Nursing Students' Perceptions of Their Own Caring Behaviors: A Multicountry Study

The relationship between psychological capital and humanistic caring ability among mental health nurses in Saudi Arabia

BACKGROUND

The ability to provide humanistic care has a significant impact on the therapeutic relationships in psychiatric services, which in turn influences patients' outcomes.

AIM

To examine the relationship between psychological capital and humanistic care ability among mental health nurses in Saudi Arabia.

METHODS

A descriptive correlational research design was implemented in this study. A convenience sampling method was used to collect information from 500 mental health nurses from a governmental mental health facility. The data were collected using the psychological capital questionnaire and the caring ability inventory.

RESULTS

The results revealed high levels of psychological capital and humanistic care ability among mental health nurses. Psychological capital significantly predicted humanistic care ability ([Formula: see text] 0.630, F(1,498) = 851.16, p< 0.001). Also, there were significant relationships between sociodemographic variables and psychological capital (age, educational level, and professional title) and humanistic care ability (age and years of experience).

CONCLUSION

Psychological capital was found to be be positively associated with the humanistic care ability of mental health nurses. The findings of this study suggest that nursing managers should explore strategies from the viewpoint of positive psychology to enhance the psychological capacity of mental health nurses to provide humanistic care abilities, which can effectively improve nurses-patients' relationships and outcomes in clinical practice.

Job satisfaction and psychological factors influence the caring behavior in nurses in Sierra Leone: a cross-sectional study

Objective

Identifying the status of caring behavior and its influencing factors in nurses is crucial for improving the quality of care for patients. However, there is a lack of studies on this in Sierra Leone. This study explored the status of caring behavior and associated factors in nurses working in Sierra Leone.

Study design

A cross-sectional descriptive survey was conducted from October 3 to December 15, 2022, with clinical nurses recruited through convenience sampling.

Methods

The participants included 360 nurses from various nursing departments from 12 hospitals in Sierra Leone. Measurements included a general information questionnaire, the Caring Behavior Inventory, Connor-Davidson Resilience Scale, McCloskey/Mueller Satisfaction Scale and Zung's Self-Rating Anxiety Scale. Descriptive statistics, one-way analysis of variance and independent-sample t-tests, Pearson's correlation analyses, and multiple regression analyses were performed.

Results

Caring behavior score was 128.97 (SD 11.967); it significantly and positively correlated with job satisfaction and resilience and negatively correlated with anxiety. Linear regression analysis showed that resilience, job satisfaction, anxiety, daily working time, and position were the main predictors of caring behavior.

Conclusion

The level of caring behavior in nurses in Sierra Leone was moderate. Resilience and job satisfaction significantly and positively predicted nurses' caring behavior. Anxiety, daily working time, and position are important factors of caring behaviors.

Implications for practice

It is suggested to create a conducive working environment, reduce the excessive workload of nurses, enhance their positive psychological state, and their job satisfaction by providing recognition and rewards to improve the level of nurses' caring behavior.

Effectiveness of caring behaviours course on decision-making and caring behaviours in undergraduate nursing students: An experimental study

BACKGROUND

Although caring is a core principle of the nursing profession, students often lack the knowledge, comprehension and ability to integrate care into all aspects of nursing practice. Students may have few opportunities to practise caring behaviours on patients who create the impression of providing care and elicit a feeling of receiving care. Studies of strategies to enhance caring behaviours in nursing education are limited.

AIM

This experimental study aimed to examine the effect of nursing caring behaviours course based on interactive learning strategies on the caring behaviours and decision-making abilities of nursing students.

METHODS

A purposive sample of 50 undergraduate students was recruited from a faculty of nursing. Students in the intervention group (n = 24) received 2 h of training per week for 14 weeks in accordance with caring behaviours course based on interactive learning strategies including discussion, brainstorming, concept mapping, reflection and simulation training. Nursing students in the control group (n = 26) received training according to other elective courses in the curriculum. Data were measured at the baseline time point, 7th week and 14th week with the Caring Behaviours Inventory and Nursing Decision-Making Instrument. Chi-square test, Mann-Whitney U-test, Friedman test and mixed repeated measures ANOVA were used to assess the data.

RESULTS

No significant difference was determined in terms of baseline caring behaviours and decision-making scores between the intervention and control groups (p > 0.05). A significant difference in caring behaviours between the two groups and time effect was not found (p > 0.05). However, there was a significant interaction between time and groups (F = 3.484, p = 0.047). There was a significant increase in the decision-making in intervention groups over time (F = 9.372, p < 0.001) and interaction between time and groups (F = 4.160, p = 0.019).

CONCLUSIONS

A deliberate strategy to raise students' awareness of caring behaviours and incorporate interactive learning methods into education enhances both caring behaviours and clinical decision-making.

Implementation and effectiveness of a nurse navigation programme based on noddings' care theory in first-year undergraduate nursing students for professional identity and career planning: A quasi-experimental study

AIMS

Development and evaluation of the effectiveness of a Nurse Navigation programme based on Noddings' Care theory on two dependent variables which were professional identity and career planning among first-year undergraduate nursing students.

BACKGROUND

First-year undergraduate nursing students generally have a low sense of professional identity and career planning, resulting in a loss of nursing power after graduation. Implemention of a Nurse Navigation program based on Noddings' Care theory may be potentially useful in cultivating their professional identity and career planning.

