The effect of technology on the caring attributes of an international sample of nurses

Nurses' Perception of Caring and Attitudes toward Caring for Dying Patients: Exploring the Relationship Using a Descriptive Cross-Sectional Design

This study examines the association between nurses' perception of caring and attitudes toward caring for dying patients in end-of-life care units. We used a descriptive cross-sectional design with convenience sampling. Data were collected from May to June 2021 through self-reported questionnaires from 303 Spanish nurses (mean age = 48 years, 78.9% female). Participants completed the Caring Dimension Inventory (CDI-25) and the Frommelt Attitudes Toward Care of the Dying scale. Demographic and training information were collected. Data were analyzed using Stata 16.0. Attitudes toward Care of the Dying Patient were significantly higher in nurses with palliative care training (β = 2.829, p = 0.018) and those who scored higher on the psychosocial (β = 0.789, p = 0.0001) and technical dimensions (β = 0.487, p = 0.011) of the CDI-25. Multivariate analysis identified the psychosocial dimension of the CDI-25 scale (β = 0.783, p = 0.0001) and palliative care training (β = 2.686, p = 0.017) as the only significant variables associated with Attitudes toward Care of the Dying Patient. Overall, nurses exhibited a positive attitude toward caring for dying patients. Our results could potentially help nursing directors identify those with the necessary qualities and training for optimal end-of-life care and to further plan training courses to provide optimal care in end-of-life situations.

A Chinese Version of the Caring Dimensions Inventory: Reliability and Validity Assessment

Caring is central to nursing practice. Chinese nurses take care for the health of about 20% of the world’s population and their perception of caring is critical. However, until recently, instrument specifically designed to measure the caring of nurses in China was not found. Caring dimensions inventory (CDI) is one of the most frequently used instrument when measuring caring and is applicable to nurses from different cultures. The aim of this study is to test the validity and reliability of the Chinese version of the 25-item CDI. The English version of CDI was translated into Chinese according to the guidelines of the World Health Organization. Content validity was conducted among seven senior nurses from different institutions in different cities in China. A convenience sample of nurses from 11 cities in China was employed. Exploratory factor analysis and confirmatory factor analysis of the CDI was carried out using a sample of 880 nurses. The overall content validity index was 0.98. Three factors (Nurturance, Collaboration, Skill) were identified in exploratory factor analysis and were confirmed by confirmatory factor analysis. The three-factor solution explains 70.15% of the total variance. The Cronbach alpha for overall the CDI was 0.97. This study demonstrated that the Chinese version of the CDI showed satisfactory reliability and validity, indicating that it could be a useful measurement to assess nurses’ perception of caring in China.

Cross-cultural adaptation and validation of the Chinese Comfort, Afford, Respect, and Expect scale of caring nurse-patient interaction competence

AIMS AND OBJECTIVES

To investigate the construct validity and reliability of the Chinese Comfort, Afford, Respect, and Expect scale, which can be used to determine clinical nurses' competence. The results can also serve to promote nursing competence and improve patient satisfaction.

BACKGROUND

Nurse-patient interaction is critical for improving nursing care quality. However, to date, no relevant validated instrument has been proposed for assessing caring nurse-patient interaction competence in clinical practice. This study adapted and validated the Chinese version of the caring nurse-patient interaction scale.

DESIGN

A cross-cultural adaptation and validation study.

METHODS

A psychometric analysis of the four major constructs of the Chinese Comfort, Afford, Respect, and Expect scale was conducted on a sample of 356 nurses from a medical centre in China. Item analysis and exploratory factor analysis were adopted to extract the main components, both the internal consistency and correlation coefficients were used to examine reliability and a confirmatory factor analysis was adopted to verify the construct validity.

RESULTS

The goodness-of-fit results of the model were strong. The standardised factor loadings of the Chinese Comfort, Afford, Respect, and Expect scale ranged from 0.73-0.95, indicating that the validity and reliability of this instrument were favourable. Moreover, the 12 extracted items explained 95.9% of the measured content of the Chinese Comfort, Afford, Respect, and Expect scale.

CONCLUSIONS

The results serve as empirical evidence regarding the validity and reliability of the Chinese Comfort, Afford, Respect, and Expect scale.

