Humanistic caring, a nursing competency: modelling a metamorphosis from students to accomplished nurses

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

[The concept of caring and its contemporary translation: the view of French doctoral candidates]

Jean Watson developed, in the United States, a conceptual model of nursing based on caring. A term sometimes translated as "to care" without properly reflecting what the concept entails. This theory has been adopted in many countries. Some authors report that it brings satisfaction to students, nurses, and managers of health facilities. Based on Watson's work, Chantal Cara built the humanist model of nursing at Montreal University. The aim of the project is to improve the well-being of patients and caregivers. It is likely to retain existing nurses and attract the next generation to the institutions which implement it.

Critical care nurses' experiences of communication-vulnerable patients in the intensive care unit and the influence on rendering compassionate care

Background

Interventions administered to critically ill patients, including mechanical ventilation, sedation or other treatments may hinder communication between patients and nurses. These communication challenges may affect critical care nurses' ability to provide compassionate, person-centred care.

Objectives

To identify nurses' experiences with patients who are communication-vulnerable in the intensive care unit and how they affect nurses' ability to offer compassionate care.

Methods

This qualitative explorative descriptive study involved nurses who worked in intensive care units from four private hospitals in Gauteng, South Africa. Focus groups were conducted with 30 critical care nurses in groups of two to six participants each. Thematic analysis was used to identify themes.

Results

Five main themes were identified based on nurses' reports of their experiences with critically ill patients who experience communication difficulties and their impact on rendering compassionate care. Themes were deductively identified based on the social purposes of communication categories. Participants indicated that communication-vulnerable patients influence their ability to provide compassionate care. Generally, the physical, emotional, social and communication difficulties of assisting communication-vulnerable patients caused nurses to feel frustrated and negative towards their work environment, which added to their work stress and sometimes resulted in compassion fatigue.

Conclusion

The study shows that various factors could impact the nurses' ability to provide compassionate care and that they require support to provide person-centred care. These factors can include the physical environment, the patient's alertness and awareness and institutional barriers. To support nurses in providing compassionate care, communication partner training may be warranted.

Contribution of the study

This study aims to increase awareness of the aspects that may contribute to compassion fatigue for nurses. By identifying these aspects greater support can be provided by facilities where nurses work.

Final-year nursing students' perceptions of humanistic education in nursing: a cross-sectional descriptive study

BACKGROUND

Humanistic education is an important part of nursing education. Final-year nursing students' perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students' perceptions of nursing humanistic education in both school and hospital.

METHODS

This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire.

RESULTS

Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1-5 scale, while their initiative to enhance humanistic qualities was relatively low. Students' satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The "monotonous teaching format" (63.6%) and "teaching methods" (64.5%) have emerged as focal points that students identified as needing attention and improvement.

CONCLUSIONS

In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students' learning motivation, and strengthening the construction of humanistic environment.

Learning to provide humanistic care and support in the context of chronic illness: Insights from the narratives of healthcare professionals in hemato-oncology

PURPOSE

To document the process by which healthcare professionals (HCPs) support people living with and beyond hematological cancer and detail how they learned from their personal and clinical experience.

METHOD

Using a narrative approach, we conducted nine semi-structured interviews with HCPs, including nurses, from a specialized care centre who support patients with hematological cancer. Interviews aimed to capture experiential learning gained from their practice. We performed a hybrid inductive/deductive content analysis on data using a framework based on sociological and educational models of experiential learning.

RESULTS

Among healthcare professionals, analysis revealed the need to provide care and support that is 'humane' and adapted to each patient. Learning to provide this type of care proved to be challenging. Over the course of their clinical experience, healthcare professionals learned to adapt the support they provided by straddling a boundary between sympathy and empathy. Learning outcomes were associated with personal-professional development among participants.

CONCLUSION

Our findings bring to light an overlooked facet of patient support in the context of cancer care, which is the acquisition of the soft skills required to deliver humanistic care and support. This learning process requires time and involves navigating between the realms of sympathy and empathy. Experiential learning is intertwined with the complexity of the often long-term patient-professional relationship that characterizes hemato-oncology. This unique relationship offers rewards for healthcare professionals on both personal and professional fronts.

