Nursing students’ perceptions of the importance of caring behaviors

Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring

BACKGROUND

Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process.

OBJECTIVES

The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring.

DESIGN

A multi-centre, cross-sectional observational study was conducted.

SETTING

The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy.

PARTICIPANTS

A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year).

METHODS

Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire.

RESULTS

Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones.

CONCLUSIONS

This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.

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.

Investigation of the relationship between nursing students' disgust sensitivity and caring behaviours

AIM

This study aimed to investigate the disgust sensitivity of nursing students, the factors affecting this sensitivity, their caring behaviors and the relationships between these components.

BACKGROUND

Disgust sensitivity has been conceptualized as the degree of disgust felt in response to various stimuli. Nursing students often encounter recognized disgust triggers in clinical practice, such as feces, mucus, urine, foul-smelling wounds and contact with the dead. The nursing students' disgust sensitivity can affect the way they think and may affect their care behaviors.

DESIGN

The study used a descriptive cross-sectional design and was conducted with nursing students in a Turkish university nursing program (n = 577).

METHODS

The study data was collected through the Disgust Sensitivity Scale-Revised Form and the Caring Assessment Questionnaire.

RESULTS

Of the students in the study, 59.6% stated that they experienced disgust while providing care. A negative relationship was found between students' total scores from the Disgust Scale and the Caring Assessment Questionnaire (p < 0.01). The students' disgust sensitivity level was high and the higher the disgust sensitivity, the fewer caring behaviors they exhibited.

CONCLUSIONS

In light of these findings, it can be said that the caring behaviors of nursing students are negatively influenced by disgust sensitivity. Hence, nurse educators need to evaluate students' disgust sensitivity, help students to identify and address their disgust emotions, deal with disgust management strategies together and be aware of when students need support.

Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study

Background

Assessing and improving patient self-efficacy are among the major roles of nurses. Nurses are also responsible for providing direct patient care, and they play a major role in improving patient care quality. Therefore, it is essential to evaluate nurses’ care-giving behaviors. This study aimed to determine the association between caring behaviors and self-efficacy in patients with cardiovascular disease.

Methods

In this cross-sectional study, 400 patients with cardiovascular disease who were admitted to hospitals in Jahrom, southern Iran, were selected through a stratified sampling. The Caring Behaviors Inventory and the Strategies Used by People to Promote Health questionnaires were used to collect data. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test and Spearman correlation coefficient in SPSS ver. 22.

Results

Results showed significant relationships between perception of caring behaviors and self-efficacy (r=0.16, P=0.001) as well as subscales of respectful deference to others (r=0.12, P=0.01), assurance of human presence (r=0.12, P=0.02), and positive connectedness (r=0.18, P=0.001). Additionally, among the subscales of caring behaviors, “attentive to others’ experience,” with a mean of 5.17±1.10, was the highest priority and “positive connectedness,” with a mean of 4.81±1.31, was the lowest priority for patients. The mean self-efficacy score was 73.94±29.78, and 169 patients (43.2%) had low self-efficacy.

Conclusions

Given the positive relationship between perception of caring behaviors and self-efficacy in patients with cardiovascular disease, self-efficacy could be improved by paying more attention to patient care priorities and improving patient perception of caring behaviors.

Nurses' Empathetic Behaviors: The Direct and Indirect Effect of Their Spiritual Orientation

Spirituality and its role in nurses' performance has gained much attention from the nursing researchers. But there is still some ambiguity about its role in improving the nurses' empathetic behaviors and factors that mediate this relation. To fill these research gaps, a sample of 247 Muslim nurses in a hospital at Shiraz, Iran, were selected and studied. Data were gathered by distributing the standard questionnaires among all of the nurses. Also, structural equation modeling and ANOVA test were used to analyze the data. It was found that nurses' spiritual orientation has a positive effect on their psychological capital and empathetic behaviors. Also, it was found that their work engagement has been affected by their level of psychological capital. Moreover, there was a significant difference between the spirituality of single and married nurses, in a way that married nurses were more spiritual. As a conclusion, it can be said that nurses' empathetic behaviors are a reflection of their spiritual orientation and marriage status.

