Mediating Effect of Motivation on the Relationship Between Lecturer Experience and Learning Environment With Caring Character Among Undergraduate Nursing Student in Indonesia

Introduction

Caring is learned through faculty role-modeling and clinical interactions, enhancing nursing students' caring character. Relationship between caring, motivation, teacher experience, and learning environment remains uncertain.

Objective

The present study aimed to explore the relationship between their caring characters, motivation, lecturer experience, and learning environment among undergraduate nursing students in Indonesia.

Methods

A cross-sectional study was conducted between December 2022 and February 2023, recruiting 550 undergraduate nursing students from 10 universities in West Java province, Indonesia. The study included instruments such as students' perceptions of learning, academic motivation scale, service quality assessment of instructional laboratories, and caring character learning instrument. The Bootstrap analysis was used to analyze the mediating effect of study variable.

Results

The study involved participants aged 20-25 years. The mean scores for caring characters, lecturer experience, motivation, and learning environment were 2.18 ± 0.97, 3.46 ± 1.20, 4.32 ± 1.53, and 5.96 ± 2.08, respectively. The results showed significant direct effects of lecturer experience on caring character, mediating effects of learning environment, motivation, and chain mediating effects of learning environment and motivation. The direct effect accounted for 44.34% of the total effect, while the indirect effect was 35.21%.

Conclusions

The study found that learning environment and motivation mediate the relationship between lecturer experience and caring characters among undergraduate nursing students in West Java, Indonesia. Emphasizing best practices and creating a student-friendly environment is crucial for fostering guidance and support.

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

AIM

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

BACKGROUND

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

DESIGN

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

Nurses' perceptions of caring activities in nursing

Aim

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

Design

A descriptive study design.

Methods

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

Results

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

A caring model for nursing education

With the many changes occurring within the health system and nursing education, ongoing shortages in the number of nurses and nursing faculty, increased incidences of incivility, and the charge to transform nursing education while upholding and transmitting the core professional values, a better understanding of the climate within nursing education is warranted. Caring is a core value of the profession of nursing and has received much attention and study, primarily in the practice setting. In nursing education much of this work has centered on the structure and processes of nursing education and the nursing student’s development of caring behaviors. This article proposes a caring model for nursing education that integrates the key concepts of organizational climate, leadership, and caring theories. The intent of the model is to provide a framework that can be used for professional nursing education that incorporates the core value of caring and develops graduates prepared to provide relationship-based, patient-centered care.

The relation between nursing students' levels of self-efficacy and caring nurse-patient interaction: a descriptive study

Background: Nursing is a process of interpersonal interaction. Objective: To determine the relationship between the self-efficacy levels and caring nurse-patient interactions of nursing students. Methods: The study was carried out with 198 students who agreed to participate. The data was collected by using personal information forms, the Caring Nurse-Patient Interaction Scale (CNPIS), and the Self-Efficacy-Sufficiency Scale (SES). Collected data were evaluated via descriptive statistics, independent group t-test, ANOVA, and Tukey HSD and Pearson Correlation analysis. Results: CNPIS sub-dimension point averages were 309.94 ± 34.71 for importance, 278.97 ± 40.81 for competency, and 264.04 ± 46.17 for feasibility. It was determined that there are statistically significant, strong, and positive relations between all sub-dimension of the scale. It was also determined that the scale sub-dimension point averages differ in a statistically significant way on the basis of certain demographic attributes (sex and age of the students (p<0.05)). Furthermore, a statistically significant, positive and medium level relation was determined between the CNPIS importance and competence point averages and SES total points (rimportance: 0.318, pimportance: 0.000; rcompetence: 0.322, pcompetence: 0.000) Conclusions: It was concluded that students scored high points from all sub-dimensions of the CNPIS. It was further determined that students with high levels of self-efficacy/sufficiency have higher levels of caring for nurse-patient interaction. Impact statement: Adequate self-efficacy and sufficiency will be able to provide better nurse-patient interaction which based on care.

The Perceptions of Professional Values among Students at a Spanish Nursing School

(1) Background: This study aims to reflect student nurses' perceptions of professional values across the four training years. (2) Methods: This study was designed as a cross-sectional study; data were collected using the Nurses' Professional Values Scale-Revised, adapted by Basurto-Hoyuelos. A total of 315 student nurses participated from a Nursing Faculty in Spain representing each of the four academic years. (3) Results: Students' perceptions of professional values were significantly correlated with their academic year. Overall, students' scores were higher in the ethics dimension. The two highest scores were for Maintain patient confidentiality for years 1 and 2 (4.77 and 4.68, respectively) and Safeguard patients' right to privacy for years 3 and 4 (4.95 and 4.98, respectively). Lower scores were observed in the professional expertise dimension across all years, and corresponded to a single item Participate in peer review (3.51, 3.38, 3.98, and 3.26, respectively). (4) Conclusions: This study is relevant as it highlights how nursing students' perceptions of professional values change overtime, even during the four years of their training. The ethics dimension was the most highly regarded across all academic years. However, the professional expertise dimension requires greater attention throughout the degree as students regarded it as less important for their immediate future.

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.

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

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

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

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

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

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

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

A comparison of the caring behaviours of nursing students and registered nurses: implications for nursing education

AIMS AND OBJECTIVES

To compare the respective views of nursing students and registered nurses on caring behaviours.

BACKGROUND

Research has indicated that nursing includes not only technical skills and professional knowledge but also the expression of care. In addition to nursing care, nurses demonstrate the acts of supporting, negotiating, reinforcing and transforming. However, little research simultaneously investigates the caring behaviours of nursing students and registered nurses.

