Differences and similarities in the perception of caring between Spanish and UK nurses

Nurses' job stress and its impact on quality of life and caring behaviors: a cross-sectional study

BACKGROUND

Nursing is considered a hard job and their work stresses can have negative effects on health and quality of life. The aim of this study was to investigate the correlation between job stress with quality of life and care behaviors in nurses.

METHODS

This cross-sectional survey design study was performed with the participation of 115 nurses working in two hospitals. The nurses were selected via the availability sampling method and data were collected by demographic characteristics, nurses 'job stress, quality of life (SF12), and Caring Dimension Inventory questionnaires.

RESULTS

The mean (SD) total scores of job stress, quality of life and caring behavior were 2.77 (0.54), 56.64 (18.05) and 38.23 (9.39), respectively. There was a statistically significant and negative relationship between total job stress scores with quality of life (r = -0.44, P < 0.001, Medium effect) and caring behaviors (r=-0.26, P < 0.001, Small effect). Univariate linear regression showed that job stress alone could predict 27.9% of the changes in the total quality of life score (β =-0.534, SE = 0.051, R^2adj = 0.279, P < 0.001) and 4.9% of the changes in the total score of caring behaviors (β =-0.098, SE = 0.037, R^2adj = 0.049 P < 0.001).

CONCLUSIONS

Job stress has a negative effect on the quality of life related to nurses' health. It can also overshadow the performance of care and reduce such behaviors in nurses, which may be one of the factors affecting the outcome of patients.

Nurses Who Are More Willing to Participate in the Fight against COVID-19: Evidence from China

When facing an infectious disease disaster, nurses’ willingness to work is critical. Nurses’ lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate in the fight against COVID-19 in China and to identify factors associated therewith. This cross-sectional study examines nurses working in 11 Chinese cities including Macau, Hong Kong, Shenzhen, Dongguan, Huizhou, Guangzhou, Zhaoqing, Foshan, Jiangmen, Zhongshan, and Zhuhai. Questionnaires were collected from 19 May to 7 August 2020. A total of 8065 questionnaires were received, of which 8030 valid questionnaires were included for analysis. A total of 53.4% of participants reported that they had signed up to support the COVID-19 pandemic response. Multivariate logistic regression analysis revealed that being single (OR = 0.72, 95% CI: 0.60–0.87), having no children (OR = 0.81, 95% CI: 0.68–0.97), possessing higher professional qualifications (OR = 1.25, 95% CI: 1.14–1.37), having a more prestigious professional title (OR = 1.68, 95%CI: 1.50–1.90), being an administrative supervisor (OR = 0.53, 95% CI: 0.45–0.63), having a higher caring dimensions inventory score (OR = 1.01, 95% CI: 1.01–1.01), working in a hospital (OR = 0.53, 95% CI: 0.39–0.72), and receiving employer-provided care training (OR = 0.77, 95% CI: 0.68–0.87) were predictive of nurses’ willingness to participate in the fight against COVID-19. We suggest that unmarried nurses should be given priority when recruiting to fight an epidemic and, for married nurses with children who are recruited to fight an epidemic, supporting measures should be provided for childcare. We suggest strengthening workplace training of caring for nurses in order to better retain and recruit qualified support for an epidemic outbreak of infectious diseases.

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.

Nursing emigration in the United Kingdom: A qualitative exploration of the Spanish nursing community

AIM

To understand and describe the experiences and perceptions of migrant Spanish nurses working in the UK.

DESIGN

Online survey with open-ended questions.

METHODS

A total of 371 participants were recruited from online groups related to Spanish nurses working in the UK.

RESULTS

Four themes emerged from their content analysis: "Motivations for emigration: running away from job insecurity and unemployment," "Professional recognition," "Seeking better life stability" and "Future neediness: between a rock and a hard place." In these results, professional recognition was highlighted as a reason to stay in the host country, although the uncertainty represented by Brexit is reversing the migration trend that began years ago. Policymakers should be aware of these experiences to promote strategies and programmes, which encourage inclusion in the host country and will help these nurses in their transition process.

Nurses' perceptions of caring activities in nursing

Aim

This study aimed to determine nurses' perceptions of caring activities in nursing.

Design

A descriptive study design.