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.

Psychometric Testing of the Persian Version of the Revised Humane Caring Scale for Patients Admitted to Critical Care Units

BACKGROUND AND PURPOSE

To determine the psychometric properties of the Persian version of the Revised Humane Caring Scale (RHCS) for patients admitted to critical care units.

METHODS

Data were collected from 337 patients admitted to critical care units. A methodological study was carried out to assess content, face and construct validity and reliability.

RESULTS

The results revealed good content validity. After the elimination of four items in the confirmatory factor analysis, a 42-item model with acceptable fit indices was confirmed. The scale had a high internal consistency. The reliability of each item was satisfactory using the intra-class correlation. Only item 33 was considered unstable and was ultimately eliminated.

CONCLUSIONS

The Persian version of the 41-item RHCS is an acceptable assessment scale for measuring patient satisfaction with humane caring in critical care units.

The evaluation of nursing students by patients instrument (ENSPA): Development and validation

BACKGROUND

Patient participation is increasingly used in different aspects of healthcare due to its positive outcomes. Still, instruments for involving patients in the evaluation of nursing students during their internship are scarce.

OBJECTIVES

To develop and validate an instrument that enables patients to evaluate nursing students during their internship.

DESIGN AND METHODS

A 3-phased validation process was conducted: (1) development of an instrument through literature and patient interviews; (2) content and response process validation by use of cognitive interviews and pilot-testing; (3) testing construct validity and reliability of the instrument which was completed by 244 hospitalized patients.

SETTINGS AND PARTICIPANTS

Patients from a variety of wards in a general hospital were recruited for the different phases. In phase 1, 17 interviews and 47 thought shower sessions with patients were performed. In phase 2, 9 cognitive interviews and pilot testing by 4 patients evaluating actual nursing students were used to refine the instrument. In phase 3, 380 patients were eligible to participate. Of these patients, 317 completed the instrument. A sample of 244 completed instruments was useful to perform the psychometric analyses. To assess the test-retest reliability, 50 patients completed the instrument twice with a 4 hour time interval.

RESULTS

The 19-item Evaluation of Nursing Students by Patients instrument (ENSPa) is designed. The ENSPa-instrument comprises 7 items that assess whether the patient can place trust in the student, 5 items evaluating person-oriented skills, 4 items appraising caring and 3 items to grade the integrity and honesty of the nursing students. Each item is scored both for importance and rating. The instrument shows high reliability and consistency ratings.

CONCLUSIONS

The ENSPa-instrument is a valuable instrument for collecting data on the performance and skills of nursing students during their internship from the patient's perspective. By receiving structured feedback from patients, important learning opportunities are created for nursing students.

Perspective and Experience of Hospital Operating Room Nurses with the Concept of Excellence: A Qualitative Study

INTRODUCTION

The provision of care according to the code of ethics is of the highest priority in operating rooms (OR). However, the exposure of the surgical team to a high level of stress may result in unethical behavior and undermine their pursuit of excellence. Since the concept of excellence is complex and there are limited published studies in the nursing literature, there was a need for in-depth research.

OBJECTIVE

The present study aimed at evaluating the perspective and experience of OR nurses with the concept of excellence.

STUDY DESIGN

The conventional qualitative content analysis method was employed to explore the concept of excellence among OR nurses.

PARTICIPANTS AND RESEARCH ENVIRONMENT

The current study was conducted on 20 OR nurses in the elective and emergency operating rooms of hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. The data were collected through in-depth semi-structured face-to-face interviews and field notes from April 2017 to June 2018.

FINDINGS

The four categories extracted from the interview data were "enhanced personality traits", "growth and development", "knowledge enhancement", and "effective teamwork". In addition, a total of 10 sub-categories were extracted.

