A cross-cultural study of the concept of caring through behaviours: patients’ and nurses’ perspectives in six different EU countries

Perceptions of caring behaviors: Experiences of nurses in Ethiopia

Caring is a universal phenomenon that influences nurse-patient interactions and feelings, forming the foundation of the nursing profession. How nurses perceive and experience caring in low-income settings is not well understood. Therefore, the purpose of this study was to explore Ethiopian nurses' perceptions and experiences of caring using a qualitative descriptive design. Individual semi-structured interviews were conducted with 13 nurses aged 28-57. Interviews were analyzed inductively using reflexive thematic analysis guided by the recommendations of Braun and Clarke. The analysis resulted in three themes: caring is the heartbeat of patient care, constraints to the provision of care, and ways to overcome constraints. The results revealed that nurses were committed to fulfilling their professional obligations and meeting patients' needs despite experiencing multiple constraints. The findings provide a comprehensive perspective in understanding nurses' experiences of caring. Their narratives demonstrate that they face constraints in their clinical practice, which limit the quality of care, including rotation and lack of resources. Cooperation between health policymakers and nurse authorities is essential for shifting the clinical environment from the prevailing traditional task-oriented approach to patient-centered care.

Effects of humanized nursing care on negative emotions and complications in patients undergoing hysteromyoma surgery

BACKGROUND

Uterine fibroids, are prevalent benign tumors affecting women of reproductive age. However, surgical treatment is often necessary for symptomatic hysteromyoma cases. This study examines the impact of humanized nursing care on reducing negative emotions and postoperative complications in patients receiving hysteromyoma surgery.

AIM

To investigate the impact of humanized nursing care on patients undergoing hysteromyoma surgery.

METHODS

Among patients who underwent hysteromyoma surgery at the Fudan University Affiliated Obstetrics and Gynecology Hospital, 200 were randomly assigned to either the control group (n = 100) or the humanized nursing care group (n = 100). The control group received traditional nursing care, while the humanized nursing care group received a comprehensive care plan encompassing psychological support, pain management, and tailored rehabilitation programs. In addition, anxiety and depression levels were assessed using the hospital anxiety and depression scale preoperatively and postoperatively. Postoperative complications were evaluated during follow-up assessments and compared between both groups.

RESULTS

The humanized nursing care group demonstrated a significant decrease in anxiety and depression levels compared to the control group (P < 0.05). The rate of postoperative complications, including infection, bleeding, and deep venous thrombosis, was also markedly lower in the humanized nursing care group (P < 0.05).

CONCLUSION

Humanized nursing care can effectively alleviate negative emotions and reduce the incidence of postoperative complications in patients undergoing hysteromyoma surgery. This approach should be considered a crucial component of perioperative care for these patients. Further research may be needed to explore additional benefits and long-term outcomes of implementing humanized nursing care in this population.

Patients' perceptions of caring behaviors at referral hospitals in Ethiopia: A cross-sectional survey

Objective

The purpose of this study was to determine patients' perceptions of nurse caring behaviors and to identify factors associated with these perceptions.

Methods

A cross-sectional study was conducted at three referral hospitals in Ethiopia. A consecutive sample of male and female patients (n = 652, response rate 98.8%) was interviewed using the Amharic version of the Caring Behaviors Inventory-16 (CBI-16, including four subscales: Assurance, Knowledge and skill, Respectful, and Connectedness) and the Patient Satisfaction Instrument (PSI). Socio-demographic and clinical factors associated with perceptions of caring behaviors were identified using multiple linear regression analysis.

Results

Patients' perceptions of nurse caring behaviors were high (total Mean = 4.86, SD = 0.72). Behaviors related to the Assurance subscale were rated the highest. The multiple linear regression analysis result showed several socio-demographic and clinical factors statistically significantly associated with patients' perceptions of caring behaviors (total mean scores). Patients who were 40-49 years (B = -0.19, P = 0.012) and single (B = -0.13, P = 0.03) scored lower on total CBI-16 scores. Whereas, patients who had a higher educational level (B = 0.35, P = 0.001), cared for at surgery units (B = 0.11, P = 0.027), and reported having spent more time with a nurse in the past 8-h shift (B = 0.16, P < 0.001) were more likely to have higher perceptions of the care they received. The CBI-16 was positively correlated with satisfaction with received care, as measured with the Patient Satisfaction Instrument (r = 0.62, P < 0.001).

Conclusion

Hospitalized patients in Ethiopia have overall high perceptions of nurse caring behaviors, especially with regard to physical-based caring, while their expectations of emotional-focused care are lower. We identified patients who were in need of care, patients aged 40-49 years and single. The time spent with nurses plays a pivotal role in patients' perceptions of nurse caring behaviors.

Exploring nursing students' perceptions from nursing role function (SP-NRF) during the COVID-19 pandemic in Ardabil Province: a cross sectional study from Iran

BACKGROUND

Perception of nursing roles among nursing students significantly influences their active engagement in nursing processes and care delivery. However, there is evidence to suggest that students' interest in and perceptions from the nursing profession at the undergraduate level are often insufficient.

OBJECTIVE

This study aimed to assess nursing students' perceptions of nursing role function and identify areas that require improvement.

METHODS

A cross-sectional study was conducted in 2021 among nursing students in the third- and fourth-years from three faculties in the Ardabil Province. The participants were selected through census sampling. The data were collected through interviews with the Standardized Professional Nursing Role Function (SP-NRF) questionnaire. Statistical analysis was performed using the SPSS-18 software at a significance level of less than 0.05.