Methods

A Turkish translation of the 25-item version of the Caring Dimensions Inventory was completed by 260 nurses working in one university hospital. Data were analysed using Mokken scaling.

Results

Technical aspects of nursing were highly endorsed items such as "observing the effects of a medication on a patient, measuring vital signs, being technically competent with a clinical procedure, consulting with the doctor" except for the item "providing privacy for a patient" which is a psychosocial item. The range of items included in the Mokken scale with "providing privacy for a patient" (mean = 4.31) as the most endorsed, and "exploring the patient's lifestyle" (mean = 2.60) being the least endorsed item. Listening to patients and involving them in their care are not considered as caring.

Mapping nursing practices in rehabilitation units in Spain and the United Kingdom: A multiple case study

Because of the crisis in the health sector with few employment opportunities, many Spanish nurses are looking for professional development abroad. No studies have mapped nursing practices across Europe. The aim of this research was to provide a comprehensive approach to understand nursing practices and features of the context in Spain and the United Kingdom within the rehabilitation unit and to discuss those practices from a patient safety point of view. Multiple case study design with thematic analysis was applied in this study. The methods for data collection were in-depth interviews, nonparticipant observations, and document analysis. Results were classified into six categories: resources, techniques and nursing procedures, patients' personal care, health education, documentation task, and attitudes and communication skills. This study concludes that differences exist between nursing practices despite both countries having similar nursing competences. In addition, the UK unit has a positive safety culture, recognizes that mistakes happen, and applies more barriers to avoid them. The study provides valuable information to help the decision-making process for Spanish nurses considering working in the UK.

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.

Perception of caring among nursing students: Results from a cross-sectional survey

BACKGROUND

Nursing is an art and science based on knowledge of professional caring. As such, the examination of how students perceive care may improve the way this concept is taught and learnt in nursing.

OBJECTIVES

To examine and describe the perception of caring among Spanish nursing students.

DESIGN

A cross-sectional design.

METHODS

From an initial population of 500 students, 321 volunteers participated in this study by completing the Caring Dimensions Inventory (CDI-25) during April 2014. Parametric tests were used to perform descriptive analyses of the dimensions of caring and the predominant factor; additionally, inferential (bivariate) analyses were performed of the dimensions of caring and of the predominant factor according to each of the independent variables. A logistic multinomial regression of the predominant psychosocial factor was calculated using the professional-technical factor as a reference, with adjustments for each of the covariates.

RESULTS

The two dimensions most identified by students in relation to caring were: Providing privacy for a patient (D23) and Listening to a patient (D13) whereas the least identified were: Putting the needs of a patient before your own (D19) and Sharing your personal problems with a patient (D16). Overall, students identified caring mostly with the Psychosocial Factor (F1) (psychosocial aspects of care). Students in their first year identified caring more with the professional-technical factor, whereas those in their third and fourth year did so with the psychosocial factor.

CONCLUSIONS

The perception of caring among nursing students is a dynamic phenomenon that is modified throughout the nurse education process. The academic year, previous work experience in healthcare and the type of access to the university influence students' perceptions of caring.

Perceptions of Caring Between Slovene and Russian Members of Nursing Teams

PURPOSE

To measure the perceptions of caring between Slovene and Russian members of nursing teams and compare the results with earlier findings in other European Union countries.

METHOD

A cross-sectional study that included nurses and nursing assistants in Slovenia ( n = 294) and Russia ( n = 531). Data were collected using the 25-item Caring Dimensions Inventory.

RESULTS

The most endorsed item for Slovene and Russian members of nursing teams was an item related to medication administration. All items that were endorsed by Russian participants were also endorsed by Slovenian participants; however, they ascribed a different level of importance to individual aspects of caring.

DISCUSSION

Compared with other European Union countries, such as the United Kingdom and Spain, Slovenian and Russian members of nursing teams endorsed more technical aspects of nursing duties as caring, suggesting cultural differences and previous influences of the biomedical model on nursing education and practice.

