Nursing therapeutics: Teaching student nurses care, compassion and empathy

The development of nursing-sensitive indicators: A critical discussion

Discussion arguments

In a science-based profession, nurses must continuously monitor and evaluate the effectiveness of their care. However, data on what constitutes nursing care in practice and the delivery process is lacking. Insufficient evidence on how nurses contribute to patient care hampers the evaluation of nursing practice.We discuss nursing-sensitive indicators, their origins, current applications, and challenges related to their use in evaluating the quality of nursing care. We analyse nursing-sensitive indicators in the context of criticisms levelled at the profession related to the lack of evidence to support their value in the larger healthcare environment.

Conclusions

We have a disjointed approach to evaluating nursing care. Current systems designed to monitor nursing care, such as metrics and data sets, are not adequate or effective for comprehensively evaluating nursing care, considering the fundamentals and values of the nursing profession.

'I didn't feel like I was a doctor': a qualitative interview study exploring the experiences and representations of healthcare professionals' capacity to deliver compassionate care and to practice self-care during the Covid-19 pandemic

OBJECTIVE

The increased demand on healthcare professionals (HCPs) during the Coronavirus Disease (Covid-19) pandemic reduces opportunities for HCPs to deliver compassionate care to patients and to maintain self-care. This study explored how HCPs understand and experience compassionate working practices during the Covid-19 pandemic to better support HCPs' wellbeing and to sustain quality of care.

DESIGN

All nineteen participants worked as an HCP during the Covid-19 pandemic, resided in the United Kingdom (UK) and took part in individual semi-structured interviews.

MAIN OUTCOME MEASURES

Using a thematic analysis approach, we developed three themes: (a) The art of compassionate care: Feeling and action, (b) The impact of Covid-19 on compassionate care and (c) Suffering during Covid-19: The importance of self-compassion and self-care.

RESULTS

Overall, the analysis illustrated the strong and negative impact that Covid-19 had on the ability to deliver compassionate care, resulting in moral injury and psychological and behavioural difficulties for HCPs, particularly in terms of self-care.

CONCLUSIONS

This research demonstrates an imperative need for organisations to better support HCPs' health and wellbeing, through a self-care system that promotes self-compassionate and self-care practices.

The effect of simulated problem learning in nursing ethics on moral sensitivity, empathy and critical thinking of nursing students: A quasi-experimental study

AIM

Compare the effects of Simulation with problem-based learning (SPBL) and Problem-based learning (PBL) in nursing ethics education on nursing students' moral sensitivity, empathy, critical thinking, test scores and teaching satisfaction.

BACKGROUND

Promoting nursing students' individual and ethical and abilities through education is an essential way to improve their ethical performance and build trustful relationship with patients. Despite significant efforts in this area, few have evaluated the effectiveness of Simulation with problem-based learning and Problem-based learning as applied to nursing ethics education.

DESIGN

A quasi-experimental design based on a non-equivalent control group pre-test/post-test.

METHODS

A quasi-experimental design was used. Participants were 161 undergraduate nursing students from two levels of a university, 88 subjects in the experimental group were taught using Simulation with problem-based learning and 73 subjects in the control group were taught using Problem-based learning. A pre-test, post-test and questionnaire were used to assess the effectiveness of student nursing ethics education. χ2 test was used to examine group differences in students' characteristics and satisfaction with teaching post-intervention. Student's t-test was used to assess group differences in scale scores and test scores.

RESULTS

Compared to the pre-test, empathy as well as critical thinking were significantly higher in the PBL group (P<0.05), but there was no significant change in moral sensitivity (P>0.05); moral sensitivity, empathy and critical thinking were significantly higher in the SPBL group (P<0.05). Moreover, this study also showed that improvement in moral sensitivity, empathy, critical thinking and grades was more significant in the SPBL group of nursing students compared to the PBL group (P<0.05) and no statistically significant difference was found between the two groups in terms of teaching satisfaction (P>0.05).

CONCLUSION

The use of Simulation with problem-based learning in nursing ethics education has a positive impact on nursing students' competency development and knowledge acquisition. Nurse educators should consider this teaching method and promote change to increase the effectiveness of nursing ethics education.

A randomized pragmatic feasibility trial to promote student perspective-taking on client physical activity level: a collaborative project

BACKGROUND

Health-care practitioners have opportunities to talk with clients about unhealthy behaviors. How practitioners approach these conversations involves skill to be effective. Thus, teaching health-care students to communicate empathetically with clients should promote effective client-practitioner conversations about health behavior change. The primary objective of this pilot trial was to assess the feasibility, acceptability, and appropriateness of a theoretically informed intervention designed to improve perspective-taking.

METHODS

For inclusion in this randomized mixed-methods parallel two-arm trial, participants needed to be a student at the investigators' Canadian university and have completed course content on behavior change communication. Using a 1:1 allocation ratio, participants in Respiratory, Physical, and Occupational Therapy; Nurse Practitioner; and Kinesiology programs were randomly assigned to full or partial intervention conditions. Full intervention participants completed a perspective-taking workshop and practiced perspective-taking prior to an in-lab dialogue with a client-actor (masked to condition) about physical activity. Partial intervention participants received the workshop after the dialogue. We assessed feasibility and appropriateness by comparing recruitment rates, protocol, and psychometric outcomes to criteria. We assessed acceptability (secondary outcome) by analyzing exit interviews.

RESULTS

We screened and randomized 163 participants (82 = full intervention; 81 = partial intervention). We fell slightly short of our recruitment success criteria (10-15 participants per program) when 2/50 Occupational Therapy students participated. We met some but not all of our protocol criteria: Some full intervention participants did not practice perspective-taking before the dialogue, because they did not see anyone during the practice period or did not have a practice opportunity. Psychometric outcomes met the criteria, except for one measure that demonstrated ceiling effects and low reliability (Cronbach's alpha < .70). There were no adverse events related to participation.

CONCLUSIONS

The intervention should be largely feasible, appropriate, and acceptable to deliver. We suggest changes that are large enough to warrant conducting another pilot study. We outline recommended improvements that are applicable to researchers and educators interested in recruitment, adherence to home practice, and online uptake of the intervention.

TRIAL REGISTRATION

This trial was registered retrospectively on November 8, 2023, at https://clinicaltrials.gov/study/NCT06123507 .

Communication strategies for expressing empathy during family-clinician conversations in the intensive care unit: A mixed methods study

OBJECTIVES

To explore communication strategies intensive care clinicians and patients' family members prefer for expressing empathy during family-clinician conversations.