RESULTS

A total of 320 nursing students participated in this study. The mean score for nursing role perception was 223.1 ± 20.3 out of 255. The results indicated significant gender differences in the mean scores of perception of the nursing role function, particularly in the supportive, professional-moral care, and professional-educational dimensions. Women scored significantly higher than men did (P < .05). Additionally, students who obtained a mean score of 19 to 20 (A) had significantly higher total scores in perception of the nursing role function than other students. Furthermore, a positive correlation was observed between students' interest in nursing and their perceived ability with nursing role perception (r = .282, P < .01) and all its dimensions.

CONCLUSION

Overall, nursing students demonstrated a favorable perception of nursing role function. However, their perception of mental and spiritual care was relatively weak. These findings highlight the need to review nursing education programs and incorporate the spiritual care dimension to enhance students' understanding of and preparation for their role as nurses.

Nurse and Patient Assessments of COVID-19 Care Quality in China: A Comparative Survey Study

During the COVID-19 pandemic, the quality of nursing care was a concern due to nurses' overwhelming workload. A cross-sectional design was conducted to compare perceptions between nurses and patients about the quality of nursing care for COVID-19 patients and to explore factors associated with these perceptions. Data were collected during the COVID-19 pandemic from 17 March to 13 April 2020 in five hospitals in Wuhan, China. Perceptions of care quality were assessed among nurses and patients using the Caring Behaviors Inventory. Nurses rated the quality of caring behaviors higher than patients. Both nurses and patients rated technical caring behaviors at high levels and rated the item related to "spending time with the patient" the lowest, while patients rated it much lower than nurses. Nurses' sex, participation in ethical training organized by the hospital, professional title, being invited to Wuhan, and length of working experience in years were significantly associated with nurses' self-evaluated caring behaviors. Moreover, inpatient setting and communication mode were significantly associated with patients' self-evaluated caring behaviors.

Perceptions of Caring Behaviors among Patients and Nurses

The concept of caring is fundamental to nursing practice. The aim of this study was to investigate patients' and nurses' caring behaviors and the possible differences between the two groups. In this descriptive and comparative study, 310 patients and 329 nurses from six general hospitals from Greece completed the Caring Behaviors Inventory-16. The mean score of Caring Behaviors Inventory-16 for patients was 78.94 (±17.85) and for nurses 80.27 (±9.36). The items "Demonstrating professional knowledge and skills" (Mean: 5.45 ± 3.62) and "Treating my information confidentially" (Mean: 5.34 ± 1.06) were the most important caring behaviors while the items "Including me in planning care" (Mean: 4.36 ± 1.56), and "Treating me as an individual" (Mean: 4.55 ± 1.46) were the least important caring behaviors for patients. For nurses, the most important caring behavior was "Treating patients" information confidentially" (Mean: 5.43 ± 0.94) and the least important was "Returning to the patient voluntarily" (Mean: 4.57 ± 3.68). Significant differences were observed in items: "Attentively listening to me/the patient" (t = -2.05, p = 0.04), "Treating me/the patient as an individual" (t = -7.82, p = 0.00), "Being empathetic or identifying with me/the patient" (t = -2.80, p = 0.00), and "Responding quickly when I/the patient call (t = -2.01, p = 0.04). Respect, privacy, and dignity were the most important caring behaviors for nurses while for patients they were knowledge, skills, and safety.

Psychometric Properties of the Caring Behaviors Inventory-16 in Ethiopia

Background: The Caring Behaviors Inventory-16 (CBI-16) is a comprehensive instrument measuring caring behaviors as experienced by patients. The study aimed to translate, culturally adapt and evaluate the psychometric properties of the CBI-16 among adult patients who speak the Amharic language. Methods: The measure was completed by 304 hospitalized patients. Construct validity was evaluated via exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and contrasted groups’ validity. Total CBI-16 scores were compared between groups that differed in self-rated satisfaction with care (Patient Satisfaction Instrument) to examine the contrasted groups’ validity. Reliability was assessed using internal consistency (Cronbach’s alpha). Results: The EFA suggested a four-factor model accounting for 66.1% of the total variance. The items loaded onto the subscales were similar to the CBI-24. The CFA supported the four-factor model with acceptable fit indices: normed Chi-square value 2.65 (X2 = 259.60, df = 98), SRMR = 0.06, and RMSEA = 0.07, CFI = 0.88 and TLI = 0.86. The contrasted groups’ validity was supported by significantly higher CBI-16 scores reported by patients more satisfied with their care (t = 3.66, p < 0.001). The reliability of the instrument was satisfactory (Cronbach’s alpha = 0.83). Conclusions: The Amharic version of the CBI-16 displayed a four-factor solution and was shown to be a valid and reliable instrument for the assessment of the perceptions of caring behaviors in Ethiopia.

Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ?

Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.

Psychological Experience of Humanistic Care Among Medical Staff in Stroke Wards: A Qualitative Research Study Conducted in China

BACKGROUND

As a special patient group, stroke patients have a significant attachment to humanistic care. However, multiple problems remain in clinical practice. Medical staff in stroke wards are the primary providers of humanistic care. Finding out the opinions of the staff that provide these medical services is vitally important for stroke patients that need access to curative and humanistic care.