DESIGN

A quasi-experimental study.

METHODS

A convenience sample of 122 first-year undergraduate nursing students from two medical universities was recruited between September 2021 and June 2022. Students in the experimental group (n = 63) participated in the Nurse Navigation programme based on Noddings' Care theory, which contained four core components, spreading over 50 lessons. Those in the control group (n = 59) underwent a traditional training programme with five components across 44 lessons. The two groups were compared in terms of their level of professional identity by Professional identity questionnaire for nurse students (PIQNS) and career planning by Career planning questionnaire (CPQ) after the training using the t-test.

RESULTS

The mean score of professional identity in the experimental group increased significantly from 51.02 ± 8.46 at baseline to 58.02 ± 8.81 after the intervention (p < 0.001), with a large effect size (Cohen's d=0.810). Also, this post-intervention score was statistically significantly higher than that (52.86 ± 9.27) in the control group (p = 0.002), with a medium effect size (Cohen's d=0.571). The mean score of career planning in the experimental group increased significantly from 81.76 ± 9.86 at baseline to 94.52 ± 10.81 after the intervention (p < 0.001), with a large effect size (Cohen's d = 1.233). Also, this post-intervention score was statistically significantly higher than that (88.25 ± 9.30) in the control group (p < 0.001), with a medium effect size (Cohen's d=0.623).

CONCLUSIONS

The Nurse Navigation programme based on Noddings' Care theory showed effectiveness in enhancing professional identity and career planning among first-year undergraduate nursing students in China. Further rigorous studies are needed to examine its effectiveness and long-term impacts on these students.

The mediating role of psychological capital on the relationship between authentic leadership and nurses' caring behavior: a cross-sectional study

BACKGROUND

Caring behavior among nurses would have an impact on patient outcomes. External organizational job resources and personal internal psychological resources are correlated to nurses' caring behavior. Authentic leadership and psychological capital were shown to be correlated with nurses' caring behavior in previous studies. However, the relationships among the three are nevertheless unclear. This study aimed to examine if psychological capital could act as a mediator between nursing managers' authentic leadership and nurses' caring behavior.

METHODS

In December 2021, a total of 3,662 nurses were recruited from 37 hospitals in Anhui Province, China. They filled out online surveys, including general demographic information, the Authentic Leadership Questionnaire, the Psychological Capital Questionnaire, and the Caring Behavior Inventory. Structural Equation Modeling and the bootstrapping procedure were used to examine the mediating role of psychological capital.

RESULTS

The scores of authentic leadership, psychological capital, and caring behavior of 3,495 nurses were 52.04 ± 13.24, 96.89 ± 17.78, and 104.28 ± 17.01, respectively. Psychological capital significantly mediated the relationship between authentic leadership and nurses' caring behavior (β = 0.378, p < 0.001, 95% confidence interval: 0.350 ~ 0.402), which made up 78.75% of the total impact (0.480).

CONCLUSION

The findings of this study suggested that nursing managers should develop an authentic leadership style, which can effectively improve nurses' caring behaviors toward patients in clinical practice. Meanwhile, nursing leaders should strengthen nurses' psychological evaluation and training, and promote nurses' caring behavior in clinical settings.

Inclination of Nursing Students Towards Ethical Values and The Effects of Ethical Values on Their Care Behaviours

A descriptive, cross-sectional study aimed to determine the inclination of nursing students towards ethical values and the effects of these values on care behaviours. The data for this study were collected from 466 students studying from May 13-24, 2019. The data were collected using a questionnaire on the sociodemographic characteristics of the students, Inclination to Ethical Values Scale (IEVS), and Caring Behaviors Inventory-24 (CBI-24). In this study, 43.1 per cent of them belonged to families who had a protective attitude. The total mean (SD) IEVS and CBI-24 scores were 63.99 (12.68) and 117.19 (17.95), respectively. The mean item score was 4.88 (0.74). A moderate positive correlation was observed between the inclination of the students towards ethical values and their care behaviours. The general family structure of the nursing students and their participation in an ethics class affected the inclination of the nursing students to ethical values and their care behaviours. This study showed that the ethical values of the students positively affected their care behaviours.

Online education and improvement of caring behaviors of nurses in pediatric wards: a quasi-experimental study

BACKGROUND

Nurses working in pediatric wards should communicate with children well and have appropriate caring behaviors according to the age of their patients, so distance education is very suitable for them due to its availability. This study aimed to determine the effect of online education on the principles of pediatric nursing care on the caring behaviors of nurses working in pediatric wards.

METHODS

This interventional (quasi-experimental) study used a simple random method to select 70 nurses working in pediatric wards and pediatric intensive care units in Kerman. The nurses in the intervention group received online training in the sky room three days a week, while nurses in the control group received routine pediatric care. The study instruments were the demographic information questionnaire and the Caring behaviors Questionnaire, which were completed by two groups before and one month after the intervention. Data were analyzed with SPSS 25. The significance level was set at P < 0.05.

RESULTS

The independent samples t-test indicated no significant differences in the mean scores of care behaviors between the intervention (256.61 ± 5.16) and control groups (257.52 ± 3.99) before the intervention (P = 0.23) but indicated a significant difference in the mean scores of caring behaviors between the intervention (275.69 ± 6.52) and control groups (254.21 ± 3.15) after the intervention. Therefore, online education increased the score of caring behaviors in the intervention group.