RELEVANCE TO CLINICAL PRACTICE

Hospital nurses increasingly demand help from patients and their family members in identifying health problems and assisting with medical decision-making. Therefore, enhancing nurses' competence in nurse-patient interactions is crucial for nursing and hospital managers to improve nursing care quality. The Chinese caring nurse-patient interaction scale can serve as an effective tool for nursing and hospital managers to evaluate the caring nurse-patient interaction confidence of nurses and improve inpatient satisfaction and quality of care.

Effects of technology on nursing care and caring attributes of a sample of Iranian critical care nurses

PURPOSE

To examine the association between attitudes of critical care nurses about influences of technology and their caring attributes.

STUDY DESIGN AND METHODOLOGY

In a cross-sectional study, firstly the psychometric properties of caring attributes questionnaire, which was developed to examine caring attributes of a sample of international nurses, was refined in a sample of 200 critical care nurses working in educational hospitals of a city in the southwest of Iran. Results of factor analysis with Varimax rotation decreased 60 items of caring attributes to 47 items which loaded under five subscales of caring negation, caring compassionate, caring advocacy, caring essence and caring communication. Secondly, attitudes of these nurses toward influences of technology on nursing care were assessed using a 22-item questionnaire, developed by the study researchers. Finally, the association between scores of caring attributes and attitudes toward influences of technology of this sample was determined.

RESULTS

There was a positive association between caring attributes and influences of technology among our study nurses. Caring attributes scores were higher in female single nurses. Although caring attributes' scores had decreased along with age and work experience, caring commitment was higher in older more experienced nurses. Furthermore, female nurses had a better attitude toward influences of technology on their care. In contrast, younger and less experienced nurses had negative views on the effects of technology on nursing care.

CONCLUSION

Continuing education and life-long learning on application of new technological equipment in nursing care and harmonising their use with caring values are necessary for nursing students and registered nurses to ensure delivering a patient-centred care, in a technologically driven environment.

Technology Dependence in Home Care: Impact on Patients and Their Family Caregivers

BACKGROUND

The purpose of this review is to explore how home technology care affects patients, family caregivers, and quality of life (QOL).

METHODS

A literature search was conducted to identify studies of home parenteral nutrition (HPN) and other technology prescribed home care.

RESULTS

Technology dependence influences health-related QOL. Patients and their family caregivers must balance the positive aspects of being in the home environment with the challenges of administering complex therapies at home. Patients and caregivers need additional support to reduce the physical, emotional, social, and financial burdens they experience.

CONCLUSIONS

More research is needed to address effective interventions to reduce patient and caregiver burdens and to improve outcomes for technology-dependent individuals. A greater level of preparedness for managing home technology and technology-related problems may improve quality of life.

The technological influence on health professionals' care: translation and adaptation of scales

Objectives:

in this study, two research tools were validated to study the impact of technological influence on health professionals' care practice.

Methods:

the following methodological steps were taken: bibliographic review, selection of the scales, translation and cultural adaptation and analysis of psychometric properties.

Results:

the psychometric properties of the scale were assessed based on its application to a sample of 341 individuals (nurses, physicians, final-year nursing and medical students). The validity, reliability and internal consistency were tested. Two scales were found: Caring Attributes Questionnaire (adapted) with a Cronbach's Alpha coefficient of 0.647 and the Technological Influence Questionnaire (adapted) with an Alpha coefficient of 0.777.

Conclusions:

the scales are easy to apply and reveal reliable psychometric properties, an additional quality as they permit generalized studies on a theme as important as the impact of technological influence in health care.

Re-establishing dignity: nurses' experiences of caring for older hospital patients

In western countries, the older population is increasing and with age follows a risk of un-health. Every fifth hospital patient is above 65 years of age. As a consequence, nursing care to older patients is a significant but tacit nursing issue. The aim of this study was to explore Danish clinical nurses' experiences of caring for older hospital patients. The study was based on Benner and Wrubel's phenomenological notion that caring as a special kind of involvement, a grasp of a situation in terms of its meaning, is primary in nursing. A qualitative secondary analysis of data from an interview study with 29 nurses and nurse assistants was performed following Van Manen's hermeneutic phenomenology. Findings show that caring mainly concerns 're-establishing dignity' especially through 'seeing the patient as a unique person', 'assisting in getting rid of the bed' and 'supporting patient appearance'. The study documents that caring for older people is about creating small everyday circumstances in which patient dignity can flourish. Shortcomings of a secondary analysis are discussed and suggestions for future research, such as how older hospital patients experience caring and dignity in relation to nursing care received, are suggested.