OBJECTIVE

The aim of the study is to explore the psychological experiences of doctors, nurses, and physiotherapists during the implementation of humanistic care in stroke wards.

METHOD

This is a qualitative phenomenological study. Medical staff (i.e., doctors, nurses, and physiotherapists) were selected from stroke wards in general hospitals (minimum level two) from 13 cities within six provinces in China. A purposive sampling method was used until saturation (n = 18). Face-to-face or video call semi-structured interviews were conducted by using a phenomenological research method. The average interview length was 60 min (range 30-90 min). The Colaizzi seven-step method was used for analysis.

RESULTS

Four themes and 12 sub-themes were extracted from the qualitative interviews of the medicine, nursing and technology staff, as follows. ➀ The ward staff reported that the behaviors of the stroke patients gradually improved when they assisted with stroke treatment idea changes, when they paid attention to solving the patients' existing problems, and when they took the initiative to create a caring atmosphere; ➁ when humanistic care in the stroke wards was carried out with consciousness and ability improvement (including proactive caring behaviors in which vocational value was not strong and in which the whole-person rehabilitation was given attention, not just implementation), the patients' behaviors improved; ➂ the stroke wards themselves were improved (the gap between the current management and the needs of medical institutions and the gap between the rehabilitation conditions and the patients' needs were addressed); and ➃ the urgent needs of the staff in the implementation of humanistic care in stroke wards were considered (the addition of full-time posts, the effective training of humanistic care, and the construction of a more harmonious doctor-patient relationship).

CONCLUSION

In implementing humanistic care in stroke wards, the consciousness and ability of the medical staff need to be improved. In addition, the practical problems and contradictions affecting the development of humanistic care must be addressed. To improve the level of humanistic care in stroke wards, attention should be paid to the overall improvement of the personal qualities of the medical staff and the integration of a humanistic management mode.

Assessing organizational culture in public mental healthcare service organizations

PURPOSE

The purpose of this paper is to investigate aspects of organizational culture among the nursing staff of public mental health services organizations in Cyprus. Specifically, highlights are provided of possible differences on the attitudes of nurses regarding actual and desired aspects of organizational culture with respect to demographic characteristics such as gender, years of service and experience.

DESIGN/METHODOLOGY/APPROACH

A descriptive explanatory type survey study was conducted in all public mental health services organizations of Cyprus. Specifically, a questionnaire was given to a representative sample of the nursing population, and data were collected and analyzed. The survey questionnaire was based on the organizational culture profile (OCP) methodology. Statistical analysis was carried out using correlational analysis, t-tests and analysis of variance (ANOVA).

FINDINGS

Results showed that there are significant discrepancies between the actual organizational culture and what is desired by staff members of public mental health services organizations in Cyprus. Further, significant differences are identified between actual and desired organizational culture moderated by the type of work, which is determined by the workplace.

ORIGINALITY/VALUE

Even though, organizational culture is a major research topic little has been done in the context of public mental healthcare organizations. Further, for the case of Cyprus, it is the first time that such a study is carried out. The results presented in this paper may provide the foundation for measures to be taken for improving the existing operation of public mental healthcare organizations.

An Evaluation of Patient Satisfaction with Nursing Care: A Qualitative Study in an Indonesian Hospital

Background

Patients experience first-hand quality services from nurses who are directly responsible for their welbeing. However, patient dissatisfaction with nursing services remains a problem in most developing countries. Therefore, this study aims to explore patient satisfaction with nursing care services in an Indonesian hospital.

Method

A qualitative study with a descriptive phenomenology method was employed. Also, in-depth interviews were conducted with 15 informants, and thematic analysis was adopted to analyze the data.

Results

The results of this study are described in the following themes and sub-themes: (1) hospital existence in public eyes: a) service commitment b) accessibility; (2) patients' background: a) religious aspect, b) cultural influence on perceiving health and sickness.

Conclusion

Hospital management needs to enhance the quality of nursing services through sustainable education programs and continuous training. These are important to improve nurses' cognition and skills, and further to ensure patient satisfaction and hospital quality.

The Role of the Nurse in Informed Consent to Treatments: An Observational-Descriptive Study in the Padua Hospital

BACKGROUND

The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process.

OBJECTIVE

This study assesses nurses' perceptions of their role in the informed consent process.

MATERIAL AND METHODS

An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November-December 2018.

RESULTS

The final sample is made up of 206 nurses-27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient's family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse's duties.

CONCLUSIONS

The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients.

Associations between gender, sex types and caring behaviours among nurses in mental health