Understanding the Essence of Caring from the Lived Experiences of Filipino Informatics Nurses

Caring is considered a unique concept in nursing because it subsumes all intrinsic attributes of nursing as a human helping discipline. Scholars have argued that caring is usually seen as an encounter between nurses and patients, but how about nurses with minimal or absent nurse-patient encounters, like informatics nurses? In this study, we explored the meaning of the phenomenon of caring to present lived experiences of caring, namely caring as actions of coming in between; caring as expressed within embodied relations; and caring and the path traversed by informatics nurses. The informatics nurse-cyborg-patient triad speaks of Filipino informatics nurses’ insightful understanding of the phenomenon of caring.

Representations of health, illness and care by Eastern European, South American and Italian nurses: A qualitative study

This qualitative study analyses the social representations of health, illness and care, considering the similarities and differences between 30 nurses from different regions. We conducted three intra-ethnic focus groups and two inter-ethnic focus groups. This study shows similarities between the nurses' representations. All participants believed that the psychological sphere affects individual's health, that disease is an imbalance between physical and psychological factors and that interpersonal aspects are essential for care. Differences emerged regarding many facets. Eastern European nurses placed more importance on psychological aspects, South American nurses emphasised interpersonal relationships and Italian nurses focused their attention on economic aspects and their impact on health, illness and care.

International rescue? The dynamics and policy implications of the international recruitmen of nurses to the UK

This paper focuses on one global aspect of the current health sector workforce policy agenda - the international recruitment and migration of health workers. It does so primarily by using a case study of the recruitment of nurses to the UK, as a means of exploring the policy challenges and associated research questions. The paper highlights the limitations in comparing national data on the nursing workforce, illustrating the extent to which currently collated national data can present a misleading picture of staff:population ratios in different countries. It then reports on the significant growth in the numbers of nurses entering the UK from other countries, using registration data. In 2001/02, more than 16 000 nurses entered the UK nursing register from non-UK sources. In this year, for the first time, the number exceeded the number of home-trained nurses. An analysis of postcode data highlights that these non-UK nurses have a younger age profile than home-based registered nurses and are more likely to report a postcode in London and south-east England. The paper also examines the push and pull factors that contribute to the international mobility of health workers. The paper concludes by examining the policy implications of this growing reliance on international recruitment, including the effect of the ethical guidelines on international recruitment introduced by the Department of Health in England.

Cultural Perceptions of Finnish Nursing Students Regarding People and Nurses of the United States: A Pilot Study

This pilot study measures cultural awareness through perceptions of 139 Finnish nursing students regarding American people and nurses. Inquiry was guided by cultural dimensions depicted in Leininger’s Sunrise Model. Statements of highest agreement were that: U.S. citizens frequently initiate lawsuits, have strong national identity, eagerly try new technological equipment, U.S. nurses have less authority than physicians, the U.S. shares technological advances with Third World countries. Statements of lowest agreement were that health care is available to all U.S. citizens, U.S. people live healthy lifestyles, U.S. nurses have knowledge of other cultures and knowledge of international health care issues, and U.S. citizens are law abiding. Almost half of the responses indicated neither agree nor disagree, with means between 2.7 and 3.3. Responses of Finnish students indicated stereotypical views of U.S. citizens and nurses.

Registered nurses' descriptions of caring: a phenomenographic interview study

BACKGROUND

Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring.

METHODS

A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth's description of phenomenography.

RESULTS

The analysis mirrored four qualitatively different ways of understanding caring from the nurses' perspective: caring as person-centredness, caring as safeguarding the patient's best interests, caring as nursing interventions and caring as contextually intertwined.

CONCLUSION

The most comprehensive feature of the nurses' collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.

Perceptions of patients and nurses towards nurse caring behaviors in coronary care units in Jordan

AIMS AND OBJECTIVES

To (1) identify the perceptions of Jordanian patients who suffer from coronary artery diseases towards nurse caring behaviours in critical care units; (2) identify the perceptions of Jordanian nurses who work in critical care units towards nurse caring behaviours; and (3) compare the perceptions of both patients and nurses towards nurse caring behaviours in critical care units.

BACKGROUND

Caring is an important concept in nursing, when nursing behaviours were perceived by patients as caring behaviours, and thus, their satisfaction with the quality of care can be improved. Therefore, it is important for nurses to be knowledgeable about the caring behaviours as perceived by patients who complained from coronary artery diseases themselves.

DESIGN

A descriptive comparative design was used.

