINE, CINAHL, and a wide range of literature including books and governmental reports were used for a discursive narrative review.

RESULTS

Caring, compassion and empathy are ill-defined; however healthcare users are clear that they know when nurses use skills and attitudes associated with these concepts. Evidence is available to show that caring, compassion and empathy can be taught and there are tools available to measure them in neophytes through their training. Central to the androgogical embedding of these concepts into nursing curricula is the development of therapeutic relationships.

CONCLUSIONS

It is possible to develop materials to enable student nurses to learn how to care using compassion and empathy. Nursing therapeutics is a term devised to describe how student nurses can exploit the therapeutic potential of any patient contact especially when related to specific and routine nursing interventions. Muetzel's model for understanding therapeutic relationships is one framework that can be adopted to help student nurses to appreciate how to build patient relationships and encourage them to move towards therapeutic advantage using care, compassion and empathy.

Baccalaureate nursing students' perspectives on learning about caring in China: a qualitative descriptive study

BACKGROUND

The need to provide humanistic care in the contemporary healthcare system is more imperative now and the importance of cultivating caring in nursing education is urgent. Caring as the primary work of nursing has been discussed extensively, such as the meaning of caring, and teaching and learning strategies to improve nursing students' caring ability. Yet attempts to understand students' perspectives on learning about caring and to know their learning needs are seldom presented. The aim of this qualitative descriptive study was to explore the baccalaureate nursing students' perspectives on learning about caring in China.

METHODS

A qualitative descriptive study using focus group interviews were undertaken in two colleges in Yunnan Province, China from February 2010 to April 2010. Purposeful sampling of 20 baccalaureate nursing students were recruited. Content analysis of the transcribed data was adopted to identify the themes.

RESULTS

Four categories with some sub-categories related to students' perspectives on learning about caring were identified from the data: 1) Learning caring by role model; 2) conducive learning environment as the incentive to the learning about caring; 3) lack of directive substantive way of learning as the hindrance to the learning about caring; 4) lack of cultural competency as the barrier to the learning about caring.

CONCLUSIONS

Both caring and uncaring experiences can promote the learning about caring in a way of reflective practice. The formal, informal and hidden curricula play an important role in the learning about caring. Cultural awareness, sensitivity and humility are important in the process of learning to care in a multicultural area.

Inflammatory bowel disease professionals' attitudes to and experiences of complementary and alternative medicine

Background

Complementary and alternative medicine (CAM) use in patients with IBD is on the increase. Patients report they use CAM when their condition is unresponsive to conventional medication or when they suffer from side-effects, negative stress and disease-related concerns. CAM use may improve patients’ well-being but it can also lead to side-effects and interactions with conventional medications. Research on attitudes to and experiences of CAM among healthcare professionals working with IBD patients is not well studied. Studies in this area could lead to enhanced awareness of and improved communication about CAM between care staff and IBD patients. The aim of this study was to explore IBD professionals’ attitudes to and experience of CAM.

Methods

Sixteen physicians and nurses, 26–70 years old, who had worked with IBD patients for 1–42 years, were recruited. Semi-structured qualitative interviews were conducted. Qualitative content analysis was performed.

Results

Participants stated patients used CAM to improve their well-being generally and there conditions specifically. Participants had a positive attitude towards CAM and respected their patients’ decision to use it, but reported a lack of CAM knowledge. They required education about CAM to be able to meet patients’ needs and provide adequate information. The result of this study indicates that there is a need for CAM education to be implemented in nursing and medical school.

Conclusions

All participants had experience of IBD patients who had used CAM in an attempt to achieve improvement and well-being. Attitudes to CAM were mainly positive, although a problematic aspect was lack of knowledge and evidence in relation to CAM. Implementing CAM education in nursing and medical school will allow healthcare professionals to gain an understanding of therapies widely used by patients with IBD. In clinical practice, using a standard questionnaire regarding CAM use allow healthcare professionals to better understand their patients’ wishes and current CAM use.

Exploring home visits in a faith community as a service-learning opportunity

BACKGROUND

Within South Africa the Psychiatric Nursing Science curriculum in undergraduate Baccalaureate nursing education utilizes home visits as a service-learning opportunity. In this context faith communities are currently unexplored with regards to service-learning opportunities. With limited literature available on this topic, the question was raised as to what are these students' and family members' experience of home visits within a faith community.

PURPOSE

To explore and describe nursing students' and family members' experiences of home visits within a faith community.

DESIGN

A qualitative approach was used that was phenomenological, explorative and descriptive and contextual in nature.

SETTING

The research was conducted within a faith community as service learning opportunity for Baccalaureate degree nursing students. This community was situated in a semi-urban area in the North-West Province, South Africa.

PARTICIPANTS

Eighteen (n=18) final year nursing students from different cultural representations, grouped into seven groups conducted home visits at seven (n=7) families.

METHODS

Comprehensive reflective reporting after the visits, namely that the students participated in a World Café data collection technique and interviews were conducted with family members.

RESULTS

Three main themes emerged: students' initial experiences of feeling overwhelmed but later felt more competent; students' awareness of religious and cultural factors; and students' perception of their role. Two main themes from the family members emerged: experiencing caring and growth.

CONCLUSIONS

There is mutual benefit for nursing students and family members. Students' experiences progress during home visits from feeling overwhelmed and incompetent towards a trusting relationship. Home visits in a faith community seems to be a valuable service learning opportunity, and the emotional competence, as well as spiritual and cultural awareness of nursing students should be facilitated in preparation for such home visits.

The legacy of "Joanna": the role of ethical debate in nurse preparation

INTRODUCTION

The author was involved in nursing "Joanna", a neonate who was born in 1980 with a serious form of spina bifida. A scenario describing the Joanna case was introduced to two groups of students in order to enhance critical thinking skills and encourage ethical debate in the classroom. Critical thinking skills, which are essential in professional practice, include the honest appraisal of intellectual positions adopted by one's self and others, and caring about the dignity and worth of each person (Ennis 1996, cited in Robinson, 2011).

METHODOLOGY

The scenario was presented as a case study to two classes, one of which comprised undergraduate nursing students, the other, mature-aged retirees. The International Council of Nurses Code of Ethics (2006) was used to critically analyze the concepts of quality of life and empowerment. The qualitative raw data was collected from both groups and compared.

DISCUSSION

Nurses are in a key position to identify potential ethical conflicts but need adequate supports in place in order to become empowered and advocate for patients. The differing attitudes towards Joanna and the care she received reflected the different quantities and types of life experiences available in the two class groups.

CONCLUSION

Nurse education programs now accept greater numbers of students from diverse backgrounds; therefore, educators need to plan for these differences in life experience when inducting students into professional practice. The outcome of introducing the scenario into the classroom demonstrates the imperative of seeking a wide variety of perspectives to develop ethical debate and preparation for professional practice.