WHAT IS KNOWN ON THE SUBJECT?: Developing sex type is the process in which one develops behavioural attributes and personality characteristics socially defined as matching one's biological sex. "Psychological androgyny" means that a person should not be judged in terms of his or her traditional sex role. "Androgynous" sex type means that a person could have both female and male characteristics, depending on the circumstances. "Androgynous" sex-type individuals show higher capacity to deal with a variety of roles and a healthier and more adaptive behaviour than those with the same gender sex typing Previous studies focused on caring behaviours while examining the difference between female and male nurses but there are no studies on differences between female and male nurses in the mental health field in relation with sex types. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: From a theoretical point of view, our study adds important information on specific associations between sex types and caring in mental health nurses. Nurses with different sex type perform caring behaviours at different levels. "Androgynous" sex-type nurses perform caring behaviours at a higher level than others do. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Our findings can contribute to raising awareness among head nurses and policy makers in the mental health field, of the differences between nurses, and among female and male nurses in mental health centres, regarding their caring behaviours. Understanding this association can assist in the recruitment and allocation of candidates in mental health nursing settings and later on, in developing appropriate instruction programs for these employees. ABSTRACT: Introduction Understanding differences in caring behaviours by sex is crucial in light of the need to encourage men to join the nursing profession. Aims To study the association between sex types and caring behaviours in female and male nurses in the mental health field. Methods Cross-sectional study including a convenience sample of 114 nurses in three mental health centres in Israel. Data were self-reported in a structured form including validated scales for the assessment of sex types and caring behaviours. ANOVA and linear regression tests were used were performed with SPSS version 21. All the analyses were 2-tailed, and p < 0.05 was considered statistically significant. Results Androgynous female and male nurses displayed higher levels of caring than other sex types. Higher levels of caring were observed in female compared with male nurses overall (p = 0.011) and in behaviours showing respect (p = 0.020) and attentiveness to patients' needs and safety (p = 0.002). Conclusion Our results suggest that different sex-typed female and male nurses in the mental health field display different levels of caring behaviours. Implications for Practice Our findings can help head nurses and policy makers in recruitment and allocation of nurses in mental health settings, as well as in developing educational programs for employees and nursing students.

Nurses' caring behaviour and its correlation with moral sensitivity

BACKGROUND

Different and contradictory results have been reported for nurses' caring behaviour and moral sensitivity.

AIMS

The present study aimed to examine the correlation between nurses' caring behaviour and moral sensitivity.

METHODS

The research was a descriptive, correlational study. Data were collected using moral sensitivity (range: 0-100) and caring behaviour (range: 24-144) questionnaires. A total of 250 nurses who worked in the clinical wards of Yasuj teaching hospitals in 2018, were selected by systematic random sampling. The collected data were analysed using SPSS version 19 for descriptive statistics and Pearson correlation tests.

RESULTS

Seventy-four percent of nurses had moderate moral sensitivity (50-74). Nurses' moral sensitivity and caring behaviour mean scores were reported to be 59.5 ± 11.1 (range: 31-87) (Potential range 0--100) and 110.99 ± 17.99 (range: 69-94) (Potential range 22-144), respectively. The Pearson test showed a positive correlation between nurses' caring behaviour and moral sensitivity at a 99% level (p = 0.001).

CONCLUSIONS

Nurses' moral sensitivity and caring behaviour were found to be moderate and good, respectively. Furthermore, there was a positive correlation between moral sensitivity and caring behaviour in nurses, that is, nurses provided better caring behaviour as levels of moral sensitivity increased.

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.

Patients' and Nurses' Perceptions of the Quality of Nursing Care in Surgical Clinics: A Multicenter Study in Turkey

BACKGROUND

The evaluation of the quality of nursing care by patients and nurses is important for improving care.

PURPOSE

The aim was to determine patients' and nurses' perceptions of the quality of nursing care in surgical clinics and influencing factors.

METHODS

The sample of this cross-sectional, descriptive, and comparative study consisted of 503 surgical patients and 308 surgical nurses. The data were collected between February 2018 and June 2019.

RESULTS

Characteristics of patients such as age, gender, complications, and nursing care scores, and the characteristics of the nurses such as being satisfied with the current clinic, their work experience in the clinic, and the number of daily surgical interventions affected the perceptions of care quality.

CONCLUSIONS

The study revealed that the patients' perceptions of the quality of care were lower than those of nurses, and some factors belonging to the patients and nurses negatively influenced the quality of care.

Hospice palliative care nurses' perceptions of spiritual care and their spiritual care competence: A mixed-methods study

AIMS AND OBJECTIVES

To understand hospice palliative care nurses' (HPCNs) perceptions towards spiritual care and their competence to provide spiritual care.

BACKGROUND

Previous research has shown that many nurses lack a clear understanding of the concept of spirituality and feel inadequately prepared to assess patients' spiritual needs. Studies on competence in spiritual care are mostly descriptive, and the evidence for improving it is limited.

DESIGN

A mixed-methods research design was used.

METHODS

Quantitative data were collected from 282 nurses in forty hospice palliative care (HPC) institutions in South Korea and analysed using descriptive statistics, independent t-test, one-way ANOVA with Bonferroni test and multiple regression. Qualitative data collection involved two stages: first, an open-ended question posed to 282 nurses, and second, focus group interviews conducted with six HPC experts. Both qualitative data sets were analysed separately using content analysis. This study followed the GRAMMS guidelines.

RESULTS

Of the six dimensions of spiritual care competence (SCC), the mean scores were highest in 'attitude towards the patient's spirituality' and 'communication', whereas the 'assessment and implementation of spiritual care' and 'professionalisation and improving the quality of spiritual care' had the lowest mean scores. Through content analysis, 4 themes regarding the meaning of spiritual care, 3 themes regarding requirements for spiritual care and 2 themes regarding preparedness for spiritual care were revealed. They perceived the needs of the understanding of spiritual care based on the attributes of spirituality, the education in systematic assessments and implementation for spiritual care with standardised terminology, and the opportunity to reflect on nurses' own spirituality.

CONCLUSIONS

Practical SCC training for HPCNs and the subsequent development of clinical practice guidelines are of vital importance.

RELEVANCE TO CLINICAL PRACTICE

The results of this study provide a useful resource to develop educational programmes for strengthening the SCC of nurses and the entire HPC team.