METHODS

A convenience sample of 150 patients who complained from coronary artery diseases and 60 critical care unit nurses completed the demographic form and the Caring Behavior Assessment scale.

RESULTS

Patients in critical care units perceived physical and technical behaviours as most important caring behaviours, whereas nurses in critical care units perceived teaching behaviours as most important caring behaviours.

CONCLUSION

There were significant differences between patient participants' and nurse participants' perceptions towards four subscales of Caring Behavior Assessment scale that should be considered when caring for patients with coronary artery diseases.

RELEVANCE TO CLINICAL PRACTICE

Patients with coronary artery diseases need well-trained and clinically competent nurses to meet their needs. 'Spiritual needs' was an important nurse caring behaviour that should be emphasised in nursing practice.

Nursing students' perceptions of obesity and behaviour change: implications for undergraduate nurse education

BACKGROUND

Rates of obesity are rising and previous research suggests this is not effectively dealt with in healthcare settings. Nurses are increasingly involved in lifestyle management of patients, and understanding the barriers to discussing weight with patients is likely to increase successful weight management. Obesity management is a role that nursing students will need to be equipped with and more likely to be targeted for future training developments in tackling the increasing rates of obesity.

OBJECTIVES

To explore the perceptions of obesity, potential barriers to successful patient weight management and training needs of nursing students.

METHODS

Qualitative, semi-structured interviews were conducted with 20 nursing students. Audiotaped interviews were transcribed verbatim and analysed using an inductive thematic approach informed by principles of grounded theory.

RESULTS

Participants reported the challenge of managing obesity in healthcare practice, such as the impact of negative attitudes in healthcare practice on patient care. Although perceived as core to their training, nursing students lacked the confidence and techniques to discuss weight management with patients. Participants also perceived the nursing curriculum as lacking a focus on obesity, and reported a need for advanced communication skills training.

CONCLUSION

Although seen as important, nurses lack the skills to facilitate weight management, leading to nurses failing to broach the issue.

PRACTICE IMPLICATIONS

Nurse educators should consider the perceptions of current students when making curriculum developments in this area.

Mokken scaling of the Caring Dimensions Inventory (CDI-25)

AIMS AND OBJECTIVES

To validate a Turkish version of the Caring Dimensions Inventory in a group of Turkish nursing students.

BACKGROUND

There are no studies about how nurses or nursing students perceive caring in nursing in Turkey. There is also no valid and reliable instrument in Turkey for evaluating caring in nursing.

DESIGN

Descriptive study design.

METHODS

Using a convenience sample of nursing students (n = 266), standard forward-back translation techniques were used with the Caring Dimensions Inventory. An expert panel considered the translations and provided content validation. A final version of the Caring Dimensions Inventory was tested with 10 nursing students, and we found no difficulties with the items in the instrument. Mokken Scaling analysis of the Caring Dimensions Inventory was used.

RESULTS

A range of psychosocial and professional/technical items was included in the Mokken scale with 'Providing privacy for a patient' as the most endorsed (mean = 4.66) item and 'Being with a patient during a clinical procedure' being the least endorsed (mean = 3.87). There is a tendency for the most endorsed items to be psychosocial with the professional/technical items being less endorsed, with the exception of the least endorsed item 'Being with a patient during a clinical procedure' which is a psychosocial item.

CONCLUSION

The Turkish version of the Caring Dimensions Inventory is a reliable instrument for measuring nurses' perceptions about caring.

RELEVANCE TO CLINICAL PRACTICE

The results using the Caring Dimensions Inventory will help to identify how caring in nursing is perceived by nursing students in Turkey. Repeating this study in different groups such as working nurses will help to determine nurses who work in clinical settings perceive caring in nursing.

Representations of health and illness by Eastern European, South American and Italian care workers: a qualitative study

This qualitative research examined the representations of health and illness presented by 30 individuals who work as care workers, from three different locations: Eastern Europe, South America and Italy. We led three focus groups for people who came from the same geographical area (intra-ethnic) and two for those from 'mixed' areas (inter-ethnic). From our content analyses, certain similarities and differences between the conceptualizations of health and illness emerged: in the intra-ethnic focus groups, Eastern Europeans focused on 'inner strengths', South Americans on 'love' and Italians on 'personal autonomy'. These peculiar traits were levelled in the inter-ethnic focus groups.