CONCLUSION

Distance education had an impact on the caring behaviors of nurses in pediatric wards and we recommend the use of e-learning to improve the caring behaviors and the quality of care of nurses.

The mediating effect of critical thinking between interest in learning and caring among nursing students: a cross-sectional study

BACKGROUND

Previous studies have explored the influence of interest in learning on caring and critical thinking, as well as the relationship between caring and critical thinking. However, the mediating effect of critical thinking in interest learning and caring among nursing students has not been clarified.

METHODS

Nursing students who enrolled for the 2021/2022 academic year in diploma, undergraduate, or graduate programs in five provinces of China (Guangdong, Sichuan, Jiangsu, Hunan and Macao). An online survey with a convenience sampling method was employed to collect data. The questionnaires were administered to 692 participants between January 20 and 26, 2022. Amos 26.0 was employed to establish the structural equation modelling and analyze the mediating effect of critical thinking on interest in learning and caring.

RESULTS

The first regression equation showed that interest in learning significantly influenced caring (β = 0.339, p <  0.001). The third regression equation showed that critical thinking significantly influenced caring (β = 0.494, p <  0.001). The effect of interest in learning on caring was less in the third equation than in the first equation (β = 0.154 vs β = 0.339), which indicates partial mediation. Furthermore, interest in learning had an indirect positive effect (β = 0.186, p <  0.001) on caring mediated by critical thinking, with 95% confidence interval of 0.142 to 0.233.

CONCLUSIONS

Critical thinking was a significant mediator of the relationship between interest in learning and caring. It is suggested that nursing colleges and instructors should take into account students' interest in learning and critical thinking as potential intervention elements to enhance caring.

Level and predictors of caring behaviours of critical care nurses

BACKGROUND

Advanced technologies in intensive care units, including artificial intelligence and digitization, has implications for psycho-emotional aspects of caring in terms of communication, involvement, and holistic provision in a safe, effective, and efficient manner. Critical care nurses must maintain a balance between their technological and humanistic caring behaviours during the provision of individualized holistic patient care. Therefore, this study was conducted to examine level and predictors of caring behaviours among critical care nurses in two Arab countries.

METHODS

A cross-sectional design was used to achieve the objective of this study, whereby a quantitative online questionnaire survey was administered to 210 adult intensive care unit nurses at two government hospitals in Sharjah (United Arab Emirates), and two university hospitals in Amman (Jordan). Based on G* Power analysis, 200 participants were adequate to run the analysis.

RESULTS

On average, 49% of the whole sample had 'good' caring behaviours. Among nurses who were working in Emirati intensive care units, 48.5% had good caring behaviours, compared to 47.4% of Jordanian intensive care unit nurses. Additionally, the results showed that predictors of caring behaviours among nurses include female gender, holding a master's degree, interest in nursing profession, and a 1:1 nurse-to-patient ratio.

CONCLUSIONS

About half of the ICU nurses in this study had low levels of caring behaviours. The present study highlights the requirement for integrating the concept of holistic and patient-centred care as the essence of the nursing profession in nursing curricula to improve the level of care provided by all nurses working in intensive care units. Continuing education programs and specific interventional programs should be directed toward predictors of caring behaviours among each specific group of nurses. Future research is needed using qualitative methods to understand what the perception of intensive care unit nurses is about caring.

Caring behaviours demonstrated to nursing students in the interpersonal relation with the faculty: A cross sectional study

BACKGROUND

Nursing students need to experience caring in their educational environment in order to learn how to care for the patients.

OBJECTIVE

The present study describes the caring model demonstrated by the faculty to the nursing students through their behaviours, from the perspective of both students and faculty members.

DESIGN

A cross-sectional, descriptive, observational study was conducted.

PARTICIPANTS

The sample included 286 students and faculty members.

METHODS

The Nursing Students' Perceptions of Instructor Caring assessing tool was used to gather the data.

RESULTS

After analysing 676 questionnaires, it was revealed a moderately high level of caring perceived by the students. The most appreciated dimension was control versus flexibility, reporting a mean value of 82.29 and a confidence interval from 81.14 to 83.44, and the least valued was appreciation of life's meanings, reporting a mean value of 63.90 and a confidence interval from 62.20 to 65.60. The students' perception of the care demonstrated by the faculty was significantly lower than the care that the latter believed to transmit in all dimensions (p < 0.001).

CONCLUSIONS

The caring perceived by the student was expressed through behaviours that inspired confidence in them, promoted a climate of learning and support, helped them to recognise the meaning of life, showed them flexibility and fostered their professional autonomy. The findings of this study can help to improve nursing education by providing a view of the interpersonal relations that the students established during their training with the faculty.

The meaning of reflection for understanding caring and becoming a caring nurse

BACKGROUND

Reflection is essential for students to learn and understand caring, their formation as human and caring beings, and their ability to meet patients in a caring way. Consequently, to facilitate nurse students' development into professionals, learning support is needed where the focus is on understanding caring and becoming caring nurses.