DISCUSSION

The findings of the present study indicated that OR nurses can achieve personal, professional, organizational, and social excellence through enhancing personality traits, peer learning, teaching ethics to the surgical team members, and educating and training patients and family caregivers through effective teamwork. A close collaboration between OR nurses and nursing managers would develop a culture of pursuit for excellence.

CONCLUSION

The findings of the present study provided a better understanding of the perception of OR nurses with the concept of excellence; based on which, optimal ethical care and an environment for the pursuit of excellence can be developed. The findings also provided evidence-based recommendations to nursing managers on how to gain the trust of patients and family caregivers, and promote the pursuit of personal, professional, organizational, and social excellence.

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Investigation of Nursing Students' Perception of Caring Behaviors

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

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

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

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

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.

The Importance and Extent of Providing Compassionate Nursing Care from The Viewpoint of Patients Hospitalized in Educational Hospitals in Kermanshah - Iran 2017

AIM

This study is an attempt to determine the importance and extent of providing compassionate nursing care from the hospitalised patients' viewpoint in educational hospitals in Kermanshah-Iran 2017.

METHODS

The study was carried out as a descriptive, analytical work in the hospitals affiliated to Kermanshah University of Medical Sciences on 300 patients in 2017. The patients were selected through convenient sampling, and Burnell Compassionate Care Scale was filled by the participants. The collected data was analysed in SPSS (v.20) using descriptive and inferential statistics.

RESULTS

The results showed that the mean and standard deviation score of importance and extent of compassionate care were 3.27 ± 0.526 and 2.80 ± 0.647 respectively. There was a significant difference between these two scores (p < 0.001). About all the factors in compassionate nursing care, there was a significant difference between the importance and extent of compassionate nursing care. The mean score of the importance of compassionate nursing care from female patients' viewpoint was higher than that of men (p = 0.032). The observers with college educations perceived the extent of compassionate nursing care less than the other groups of participants (p = 0.008).

CONCLUSIONS

There was a significant difference between the importance and extent of compassionate nursing care from the patients' point of view. This highlights negligence by the nurses of this critical aspect of care. It is recommended, therefore, to add compassionate nursing care to nursing programs and commission more research works on other groups of health care personnel.

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.

A quasi-experimental study of the effect of teaching Orem's self-care model on nursing students' clinical performance and patient satisfaction

AIMS

This study aims to determine the effect of teaching Orem's self-care model on nursing students' clinical performance and patient satisfaction.

DESIGN

The study was a quasi-experimental, non-randomized, two-group design with posttest.

METHODS

In this quasi-experimental study, 66 nursing students were selected via convenience sampling method. The intervention group was trained based on Orem's self-care model and the control group based on the routine nursing process method. Both groups cared patients for a week. Students' performance was evaluated during the clinical course by performance observation checklist and patient satisfaction was assessed at the end of clinical course using patient satisfaction form. Data were analysed in SPSS software using chi-squared, Fisher Exact test, Mann-Whitney, t test and two-way ANOVA.

RESULTS

Clinical performance evaluation mean score in the intervention group was significantly higher than that of the control group. However, patient satisfaction scores in both the control group and intervention group did not show statistically significant differences. Orem's self-care model showed a 23% improvement in students' performance. It is recommended to use Orem's self-care model for undergraduate courses, especially in clinical training.

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.].

How do student nurses learn to care? An analysis of pre-registration adult nursing practice assessment documents

There is international concern about the quality of nursing in resource constrained, high technology health care settings. This paper reports findings from a research study which explored the experiences and views of those involved in the education and learning of 'caring' with adult pre-registration students. A novel dataset of 39 practice assessment documents (PADs) were randomly sampled and analysed across both bachelors and masters programmes from September 2014-July 2015. Using an appreciative enquiry approach, the Caring Behaviours Inventory aided analysis of qualitative text from both mentors and students within the PADs to identify how student nurses learn to care and to establish whether there were any differences between Masters and Bachelors students. In contrast with existing research, we found a holistic, melded approach to caring. This combined softer skills with highly technologized care, and flexible, tailored approaches to optimise individualised care delivery. Both of these were highly valued by both students and mentors. Pre-registration MSc students tended to have higher perceptual skills and be more analytical than their BSc counterparts. We found no evidence to suggest that caring behaviour or attitudes diminish over the course of either programme.