DESIGN

A cross-sectional study was conducted.

METHODS

A total of 657 subjects participated in this study. The research tool was a self-administered structured questionnaire. Data were analysed using descriptive statistics, one-way analysis of variance, t-test and chi-square test.

RESULTS

The results showed that the most important caring behaviour is 'knowing the patient', while the least is 'advocating for the patient', which includes caring behaviours to respect the patient's and family's best interests, and voicing for them, possibly because this behaviour is more difficult for nurses to practice in the Taiwanese culture. Moreover, there was no significant difference in the caring behaviours between nursing students and registered nurses. However, age was found to be a significant difference in the caring behaviours of nursing students and registered nurses.

CONCLUSION

Caring behaviour is essential in clinical practice. Based on the results, this study suggested that role models should be provided to nursing students to develop proper caring behaviours. Nursing faculty can boost nursing students' interests in learning caring behaviours by incorporating diverse teaching strategies to enhance the effectiveness of caring behaviours.

RELEVANCE TO CLINICAL PRACTICE

Much attention should be focused on education about awareness of caring behaviour for both nursing students and nursing staff. This study addressed that nursing administrators and faculty members should emphasise the importance of the essence of caring. Consequently, nursing curricula and training of nurses need to be concerned with implementing caring behaviour in clinical practice.

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

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

Comparison of Caring Ability Between Chinese and American Nursing Students

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

Principle-based concept analysis: Caring in nursing education

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

Perceptions matter: faculty caring, campus racial climate and academic performance

AIM

Examine the influence of students' perception of faculty caring on academic performance and the moderating role of students' perceptions of campus racial climate.

BACKGROUND

There is limited knowledge on how students' perceptions of faculty caring, campus racial climate and academic performance are linked. Understanding this nexus is crucial to improving nursing education.

DESIGN

Secondary analysis of a cross-sectional data obtained from seven undergraduate nursing programs in Texas, USA.

METHOD

Data were from 385 students enrolled in Medical-Surgical 1 over three semesters (March 2010-December 2010). Six sets of factor analytic scores derived from 31 original perceptions of faculty caring items served as predictors; one set of scores derived from seven original perceptions of campus racial climate items served as moderating variable in a regression model. Numeric grade was the outcome variable.

RESULTS/FINDINGS

Perception of faculty having a positive outlook/compassion had an enhancing effect on performance. As students' perceptions of campus racial climate became increasingly discriminating, the positive association between perceptions of faculty's trust in students' judgment and academic performance became increasingly strong.

CONCLUSION

Results highlight ways by which students' perception of micro-level social reality (dyadic interaction) might interact with their perception of meso-level social reality (social environment) to influence their academic performance.

Ethical violations in the clinical setting: the hidden curriculum learning experience of Pakistani nurses

Background

The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan’s healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners.

Methods

The means of inquiry for this study was qualitative, with 20 interviews and four focus group discussions used to identify nurses’ clinical experiences of ethical violations. Content analysis was used to discover sub-categories of ethical violations, as perceived by nurses, within four pre-defined categories of nursing codes of ethics: 1) professional guidelines and integrity, 2) patient informed consent, 3) patient rights, and 4) co-worker coordination for competency, learning and patient safety.

Results

Ten sub-categories of ethical violations were found: nursing students being used as adjunct staff, nurses having to face frequent violence in the hospital setting, patient reluctance to receive treatment from nurses, the near-absence of consent taken from patients for most non-surgical medical procedures, the absence of patient consent taking for receiving treatment from student nurses, the practice of patient discrimination on the basis of a patient’s socio-demographic status, nurses withdrawing treatment out of fear for their safety, a non-learning culture and, finally, blame-shifting and non-reportage of errors.

Conclusion

Immediate and urgent attention is required to reduce ethical violations in the healthcare sector in Pakistan through collaborative efforts by the government, the healthcare sector, and ethics regulatory bodies. Also, changes in socio-cultural values in hospital organisation, public awareness of how to conveniently report ethical violations by practitioners and public perceptions of nurse identity are needed.

Third year nursing students' viewpoints about circumstances which threaten safety in the clinical setting

BACKGROUND

Evidence emphasizes that learners, educators, clinicians, programs, and organizations share the responsibility for establishing and maintaining safety throughout undergraduate nursing education. Increased knowledge about students' perceptions of threats to safety in the clinical setting may guide educators' efforts to promote the development of safe novice practitioners while preserving patient safety.

OBJECTIVE

The purpose of this study was to describe third year nursing students' viewpoints of the circumstances which threaten safety in the clinical setting.

METHODS

Using Q methodology, 34 third year Bachelor of Science in Nursing students sorted 43 theoretical statement cards. Each card identified a statement describing a threat to safety in the clinical setting. These statements were generated through a review of nursing literature and consultation with experts in nursing education. Centroid factor analysis and varimax rotation identified viewpoints regarding circumstances that most threaten safety.

RESULTS

Three discrete viewpoints and one consensus perspective constituted students' description of threatened safety. The discrete viewpoints were labeled lack of readiness, misdirected practices, and negation of professional boundaries. There was consensus that it is most unsafe in the clinical setting when novices fail to consolidate an integrated cognitive, behavioral, and ethical identity. This unifying perspective was labeled non-integration.

CONCLUSION

Third year nursing students and their educators are encouraged to be mindful of the need to ensure readiness prior to entry into the clinical setting. In the clinical setting, the learning of prepared students must be guided by competent educators. Finally, both students and their educators must respect professional boundaries to promote safety for students and patients.

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

INTRODUCTION

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

AIM

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

METHODOLOGY

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

FINDINGS

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

CONCLUSION

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