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.

Emotions of Orthopaedic Arthroplasty Patients: A European Survey

METHODS

This was a pre/post-observational study examining patients' emotions before and during elective knee or hip replacement surgery for osteoarthritis in seven European Union countries to identify factors related to better emotional status at discharge.

INSTRUMENTS

In addition to demographic data, information was collected on quality of life (EuroQoL five-dimension questionnaire), hospital expectations (Knowledge Expectations of Hospital Patients Scale), symptoms, and experienced emotions.

ANALYSIS

Total negative emotions scores at baseline and discharge were transformed into median values. Multivariate analysis identified the baseline factors related to better emotional status at discharge.

RESULTS

Patients (n = 1,590), mean age 66.7 years (SD = 10.6), had a significant reduction in the frequency of total negative emotions at discharge as compared with baseline. The multivariate model showed better health status (odds ratio [OR] = 1.012; p = .004), better emotional status at baseline (≥24 points), and shorter duration of hospital stay (OR = 0.960; p = .011) as independent factors associated with better emotional status at discharge (OR = 4.297; p = .001).

CONCLUSIONS

Patients undergoing elective knee or hip replacement surgery for osteoarthritis improve their emotional status during hospitalization, with fewer negative emotions at discharge. Good emotional status, feeling of higher health status at baseline, and shorter hospitalization were independently associated with better emotional status at discharge.

Experiences of caregiving and quality of healthcare among caregivers of patients with complex chronic processes: A qualitative study

Aim To explore the perceptions of main caregivers regarding caring for chronic complex patients in two different regions of Spain.

BACKGROUND

Spain is a country with an ageing population and a high number of people with chronic diseases. It is well known that the role of the caregiver is important to ensure quality of life and appropriate care.

METHODS

Qualitative design using focus groups. Five focus groups, from two different regions, were conducted with 22 caregivers of people with chronic complex diseases to explore their personal experience, examine the quality of care received by the patient and their family and to develop strategies for the improvement of the quality of health care. The focus groups were audio and video recorded. The transcriptions of the focus group sessions were exported to qualitative software analysis MAXQDA 2018.2. The qualitative content analysis was based on different analytical cycles.

RESULTS

In general terms, caregivers would refer to accepting the care of their family members, but they highlight many negative aspects such as tiredness, lack of help and overload of care. They indicated general satisfaction with the health system but indicated that help was insufficient and that strategies to better address the situations of the complex chronic patient should be improved. The main categories observed were: Conclusions. Complex chronic illnesses are increasingly common at present, generating important consequences on the lives of patients and that of their caregivers. The design of any health strategy for facing the dilemma of chronic illnesses, must necessarily include the vision of the caregivers.

Nurses' Self-Assessment of Caring Behaviors in Nurse-Patient Interactions: A Cross-Sectional Study

Nurse-patient interactions based on caring behaviors ensure better working conditions and better-quality healthcare. The aim of this quantitative study is to examine how nurses self-assess the frequency of applying caring behaviors in nurse-patient interactions and to identify the differences in the application frequency of caring behaviors in relation to work experience and education level. The respondents were Bachelor of Science (BSc) nurses and nurses with basic training (VET) employed in different clinical departments of the Clinical Hospital Center in Croatia. The survey used the "Caring Nurse-Patient Interactions Scale (Nurse Version)". The respondents assessed the caring behaviors from the subscale "needs" as the most frequently applied (median (Me): 4.7; interquartile range (IQR): 4.4-4.9), while the least frequently applied were the procedures from the subscale "sensitivity" (Me: 3.8; IQR: 3.2-4.3). The VET nurses reported applying caring behaviors to the subscales "hope" (p < 0.001), "problem-solving" (p = 0.003), and "environment" (p = 0.021) more frequently than BSc nurses did. Compared with less experienced respondents, the respondents with more than 30 years of work experience applied the caring behaviors on the subscales "sensitivity" (p = 0.009), "expression of emotions" (p = 0.001), "problem-solving" (p = 0.008), and especially "humanism" and "spirituality" (p < 0.001) more frequently. The results indicate that respondents are more focused on applying skills or carrying out a task than on caring behaviors which is about demonstrating compassion, loving kindness, and relationships.

Caring in community nursing practice: Inductive content analysis reveals an inter-dynamic system between patients and nurses

AIMS AND OBJECTIVES

To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses.

BACKGROUND

An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person-centred care with their clients. Furthermore, most community nurses-especially in China-lack systematic education and training about caring because the practical meaning of caring in community practice is unknown.

DESIGN

The qualitative study described herein employed inductive content analysis.

METHODS

Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty-one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used.

RESULTS

Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter-dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship-based framework of caring in community nursing practice was constructed.

CONCLUSIONS

Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care-in China or elsewhere.

RELEVANCE TO CLINICAL PRACTICE

The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.

Dignity, privacy, respect and choice-A scoping review of measurement of these concepts within acute healthcare practice

AIMS AND OBJECTIVES

To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings.

BACKGROUND

Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements.

DESIGN

A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist.

METHODS

Using the five recommended steps-identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results-three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019.

RESULTS

Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items.

CONCLUSIONS

This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field.

RELEVANCE TO CLINICAL PRACTICE

This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned.

Perceptions of inpatients and nurses towards the importance of nurses' caring behaviours in rehabilitation: A comparative study

AIMS

This study was conducted to describe and compare nurses' and inpatients' perceptions of caring attitudes and behaviours in rehabilitation.

