Caring Behaviors Inventory-24: translation, cross-cultural adaptation and psychometric testing for use in a Swedish context

A Systematic Scoping Review on Dignity Assessment Tools

CONTEXT

The provision of person-centered dignity-conserving care is central to palliative care. It is important to reevaluate current methods of assessing dignity as the concept of dignity is multifaceted.

OBJECTIVES

The aim of this study is to understand the tools which are used to assess a patient's dignity and the elements of dignity evaluated in these tools.

METHODS

Two independent and concurrent Systematic Evidence-Based Approach guided systematic scoping reviews (SSR in SEBA) on existing dignity assessment tools and on accounts of assessments of dignity were carried out. The SSR in SEBA on dignity assessment tools involving PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Scopus, and CINAHL databases saw 22 full-text articles included from the 645 articles reviewed. The SSR in SEBA on accounts of assessments of dignity featured in the PubMed database identified 102 full-text articles which saw 46 articles included.

RESULTS

The domains identified were factors affecting patients' definition of dignity; elements of dignity-conserving care; and components of effective tools.

CONCLUSION

Current accounts to assess dignity and assessment tools fail to capture shifting self-concepts of dignity holistically. A portfolio-like appraisal of dignity is proposed to achieve assessments that are timely, longitudinal, and patient-specific. Portfolio-based assessments by members of the multidisciplinary team will better direct timely evaluations of relevant aspects of changing concepts of dignity, without losing the patient's holistic perception of dignity.

A comparison of perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students

BACKGROUND

The population of women in homelessness in Europe is increasing and women in homelessness experience multiple healthcare needs. However, there is insufficient understanding about how perceptions of caring behaviours compare between women in homelessness as patients and nurses in their clinical practice.

AIM

This study aimed to investigate perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students.

METHODS

A cross-sectional design was used with convenience sampling to recruit groups of women in homelessness (n = 37), Registered Nurses (n = 92) and nursing students (n = 142) in Stockholm, Sweden. Between August 2019 and December 2020, data were collected through face-to-face interviews or online, using the Caring Behaviours Inventory-24 instrument. Data were analysed using descriptive statistics and group-comparing hypothesis tests.

RESULTS

Overall, women in homelessness' perceptions of caring behaviours were significantly lower than nursing students (p < 0.001), who in turn scored significantly lower than Registered Nurses (p < 0.001). The Knowledge and Skill domain had the highest score, and the Connectedness domain had the lowest score in all three groups. The ranking of the individual items according to score varied between the groups. However, all three groups had the highest score for the Knowing how to give shots, IVs, etc., item and the lowest score for the Helping the patient to grow item.

CONCLUSION

Healthcare providers and nurse educators should consider incongruences and congruences in caring behaviours to better prepare Registered Nurses and nursing students to contribute to increased health equity, and more targeted clinical practice for women in homelessness.

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

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

Caring Behaviors Inventory-24: translation, cross-cultural adaptation, and psychometric testing for using in nurses and patients

BACKGROUND

To measure caring behaviors, it is necessary to have an instrument adapted based on the contextual culture. This study aimed to translate Caring Behaviors Inventory-24 (CBI-24) into Persian and determine its psychometric properties.

METHODS

This is a methodological study conducted to translate and then psychometrically test The CBI-24. The forward-backward translation was conducted using the World Health Organization (WHO) model and Wild et al. (2005) approach. The face, content, and construct validity of the inventory were assessed using cognitive interviews (10 nurses and 10 patients), expert panel deliberations (10 experts), and the exploratory and confirmatory factor analyses (300 nurses and 300 patients), respectively. The reliability was determined using the internal consistency (300 nurses and 300 patients) and test-retest method (30 nurses and 30 patients).

RESULTS

After translating the CBI-24 and combining its items, the forward translation was initially conducted and the final backward translation was then sent to the developer for confirmation. The final version of the inventory was prepared after the completion of cognitive interviews. The content validity index of all items was reported to be more than 0.8 and good. The Cohen's kappa coefficient of all items was also shown to be higher than 0.74 and excellent. The factor loading of all items except item 19 was above 0.3. Item 19 was removed since it caused the alpha value of the respectfulness dimension to be 0.32. The Cronbach's alpha and the correlation coefficient of the whole inventory were calculated to be 0.95 and 0.88, respectively.

CONCLUSION

The Persian version of CBI-24 can be a suitable tool for measuring caring behaviors among patients and nurses.

Investigation of Caring Behavior and Caring Burden and Their Associated Factors among Nurses Who Cared for Patients with COVID-19 in East Guilan, the North of Iran

Background

Nurses experience caring burdens, which can affect their caring behaviors. Caring for highly infectious patients, in particular COVID-19, is a new phenomenon and little is known about it. Considering that caring behaviors can be influenced by various factors and cultural differences of the society, it is necessary to conduct studies about caring behaviors and caring burdens. Thus, this study aimed to determine caring behavior and caring burden and their relationship with some associated factors among nurses who cared for patients with COVID-19.

Materials and Methods

This cross-sectional, descriptive design study was conducted by census sampling on 134 nurses working in public health centers in East Guilan, the north of Iran, in 2021. The research instruments included the Caring Behavior Inventory (CBI-24) and the Caregiver Burden Inventory (CBI). Descriptive and inferential statistics were used to analyze the data using SPSS software version 20 with a significant level of 0.05.

Results

The mean score of caring behavior and caring burden in nurses was 126.50 (SD = 13.63) and 43.65 (SD = 25.16), respectively. There was a significant relationship between caring behavior and some demographic characteristics (education, place of living, and history of COVID-19) and between caring burden and some demographic characteristics (housing status, job satisfaction, intention to change job, and history of COVID-19) (p < 0.05).

Conclusions

Findings showed that despite the new emergence of COVID-19, the caring burden on nurses was moderate and they had good caring behavior. Despite these results, it is necessary for the relevant managers to pay special attention to protecting health workers during a national crisis such as COVID-19 so that they experience less caring burden and improve caring behavior.

Perception of caring behavior and associated factors among nurses and midwives working in public hospitals in Southern Ethiopia

Objective

This study aimed to assess the perception of caring behaviors and associated factors among nurses and midwives who provided maternal health care services at Sidama region public hospitals, Hawassa, Ethiopia.

Methods

An institutional-based cross-sectional study design was used on a sample of 269 nurses and midwives working in maternity wards in Sidama region public hospitals. A self-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression analysis was used to identify factors associated with nurses' and midwives' perceptions of caring behaviors.

Results

Totally 261 nurses and midwives participated the survey. Based on the mean score, participants' perception of caring behavior was classified as higher and lower. According to this study, 75.1% (196/261) of nurses and midwives demonstrated a higher perception of caring behavior. Respondents' age, professional satisfaction, personal satisfaction, midwife/nurse-doctor relationship and workload were significantly associated with their perception of caring behavior.

Conclusions

Assessing the nurses' and midwives' perception of caring behavior and related factors is crucial for providing high-quality nursing and midwifery interventions. It is suggested to create a positive and conducive caring behavior in the organization by reducing excessive workload of nurses and midwives, as well as enhancing nurse/midwife-doctor relationship, and increasing their job satisfaction by providing recognition and reward will improve nurses' and midwives' caring behavior.

The relationship between attitudes to homelessness and perceptions of caring behaviours: a cross-sectional study among women experiencing homelessness, nurses and nursing students

Background

Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students.

Methods

A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman’s rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher’s z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results.

Results

Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively.

Conclusions

To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.