Standardized training nurses's humanistic care practice ability: A cross-sectional survey in western China during COVID-19

AIM

This study aims to investigate the current status and determinants of humanistic care practice abilities among standardized training nurses in China during the post-COVID-19 era, as well as to propose management strategies.

DESIGN

A cross-sectional study.

METHODS

Deliberately chosen were 517 standardized training nursing students from a provincial-level training facility in western China.

RESULTS

The respondents had a mean ± SD age of 21.23 ± 1.34 years, and 92.0% of them voluntarily opted for the nursing profession. Almost all (99.8%) respondents had at least a college degree. The standardized training nurses scored an average of (130.31 ± 14.18) on humanistic care ability, which was significantly related to some sociodemographic variables. The average scores for the five dimensions of nursing communication ability, psychological adjustment ability, moral and legal application ability, nursing aesthetic ability, and care practice ability were 30.78, 17.61, 32.23, 18 and 31.67, respectively. All these dimensions showed positive correlations with the overall score of humanistic care practice ability.

The chain mediating effect of empathy and communication ability on emotional intelligence and caring ability of nursing students

Background

The implementation of humanistic care is conducive to providing high quality nursing, improving patient satisfaction and establishing harmonious nursery-patient relationship. Current researchs show that humanistic caring ability is affected by emotional intelligence, empathy, interpersonal communication. But the exact relationship and internal mechanism of such factors have not been fully understood.

Objective

To explore the multiple mediating effect of empathy and communication ability on nursing students' emotional intelligence and caring ability.

Methods

A case study was conducted by examining a sample of 1,165 nursing students from a junior college in Anhui, China. The multidimensional scales, and a self-designed demographic characteristics questionnaire were utilized. Path relationships and mutual effects were tested using structural equation modeling (SEM).

Results

Emotional intelligence, empathy, and communication ability were found to positively affect nursing students' caring ability, as well as positive interrelationships with one another (standardized estimate = 0.312-0.584, p < 0.001). Communication ability and empathy play an important role in mediating the association between emotional intelligence and caring ability, and the effect sizes are 0.169 and 0.121, respectively, while the effect value of empathy and communication ability in emotional intelligence and caring ability was 0.034, which showed partial mediation of the association. The indirect effect of the structural equation was 77.14%.

Conclusion

The chain mediating role of empathy and communication ability in emotional intelligence and caring ability is explored, which not only enrichis previous studies, but also reveals the mechanism of emotional intelligence's influence on caring ability. It is essential to continuously improve nursing students' caring ability. From the perspective of nursing educators, they need to develop targeted approaches to help the nursing student improve their emotional intelligence, empathy, and communication skills, further enhancing their caring ability.

Influencing factors of humanistic care ability and its dimensions among mental health workers during the COVID-19 pandemic: an online cross-sectional study

BACKGROUND

In psychiatric services, humanistic care ability significantly affects the quality of the therapeutic relationship and thus affects the therapeutic outcomes for patients. Mental health workers may be confronted with more obstacles in humanistic care during the COVID-19 pandemic wherethe authors aimed to explore the capacity level of humanistic care among mental health workers and its potential influencing factors.

METHOD(S)

An online cross-sectional survey was conducted among 262 mental health workers working in Chongqing, China, from December 2020 to January 2021. Data were collected by the Caring Ability Inventory (CAI), the Psychological Capital Questionnaire (PCQ-24), the Eysenck Personality Questionnaire-Revised, and the Short Scale for Chinese (EPQ-RSC). Multiple linear regression analysis was used to explore the influencing factors of humanistic care ability.