RESEARCH METHODOLOGY/DESIGN

Mixed-methods survey study.

SETTING

Two medical ICUs of a German academic tertiary care hospital.

MAIN OUTCOME MEASURES

Using a self-developed online survey with closed and open-ended questions with free-text options, the participants' preferences of communication strategies for expressing empathy were investigated. Quantifiable similarities and differences were determined by statistical analysis. Qualitative themes were derived at by directed content analysis.

FINDINGS

The responses of 94 family members, 42 nurses, and 28 physicians were analysed (response rate: 45.3 %). Four communication strategies were deduced: (1) reassuring the families that the intensive care unit team will not abandon neither them nor the patient, (2) acknowledging emotions and offering support, (3) saying that the families are welcome and cared for in the intensive care unit, (4) providing understandable information. In comparison, the families considered an expression of nonabandonment as more empathic than the physicians did (p =.031,r = 0.240), and those expressions focussing solely on the family members' well-being (p =.012,r = 0.228) or comprising evaluative wording ("good", "normal") (p =.017,r = 0.242) as less empathic than the nurses did. Unanimously advocated nonverbal communication strategies included to listen attentively and to avoid interrupting as well as being approachable and honest.

CONCLUSION

The participants' preferences supported expert recommendations and highlighted that it is not only important what the clinicians say but also how they say it. Further research is needed to elucidate ways of successfully expressing empathy during family-clinician conversations in the intensive care unit.

IMPLICATIONS FOR CLINICAL PRACTICE

Intensive care unit clinicians are encouraged to practice active listening and to express their caring and nonabandonment. It is further suggested to reflect on and adjust pertinent nonverbal behaviours and relational aspects of their communication, as applicable.

Item development for a patient-reported measure of compassionate healthcare in action

BACKGROUND

Compassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient-reported measure, one that captures the observable actions of compassionate care delivery or 'compassionate healthcare in action' by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout.

METHODS

A multistage mixed-methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two-round modified online Delphi process.

RESULTS

Consensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development.

CONCLUSIONS

This item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process.

PATIENT OR PUBLIC CONTRIBUTION

This study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages.

An Exploration of Pediatricians' Professional Identities: A Q-Methodology Study

Professional identities may influence a wide range of attitudes, ethical standards, professional commitments and patient safety. This study aimed to explore the important elements that comprise pediatricians' professional identities. A Q-methodology was used to identify the similarities and differences in professional identity. Forty pediatricians were recruited from two tertiary referral hospitals in Taiwan. A list of statements was developed by five attending physicians and three residents. R software was used to analyze the Q-sorts to load the viewpoints and formulate the viewpoint arrays. Additional qualitative data-one-to-one personal interviews-were analyzed. Twenty-eight of forty pediatricians, 11 males and 17 females, with an average age of 39.9 (27-62) years, were associated with four viewpoints. We labeled the four viewpoints identified for professional identity as (1) professional recognition, (2) patient communication, (3) empathy and (4) insight. The professional recognition viewpoint comprised of youngest participants-28-36 years-with the majority as residents (77.8%), while the empathy viewpoint comprised the oldest participants-38-62 years-with all as attending physicians. All participants in the empathy and insight viewpoints were married. This study found professional identity to be a multifaceted concept for pediatricians, especially in the areas of professional recognition, patient communication, empathy and insight into patient care.

Effect of empathy nursing combined with SBAR communication system on the negative emotions and nursing quality of children with tracheotomy

BACKGROUND

Situation, Background, Assessment, and Recommendation (SBAR) is a structured method for communicating critical information that requires immediate attention and action.

OBJECTIVE

To study the effects of empathy nursing combined with the SBAR communication system on the negative emotions and nursing quality of children undergoing tracheotomy.

METHODS

This is a clinical observational study. A total of 100 tracheotomy patients who were cared for in the pediatric intensive care unit (subsequent treatment in the tracheotomy clinic or otolaryngology ward) of our hospital from September 2021 to June 2022 were recruited and assigned at a ratio of 1:1 either into a control group (empathic care) or an observation group (empathic care combined with SBAR) using a randomized method. Further, the postoperative anxiety self-rating scale scores, negative emotions, hope index, and nursing quality were compared between the two groups.

RESULTS

After nursing, the psychological resilience scale score of the observation group was higher than that of the control group, whereas the anxiety self-rating scale score was significantly lower than that of the control group (all P< 0.05). Basic and special nursing, knowledge awareness, and safety management of the two groups of patients improved significantly, with higher results in the observation group than in the control group (P< 0.05).

CONCLUSION

Empathy nursing combined with the SBAR communication system considerably improves postoperative negative emotions and enhances the quality of nursing care for patients undergoing tracheotomy.

Patient's views of empathic and compassionate healthcare interactions: A scoping review

BACKGROUND

Compassion and empathy are integral to safe and effective patient care. However, to date, most studies have focused on exploring, defining, measuring and analysing empathy and compassion from the perspective of researchers or clinicians. There has been limited attention to the perspectives of patients.

OBJECTIVE

The objective of this scoping review was to map the literature to identify patients' views of healthcare provider behaviours that exemplify empathic and compassionate interactions.

METHOD

This review used the Joanna Briggs Institute scoping review methodology. A comprehensive search of eight electronic databases was conducted with English language studies published in the last 10 years considered for inclusion.

RESULTS

Database searching resulted in 459 records for initial screening. After de-duplication and conducting a title and abstract review, 32 full-text articles were screened for eligibility. A total of 14 studies met the inclusion criteria and were critically reviewed using the Mixed Methods Appraisal Tool. The included papers profiled studies that had been conducted in clinical settings across seven countries. The healthcare encounters described in the papers were with a range of healthcare providers. Two overarching and interconnected categories of behaviours were identified as indicative of empathic/compassionate encounters: (1) communication skills such as listening, touch, body language, eye contact and positive demeanour; and (2) helping behaviours demonstrated by small acts of kindness that go beyond routine healthcare.

CONCLUSION

Given the breadth of studies describing the positive impact of empathy/compassion on people's physical and psychosocial wellbeing, the results from this review are valuable and shed new light on patients' views and experiences. The results provide a deeper understanding of healthcare provider behaviours that exemplify empathic and compassionate healthcare interactions and can be used to inform the education and training of healthcare providers from all disciplines.