Evaluation of a caring education program for Taiwanese nursing students: a quasi-experiment with before and after comparison

BACKGROUND

Caring is an essential component in nursing curricula. However, how caring can be accomplished effectively has rarely been taught to nursing students.

OBJECTIVES

To examine acceptability and preliminary efficacy of a caring education program for nursing students in Taiwan.

METHODS

Students were recruited to participate in a pre-post-test quasi-experimental study. Students self-selected into a control group (n=33) or an experimental group (n=35). The experimental group registered for a 13-week caring education program based on Watson's 10 creative factors through multiple teaching strategies. The Caring Behaviors Assessment (CBA) was used to collect data at weeks 1 and 13. Content analysis was used to reach the main descriptions of caring education from an experimental group of nursing students.

RESULTS

The experimental group reported a significantly higher score of caring behaviors after participating in the education program (t=3.4, p=.00). The score of each CBA subscale in the experimental group was significantly enhanced from week 1 to week 13, except in the existential/phenomenological/spiritual dimension. Qualitative results supported that a caring education could help nursing students by building caring behaviors which could be adapted to clinical situations.

CONCLUSIONS

The findings support the credibility of caring-focused teaching strategies and such focused caring programs are acceptable and show efficacy for nursing students.

The multidimensionality of caring: a confirmatory factor analysis of the Caring Nurse-Patient Interaction Short Scale

AIM

This paper is a report of a study to evaluate the construct validity of the four-dimensional Caring Nurse-Patient Interaction-Short Scale using confirmatory factor analysis.

BACKGROUND

Validating theoretical structures of caring is an ongoing challenge in the discipline of nursing. Our previous work has contributed to this literature by the exploration of the dimensionality of the Caring Nurse-Patient Interaction Short Scale via an exploratory factor analysis. The Caring Nurse-Patient Interaction Short Scale comprises 23 items reflecting four caring domains: humanistic care, relational care, clinical care and comforting care.

METHOD

A methodological study was conducted involving a convenience sample of 531 nursing students in a baccalaureate nursing programme (20% were already Registered Nurses). Data were collected in 2002 and 2004. Confirmatory factor analysis of the Caring Nurse-Patient Interaction Short Scale was performed.

FINDINGS

As expected with large samples and models, the chi-squared-associated P-value was statistically significant (chi2 = 811.43, d.f. = 224, P < 0.01). However, the other indices reached acceptable levels with 0.054 for the standardized root mean-squared residuals, 0.070 for the root mean-square error of approximation, 0.88 for the goodness of fit index, 0.98 for the comparative fit index and 0.97 for the normal fit index. The factor loadings for all items with their hypothesized factor were > or = 0.48 and statistically significant at the 0.01 level.

CONCLUSION

The Caring Nurse-Patient Interaction Short Scale model was judged to fit the data adequately. Although further testing of the scale with different samples of patients is warranted, our model emerged as a middle-range theory during the construct validity process and still reflects Watson's theory while offering a structure that is testable in clinical research.

Being a real nurse – Concepts of caring and culture in the clinical areas

In this paper we discuss the issues of caring and culture in practice settings and how they affect student nurses in their endeavours to learn how to be a 'real nurse'. Drawing upon differing conceptions of 'caring' we discuss the notion as a pivotal factor in becoming a nurse. We examine the degree to which boundaries are changing, not least those in which students seem currently to define the bedrock of physical and emotional care as belonging to health care support workers whom they will merely supervise. Complicating this picture are developments in medical and nursing boundaries which may, or may not help to 'professionalise' nursing. We conclude by arguing that complex cultural norms and the negotiated order of health care need to be properly recognised by curriculum developers if, within contemporary higher education nurses are to be fit for purpose and practice.

A dimensional structure of nurse-patient interactions from a caring perspective: refinement of the Caring Nurse-Patient Interaction Scale (CNPI-Short Scale)

AIM

This paper reports the development of a short version of the Caring Nurse-Patient Interaction Scale.