Faculty-Student Caring Interaction in Nursing Education: An Integrative Review

Introduction: Faculty- student caring relationship in nursing education has been offered as enhancing students’ learning experiences to care , desire to care for others and self-actu­alization. This review therefore was carried out to analyze faculty-student caring interactions in nursing education.

Methods: This concept analysis of caring in the nursing education was conducted based on Broom methodology of integrative review. The literature was consisted of two books from two known theorists, and 47 relevant articles. They retrieved from English data bases including MEDLINE, CINAHL, ERIC, SCOPUS, and SID, with based on the keywords of caring and "nursing education", during the period 2005-2014.

Results: Caring in nursing education refers to faculty-student interaction based on ethical and human values. The development of values and moral principles in education, flexibility in educational processes, application of objective patterns in learning, and dynamism in educational processes are identified as caring concept attributes in teaching-learning process. This requires environmental support, constant human relationship, and knowing. Internalization of values, achieving self-esteem, peace, and towards human evolution were the main achievements of the concept of caring in nursing education.

Conclusion: The details obtained from the dimensions of "caring" concept in this study could be utilized by nursing education researchers and designers in order to develop content and structure for educational programs.

Perception of futile care and caring behaviors of nurses in intensive care units

OBJECTIVES:

Futile medical care is considered as the care or treatment that does not benefit the patient. Staff of intensive care units experience moral distress when they perceive the futility of care. Therefore, this study aimed to determine the relationship between perceptions of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units.

METHOD:

This correlation, analytical study was conducted with 181 nursing staff of the intensive care units of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a three-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were investigated using SPSS, version 19. Pearson's correlation coefficient, partial correlation, t-test, and analysis of variance tests were performed to assess the relationship between the variables.

ETHICAL CONSIDERATIONS:

The study was reviewed by the ethics committee of the Mazandaran University of Medical Sciences. Informed consent was obtained from participants.

RESULTS:

Our findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care, and most of them (98.9%) had desirable caring behaviors in taking care of patients in the final stages of life. The nurses believed that psychosocial aspects of care were of utmost importance. There was a significant negative relationship between perception of futile care and caring behavior.

CONCLUSION:

Given the moderate perception of nurses concerning futile care, and its negative impact on caring behaviors toward patients, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care.

Nurses' caring and empathy in Jordanian psychiatric hospitals: A national survey

Nurses working in psychiatric hospitals need to acquire the skills of therapeutic communication and empathy, and have higher levels of caring. The present study aims to investigate the level of caring and empathy among nurses working in psychiatric hospitals. A cross-sectional survey was utilized to collect data from 205 nurses recruited from three psychiatric hospitals in Jordan. The Background Information Questionnaire, Modified Caring Dimensions Inventory, and Toronto Empathy Questionnaire were administered to the recruited participants. The findings revealed that the sampled nurses had a high level of caring and empathy. Significant correlations were found between caring and having a specialized training in mental health nursing, and having organizational and managerial support. However, no significant correlations were found between empathy and participants' characteristics. Specialized training in mental health nursing, having organizational and managerial support, and empathy were found predictors for caring.

Principle-based concept analysis: Caring in nursing education

INTRODUCTION

The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles.

METHODS

A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software.

RESULTS

The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as "caring pedagogy," "value-based education," and "teaching excellence," caring in nursing education does not have exact and clear conceptual boundaries (logic principle).

CONCLUSION

Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development.