Using the caring dimensions inventory as an indicator of person-centred nursing

AIMS

This paper reports findings from a large-scale quasi-experimental study that used a measure of caring as a means of evaluating person-centred nursing and aims to illustrate the synergy between the concepts of caring and person-centredness.

BACKGROUND

Evidence would suggest that effective person-centred nursing requires the formation of therapeutic relationships between professionals, patients and others significant to them in their lives and that these relationships are built on mutual trust, understanding and a sharing of collective knowledge. This correlates with the conceptualization of caring that is underpinned by humanistic nursing theories.

DESIGN

A pretest post-test design was used in this study to evaluate the effect of person-centred nursing on a range of outcomes, one of which was nurses' and patients' perception of caring.

METHODS

The Person-Centred Nursing Index was the main data collection tool. The Caring Dimension Inventory and Nursing Dimensions Inventory, were component parts of the Person-Centred Nursing Index and were used to measure nurses' and patients' perceptions of caring. The Person-Centred Nursing Index was administered at five points in time over a two-year intervention period.

RESULTS

Nurses had a clear idea of what constituted caring in nursing, identifying statements that were reflective of person-centredness, which was consistent over time. This was in contrast to patients, whose perceptions were more variable, highlighting incongruencies that have important implications for developing person-centred practice.

CONCLUSION

The findings confirm the Caring Dimension Inventory/Nursing Dimensions Inventory as an instrument that can be used as an indicator of person-centred practice. Furthermore, the findings highlight the potential of such instruments to generate data on aspects of nursing practice that are traditionally hard to measure.

RELEVANCE TO CLINICAL PRACTICE

The findings would suggest that nurses need to be aware of patients' perceptions of caring and use this to influence changes in practice, where the prime goal is to promote person-centredness.

The value of nursing: a literature review

This article is part of a wider study entitled Value of Nursing, and contains the literature search from electronic databases. Key words for the search included 'values of nursing', 'values in nursing', 'organisational values' and 'professional identity'. Thirty-two primary reports published in English between 2000 and 2006 were identified. The findings highlight the importance of understanding values and their relevance in nursing and how values are constructed. The value of nursing is seen to be influenced by cultural change, globalization, and advancement in technology and medicine. These factors are crucial in providing a more structured and measured view of what nursing is, which will result in greater job satisfaction among nurses, better nurse retention and enhanced patient care within a supportive and harmonious organization. The findings of this review have implications for policy makers in recruitment and retention in determining the global value of nursing.

Lamentation and loss: expressions of caring by contemporary surgical nurses

AIM

This paper is a report of a phenomenological study of caring from the perspective of nurses working on surgical wards.

BACKGROUND

While care and caring are complex foundational nursing concepts which have received considerable and ongoing attention from theorists, researchers and clinicians, there has been little research into caring on surgical units.

METHOD

A convenience sample of ten nurses working on surgical units in a public teaching hospital in Canada was interviewed using van Manen's phenomenological approach. Data were collected during 2001 using semi-structured interviews.

FINDINGS

The major theme of lamentation and loss was identified from the data. Participants revealed a dichotomous tension between what caring should be and what actually occurs. This tension was pervasive and generated lament - an expression of grief and mourning for the loss of caring. The essential structures supporting this theme included lack of time, lack of caring support, tasking, increased acuity, lack of continuity of care, emotional divestment and not caring for each other. Loss and sadness were articulated and participants lamented and grieved about the loss of care in contemporary practice.

CONCLUSION

The forces and influences described by participants undermined caring in the new practice milieu. If this is a glimpse of the future, then the values of the nursing profession may be under siege. Caring as the central core, the essence or unifying concept of nursing may be subject to marginalization in contemporary practice.

Differences in European critical care nursing practice: a pilot study

The purpose of this pilot study was to determine if there are differences in nursing practice between critical care units across Europe, if these practices are related to the perceived level of incorporation of evidence into nursing practice and/or to regional differences. Nurses attending the nursing session of the bi-annual conference of the European Society of Intensive Care Medicine were asked to fill out a two page questionnaire which addressed five areas of practice: physical care, pain management, monitoring, weaning and ethical issues. Some differences were found between regions although there were no differences in the perception of whether these protocols were evidence-based.