RESULTS

Mental health workers' humanistic care ability is at a low level, with a score of 186.47 ± 21.34. Psychological capital is positively associated with humanistic care ability (β[95%CI] = 0.41 [0.46-0.77], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.51 [0.30-0.47], p < 0.001; patience: β[95%CI] = 0.48 [0.17-0.28], p < 0.001). Psychoticism is negatively associated with humanistic care ability (β[95%CI] = -0.28 [-5.18 - -2.51], p < 0.001) and its three dimensions (cognition: β[95%CI] = -0.12 [-1.57 - -0.17], p < 0.05; courage: β[95%CI] = -0.17 [-1.7 - -0.32], p < 0.01; patience: β[95%CI] = -0.19 [-1.33 - -0.36], p < 0.01). Extroversion is positively associated with humanistic care ability (β[95%CI] = 0.19 [0.69-2.08], p < 0.001), and its two dimensions (cognition: β[95%CI] = 0.19 [0.32-1.05], p < 0.001; courage: β[95%CI] = 0.27 [0.5-1.23], p < 0.001). Neuroticism is negatively associated with humanistic care ability (β[95%CI] = -0.13[-1.37 - -0.19], p < 0.01) and its one dimension (courage: β[95%CI] = -0.25 [-0.98 - -0.35], p < 0.001).

CONCLUSION(S)

The research has found that the humanistic care ability of mental health workers is at a low level, and the psychological capital and personality traits are significant factors influencing the humanistic care ability and its sub-dimensions. Interventions to improve the psychological capital of mental health workers or to promote the change of personality traits they want are recommended, thereby to promote humanistic practice.

Undergraduate nursing students' experiences of practicing caring behaviours with standardised patients

RATIONALE

Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis.

AIM

The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient.

METHOD

A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience.

RESULTS

One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient.

CONCLUSION

When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences.

Validity and reliability of the Korean version of the Humanism Scale Short Form: A cross-sectional study

AIM

To examine the reliability and validity of a Korean version of the Humanism Scale Short Form.

DESIGN

A cross-sectional descriptive design.

METHODS

This study involved 191 nurses in Korea. Data were collected from 1 May to 30 June 2019. Bilingual nursing professionals translated the scale into Korean, and reverse translation was performed. Validity and reliability were assessed, and the correlation coefficients of the developed scale were compared with those of the Korean version of the Empathy Quotient Scale and Compassion Competence Scale to evaluate concurrent validity.

RESULTS

Exploratory factor analysis with 15 items showed that two factors (human equality and respect for human beings) explained 50.86% of the variance. Cronbach's alpha for the overall scale was 0.88. Thus, the scale has acceptable reliability and validity. Humanism measures can predict a nurse's approach to holistic care and provide fundamental data for developing programs to improve integrated caring capacities.

Nurses' perspectives on the application of humanistic anatomical knowledge in clinical practice

Knowledge of human anatomy is vital for nurses. Medical educators use a variety of educational pedagogies, including the use of cadavers, to cultivate nursing students into competent and professional care providers and to help them gain authentic experience and knowledge before entering the workplace. Studies have provided numerous examples of students with positive learning experiences in human-centric (humanistic) anatomy courses; however, whether these positive experiences translate into effective clinical practice remains largely unknown. This study explored nurses' perspectives on the effects of a humanistic anatomy program on their nursing practice. Focus groups with semi-structured interview guidelines were conducted to collect data. Twenty-one nurses working in hospitals in Taiwan participated and divided themselves into four groups on the basis of willingness to participate and availability. The interviews were recorded using smartphones, and the recordings were transcribed using a computer. The transcriptions were then checked word by word artificially and analyzed by hand. Three main themes emerged during the analysis: adapting to the professional journey, managing time when providing humanistic care, and cultivating professionalism. The results demonstrate educators' expectations that humanistic anatomy education for nursing students expands students' professional knowledge and helps them develop humanistic competencies as professional nurses.

The empathy level and caring behaviors perceptions of nursing students: A cross-sectional and correlational study

PURPOSE

The aim of the study was to investigate the empathy level and caring behaviors perceptions of nursing students.

METHOD

This cross-sectional and correlational study was conducted with 276 nursing students.

RESULTS

The mean Empathic Tendency Scale score was 62.71 ± 5.10 (min. 20 to max. 100), indicating a low level of empathy. The mean of the Caring Assessment Questionnaire was 5.42 ± 0.80 (min. 1 to max. 7), showing a good perception of caring behaviors. There was a positive, low, and significant relationship between empathy and caring behaviors (r = 0.286, p < 0.001).

CONCLUSION

This study revealed that nursing students have low-level empathy and high-level caring behaviors.