Impact of Instructors' Caring on Students' Perceptions of Their Own Caring Behaviors

PURPOSE

The aim of this study was to identify the correlation between instructors' and students' caring behaviors and to explore the impact of instructors' caring on students' perceptions of their own caring behaviors.

DESIGN

A descriptive, nonexperimental design was used in this study.

METHODS

A total of 586 student nurses from four countries (Greece, the Philippines, India, and Nigeria) were recruited to participate in this study during the months of September 2013 to January 2014. Data collection was based on interviews using two standardized questionnaires: the Nursing Students' Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Inferential statistics such as the Pearson r correlation and regression analysis were used to determine correlations between relevant variables.

FINDINGS

Student nurses perceived "instills confidence through caring" (mean = 4.275, SD = 0.755) as the most frequently demonstrated subscale, while "control vs. flexibility" (mean = 3.469, SD = 0.701) was the least demonstrated subscale. The highest self-reported subscale in the CBI was "assurance" (mean = 4.796, SD = 0.949), while "connectedness" (mean = 4.541, SD = 0.985) was the lowest self-rated subscale. The NSPIC correlated significantly with the CBI (r = .587, p < .001). Four of the five subscales in the NSPIC correlated significantly with the CBI when considered individually; the exception was the "Supportive learning climate" subscale (r = .009, p < .40). Among the NSPIC subscales, "instills confidence through caring" explained 32% in the CBI and "appreciation of life's meaning" explained 3% in the CBI.

CONCLUSIONS

Instructors' caring behaviors influenced nursing students' caring behaviors positively. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.

CLINICAL RELEVANCE

The knowledge generated from this study provides direction in developing useful and effective caring strategies and curricular programs for nursing students. Understanding this concept in a cross-cultural context is necessary in order to develop an international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.

Nurses' and midwives' acquisition of competency in spiritual care: a focus on education

BACKGROUND

The debate that spirituality is 'caught' in practice rather than 'taught' implies that spiritual awareness comes about through clinical experience and exposure, requiring no formal education and integration within the curricula. This is challenged as it seems that providing students with a 'taught' component equips students with tools to identify and strengthen resources in 'catching' the concept.

AIM

This study forms part of a modified Delphi study, which aims to identify the predictive effect of pre- and post-registration 'taught' study units in spiritual care competency of qualified nurses/midwives.

METHODS

A purposive sample of 111 nurses and 101 midwives were eligible to participate in the study. Quantitative data were collected by the Spiritual Care Competency Scale (SCCS) (Van Leeuwen et al., 2008) [response rate: nurses (89%; n=99) and midwives (74%; n=75)].

RESULTS

Overall nurses/midwives who had undertaken the study units on spiritual care scored higher in the competency of spiritual care. Although insignificant, nurses scored higher in the overall competency in spiritual care than the midwives.

CONCLUSION

'Taught' study units on spiritual care at pre- or post-registration nursing/midwifery education may contribute towards the acquisition of competency in spiritual care.

First and Fourth-Year Student's Perceptions about Importance of Nursing Care Behaviors: Socialization toward Caring

INTRODUCTION

The essence of professional nursing is caring and so, nursing education must make caring as a significant part of their curricula. In this regard, little research exists about how nursing students perceive caring. The aim of this study is to investigate the nursing students' perception toward caring and thus, the impact of socialization process on their perception of caring will be determined.

METHODS

A cross-sectional study was done among all first and fourth-year nursing students (n=230) in Tabriz and Urmia faculties of nursing, 2012. Data were collected using Larson's Caring Questionnaire that assessed the importance of nursing care behaviors (n=50) in six dimensions: "being accessible", "explains and facilitates", "comforts", "anticipates", "trusting relationship" and "monitors and follows through".

RESULTS

The importance of caring behaviors was evaluated by the first and fourth-year nursing students in moderate to high level and also, the both groups considered higher ranks for "monitors and follows through" and "being accessible" and lower ranks for "anticipates" and "trusting relationships". The fourth-year students only ranked "explains and facilitates" higher than the first-year students, but the "comforts" dimension is not differed significantly between groups.