AIM AND RESEARCH QUESTIONS

The exploratory study aim is to gain knowledge of the meaning of reflection in first-term nursing education, and how reflection grounded in caring theory can deepen the students' understanding of caring and their professional formation of becoming a caring nurse.

METHOD

Data consisted of individual written reflections and were collected from 64 nursing students from Norway, who had completed their instruction in caring theories and participated in four reflection groups where they reflected on caring and becoming a caring nurse. A thematic analysis was used.

FINDINGS

The results are based on the three main themes, Reflection provides an understanding of caring by developing a language for caring; Reflection provides an understanding of seeing the person behind the illness; and Reflection contributes to increased self-understanding and awareness of oneself as a caring nurse.

CONCLUSIONS

Instruction in caring theories and participation in reflection groups, with reflection grounded in caring theory, has a key function in facilitating students' development of a language for caring in nursing and appropriation of caring theory. The appropriation of caring theory provides a foundation for the nurse students to see themselves within a broader perspective and is important for mutual support in the professional formation of becoming a caring nurse. The expected outcome of such integration is a nursing curriculum that progressively supports the development of nursing students professionally and personally in the formation of becoming a caring nurses.

Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach

Background

Nursing workload and its effects on the quality of nursing care is a major concern for nurse managers. Factors which mediate the relationship between workload and the quality of nursing care have not been extensively studied. This study aimed to investigate the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and quality of nursing care.

Methods

In this cross-sectional study, 311 nurses from four different hospitals in center of Iran were selected by convenience sampling method. Six self-reported questionnaires were completed by the nurses. The data were analyzed by SPSS version 16. Structural equation modeling was used to determine the relationships between the components using Stata 14 software.

Results

Except direct and mutual relationship between workload and quality of nursing care (P ≥ 0.05), the relationship between other variables was statistically significant (P < 0.05). The hypothesized model fitted the empirical data and confirmed the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion in the relationship between workload and the quality of nursing care (TLI, CFI > 0.9 and RMSEA < 0.08 and χ²/df < 3).

Conclusion

Workload affects the quality of the provided nursing care by affecting implicit rationing of nursing care, job satisfaction and emotional exhaustion. Nurse managers need to acknowledge the importance of quality of nursing care and its related factors. Regular supervision of these factors and provision of best related strategies, will ultimately lead to improve the quality of nursing care.

Determining the relationship between spirituality and perceptions of care in nursing students: A cross-sectional study

BACKGROUND

Caring is a core value in nursing education and many of its features can be measured as specific behaviors. It is not clear how nurses' spirituality affects their caring behavior.

PURPOSE

The aim of this study was to investigate the relationship between spirituality and spiritual care and nursing students' perceptions of care.

DESIGN AND METHODS

This was a descriptive cross-sectional study. The study sample consisted of 467 students in the nursing department of a university in Northeastern Anatolia. Data were collected using a descriptive information form, the Care Assessment Report Evaluation Q-sort (CARE-Q), and the Spirituality and Spiritual Care Rating Scale (SSCRS). Data were analyzed using frequency, percentage, mean, t-test, analysis of variance, and Kruskal-Wallis H, Mann-Whitney U, correlation, and regression tests.

RESULTS

The mean age of the participants was 21.14 ± 1.97 years, 55.0% were women, and 63.0% said that nursing was their preferred profession. Most of the students rated their knowledge of spirituality and spiritual care as adequate (17.6%) or partially adequate (48.0%). CARE-Q and SSCRS scores were significantly higher among female students who chose a career in nursing to help people, want to obtain their master's degree, and agreed that providing care is nurses' primary duty (p < 0.05). There was a weak positive correlation between CARE-Q and SSCRS scores (p < 0.001; r = 0.369).

CONCLUSION

There was a significant relationship between CARE-Q and SSCRS scores (p < 0.05).

PRACTICE IMPLICATIONS

To promote holistic care, nursing students should be provided training on spirituality and spiritual care, with emphasis on the role of nurses in care.

Perception of nursing students from the Middle East about caring: A descriptive, comparative, cross-sectional study

AIM

To investigate the perception of undergraduate nursing students in different countries in the Middle East about caring.

DESIGN

A cross-sectional, descriptive, comparative design.

METHODS

A total of 1,582 nursing students from six different countries in the Middle East completed the Caring Dimensions Inventory.

RESULTS

The total mean score of caring was 138.8 (± 15.8), indicating a high level of caring. The highest mean score was for nursing students from Egypt (M = 145.37 ± 15.97), whereas the lowest was for nursing students from Palestine (M = 135.36 ± 13.48). The caring perception was more significant for female students than male students, and no significant correlation was found between students' ages and caring scores.

CONCLUSIONS

The high level of caring among nursing students reflects the involvement of caring behaviour in the nursing curricula, which motivates nursing schools to continue stressing the importance of caring and to enhance this behaviour among their graduates.

PATIENT OR PUBLIC CONTRIBUTION

Improving the students' caring competencies as recommended by the study will influence the caregiving quality in the future that will be reflected in nurse-patient caring relationships and raise the patients' and public satisfaction with nursing care.