How radiography educators teach the concept of caring to undergraduate radiography students

INTRODUCTION

Caring is a key part of a radiographers work and the education of student radiographers. Despite recent literature highlighting the importance of putting the patient at the centre of care and being caring, research describing the educational approaches used by radiography educators to facilitate the teaching of caring is lacking. The aim of this paper is to explore the teaching and learning strategies used by radiography educators to facilitate the development of caring in students.

METHODS

A qualitative, exploratory research design was used. Purposive sampling was used to select radiography educators (n = 9). This was followed by quota sampling to ensure all four radiography disciplines, namely diagnostic radiography, diagnostic ultrasound, nuclear medicine technology and radiation therapy were represented in the sample. Data was analysed thematically and themes were identified.

RESULTS

The findings indicated that radiography educators use teaching strategies such as peer role play, learning through observation and role modelling to facilitate teaching and learning of caring.

CONCLUSION

The study suggested that although radiography educators know the teaching strategies that facilitate caring, aspects such as clarification of professional values and the refinement of reflection seems to be lacking.

IMPLICATIONS FOR PRACTICE

The teaching and learning approaches that can assist students in developing as caring radiographers can add to the evidence-based pedagogies that shape the teaching of caring in the profession.

Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.

Assessment of Compassion Fatigue and Empathy Levels in Nurses During the COVID-19 Outbreak: Turkey's Case

This study was conducted to determine the compassion fatigue level of nurses and to review several variables believed to be associated with it; in addition, an assessment is made of empathy levels in the same group. This is a cross-sectional study conducted from December 2021 to May 2022 on nurses working at a city hospital linked to the Turkish Ministry of Health. The study group consisted of 616 nurses. A Personal Information Form, the Compassion Fatigue-Short Scale (CF-SS), and the Jefferson Scale of Empathy were used to collect data. Data were collected through face-to-face interviews. Student's t-test, One-Way Analysis of Variance, and Multiple Linear Regression Analysis were used for data analysis. The statistical significance value was accepted as p < 0.05. The study group consisted of 499 (81.0%) females and 117 (19.0%) males, and their ages ranged from 20 to 51, with a mean age of 29.2 ± 6.9 years. The scores obtained from the CF-SS ranged from 16 to 130, with a mean score of 70.96 ± 25.04. The level of compassion fatigue was found to be higher in participants with a low family income, those who work more than 40 h a week, those who chose their profession unwillingly, those who are not satisfied with their profession, and those with a history of contact with a COVID-19 patient (p < 0.05 for each group). There was a significant association between levels of compassion fatigue and empathy (r = 0.92; p = 0.220). The level of compassion fatigue was found to be moderate in the nurses observed. The factors affecting the level of compassion fatigue included gender, family income, reasons for choosing nursing as a profession, the number of patients given daily care by the nurses, satisfaction with their profession, and history of contact with a COVID-19 patient. More extensive studies focusing on the association between compassion fatigue and empathy in nurses are needed.

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.

"Compassion is the mainstay of nursing care": A qualitative study on the perception of care and compassion in senior nursing students

PURPOSE

To describe nursing students' perceptions of care and compassion in the context of the clinical environment.

DESIGN AND METHODS

This phenomenological study data were collected by focus groups and Giorgi et al. stages used in the data analysis.

FINDINGS

Sixteen students participated in this study. Four themes and 12 subthemes were determined. The themes were "Discovering the existence of care and facing up to care", "advancing on the road to becoming a nurse: from theory to practice," "compassionate care, beyond medical care," and "the effect of nursing education on professional compassion."

PRACTICE IMPLICATIONS

This study showed that nursing students grew by giving care and knowledge. In addition, compassionate care is gained by real-life stories and a supportive environment.

A scoping review of spirituality and religiosity in people who have had a kidney transplant

AIM

To conduct a scoping review to discover what is known about the presence of spirituality and religiosity in people who have received a kidney transplant.

DESIGN

Using Arksey and O'Malley's five-stage framework, a scoping review of seven key databases was performed in June 2020. The scoping review follows the PRISMA extension for scoping review process.

METHODS

CINAHL, MEDLINE, Embase, OvidPsychINFO, JBI, Scopus and Cochrane databases were searched to identify original research, from which seven studies were identified with only four meeting the criteria. The search strategy focused on studies that were published between January 2000-May 2020.

RESULTS

In synthesizing the available research, two key areas of interest were identified within the included studies, (1) clinical outcomes (medical adherence, renal function and transplant-related outcomes) and (2) well-being outcomes (locus of control and coping).

Empathy and Attitude upon An Aged Body: Aged Simulation Suit Among Undergraduate Physiotherapy Students

Background and Purpose: When empathy and attitude levels of health professionals are high, patient compliance and satisfaction are increased. The purpose of this study was to assess the empathy and attitude levels of undergraduate physiotherapy students towards older people before and after wearing the aged simulation suit by performing pre-defined related scenarios. Methods: The aged simulation suit was put on 63 students to complete the pre-defined scenarios, which included reading, eating, walking, and sitting to determine the experiences and emotions of students via semi-structured questions and interviews. The empathy and attitude levels were evaluated using the Jefferson Scale of Empathy-Health Professions Students (JSE-HPS) version and Kogan's Attitudes Towards Old People (KAOP) scales at baseline and immediately after performed scenarios. Results: The scores of the JSE-HPS and its sub-scales, including "perspective-taking" (p=0.000) and "compassionate care" (p=0.008), were significantly improved, while "standing in patient's shoes" was significantly decreased after the intervention (p=0.005). KAOP positive items were found to be higher compared to the baseline results (p=0.040). Besides, 87.1% of the students stated that their behavior towards older people would change positively. Conclusion: Using aged simulation suits may be an effective educational technique that positively contributes to undergraduate physiotherapy students' attitudes and empathy.

Compassion Competence Among Nursing Students From Different Cultures: A Multinational Study

BACKGROUND

Compassion competence is a nurse's ability to provide patient-centered care and communicate with patients in a sensitive and insightful manner. This descriptive cross-sectional survey study aimed to assess the compassion competence of a multinational group of nursing students.

METHOD

A total of 1,158 undergraduate nursing students participated in this study, and stratified random sampling method was used to select participants from the 100 study level to the 400 or 500 level. Data were collected using the Compassion Competence Scale.

RESULTS

Significant differences were found in students grouped by country of residence, marital status, and level of study. Age had a significant relationship with compassion competence, whereas gender did not. Students had high mean scores on sensitivity to patient needs across all countries.