METHODS

A comparative descriptive design was used. Perceptions of caring attitudes and behaviours were compared between 34 nurses working in rehabilitation and 64 elderly patients, using the Caring Nurse Patient Inventory-23, to explore Watson's carative factors through four dimensions. Patients' and nurses' ratings of importance for each dimension were compared. The study data were collected from 8 November 2017 to 5 May 2018.

RESULTS

Patients' and nurses' responses showed high scores in terms of their perceptions of caring, with nurses having the higher scores, and significant differences were found between patients and nurses. Patients scored items linked to clinical aspects of caring as the most important, whereas nurses scored items linked to humanistic and clinical caring as equally important. Comfort care was considered important for nurses and patients. Both groups considered relational caring items as the least important.

CONCLUSION

Results show that patients and nurses value clinical aspects of care, which is the visible aspect of care. The Caring Nurse Patient Inventory-23 is a reliable instrument to measure the nurses' and patients' perception of caring behaviours in rehabilitation.

Psychometric Evaluation of the Caring Behaviors Inventory in Turkish Nurses and Patients

BACKGROUND AND PURPOSE

Instruments developed specifically to measure nurse caring behaviors need to be assessed in different cultural contexts. The purpose was to translate the Caring Behaviors Inventory (CBI) into Turkish and evaluate its psychometric properties.

METHODS

This was a methodological study with 356 nurses and 363 patients. Linguistic, content validity, and construct validity tested for the validity of scale. Internal consistency and test-retest were calculated for reliability of scale.

RESULTS

Exploratory factor analysis identified 30 items that could be categorized under three factors. Cronbach's α for the CBI was .97 for nurses and .99 for patients.

CONCLUSIONS

The Turkish version of the CBI is a valid and reliable instrument for measuring caring behaviors.

Cultivating a Therapeutic Compassionate Relationship: The 3S Approach

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

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

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

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

BACKGROUND

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

OBJECTIVE

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

DESIGN

A cross-sectional descriptive study design was used.

SETTINGS AND PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Perinatal women's satisfaction with nurses caring behaviours in teaching hospitals in China

BACKGROUND

Adequate caring behaviours provided by nurses can increase patients' satisfaction of care. Yet few researchers have examined women's satisfaction in nurses' caring behaviours in China and then published the study in English.

AIM

The aim of this study was to identify the level of women's satisfaction with nurses' caring behaviours during the antenatal, childbirth and postnatal periods.

METHODS

A descriptive, cross-sectional study was performed using a sample of 422 postpartum women of two teaching hospitals in Wuhan, China. A structured questionnaire on socio-demographic information was completed, and a satisfaction scale of 60 items concerning nurses' caring behaviours was measured.

RESULTS

The findings showed that participants reported a good satisfaction score for nurses' caring behaviours during all three periods. Behaviours on the 'Monitor' subscale obtained the highest score (a mean score of 4.46 for the antenatal period, 4.64 for the childbirth period and 4.31 for the postnatal period). The subscale with the second highest score was 'Human respect' (4.53, 4.27 and 4.56, respectively), while the subscale with the lowest score was 'Trust' (3.78 and 3.98). The statistical significances of the demographics of the women were shown concerning their perceived satisfaction of five subscales of caring behaviours.

CONCLUSION

The study revealed no statistically significant differences in the perceived satisfaction in nurses' caring behaviours between the antenatal, childbirth and postnatal periods. However, nursing administration development projects that focus on caring are still needed. Additionally, more studies that reflect Watson's theory of human caring on the maternity population should be conducted with a larger sample size.

The Interaction with Disabled Persons Scale: translation and cross-cultural validation into Greek

AIM

Cross-cultural adaptation of the Interaction with Disabled Persons Scale (IDPS) into Greek.

METHODS

The IDPS was forward and back-translated by two bilingual physiotherapists and a Greek-English translator, respectively. Greek-speaking health professionals provided modifications in order to develop the final version of the Scale. Health professionals filled in the Greek version of the IDPS and the Caring Behaviors Inventory (for criterion validity). The factors of the Greek IDPS were extracted as well. After 8-10 days, the scale was re-distributed to the same health professionals (test-retest reliability) and to a general population sample (discriminant validity).

RESULTS

Eighty-seven health professionals (36 ± 7.6 years) and 80 general population participants (44 ± 11.6 years) participated. There was a trend for the Greek IDPS variability to predict the variability of the Caring Behaviors Inventory (r² = 0.05; p = 0.054), but the coefficient of determination was low. An explanatory factor analysis extracted four factors explaining 66.66% of the total variance, confirmed by reliability analysis. The health care professionals had a significantly lower score than the general population in the Greek IDPS (mean difference: -11.0; confidence interval: -7.3 to -14.7), indicating familiarisation with the management of people with disability. The scale reliability and internal consistency were excellent; ICC_(2,1) = 0.92 (confidence interval: 0.87-0.95) and Cronbach's α = 0.96 respectively. No ceiling or floor effects were observed.

CONCLUSIONS

Substantial validity and reliability were observed for the Greek IDPS to assess Greek health professionals' attitudes towards people with disabilities.Implications for rehabilitationThe Greek IDPS version was shown to be comprehensible, and has demonstrated a sufficient amount of validity and reliability for assessing the perceptions and attitudes of Greek health professionals towards people with disabilities.Exploring attitudes towards people with disabilities in Greek-speaking populations, especially health professionals, with a scale such as the Greek IDPS is very important as it can help promote positive changes in approaches towards disability.