Caring Ability and Professional Values of Polish Nursing Students-A Cross-Sectional Study

Caring ability and professional values developed and shaped during nursing university studies are often recognised as fundamental components of education and professional nursing attitudes. The aim of this study was to analyse the relationship between caring ability and professional values among nursing students and their correlation with selected sociodemographic variables. A cross-sectional study was conducted among a convenience sample of 379 nursing students. During the research, the Polish versions of the Caring Ability Inventory and the Professional Values Scale were used. The overall result in the Professional Values Scale was 108.78 (SD = 16.17)-which is considered average, and in the Caring Ability Inventory 189.55 (SD = 18.77)-which is considered low. Age correlated negatively with the professional values of students in total and in the subscale "care"; in contrast, "gender", "place of residence" and "financial situation" did not show any correlation with the level of students' professional values and caring ability. The professional values and caring abilities of nursing students depended on the year and mode of study and the type of university. The results of the study revealed that the caring ability and professional values of nursing students undergo changes during their education.

The relationship between nursing students' professional attitudes and caring behaviors: A cross-sectional study

PURPOSE

This study aimed to determine the relationship between nursing students' professional attitudes and caring behaviors.

DESIGN AND METHODS

The research is a cross-sectional, descriptive, and correlational study. The study was conducted with 202 nursing students. The participation rate was 95%.

FINDINGS

The total Instrument of Professional Attitude for Student Nurses mean score was 106.708 ± 20.24 and the Caring Behaviors Inventory-24 mean score of the nursing students was 5.23 ± 0.88. A positive weak correlation was found between total Instrument of Professional Attitude for Student Nurses scores and sub-dimension scores, and Caring Behaviors Inventory-24 total scores of nursing students (p < .05).

PRACTICE IMPLICATIONS

The present study has demonstrated that the professional attitudes of students positively affect caring behaviors.

Caring ability of nursing students pre- and post-internship: a longitudinal study

Background

Nursing students’ internship experiences may significantly impact their caring ability. However, there is a lack of comprehensive evaluation of undergraduate nursing students' caring ability pre-and post-internship in China. This study aimed to explore the differences in the caring ability of undergraduate nursing students before and after internship.

Methods

The sample comprised 305 undergraduate nursing students who had undergone internships during 2018–2020 in three hospitals in Changsha, China. Caring Ability Inventory was used to measure and compare nursing students' caring ability before and after internship. Descriptive statistics and paired t-test were employed to analyze data in SPSS software (version 22.0).

Results

A total of 300 students completed the survey (response rate = 98.37%). The overall score of caring ability and scores of cognitive and patience dimensions were higher after internship than before internship (P < 0.05). There was no significant improvement in the courage dimension (P > 0.05).

Conclusions

Caring ability of undergraduate nursing students in China was at a low level, their overall caring ability significantly improved after the internship, indicating a positive relationship between internship and caring ability. Nursing educators and clinical nurses should emphasize the importance of caring ability development in internship planning and encourage nursing students to engage more with patients.

Supplementary information

The online version contains supplementary material available at 10.1186/s12912-022-00921-2.

Aesthetic expression of caring in nursing among Japanese undergraduate nursing students

BACKGROUND

Caring is the heart of nursing. However, not many understand the significance of caring in nursing from the perspectives of undergraduate nursing students, especially in Japan.

AIM

To describe caring in nursing among Japanese nursing students as learned and communicated through their aesthetic expressions.

METHODS

The study employed hermeneutic phenomenology. Sixty-one Japanese nursing students in their second year of baccalaureate degree studies participated. Constituting the data were art-based graphic expressions, such as drawings and written reflections on the drawings, as a response to the question of how the participants describe their meanings of caring in nursing. The thematic analysis method was used to analyze and interpret the data. The trustworthiness of the research was established following Lincoln and Guba's criteria.

FINDINGS

Seven thematic categories were identified. These categories include (1) Engaging with others; (2) Knowing each other; (3) Being with other persons; (4) Nurturing intimate personal growth; (5) Supporting wholeness of persons; (6) Vacillating rhythm; and (7) Intensifying competency.

CONCLUSION

This study described the understanding of caring in nursing among undergraduate Japanese nursing students during their second year of study. The caring in nursing focused on reciprocal relationships, whole-person relating, and practice competency. Findings suggested that nurse educators should develop teaching-learning strategies for nursing students to continuously grow as caring persons.

Self-compassion influences the caring behaviour and compassion competence among saudi nursing students: A multi-university study

AIM

This research investigated the perceptions of Saudi nursing students regarding self-compassion and examined its influence on their caring behaviour and compassion competence.

DESIGN

This is a quantitative and cross-sectional study.

METHODS

This multiuniversity study surveyed a convenience sample of 961 nursing using the Self-compassion Scale, Compassion Competence Scale and Caring Behavior Inventory-16 version. Standard multiple analysis was performed separately for caring behaviour and compassion competence as dependent variables. For both models, the self-compassion dimensions and the demographic variables were considered predictor variables.

RESULTS

The students reported their self-compassion moderately, with mindfulness receiving the highest mean and self-judgment receiving the lowest mean. Significant differences were observed on self-compassion of students between universities. Caring behaviour and compassion competence were also rated moderately by the students. "Self-kindness" and "common humanity" were identified as significant predictors of caring behaviour, whereas "self-kindness," "self-judgment," "common humanity" and "mindfulness" were significant predictors of compassion competence.

Caring in process: A 3-year qualitative longitudinal study of nursing students

AIM

This paper aims to describe caring perceptions and behaviors among student nurses in Italy as they progress through their nursing education.