CONCLUSION

Effective communication skills and insights into patient problems are important aspects of compassion competence, and undergraduate nursing programs should emphasize both of these aspects. [J Nurs Educ. 2022;61(6):289-295.].

Evaluating the relationship between empathy, pain knowledge and attitudes among nursing students

BACKGROUND

It is essential for nurses to manage pain effectively. Nurses start to learn about pain while still students. Pain assessment is more effective with knowledge of pain, positive attitude, and empathy. Nurse educators should evaluate nursing students' knowledge and attitudes toward pain management and their relationship with empathy and should revise the curriculum accordingly. No published studies have been found to date where the relationship between nursing students' knowledge and attitudes toward pain and empathy has been investigated.

OBJECTIVES

This aim of this study was to determine the factors affecting pain knowledge and attitudes of nursing students, and to evaluate the relationship between students level of empathy and pain knowledge and attitudes.

DESIGN

This study was a quantitative, descriptive-correlation design.

SETTINGS AND PARTICIPANTS

The study population was 150 students who were studying in the third and senior grades a nursing department in North Cyprus. The sample included 133 nursing students.

METHODS

Data were collected with the 'Student Descriptive Information Form', 'Knowledge and Attitude about Pain' questionnaire, and the "Basic Empathy Scale" (BES). The data were evaluated with descriptive analysis, nonparametric tests, and correlation analysis by using SPSS 20.0 program.

RESULTS

Mean affective and cognitive empathy scores were 30.16 (SD = 4.42) and 29.29 (SD = 2.65), respectively, and the mean score obtained from the Nurses' Knowledge and Attitudes Survey Regarding Pain was 13.50 (SD = 3.22). Furthermore, 91% of the participants stated that the patient is the most accurate judge of the intensity of pain, but only 1.5% of them responded correctly to questions on pharmacological methods of pain therapy. A weakly positive correlation was found between cognitive (r = 0.100, p = 0.252) and affective (r = 0.013, p = 0.881) empathy levels and pain knowledge and attitudes; nevertheless, this was not statistically significant (p > 0.05).

CONCLUSIONS

The study results indicate that curricula regarding pain management should improve the knowledge and attitudes of nursing students toward pain management. Seminars and practical training about how to use empathy in pain management should be planned and clinical practice should be scheduled more frequently.

Compassion within an academic setting: Experiences of student nurses

Compassion is fundamental to the delivery of quality nursing care and is an expected core competency that students must achieve to become a registered nurse. Nurse educators have a role in teaching compassion and in cultivating compassionate behaviours, among students, thus this novel study explores the student nurse's experience and understanding of compassion within the academic setting. A qualitative descriptive study using digitally recorded focus group interviews was undertaken with student nurses (n = 32) to explore their experiences of compassion in an academic setting. Data analysis was performed based on Braun and Clarke's framework of thematic analysis. Three themes were identified: students understanding of compassion, students experience of compassion within the academic setting and supporting compassion in an academic space. Student nurses reported their experiences of compassion as predominantly positive. They advocated for further 'space' within the curriculum for more formalised approaches to foster supportive relationships and to improve their experience of compassion within the academic setting. It is important to understand students' perspectives as this can guide teaching practice, organisational policy reform, and future research.

Compassionate communication levels of nursing students: Predictive role of empathic skills and nursing communication course

PURPOSE

This study aims to determine the compassionate communication levels of nursing students and the predictive roles of empathic skills and nursing communication courses.

DESIGN AND METHODS

This descriptive study was conducted with 430 nursing students and data were analyzed using a descriptive information form, Compassionate Communication Scale (CCS), and Empathic Skill Scale (ESS).

FINDINGS

A positive relationship was found between the students' ESS and CCS scores (r = .23 p = 0.001). Empathic skills (β = 0.43, p = 0.001), predicted compassionate communication (β = 0.23, p = 0.001), compassionate conversation (β = 0.43, p = 0.001), and compassionate touch (β = 0.18, p = 0.001).

PRACTICE IMPLICATIONS

Skills of compassion and empathy positively affect each other; therefore, it is important to adopt strategies that strengthen the empathic skills of nursing students during academic education and to include empathy and compassion in the curriculum.

Non-academic factors influencing the development of empathy in undergraduate nursing students: a cross-sectional study

BACKGROUND

Empathy is described as a core competence of nursing. There is abundant research evidence supporting that empathy varies according to personal characteristics and targeted training. The aim of this study was to characterize non-academic factors (personal and environmental) influencing the development of empathy in undergraduate nursing studies who are not receiving a targeted training in empathetic abilities in their nursing schools.

METHODS

A cross-sectional study was performed in the three nursing schools located in Cusco city, Peru (two private and one public). The Jefferson Scales of Empathy, Attitudes toward Physician-Nurse Collaboration, and Lifelong Learning, the Emotional Loneliness Scale for Adults, and the Scale of Life Satisfaction, were applied as the main measures. Also, information regarding gender, nursing school, and age, were collected. After psychometric properties were assessed, all measures were used in the development of a multivariate regression model to characterize factors of influence in empathy.

RESULTS

In a sample composed by 700 undergraduate nursing students (72 males and 628 females), a multivariate linear regression model was created. This model explained the 53% of variance of empathy and fitted all conditions necessary for inference estimations. Teamwork abilities, loneliness, age, sex, subjective well-being, and nursing school, appeared as factors influencing the development of empathy in patients' care.

CONCLUSIONS

Findings have indicated that, in absence of a targeted training, individual characteristics and characteristics associated with social and family environments play an important role of influence in the development of empathy in nursing students. These findings are also in consonance with others previously reported in different cultural settings including high-, middle- and low-income countries.

Applying communication skills in the provision of family-centred care: a reflective account

Providing family-centred care is fundamental to children's nursing and requires the development of therapeutic relationships with parents, notably parents of children who are acutely unwell. Gaining parents' trust and engaging them in their child's care involves the use of optimal verbal and non-verbal communication techniques. Children's nursing students need to develop skills and confidence in using these techniques. This article is a reflective account by a children's nursing student on how communication concepts and techniques learned at university can be applied to practice. The student had undertaken a theoretical and practical communication module during which she had been introduced to techniques such as active listening and the SURETY model shortly before starting a practice placement in an acute care setting. Here she uses the 'What?, So what?, Now what?' framework to reflect on and learn from her placement. The article demonstrates how complementing theoretical knowledge with experiential learning, and combining this with reflection on action, can enhance students' confidence to deliver family-centred care.