CONCLUSION

The findings demonstrated that nursing education in this study has not likely succeeded in producing intended changes in the nursing students' perceptions. It is recommended to exactly find the perceptual changes or in principle the professional socialization process of nursing students, more research using longitudinal designs be conducted to examine the differences in students' perceptions of caring upon entering and completing the nursing program.

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.

Gender differences in the academic and clinical performances of undergraduate nursing students: a systematic review

OBJECTIVES

Nursing is often regarded as a female-dominated profession. Many nursing curricula are received by mainly female students. It is uncertain how male students behave in this environment of nursing education in hospitals and universities. This article aimed to review gender differences in the academic and clinical performances of undergraduate nursing students.

DESIGN

A systematic review was assessed and different themes were extracted by inductive approach.

DATA SOURCES

A search strategy was carried out for the period 2006-2011 utilising six computerised databases: Academic Search Premier, CINAHL, ERIC, MEDLINE, ScienceDirect, and the Wiley Online Library.

REVIEW METHODS

Research studies were included and screened by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. All articles in English that met our aim were selected and relevant results were abstracted and thematised.

RESULTS

Fifty-five articles were included. Five themes were generated from the literatures, including the differences of academic, clinical, psychological, nursing profession identity and health concept between male and female nursing students.

CONCLUSIONS

Both genders performed similarly in different aspects. Most studies revealed that the clinical placement satisfaction of male students was similar to that of female, despite the negative experiences the former faced during obstetric placement. Further research is needed to examine the gender differences in studying and make changes in the nursing curricula to accommodate with male students.

Measuring the qualities of nurses: development and testing of the Qualities of Nurses Scale

AIM

This paper reports on the creation, development and testing of a new instrument to measure qualities of nurses, known as the Qualities of Nurses (QON) scale, applicable to student nurses.

BACKGROUND

High attrition rates within nursing programs and during early postgraduate years are an international phenomena. Mismatches between idealized perceptions of nursing and the realities of education and clinical experiences have been identified as contributing factors.

METHOD

A survey method was used to elicit responses to scale items from 678 first-year nursing students at a large university.

RESULTS

A one-factor 12-item solution explaining 47 percent of variance in the construct was demonstrated.

CONCLUSION

The QON can assist in the initial assessment and ongoing monitoring of changes in students' perceptions of nurses. Using the QON, researchers and educators can identify initial student nurses' perceptions and any changes associated in educational or other events that ultimately could be manipulated to reduce attrition.

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

Cette étude a exploré la signification d’une relation positive client-infirmière pour les personnes âgées atteintes de maladies chroniques qui reçoivent les soins à domicile. Pour les besoins de cette étude phénoménologique, huit participants âgés de 65 à 86 ont été sélectionnés à partir du Sud-Ouest Centre communautaire d’accès aux soins [or retain as Southwest Community Care Access Centre (SW-CCAC)]? à London, Ontario. Des données narratives ont été recueillies par des entrevues en profondeur capturé sur cassette audio, tout en utilisant un guide d’entretien semi-structuré. L’analyse et l’interprétation des entrevues ont révélé que le sens d’une relation client-infirmière positive de ces personnes âgées englobait deux tendances de sens: avoir de confort, et étant relié au sein de cette relation. Ces deux modèles ont été contextualisés par être une personne âgée avec une maladie chronique et ont été socialement construits à travers l’expérience d’avoir créé un rapport positif. Bien que des recherches supplémentaires sont nécessaires, les connaissances acquises ajouter à ce que l’on sait déjà au sujet de la théorie et la pratique de la promotion de la santé relationnelle pour les personnes âgées vivant avec des maladies chroniques et recevant les soins à domicile.

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.