BACKGROUND

As nursing students are potential nurses of the future, there is an expectation that in addition to appropriate academic qualifications, they will develop appropriate caring behaviors/attitudes. However, there has been some evidence that the educational process does not always modify their caring perceptions/behaviors or that the direction of the change is not always positive.

DESIGN

A qualitative longitudinal design with three data collection points, was performed from October 2013 to October 2016 at the University of Verona, Trento Campus.

METHODS

Semi-structured interviews were conducted at the time of entry into a 3-year bachelor's degree program in nursing and at the end of the second and third years. Observation of the students during their clinical practice was carried out at the end of each of the three years of education. Thirty students commenced the study and 24 finished. Data were analyzed using a phenomenological approach.

RESULTS

The iterative process of analyzing interviews and observations resulted in nine themes collectively from all three stages: establishing a trusting relationship with the patient, satisfying the patient's needs, paying attention, being respectful, being competent, giving time, being concerned with the emotional dimension, acting within context to facilitate caring actions and giving information.

CONCLUSIONS

At the end of the third year the students' concept of caring was enhanced; their initial generic or lay view of caring turned into an intentional, competent, conscious, accountable and realistic caring approach.

Job engagement and satisfaction are associated with nurse caring behaviours: A cross-sectional study

BACKGROUND

There is a scarcity of literature assessing the impact of job engagement and satisfaction in the nurse's caring behaviours. This study aims to identify how these factors affect the caring behaviours of nurses.

METHODS

This study used a cross-sectional design and employed self-report questionnaires. A total of 549 nurses from private and government hospitals participated in the survey conducted in the year 2019. Descriptive and inferential statistics were utilized to analyse the data.

RESULTS

Results revealed that the nurses display high caring behaviours and job engagement and moderate sense of satisfaction. Remarkably, there are no profile variables significantly related to the nurse's caring behaviours. Findings suggest that job engagement and satisfaction are significantly associated with the nurses' caring behaviours.

CONCLUSION

Factors such as job engagement and satisfaction affect nurses' caring behaviours.

IMPLICATIONS TO NURSING MANAGEMENT

Health organisations must provide strategies to increase job engagement and satisfaction of nurses to yield high caring behaviours, which is vital to the achievement of patient safety.

Emotional impact of clinical practice in Burns Unit among nursing students: a qualitative study

Background and aim of the work.

In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative.The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit.

Methods.

A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview.

Results.

Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth.

Conclusions.

In light ofthe results, we highlight that nurse trainers should support studentsto take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably. (www.actabiomedica.it)

Predictors and priority of caring behaviours in intensive care units

BACKGROUND

There is an increasing number of studies addressing nurses' perception of caring behaviours; however, on the issue of quality of care, it is important to understand why nurses focus more on certain elements of caring than others, and this needs to investigate influencing factors on, priorities, and predictors of caring behaviours.

AIMS

The main goal of this study was to determine the predictors and priorities of nurses' caring behaviours in intensive care units to improve the quality of care and patient outcomes.

METHODS

This is a cross-sectional survey of nurses working in adult and pediatric ICUs in Iran. The participants were 470 ICU nurses from eight hospitals in Iran. Data were collected over 6 months in 2018 using the Persian version of "Caring Assessment Report Evaluation Q-Care"; "Determinants of Nurse Caring Behaviors"; and a demographic data form.

RESULTS

By broad descriptive and analytical analysis, thirteen items were recognized as predictors of caring behaviours. The most important individual predictors reported as "interest in the nursing profession," "moral obligation," and "job experience," respectively. The most important perceived nursing behaviours were, respectively, subscales of "accessible," "monitors/follow-through" and "explains/facilitates."

CONCLUSION

The results provide insight into new and context-specific predictors of nurses' caring behaviours. These findings suggest that nursing managers, besides selecting skilful staff for ICUs, may consider employing those of higher "interest in the nursing profession"; "moral obligation"; and "job experience." They, also, need to be aware that organizational culture, climate, and values have a great impact on the caring behaviours of nurses. This could help them to handle the complex issue of improving the quality of care more efficiently.

Perceptions of Caring Behavior Among Undergraduate Nursing Students: A Three-Cohort Observational Study

Introduction

Increase in the knowledge of "caring science" among nurses plays a key role in ensuring a correct caring behavior towards patients. Caring training for students is a priority in nursing education, but unfortunately there are limited and conflicting studies which explore this outcome. The purpose of this observational study was to explore the perceptions of caring behaviors by nursing students during their clinical practice training in order to highlight if the level of caring behaviors changes as the nursing course progresses.

Materials and Methods

The Caring Behaviors Inventory-24 (CBI-24) was administered to 331 students, enrolled in the three years of an Italian Nursing Course, who accepted to participate in the study (89.2% response rate). The data were analyzed using SPSS software version 26.0 (SPSS Inc., Chicago, IL).

Results

The total mean score of CBI-24 was 4.82 in the first, 5.12 in the second and 5.26 in the third-year students. The CBI-24 dimensions "Responding to individual needs" and "Being with" obtained the highest scores among the students of the first year. At the end of the first year, our students were already able to perform expressive caring, whereas instrumental caring developed at a high level in the second and third years. We did not highlight any statistically significant difference between the two gender CBI-24 item scores.