"Walking in Their Shoes": The effects of an immersive digital story intervention on empathy in nursing students

AIM

To evaluate the effects of a novel, immersive digital story intervention on empathy.

DESIGN

A randomized trial with three phases.

RESULTS

A total of 238 2nd year nursing students were recruited between May 2018 and December 2019. At baseline, no significant differences in empathy between the groups were found (p = .760). However, at post-test, empathy was significantly higher in the intervention group (M: 118.76, SD: 10.65) than it was in the control group (M: 114.60, SD: 15.40) (p = .012). At follow-up, there were no significant differences in empathy between the groups (p = .364).

CONCLUSION

The intervention resulted in an immediate increase in empathy in nursing students. However, further development of effective intervention delivery modes and fundamental redesign of the intervention itself would be needed to sustain this improvement over the long term.

Effect of multi-disciplinary teaching on learning satisfaction, self-confidence level and learning performance in the nursing students

AIM

The aim of this study was to design a multidisciplinary teaching method that combines game-based learning with a clinical situation-based teaching program and to test learning motivation, learning satisfaction and self-confidence.

BACKGROUND

Research has suggested that game-based learning and clinical situation-based teaching can effectively capture student attention and stimulate student learning motivation as well as increase learning satisfaction and self-confidence.

DESIGN

The randomized and experimental design used in this study was a pretest-posttest control group design.

METHODS

This study recruited participants from a technical college in the north of Taiwan. The experimental group (receiving multidisciplinary teaching) comprised 48 participants and the control group (receiving traditional teaching) comprised 50 participants. Participants took a pretest before the multidisciplinary teaching intervention, received a total of 12 weeks of intervention and then took a posttest within 1 week of the end of the course. These participants completed a questionnaire regarding learning satisfaction, confidence and learning performance.

RESULTS

The multidisciplinary teaching intervention improved learning satisfaction (t = 7.36, p < 0.001), self-confidence (t = 7.34, p < 0.001) and learning performance (t = 6.66, p < 0.001). Multidisciplinary teaching interventions can improve learning satisfaction, self-confidence and learning performance among nursing students.

CONCLUSIONS

Multidisciplinary teaching should be promoted in the context of nursing teaching and students have the multidisciplinary learning.

Determinants of compassion in providing care to older people: Educational implications

BACKGROUND

Care provision underpinned by compassion builds trust and ensures a deeper understanding of the health needs of older people. Yet nursing curricula in the United Kingdom focus on knowledge and skill acquisition rather than caring with compassion. This negatively impacts on the quality of care. Despite this, there is limited research on compassion in the care of older people.

AIM

To explore the views of nurse educators (NE), pre-registration nursing students (PNS) and clinical mentors (CM) of the determinants of compassion in the care of older people.

METHODS

A generic qualitative research design was used. Data were collected using semi-structured interviews with 39 participants (NE = 8; CM = 8; PNS = 23). These were digitally-recorded, fully transcribed and analysed thematically using NVivo software.

FINDINGS

Three main themes emerged from the data analysis: the meaning of compassion, extrinsic determinants of compassion in care, and intrinsic determinants of compassion in care.

DISCUSSION

The outcome of this study suggests that nurses and students think that compassion speeds up older people's recovery and enhances the quality of care. NEs consider its application in clinical practice a demonstration of competence.

CONCLUSION

The inclusion of compassion in practical sessions of pre-registration nursing curricula and in the care of the older person may result in improved understanding of the latter and provision of holistic, safe and effective care.

StARTalking: An Arts and Health Program to Support Undergraduate Mental Health Nursing Education

Community arts and health programs are recognized as powerful contributors to mental health and wellbeing, reducing social isolation and strengthening community connection. They attract individuals with diverse lived experience and are invaluable learning environments for consumers and undergraduate mental health nursing students. This paper reports on the evaluation of StARTalking, a community arts and health program in Melbourne, Australia. The study aimed to better understand the consumer and student experience participating in the program. The themes, Finding connection/Taking time out, clearly indicate that embedding arts and health in mental health nursing education supports consumer and student learning, health and wellbeing.

Attitudes Toward Epilepsy Among Parents of Children With Epilepsy in Southern China

Purpose: To evaluate the attitudes toward epilepsy among parents of children with epilepsy (CWE) in China and identify some related factors for future interventions for parents to offer more social support for CWE.

Method: The Chinese Public Attitudes Toward Epilepsy (CPATE) scale was administered to 234 parents of CWE and 203 parents of normal children in Xiangya hospital during 2019–2020.

Results: The cumulative score of the parents of CWE (26.427 ± 6.688) was significantly lower than that of the normal children group (32.330 ± 7.234, p < 0.001). Subanalysis showed more positive attitudes among parents of CWE than the control group (p < 0.001) toward education (4.765 ± 1.985 vs. 6.621 ± 2.419), social life (6.556 ± 2.456 vs. 8.010 ± 2.683), marriage (9.586 ± 2.675 vs. 11.025 ± 2.900), and employment (3.876 ± 1.364 vs. 4.5123 ± 1.283). The attitudes toward epilepsy among parents of CWE with seizures in public (27.16 ± 6.66) or during sleep (27.10 ± 6.38) were more negative than those without (25.35 ± 6.62 and 25.08 ± 7.10, respectively) (p < 0.05). In addition, female and low income were negatively related to parents' attitudes toward epilepsy.

Conclusions: More active policy guidance and adequate social support should be given to parents of children with seizures in public or during sleep to instruct their children to form a positive perception about epilepsy, which is expected to have a positive impact on their social abilities in the future.

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.

Communication experiences of family caregivers of hospitalized adults with intellectual and developmental disabilities-A qualitative study

Aim

To explore communication experiences between family caregivers of adults with intellectual and developmental disabilities (I/DD) and healthcare personnel during hospitalization.

Design

A qualitative descriptive study approach with interviews of family caregivers was used.

Method

Face-to-face, semi-structured interviews were conducted from June-September 2015 with ten family caregivers of adults with I/DD. Participants were recruited through an advocacy organization in the north-eastern United States. Data were analysed by content analysis. The Standards for Reporting Qualitative Research was the chosen checklist.

Results

The four overarching themes: "Need for Advocacy"; "Need for Better Communication"; "Sense of Abandonment"; and "Lack of Confidence" along with 12 subthemes were identified. Overall, participants reported miscommunications leading to instances of mistrust in hospital staff's competence to deliver quality patient care.

Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training

AIMS AND OBJECTIVES

To identify whether a Compassionate Mind Model-based curriculum reduces students' perceived fears of compassion and improves their professional well-being.

BACKGROUND

Enabling compassion is mandatory within nurse education but evidencing it is challenging. Research suggests that application of the Compassionate Mind Model might reduce students' fears of compassion and also decrease compassion fatigue. This study reports outcomes of a post-registration curriculum based on that model for training Specialist Community Public Health Nurses (Health Visiting).

DESIGN

A quantitative, prospective evaluation of a 12-month training course for Health Visiting students. Reporting was guided by the STROBE checklist for observational studies.

METHODS

Fears of compassion scales were applied at course start (time 1), mid-point (time 2; +6 months) and end (time 3; +12 months) to evaluate fears of compassion of 26 post-registration student Health Visitors (81% of course cohort) who provided data at all three points. The Professional Quality of Life tool was administered simultaneously to evaluate compassion satisfaction and burnout/secondary traumatic stress (compassion fatigue).

RESULTS

Between time 1 and time 3, mean fears of compassion scores decreased by 16.6-48.5% (repeated measures analysis of variance); mid-point scores were intermediary. At time 3, compassion satisfaction had increased slightly (+4.1%), negatively correlated with fears of compassion for self (r = -0.602; p = .001; n = 26) and fears of receiving compassion from others (r = -0.568; p = .002; n = 26). Burnout score decreased by 18.7%, correlated positively with fear of compassion for self (r = 0.493; p = .011; n = 26) and fear of receiving compassion from others (r = 0.615; p = .001; n = 26). Secondary traumatic stress score decreased by 16.5% but was not correlated with any fear of compassion.

CONCLUSION

Findings suggest that application of the Compassionate Mind Model might reduce practitioners' fears of compassion linked to a decrease in risk of compassion fatigue.

RELEVANCE TO CLINICAL PRACTICE

The Compassionate Mind Model could provide an effective vehicle to promote compassion and nurse well-being.

Strategies and resources for nurse leaders to use to lead with empathy and prudence so they understand and address sources of anxiety among nurses practising in the era of COVID-19

Aims

Identify strategies and resources for nurse leaders to use to lead with empathy and prudence to improve quality of care and to ease the psychological toll on nurses caring for patients with COVID‐19.

Background

In a 2020 report, clinicians caring for patients during the COVID‐19 pandemic said their healthcare leaders needed to: ‘hear me, protect me, prepare me, support me, and care for me’. These words provide an action plan for nurse leaders to communicate, educate and support nurses to practice competently and safely (physically and mentally) in the context of COVID‐19.

Design

Discursive paper.

Method

Identification and inclusion of relevant international evidence with clinical discussion.

Findings

Nurse leaders can mobilise system and individual level strategies and resources to support nurses to manage pandemic‐related issues including: anxiety due to the risk of infection, supporting anxious children, mitigating moral injury; providing safe and quality nursing care for patients with COVID‐19 and end‐of‐life care as needed; supporting relatives who cannot be present with a dying relative and care for grieving relatives and colleagues. We categorise a selection of evidence‐based, online sources providing current COVID‐19 information, practice updates and resources to develop personalised self‐care plans to ease anxiety and support renewal and resilience.

Conclusions

Nurse leaders must ensure adequate PPE supply, upskill nurses to provide safe, quality care for patients with COVID‐19 and promote restorative self‐care plans.

Relevance to clinical practice

The strategic actions nurse leaders take today can positively impact nurses' well‐being and ability to provide safe and quality care for patients in the context of COVID‐19.

A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement

AIMS AND OBJECTIVES

To use a poststructuralist framework to critique historical, social and institutional constructions of emergency nursing and examine conflicting discourses surrounding suicide prevention. The aim is to also demonstrate practical guidance for enhancing emergency nursing practice and research with regard to suicide prevention.

BACKGROUND

Emergency departments have been historically constructed as places for treating life-threatening physical crises, thereby constructing other "nonurgent" health needs as less of a priority. Physical needs take priority over psychological needs, such as suicide-related thoughts and behaviours, negatively impacting the quality of care that certain groups of patients receive.

DESIGN

A theoretical analysis of the published literature on the topic of emergency nursing and suicide prevention was conducted and analysed using a poststructuralist framework.

METHODS

Relevant literature on the topic of emergency nursing related to suicide prevention was analysed for a poststructuralist construct of power, language, subjectivity and discourse. Implications to practice and research were identified, as well as expanding emergency nursing using a poststructuralist framework. SQUIRE guidelines were used (see Supporting Information).

DISCUSSION

The emergency department is a critical point of intervention for patients with urgent and life-threatening needs. However, the biomedical model and historical, social, and institutional expectations that influence emergency nurses' beliefs and values do not effectively respond to the needs of suicidal patients. One step to address this issue is to deconstruct the current understanding of emergency nursing as a treatment for only life-threatening physical crises in order to become inclusive of psychological crises such as suicide-related thoughts and behaviours.

RELEVANCE TO CLINICAL PRACTICE

How a poststructural framework can be used to expand emergency care is discussed. Examples include empowering nurses to challenge the "taken-for-granted" emergency nursing and recognizing the health needs that fall outside of the dominant discourse of emergency care.

Perceptions of an evidence-based empathy mobile app in post-secondary education

Cognitive empathy (also known as perspective-taking) is an important, teachable, skill. As part of a knowledge translation project, we identified a) interest in an evidence-based cognitive empathy mobile app and b) which faculties believe that cognitive empathy is important for their profession. Students (n = 638) and instructors/professors (n = 38) completed a university-wide survey. Participants in Education, Social Work, and the Health Sciences were among those most interested in the app. The majority of participants said that they would prefer for the app to be free or less than $3 for students. Most participants preferred a one-time payment option. Across 17 faculties, all but one had 60% or more of its sampled members say that cognitive empathy is important for their profession. Results illuminate perceptions of cognitive empathy instruction and technology. Results also provide insight into issues to consider when developing and implementing an educational communication app.