Caring Models in Geriatric Rehabilitation: An Integrative Review

To promote excellence in care, person centered care based on humanistic values are essential. This integrative literature review summarizes the current research on the use of a caring model or approach in rehabilitation wards for elderly and explores the issues or benefits on patient's care or on patient-nurse interactions.

Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews

AIM

To explore the impact of culture on health, healthcare provision and its contribution towards health inequity experienced by some marginalised communities.

BACKGROUND

Health inequity is a global issue, which occurs across and within countries, and is the greatest barrier to worldwide health and the development of the human race. In response to this challenge, there is an international commitment to ensure universal health coverage based on the fundamental principle that individuals should be able to access healthcare services they need. Despite this, there is clear evidence that indigenous and other cultural minorities such as New Zealand Māori and Gypsy Roma Travellers still experience far poorer health outcomes when compared to the majority population. Furthermore, when they do access health care, their experiences are often not positive and this in turn results in reluctance to access preventative health care, instead accessing health services much later, reducing treatment options and compounding higher mortality rates. What is often not explored or examined is the impact of the different cultural beliefs of individuals in these communities and the nurses caring for them.

DESIGN

This is a position paper drawing upon research experience with New Zealand Māori and Gypsy Roma Travellers. We critically review the experiences of health inequity of marginalised communities. It does so by examining how these communities may have a different world view to the nurses caring for them, and it is this lack of understanding and valuing of alternative worldviews that contributes to the poorer health outcomes both communities face.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE

As nurses work with many different individuals and groups, we have to find ways of ensuring a more embracing, culturally responsive healthcare environment which respects and values the beliefs of others.

How do patients experience caring? Scoping review

OBJECTIVE

Summarise empirical research into patients' experiences of caring in order to promote this as a core condition for the work of health professionals.

METHODS

A review team: carried out a scoping review with a phenomenological orientation that did not privilege any profession or context of care; comprehensively searched six databases from inception to the present, including all English language articles that report patients' lived experiences of caring; and identified and contrasted uncaring experiences.

RESULTS

43 articles straddled nursing, medicine, and physiotherapy, and a wide range of care settings. Patients experienced caring when competent professionals displayed positive attitudes, communicated effectively, formed relationships, helped them navigate clinical services, and engaged emotionally.

CONCLUSION

This research provides a rich description of caring, which was derived from patients', rather than professionals', experiences.

PRACTICE IMPLICATIONS

Whilst publications and basic professional curricula are dominated by the perspectives of single professions, this research describes patients' experiences that can prepare all health professionals to be caring in collaborative, interprofessional practice.

Pattern of exposure to information and its impact on seasonal influenza vaccination uptake in nurses

BACKGROUND

Uptake of annual influenza vaccination of healthcare workers (HCWs) varies, and remains at a suboptimal level in many countries. As HCWs are often exposed to a variety of information about vaccination, the pattern of exposure may impact their decision; this deserves further investigation.

METHODS

Practising nurses in Hong Kong were invited to participate in an anonymous online survey in February 2016, after the winter seasonal peak. The questionnaire covered demographics, work nature and experiences, vaccination uptake history and reasons for vaccination decisions. Two behavioural categories for access to information were defined - passive exposure to information and active information-seeking - differentiated by the source, type and nature of information accessed. Chi-squared test, Mann-Whitney U-test and logistic regression were performed to compare vaccinated and unvaccinated nurses.

RESULTS

In total, 1177 valid returns were received from nurses. The median age of respondents was 32 years and 86% were female. The overall vaccination rate was 33%. Passive exposure to information from the workplace, professional body and social network was not predictive of vaccination decision, but passive exposure to information from mass media was predictive [odds ratio (OR) 1.78]. Active information-seeking, such as consulting a senior (OR 2.46), organizing promotional activities (OR 2.85) and undertaking an information search (OR 2.43), was significantly associated with increased vaccination uptake. A cumulative effect could be demonstrated for active information-seeking (OR 1.86), but not for passive exposure to information.

CONCLUSION

The current strategy of promotions and campaigns for seasonal influenza vaccination in HCWs may not be effective in increasing vaccination coverage. Measures targeting information-seeking behaviours may serve as an alternative approach.

Reintroduction failure is common among adolescents after double-blind placebo-controlled food challenges

AIM

There has been a lack of research on adolescents who undergo double-blind placebo-controlled food challenges. The aim of this study was to investigate food allergic adolescents' experiences and consequences of double-blind placebo-controlled food challenges.

METHODS

This qualitative, descriptive interview study included 17 adolescents aged 14-15 years with total elimination of cows' milk, hens' eggs or cod due to food allergies. The participants, who were initially identified from a large population-based cohort study, were interviewed 18 months after completing their challenges.

RESULTS

The double-blind placebo-controlled food challenge proved to be a complex experience for the adolescents, involving fear of potential reactions and the hope that the food could be reintroduced. Experiences during the challenge were described in three themes: facing fears in a secure environment, being hesitant but curious about unknown tastes and waiting for unknown food reactions. Experiences after the challenge were described in two themes: gaining control and freedom and continuing old habits. A negative challenge was not consistently associated with the reintroduction of the challenged food.