Conclusion

In light of our results, we put in evidence that Nursing Degree Programme favours the development in students of both relational and technical components of caring behaviors. We hope that in future students' self-assessment of caring behaviors could be considered an educational outcome for Nursing Programme.

Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study

BACKGROUND

Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high-quality care. There are challenges in designing and implementing interventions to improve nurses' caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients.

AIM

To describe the caring ability of nurses and its potential predictors in China.

METHODS

From January to February 2018, a cross-sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio-demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted.

RESULTS

Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho' norm, an international scoring standard of nurse's caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance.

CONCLUSIONS

Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.

Analysis on professional identity and related factors among Chinese general practitioners: a National Cross-sectional Study

BACKGROUND

Studies on professional identity and related factors among Chinese general practitioners (GPs) are unavailable. The objective of this study was to investigate the professional identity level of GPs in China and explore factors associated with GPs' perceptions of their professional identity.

METHODS

A multistage stratified random sampling method was used to collect data with a structured self-administered questionnaire from 3236 GPs working in community health service institutions (CHIs) in China between October, 2017 and February, 2018. Professional identity was measured by the 13 items scale. Descriptive statistics were calculated and groups' differences were estimated using nonparametric tests. Multiple linear stepwise regression analysis was used to analyze factors associated with professional identity among GPs.

RESULTS

Based on a total score of 65 on the professional identity scale, the average score for GPs' professional identity was 51.23 (SD = 6.56). Multiple linear stepwise regression analysis showed that GPs who practiced in Central China, with an administrative responsibility, at a moderate or higher income level, who frequently worked overtime, had more occupational development opportunities, with a higher level of job satisfaction and older GPs had higher levels of professional identity.

CONCLUSIONS

Professional identity level among GPs in China is high. Region, administrative responsibility, income level, working overtime, occupational development opportunities, age, and job satisfaction were significant predictors of professional identity.

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.

Nursing students' perception of patient-centred care: A qualitative study

Aim

This study aimed to explain the understanding of nursing students from the concept of patient-centred care.

Design

This is an explorative and descriptive-qualitative design.

Methods

The participants consisted of 15 nursing students who were selected through purposeful sampling, and data were collected through in-depth, semi-structured interviews and analysed using a qualitative content analysis.

Results

Data analysis led to the identification of three categories including the following: the inevitability of patient-centred care, the patient-centredness in comprehensive care and the importance of nursing process in patient-centred care. Introducing students to the concept of patient-centred care and how it can be achieved seems necessary during nursing education. Introducing a module on patient-centred care to the nursing curriculum is suggested to familiarize students with this concept.

Psychometric testing of the Caring Behaviors Inventory for nursing students

AIM AND OBJECTIVE

To test the psychometric properties of the nursing students' version of the 24-item Caring Behaviours Inventory.

BACKGROUND

Caring is at the heart of nursing and should also be a core value in nursing education. Caring can be manifested through measurable behaviours. The Caring Behaviors Inventory is a valid and reliable measure of nurses' caring behaviours in clinical settings. It has already been used among nursing students, but it needs more psychometric testing.

DESIGN

Cross-sectional validation study.

METHOD

The questionnaire was filled in by 300 undergraduate nursing students at two Italian universities in May 2016. Exploratory factor analysis was conducted using Mplus maximum likelihood with GEOMIN oblique rotation. A multifaceted approach was used to evaluate the model fit. The STROBE checklist for cross-sectional studies was followed.

RESULTS

Four dimensions were identified: "being with," "doing with competence," "responding to individual needs" and "providing effective care." Adequate fit indices and high reliability of the factors were found. Correlations between factors were positive and significant.

CONCLUSION

This study makes it possible to use the same tool to compare the caring practices perceived by students, nurses and patients. Further studies with bigger samples could be stratified to investigate the associations between caring levels and student characteristics. The Caring Behaviors Inventory can be used to call attention to caring in nursing education, helping to make this concept less elusive.

RELEVANCE TO CLINICAL PRACTICE

The effective self-assessment of nursing students' caring behaviours offers opportunities for reflection on their caring practice. This could improve the caring level of their behaviours in clinical practice and help them to become caring nurses in the future.

Assessment of reliability and validity of the Spanish version of the Nursing Students' Perception of Instructor Caring (S-NSPIC)

The care that clinical instructors demonstrate to students is essential for their education, considering the strong impact it has on their future relationships with patients, relatives, and other health professionals. Nursing Students’ Perceptions of Instructor Caring (NSPIC) is an instrument designed to assess nursing students’ perceptions of instructor’s caring behaviors. A trans-cultural, conceptual, and psychometric validation study was conducted with 315 nursing students at the University of Seville during their clinical practices in three regional hospitals. The NSPIC was translated and adapted to Spanish. The content validity was established by a panel of experts. To assess concurrent validity the culturally adapted Spanish version of the Clinical Placement Evaluation Tool (CPET) was used as a gold standard. The construct validity was determined by an exploratory factor analysis to identify the internal structure of the NSPIC-S. The internal consistency was established by Cronbach’s α and the intra-observer reliability for each item was established by test-retest. The content validity index varied between 0.53 and 0.93 and the correlation to the CPET was moderate. The factor analysis revealed a structure of five factors, one of which differed from the original scale. The value of Cronbach’s α was 0.95 and intraclass correlation coefficients varied between 0.5 and 0.89. Our study provided a culturally adapted version of the NSPIC, valid and reliable to be used in the Spanish context, the NSPIC-S.