Attributes associated with person-centered care competence among undergraduate nursing students

Person-centered care is widely recognized as a promising practice to improve patient care quality. However, little is known about the competencies of nursing students who are essential to providing high-quality person-centered care. In this study, relevant attributes, including professional nursing competence, empathy, and self-awareness, were examined in relation to person-centered care competence among South Korean nursing students while controlling for individual characteristics, including age, gender, religion, and academic performance. Data were collected from 213 senior students enrolled in four nursing schools in South Korea from November 15 to 30, 2017. The mean age of the nursing students in the sample was 23 years. Data were analyzed using multiple regression analyses while accounting for the students nested in their schools. Professional nursing competence and empathy were strongly associated with person-centered care competence among nursing students. Of the five aspects of professional nursing competence, human understanding and communication skills were the most likely to be associated with person-centered care competence. Moreover, there were few variations across nursing schools in the levels of professional nursing competence. Our findings corroborate the importance of developing better communication skills and empathy to improve and maintain person-centered care competence among nursing students who belong to a new generation.

Effects of a person-centred care intervention in an intensive care unit: Using mixed methods to examine nurses' perspectives

AIM

We identified nurses' experiences and changes in person- and family-centred care (PFCC) after applying a family-visiting programme in an intensive care unit (ICU).

BACKGROUND

Critical care provision is shifting to include communication among patients, families and health care providers.

METHODS

We used mixed methodology and a group pre- and post-test design. In 2019, 30 ICU nurses completed an 8-week programme, including keeping a diary and completing fundamental care activities. A survey of PFCC nursing performance was completed pre- and post-programme, and 15 nurses were interviewed post-programme. Performance differences were examined through paired t tests; qualitative data were analysed by thematic analysis.

RESULTS

The pre- and post-scores were 3.06 ± 0.34 and 4.00 ± 0.29, respectively (t = 17.38, p =.000), and five main themes and 13 subtopics were revealed. Most nurses 'discovered the importance of nursing through a truthful relationship with ICU patients' families'.

CONCLUSION

For effective PFCC, changes in nurses' perceptions and hospital organisation are required, such as improving the ICU working environment, assigning suitable health care personnel to provide care and implementing open-visit programmes.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital policymakers and nurse managers should take care to provide staff support and high-quality patient care to realize effective PFCC.

Professional relationships between nephrology clinicians and patients: a systematic review

BACKGROUND

Nephrology nurses and patients expressed that the clinician-patient relationship in a haemodialysis (HD) unit might be best described as being part of an extended family. However, there is a risk that professional boundaries may become blurred due to the perceived closeness of this relationship.

OBJECTIVE

This systematic review sought to explore the experiences of nephrology clinicians in establishing and maintaining a professional relationship with people experiencing end-stage kidney disease who are receiving HD treatment.

METHOD

A search strategy was created using JBI systematic review guidelines for six databases (PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library and JBI library). Qualitative studies were eligible for inclusion when the participants were nephrology clinicians who provided HD treatment or management of patients in a hospital outpatient HD unit or a community HD centre.

RESULTS

Three studies met the inclusion criteria and the findings were synthesised into two themes (1) establishing a professional relationship and (2) coping mechanisms. All three studies focused on nephrology clinicians realising the importance of treating patients as individuals. Nephrology clinicians demonstrated advanced communication skills, empathy and compassion when interacting with patients, which seemed to contribute to patient satisfaction. This systematic review found some qualitative evidence to explain how nephrology clinicians establish and maintain a professional clinician-patient relationship with patients in the HD unit.

CONCLUSION

This review highlighted a significant gap in research concerning the trajectory of the clinician-patient relationship across all members of the renal multidisciplinary health care team.

A model to facilitate the teaching of caring to diagnostic radiography students: Original research

BACKGROUND

Healthcare has moved towards a patient-centred caring environment. Radiography students have described feeling unprepared for daily patient interactions therefore, it is essential for educators to facilitate the development of caring attributes in students.

OBJECTIVE

The objective of this article is to describe the process that was followed in order to develop a model to facilitate the teaching of caring to diagnostic radiography students.

METHOD

A qualitative, theory-generating, exploratory and descriptive research design was used. Phase one was a descriptive, exploratory study that utilized focus group interviews to explore and describe the concept of caring from the perspective of first year diagnostic radiography students. Phase two, the focus of this article, was the theory generation phase of the study which began with identifying a central concept from the focus group interview results. The central concepts were then defined according to dictionary and literature sources and relationships between the identified concepts were created. Thereafter, the model was developed.

RESULTS

The central concept was identified as the "facilitation of a culture of caring". This concept was then defined, classified and described.

CONCLUSION

This model as a framework of reference could assist diagnostic radiography educators in facilitating the teaching of caring among student radiographers.

Nurses' Empathy in Different Wards: A Cross-Sectional Study

Background:

Empathy is an important component of the nurse-client relationship and nursing care. The current study aimed to compare nurses' level of empathy with patients in critical care units, psychiatric, and emergency wards.

Materials and Methods:

The present cross-sectional study was conducted on 112 nurses selected by convenience sampling in three educational hospitals affiliated with Isfahan University of Medical Sciences, Iran from June to September 2017. Data collection tool was a two-part questionnaire consisting of sociodemographic data (such as age, gender, and work experience) and Jefferson Scale of Empathy (JSE) containing 20 items, scored according to Likert scale from totally agree (7 points) to totally disagree (1 point). In total, the maximum score was 140 and the minimum score was 20. Data were analyzed using SPSS version 16 as well as descriptive and analytical statistical tests (multiple regression).

Results:

The mean (SD) empathy score of nurses working in critical care units, emergency, and psychiatric wards was 87.51 (6.65), 87.59 (4.90), and 90.71 (7.12), respectively. Regarding the regression models, it was observed that only the work experience was a significant predictor for empathy (β = 0.19, p = 0.04). This model predicted 3.50% of variances in the nurses' empathy.

Conclusions:

Nurses' level of empathy in this study was above average with equal scores in different wards. Therefore, increasing the nurses' level of empathy is essential in interventional studies.

Cultivating a Therapeutic Compassionate Relationship: The 3S Approach

In the last decade, a plethora of healthcare research and literature was produced and, indeed, confirms the absolute need to cultivate a therapeutic and compassionate relationship between carer and patient/family, especially in the face of a long-term and /or life-threatening condition. We introduce the 3S model as an approach to cultivate a therapeutic relationship between the carer and the patient/family. It is based on some fundamental traditional skills which may be innate for some but may need to be awakened and cultivated for others, all for the benefit of each of the members of the involved triad: patients, family, and healthcare professionals. The 3S approach aids in developing a therapeutic relationship that involves compassion and can be easily applied with significant results, especially in the context of chronic disease management. However, more research is needed to quantify the impact of this 3S approach on the therapeutic relationship and chronic disease management.