BACKGROUND

Since the 1980s several instruments have been developed to assess external aspects of caring. They involve using an inductive process of knowledge development to investigate the underlying structure of caring, and few reflect an explicit underlying caring theory. We developed the Caring Nurse-Patient Interactions Scale (CNPI-Long Scale) based on both inductive and deductive processes to assess attitudes and behaviours associated with Watson's 10 carative factors. Two issues led us to abridge our original 70-item scale into a more concise Short Scale (CNPI-Short Scale). First, many of our subscales were moderately to highly correlated, which is an empirical reflection of the theoretical non-independence of the carative factors. Secondly, a 70-item questionnaire was difficult to be deal with in the clinical research setting with severely ill patients because of its length.

METHOD

Items selected were determined by factor analysis, with specific theoretical and empirical requirements. Data were collected in September 2003 from 377 nursing students beginning their first, second or third year of a nursing programme.

RESULTS

The Short Scale comprises 23 items, reflecting four caring domains: Humanistic Care (four items), Relational Care (seven), Clinical Care (nine) and Comforting Care (three). All items are related to their theoretical domain alone (i.e. factor loading >or=0.40). Alpha coefficients for the four domains were adequate (0.63-0.74, 0.90-0.92, 0.80-0.94 and 0.61-0.76 respectively).

CONCLUSIONS

The CNPI-Short Scale, has potential for use in clinical research settings, particularly when questionnaire length is an issue. It is a useful tool for research aimed at demonstrating that caring is indeed fundamental to nursing.

An exploration of the caring attributes and perceptions of work place change among gerontological nursing staff in England, Scotland and China (Hong Kong)

This study investigates caring attributes and perceptions of work place change among qualified and unqualified nursing staff working with older people in three countries. A Modified Caring Attributes Questionnaire and Perception of Workplace Change Schedule were administered to 737 staff. Caring attributes scores were highest for nurses working in long stay settings, and lowest in nurses aged 25-29 years. Nurses in Hong Kong appear better educated than UK counterparts. Staff development seemed more common in long stay settings. Results suggest workplace changes limiting care quality were more pronounced in Scotland. Reported job satisfaction and moral were lowest in the UK group.

A profile of the caring attributes of Hong Kong and Thailand psychiatric nurses

Despite the unique cultural characteristics of psychiatric nurses in Hong Kong and Thailand little has been written about them or their caring practices. This study set out to examine the caring practices and demographic features of nurses working in these two countries where the development of the nursing education system has distinct similarities, yet where culture, career paths and qualifications differ. The Caring Attributes Questionnaire (CAQ), previously used in general nursing samples, was modified and validated for the study and administered to 275 and 227 psychiatric nurses in Hong Kong and Thailand, respectively. The results showed that more of the Hong Kong nurses were educated at the degree level and they tended to be younger, while both had around the same number of years of experience. The CAQ scores increase significantly with position, age and years of experience in the Hong Kong sample yet not for qualifications, while there were no significant differences detected in the Thai sample. The Thai sample had significantly lower CAQ scores and the results suggest that neither education nor experience modify these qualities of a psychiatric nurse, and it may be that nurses are still learning "on the job" rather than in the school. These findings are discussed in the light of findings from other international studies and recommendations for future studies are made.

An archaeology of caring knowledge

BACKGROUND

There have been repeated attempts, especially during the last 20 years, to say precisely what caring in nursing is. Authors who undertake this task usually begin with the observation that the concept of caring is complex and elusive, and suggest that their contribution will help to clarify this most confused of notions. However, they are always followed by other authors, who do exactly the same thing. We seem to be no closer, now, to a clarification of caring than we have ever been.

AIM

The paper offers a diagnosis of this situation, and explains why the project of retrieving caring from its elusiveness is an impossible one. I will suggest that this has nothing to do with the concept of caring, as such. Rather, the impossibility of the task follows from what these authors take to be knowledge of caring.

METHOD

I present an analysis of some presuppositions about what knowledge is. These presuppositions pervade the literature on caring, and can be summarized as follows: knowledge of caring is an aggregate of things said about it, derived from a potentially endless series of associations, grouped into attributes on the basis of resemblances, and conceived as a holistic description of the phenomenon. Further, I suggest that this analysis is akin to the one which Foucault offers of sixteenth century knowledge.

CONCLUSIONS

The analysis suggests that this way of knowing is approximately 350 years out of date, and explains why the task of arriving at knowledge (in this sense) is impossible. Moreover, Foucault's claim that sixteenth century knowledge is "plethoric yet absolutely poverty-stricken" applies, with equal force, to nursing's knowledge of caring.