The effect of gender role orientation on student nurses' caring behaviour and critical thinking

AIM

We explored the impact of gender role orientation (masculinity and femininity) on student nurses' caring behaviour and critical thinking.

BACKGROUND

Caring and critical thinking are at the core of professional nursing education. Previous studies revealed inconsistent findings regarding the impact of gender roles on caring behaviour and critical thinking.

DESIGN AND METHODS

We employed a quantitative correlational study. Nursing students (N = 449; female = 310, male = 139) who had at least had one month of clinical practice experience were recruited from four universities in Taiwan. Students' ages ranged from 19 to 29 years (Mean age = 21.24 years, SD = 1.28). Data were collected from August 2016 to July 2017, using three questionnaires: Taiwan Critical Thinking Disposition Inventory (CTDI), Caring Assessment Report Evaluation Q-sort Scale (CARE-Q), and Bem Sex Role Inventory (BSRI). Partial least squares structural equation modelling and generalized linear models were conducted to test the research model and hypotheses.

RESULTS

Findings indicated that students who reported higher caring and masculinity presented greater critical thinking (ß = .37 and ß = 0.24, respectively; ps < .001). Students' gender, age, femininity, or clinical practice experience, however, were not significantly associated with critical thinking (ß = -0.01, ß = 0.09, ß = .10, and ß = 0.01, respectively; ps > .05). In addition, students who reported higher masculinity and femininity presented greater caring behaviour (ß = .22 and ß = 0.38, respectively; ps < .001). Students' gender, age or clinical practice experience were not significantly associated with caring behaviour (ß = .04, ß = .03, and ß = -0.05, respectively; ps > 0.05). The findings confirmed a direct influence of caring and masculinity on critical thinking. Masculinity indirectly affected critical thinking via caring behaviour. Caring and masculinity accounted for 34.4% of the variance in critical thinking, and masculinity and femininity accounted for 29.1% of the variance in caring behaviour.

CONCLUSION

Our study confirms the effect of age, gender role, and caring behaviour on critical thinking. We recommend that the cultivation of nursing care behaviour focus on students' gender role orientation. In addition, clinical nurse educators, when working with male students on patient caring, should consider their gender role orientation and support male nursing students' ways of presenting caring behaviours.

Impact of Interprofessional Simulation on Nursing Students' Attitudes Toward Teamwork and Collaboration

BACKGROUND

The purpose of this study was to examine the influence of a multipatient, interprofessional simulation session on nursing students' attitudes toward nurse-physician collaboration using the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration.

METHOD

Final-semester nursing students, along with medical resident and students from other health programs, participated in a simulation exercise that included a period of prebriefing, simulation, and debriefing. Participants completed pre- and postsimulation surveys to assess the impact on collaboration.

RESULTS

In total, 268 nursing students completed the survey. Participants had a more positive attitude toward nurse-physician collaboration following the simulation event, compared with prior to it. Significant differences between male and female nursing students were found on mean postsimulation scores and for three of the four subscales of the tool.

CONCLUSION

Interprofessional simulation may be an effective way to enhance collaborative relationships, which ultimately may influence patient safety and quality of care. [J Nurs Educ. 2017;56(6):321-327.].

The caring concept, its behaviours and obstacles: perceptions from a qualitative study of undergraduate nursing students

Developing caring competences is considered to be one of the most important aims of undergraduate nursing education and the role of clinical placement is recognised as special in this regard. Students' reflection on caring, their experience and obstacles in being caring is recommended as a key strategy in the process of teaching and studying the nursing discipline. Therefore, the aim of this study was to describe the concept of caring, its manifestations and possible obstacles while caring, as perceived by first-year nursing students before and after their first clinical placement. Qualitative content analysis of 15 Polish students' narratives written before and after their clinical experience in the form of text-diaries was undertaken. The findings revealed that students entered their nursing education with a deep humanistic vision of caring both on theoretical and practical levels and the first clinical placement has enriched this vision. Expressive caring was more appreciated by students than the instrumental one and their concept of caring was coherent with the caring behaviours as described in their narratives. Several internal and external obstacles for caring have been reported by students, indicating a specific tension between their ideal of caring and their practical experience of caring in the clinical reality.

Comparison of Caring Ability Between Chinese and American Nursing Students

This descriptive comparative study aimed to compare caring ability between Chinese and American nursing students. A survey was conducted in 544 Chinese and 109 American nursing students using Caring Ability Inventory and socio-demographic data sheet. The results indicated that the Chinese nursing students reported significantly lower scores in the Caring Ability Inventory total and three subscales ( p < .001) compared with their American counterpart. Years of program and number of siblings were factors affecting the Caring Ability Inventory scores among Chinese students ( p < .05), whereas program, marital status, prior work experience, and gender were found to influence the Caring Ability Inventory scores of American students ( p < .05). Some gaps and differences between the Chinese and America nursing students’ caring ability were identified. Nurse educator should leverage the influencing factors to strengthen the caring ability of nursing students in both countries.