Compassionate love, burnout and professional commitment in nurses

AIMS

To determine the effects of compassionate love on burnout and professional commitment in nurses.

BACKGROUND

Compassionate love as 'other-centred' love is referred to as altruistic love, unconditional love and unreciprocated love. Compassionate love has an important role among nurses in moderating burnout and increasing professional commitment.

METHODS

One-hundred ninety-four nurses working at two public hospitals in Turkey completed four self-report instruments: socio-demographics, the Compassionate Love Scale, the Burnout Measure-Short Version and the Nursing Professional Commitment Scale.

RESULTS

A statistically significant inverse relationship was found between Compassionate Love Scale and Burnout Measure-Short Version scores, while Compassionate Love Scale scores were significantly and positively associated with Nursing Professional Commitment Scale scores. Participants with children had higher Compassionate Love Scale scores while those participating in the arts had lower Burnout Measure-Short Version scores. Nurses with intensive care experience had higher Nursing Professional Commitment Scale scores.

CONCLUSION

There is a positive relationship between compassionate love and professional commitment, a negative relationship between compassionate love and burnout. Further research is needed to test compassionate love interventions.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers may use the results of this study in encouraging and rewarding acts of compassionate love towards colleagues and patients.

Exploration of empathy in Cyprus nursing and health care students: A mixed method study

Developing professionals who are perceptive to the needs of patients and can respond by expressing empathetic behavior is one of the aims of health care education. The aim of this study was to explore the level of empathy in health care students through a mixed method. The quantitative approach included the use of the Jefferson Scale of Empathy and the qualitative a focus group approach to further deepen into the descriptive results. 869 health care students (RR=81%) participated in the study and the level of empathy ranged from 42 to 139 with a mean score of 100.6 (20-140 scale). Significant statistical differences were found between the disciplines (F=8.6, p-value<0.001) and gender (p-value<0.001) with nursing students and women scoring the higher levels. Two focus groups of ten participants each were conducted with 3^rd and 4^th year nursing students. Four themes were derived from the analysis of these data a) empathy as an imperative component of care b) contact with the clinical reality c) the influence of family and choice of studies d) gender stereotypes. There is a lack of mixed methodologies in the empathy research and this study provided the opportunity of a better understanding of the health care students' views.

An international cross-cultural study of nursing students' perceptions of caring

BACKGROUND

Single studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures.

OBJECTIVE

To determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students.

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

The study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation.

METHODS

The 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results.

RESULTS

The results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the 0.05 significance level. The main effect for country was F(3, 596) = 3.591, p < 0.0136 indicating a significant difference in CDI-25 between Slovenia (M = 108.9, SD = 9.2), Russian Federation (M = 107.1, SD = 8.2), China (M = 102.8, SD = 9.7) and Croatia (M = 110.0, SD = 8.6).

CONCLUSIONS

Perceptions of caring in nursing students differ across countries, probably due to different educational systems, curricula, cultural differences and societal values. Implementing caring theories in nursing curricula could help students to cultivate caring during their education.

Investigation of Nursing Students' Perception of Caring Behaviors

Introduction: Nursing is a caring profession. Developing nursing student’s perception of the care remains one of the most important goals of the education process.

Methods: A descriptive-correlational study was carried out in order to identify the caring behaviors, perceptions and associated factors of the nursing students. The target group of the study consisted of 530 nursing students. The data were collected by using the "demographic characteristics form" and "Caring Assessment Questionnaire" (Care-Q). T-test and ANOVA were used in the statistical analysis of the data. Multiple Regression Analysis - Hierarchical Model was used for the analysis of determination.

Results: Mean (SD) of total Care-Q points of the students was 5.0 (0.9), the highest average score of the sub-groups was 5.5 (1.1) in the trusting relationship sub-group; and the lowest average points was 4.5 (1.2) points in the Anticipates sub-group. It was concluded that the perceptions of the students about the caring behaviors is at a good level, and the perceptions of the students about the caring behaviors was affected by the attitudes, plans and experiences of the students about the profession.

Conclusion: Developing the confidence of the students during the nursing education, ensuring the opportunities for empathy and developing the course contents on the bases of the concept of care are the applicable results of this study.

Perception of compassion and professional values in nursing students: A cross-sectional multivariate analysis from Turkey

Professional values have been acknowledged as the foundation of nursing care, and compassion is recognized as one of these professional values. The aim of this study was to determine the relationship between compassion and professional values and the factors that affect the perceptions of nursing students. A cross-sectional research design was used. There were two sample groups: 141 first-year and 185 third-year nursing students (N = 326). The data were collected using a Personal Information Form, a Compassion Scale and the Nursing Professional Values Scale-Revised. Study data were evaluated with univariate and multivariate regression analyses. No statistically significant difference was found between the students' compassion levels. At the same time, the mean professional values score of the third-year students was determined to be statistically significantly higher. Furthermore, it was determined that the compassion levels of female students were greater than those of male students, and the perception of professional values of those whose fathers' education levels were high was greater. This study concluded that professional values increased as education levels increased but the level of compassion did not change. It is suggested that nursing education be shaped in order to include factors affecting the perception of professional values and compassion levels.

Home level bureaucracy: moving beyond the 'street' to uncover the ways that place shapes the ways that community public health nurses implement domestic abuse policy

Street-level bureaucracy is an increasingly useful way to understand how strategic policy is implemented in day-to-day practice. This approach has uncovered the ways that individual health and social care practitioners work within institutional constraints to influence policy implementation at the micro-level. Nonetheless, despite the diversity of settings where these street-level bureaucrats (SLBs) work, little attention has been focused on the impact of place on policy delivery. This paper draws on empirical research to examine the ways that delivering government domestic abuse policy in the intimate space of the family home shapes the delivery of strategic policy in the everyday. Drawing on qualitative research with Health Visitors (HVs) in the UK in 2016, the study findings illuminate the ways that the material, socio-spatial and idealised boundaries of the family home shape the implementation of policy. Key themes in the HV's narratives emerged as they described themselves as both a danger and in danger in the family home. In challenging the ontological security of the home (Giddens 1990) - privacy, security and control are key concepts here - HVs described how they shape their actions to achieve policy outcomes while simultaneously managing threats to the home, to professional identity and to self.