The View of Nurses toward Prioritizing the Caring Behaviors in Cancer Patients

INTRODUCTION

There are many opportunities for nurses to assist improving patient's ex-perience of cancer. In fact, in every stage of cancer process, nurses can provide the re-quired and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients' satisfaction toward nursing services. However, a few studies have ever been done about perception of oncology nurses about prioritization of caring behaviors.

METHODS

This was a descriptive study done among all the nurses of oncology wards (n = 40) in Shahid-Ghazi-Tabatabaei Hospital of Tabriz in 2009. Data collection performed using Larson's CARE-Q tool that assessed the importance of caring beha-viors in six subscales as the following: "Monitors and follows through", "Explains and facilitates", "Physical and emotional comforts", "Trusting relationship", "Anticipates" and "Being accessible".

RESULTS

In this study, the importance of caring behaviors was evaluated in moderate to high level and the priorities of care dimensions were deter-mined. "Monitors and follows through" and "Being accessible" received a high priority and "Anticipates", "Explains and facilitates", "Physical and emotional comforts" and "Trusting relationship" were given the low priority by nurses.

CONCLUSION

The difference of caring prioritization by the nurses of this study compared to other studies can be attributed to the influence of cultural background on caring. Considering the high prioritizing of "Monitors and follows through" and "Being accessible", nursing service officials and planners are recommended to attempt providing prerequisites of these two caring aspects.

Perceptions of "caring" in nursing education by Pakistani nursing students: an exploratory study

INTRODUCTION

Caring is considered to be a highly abstract concept. Nurturing a caring attitude in nursing education is important as this is the first place for students to learn about the most significant values and essence of their profession.

AIM

The aim of the study was to describe the concept of caring from the perspective of nursing students.

METHODOLOGY

An exploratory research design was utilised for this study. Eight senior nursing students from one government institute (College of Nursing) in X country were recruited as study participants. Data was generated through in-depth one-to-one interviews and analysed using Creswell's six-step guide for qualitative data analysis. The interviews were tape recorded and a "member check" technique was used.

FINDINGS

The study results found the themes of caring as a mothering relationship, helping attitude, limit setting, communication, and a source of empowerment and development.

CONCLUSION

The implications of the findings for nursing education, faculty development, and research are described in the study.

An Exploration of the Nature of Caring Relationships in the Writings of Florence Nightingale

The purpose of this qualitative, historical field study was to identify the nature and attributes of caring relationships as depicted in the writings of Florence Nightingale. Latent content analysis was the methodology used for the discovery and analysis of words, ideas, and themes from selected Nightingale works. Five themes were identified that represented a caring relationship: attend to, attention to, nurture, competent, and genuine. These themes are congruent with Nightingale’s threefold concept of nursing. Watson’s carative factors were used to cross-validate the results. The findings of this study indicate that the phenomenon of caring relationships in nursing has been a part of our professional language since Victorian times. Historical research provides a sense of connectedness to nursing’s past and contributes to the ongoing education of nurses and further development of the nursing profession.

No essence no self: using a Buddhist perspective to characterize the nature of nursing

A fresh perspective is needed on the historical roots and contemporary politics of the essentials of nursing. In the 21st century, the profession needs to move past separatist thinking and the pursuit of identifying what can be called a professional self. Two ways that nurses have tried to characterize a professional self is through claiming caring as the essence of nursing and using the esoteric taxonomy system of nursing diagnoses. The Buddhist teaching of nonself (anatman) is proposed as an alternative way of viewing the nature of the profession.

Therapeutic letters in undergraduate nursing education: Ideas for clinical nurse educators

Therapeutic letter writing (TLW) is a well-known intervention in family nursing practice but it has been overlooked as a strategy in nursing education to promote relationship-building. This article reviews what is known about TLW and presents what was learned by adding a TLW assignment to undergraduate clinical nursing courses. This paper adds to the evidence supporting TLW as an effective clinical teaching strategy to promote students relational skills and to recognize patients' strengths. TLW has benefits for students, patients and faculty.