PRACTICE IMPLICATIONS

Throughout the educational process, the students' caring competencies, which include empathy and caring behaviors, developed. It is suggested that humanistic and value-oriented pedagogical approaches be incorporated into nursing curricula.

Psychological capital has a positive correlation with humanistic care ability among nurses

Objective

With the improvement in health awareness, humanistic care ability of nurses has become a focus of public attention. The aim of the study was to confirm the relationship between psychological capital and humanistic care ability of nurses, and to provide suggestions on improving the humanistic care ability of nurses.

Methods

A cross-section survey was conducted. Three hundred thirty-nine nurses were recruited from a tertiary general hospital in Taizhou, China. Psychological capital and humanistic care ability were measured using a self-reported questionnaire. Correlation analysis and stepwise multiple regression analysis were performed to analyze the correlation between psychological capital and humanistic care ability.

Results

The psychological capital and humanistic care ability scores were 91.57 ± 13.96 and 189.08 ± 20.37, respectively. Differences in psychological capital scores across professional titles (F = 4.88, p = 0.01), departments (F = 3.69, p < 0.001), years of work (F = 4.68, p < 0.001), and marital status (t = 3.25, p < 0.001) were statistically significant. There were statistical differences for the humanistic care ability scores among nurses based on marital status (p = 0.01). The total psychological capital scores and the four sub-dimensions scores were positively correlated with the humanistic care ability scores among nurses. Self-efficacy was the main predictor of nurses’ humanistic care ability.

Conclusion

Psychological capital positively affected the humanistic care ability of nurses. Self-efficacy was the main predictor of humanistic care ability. Nursing managers can formulate strategies from the perspective of positive psychology to improve humanistic care ability of nurses.

Nursing Students and Nurses' Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

BACKGROUND

Most nursing education programs prepare their students to embody humanism and caring as it is expected by several regulatory bodies. Ensuring this embodiment in students and nurses remains a challenge because there is a lack of evidence about its progressive development through education and practice.

PURPOSE

This manuscript provides a description of nursing students' and nurses' recommendations that can foster the development of humanistic caring.

METHODS

Interpretive phenomenology was selected as the study's methodological approach. Participants (n = 26) were recruited from a French-Canadian university and an affiliated university hospital. Data was collected through individual interviews. Data analysis consisted of an adaptation of Benner's (1994) phenomenological principles that resulted in a five-stage interpretative process.

RESULTS

The following five themes emerged from the phenomenological analysis of participants' recommendations: 1) pedagogical strategies, 2) educators' approach, 3) considerations in teaching humanistic caring, 4) work overload, and 5) volunteerism and externship.

CONCLUSION

The findings suggest the existence of a challenge when using mannikins in high-fidelity simulations with the intention of developing humanistic caring. The findings also reaffirm the importance of giving concrete and realistic exemplars of humanistic caring to students in order to prevent them from making "communication" synonymous to "humanization of care".

Role of self-efficacy in nursing organizational climate: A way to develop nurses' humanistic practice ability

AIM

This study aimed to investigate the impact of self-efficacy on the relationship between organizational climate and humanistic practice ability (HPA) in Chinese nurses.

BACKGROUND

To date, studies on the effect of organizational climate on nursing care have focused on care outcomes rather than care processes. Thus, this effect remains poorly understood.

METHODS

A total of 757 participants were sampled from three tertiary hospitals in Guangdong Province from November to December 2019; subsequently, they completed a structured electronic questionnaire. A structural equation model was used to explore the impact of nursing organizational climate on nurses' HPA.

RESULTS

A total of 688 valid questionnaires were collected. The nurses' average HPA score was 107.82 (SD 12.47). There was a positive correlation between organizational climate and HPA (r = .409, p < .05). Additionally, self-efficacy mediated this relationship (p < .01).

CONCLUSIONS

This study provides new insights into nursing organizational climate, self-efficacy and nurses' HPA.

IMPLICATIONS FOR NURSING MANAGEMENT

The significant mediating effect of self-efficacy suggests that managers should implement nurse professional development programmes using targeted strategies to foster greater self-efficacy, which could improve the quality of care and nurse-patient relationships.