CONCLUSION

This study highlighted the importance of considering the adolescents' expectations and experiences of the challenge and the reintroduction process to ensure desirable changes in their dietary habits. Follow-ups should be performed regardless of the outcome of challenges.

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

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

Reconciling conceptualisations of the body and person-centred care of the older person with cognitive impairment in the acute care setting

In this article, we sought reconciliation between the "body-as-representation" and the "body-as-experience," that is, how the body is represented in discourse and how the body of older people with cognitive impairment is experienced. We identified four contemporary "technologies" and gave examples of these to show how they influence how older people with cognitive impairment are often represented in acute care settings. We argued that these technologies may be mediated further by discourses of ageism and ableism which can potentiate either the repressive or productive tendencies of these technologies resulting in either positive or negative care experiences for the older person and/or their carer, including nurses. We then provided examples from research of embodied experiences of older people with dementia and of how nurses and other professionals utilized their inter-bodily experiences to inform acts of caring. The specificity and individuality of these experiences were more conducive to positive care experiences. We conclude the article by proposing that the act of caring is one way nurses seek to reconcile the "body-as-representation" with the "body-as-experience" to mitigate the repressive effects of negative ageism and ableism. The act of caring, we argue, is the essence of caring enacted through the provision of person-centred care which evokes nurses to respond appropriately to the older person's "otherness," their "variation of being" while enabling them to enact a continuation of themselves and their own version of normality.

Nursing students' perceptions of their instructors' caring behaviors: A four-country study

BACKGROUND

Caring is the core and essence of the nursing profession. Nurse educators, are in a key position to role model for perspective nurses the role of caring while including caring as a vital component in a nursing curriculum.

OBJECTIVES

This paper is a report on students' perceptions of instructors' caring behavior in four countries: India, Greece, Nigeria, and the Philippines.

METHODS

This study utilized a quantitative, cross-sectional, comparative approach. A total of 450 nursing students participated with an almost equal nursing student frequency distribution. The main instrument used in this study was the Nursing Students' Perceptions of Instructor Caring (NSPIC). The study was conducted during the months of September 2013 to January 2014. Descriptive statistics, correlations analysis, linear regression model and one-way analysis of variance (ANOVA) were used to analyze the data collected.

FINDINGS

The highest rated subscale in the NSPIC was "instills confidence through caring" (M=4.268, SD=0.964), while the lowest ranked subscale was for the subscale "Control versus flexibility" (M=3.609, SD=1.076). No significant correlations were found between the NSPIC scale and gender (F=0.060, p=0.807), age (F=3.220, p=0.073), educational level (F=0.100, p=0.752) and family status of students (F=1.417, p=0.235), except the country of origin (F=3.703, p=0.012, η(2)=0.024).

CONCLUSION

With this study as an initial investigation into ascertaining nursing instructors caring focused on a cross-country approach, nurse educators can utilize this information to better portray their role as a nurse educator when being perceived by their nursing students.

Who cares? A critical discussion of the value of caring from a patient and healthcare professional perspective

BACKGROUND

This study was undertaken in order to discover and illuminate the essential caring behaviours valued by both patients and staff in an orthopaedic setting within a district general hospital in the United Kingdom.

OBJECTIVES

This descriptive study was undertaken in order to acquire a greater understanding of perceptions of caring from both patient and orthopaedic healthcare professional perspectives.

METHODS

A sample of 30 patients and 53 healthcare professionals consisting of doctors, nurses, physiotherapists and occupational therapists were asked to complete the Caring Behaviours Inventory (CBI) questionnaire (Wolf et al., 1994). Data were analysed using descriptive and inferential statistics.

RESULTS

The findings revealed both similarities and differences relating to the importance of positive caring behaviours exhibited during caring interactions. Healthcare professionals working in the orthopaedic setting acknowledged the value of similar positive caring behaviours to those of the patient group but ranked the importance of these differently.

DISCUSSION

Several important insights into perceptions of caring have been gained. These relate to an overall understanding of the caring behaviours that are considered of importance to patients and healthcare professionals; the differences that exist between the caring perceptions of both groups and the factors which influence these perceptions.

Nursing therapeutics: Teaching student nurses care, compassion and empathy

BACKGROUND

Debate continues regarding whether humanitarian values such as care and compassion can be taught or are innate in individuals who wish to become nurses.

OBJECTIVES

To undertake a discursive review of the literature on caring, compassion and empathy. To understand the teaching and learning issues associated with these concepts. To design and implement an Undergraduate Unit of study which addresses the development of caring, compassion and empathy in student nurses.

METHODS/DATA SOURCES

MEDLINE, CINAHL, and a wide range of literature including books and governmental reports were used for a discursive narrative review.

RESULTS

Caring, compassion and empathy are ill-defined; however healthcare users are clear that they know when nurses use skills and attitudes associated with these concepts. Evidence is available to show that caring, compassion and empathy can be taught and there are tools available to measure them in neophytes through their training. Central to the androgogical embedding of these concepts into nursing curricula is the development of therapeutic relationships.

CONCLUSIONS

It is possible to develop materials to enable student nurses to learn how to care using compassion and empathy. Nursing therapeutics is a term devised to describe how student nurses can exploit the therapeutic potential of any patient contact especially when related to specific and routine nursing interventions. Muetzel's model for understanding therapeutic relationships is one framework that can be adopted to help student nurses to appreciate how to build patient relationships and encourage them to move towards therapeutic advantage using care, compassion and empathy.