Caring in nursing: a multivariate analysis

The dimensions underlying the perceptions of caring among nurses were investigated using the Edinburgh Caring Dimensions Inventory (CDI). Exploratory and confirmatory factor analysis techniques were used. While there was a general caring factor on which the majority of the items in the CDI loaded, there were two separable major dimensions to caring, namely 'psychosocial aspects' and 'professional and technical aspects'. In addition, two smaller dimensions were identified that were both related to self-giving, and it is postulated that these refer, respectively, to appropriate and inappropriate self-giving in nursing.     

A longitudinal study into the perceptions of caring and nursing among student nurses

A longitudinal study of a cohort of student nurses was undertaken in order to investigate whether changes in perceptions of nursing and caring take place and how perceptions of nursing and caring are related. The Caring Dimensions Inventory (CDI) and the Nursing Dimensions Inventory (NDI) were employed for data collection at entry to nurse education and after 12 months. There were significant changes in the scores of a range of items in both inventories which suggested that student nurses lose some of their idealism about nursing and caring after 12 months in nurse education. While the overall ranking of items in the inventories was very similar, it was possible to distinguish between the inventories at entry to training and to observe a change, particularly in the CDI, over time by means of Mokken scaling. Nursing and caring would appear to become more synonymous to the student nurses after 12 months in nurse education. Factors scores, for factors identified in the CDI in a previous study, were used to investigate whether these scores changed at 12 months into nurse education compared with entry. No significant changes were detected.     

Differences and similarities in the perception of caring between Spanish and UK nurses

The aim of the present paper was to compare and contrast perceptions of caring in nursing between Spanish and UK nurses. There are no previous studies comparing directly the perceptions of caring across cultures in nursing. A survey method was used employing the 25-item Caring Dimensions Inventory. Data were Mokken scaled for comparison with data from a previous study and scores for common items on the 25-item Caring Dimension Inventory for Spanish and UK nurses were correlated. There were similarities and differences between Spanish and UK nurses' perceptions of caring: many similar items were incorporated into Mokken scales but the endorsement of items did not correlate. The present work demonstrates that it is possible to measure differences and similarities in perceptions of caring. The study design could be improved and such work could be valuable in cross-cultural work with nurses.     

护理本科生对照护内涵认知的研究

目的探讨护理本科生对照护内涵的认知情况。方法采用照护内涵量表对5个年级429名护理本科生进行问卷调查。结果①各个年级对照护内涵的72％（18／25）条目认知基本一致,表现出较高的认同率（〉80％）;但在28％（7／25）条目上年级之间差异具有统计学意义（P〈0．05）,表现出相对较低的认同率（〈80％）,提示护生缺少整体护理观念。②认同率最低的2个项目是：与患者分享个人的事情（19％）和帮助患者的日常生活（44％）。前者可能与民族文化有关,后者提示护生生活护理知识需要加强。结论应对护理本科生加强整体护理观念的教育;这种教育不仅依靠学校,更需要临床实践营造良好的环境和氛围。另外建议预防护生出现“身心疲惫综合征”,并对本文使用的照护内涵量表进行文化调适。     

Dependency in autonomous caring – night nurses’ working conditions for caring in nursing

Scand J Caring Sci; 2010; 24; 312–320
Dependency in autonomous caring – night nurses’ working conditions for caring in nursing Few research studies have focused on nurses’ working conditions for caring provided at night, and these studies have mainly described nurses’ work in hospital settings, not in a municipal, social‐care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses’ caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses’ experiences of their working conditions for caring in nursing. All municipal night‐duty nurses (n = 7) in a medium‐sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses’ role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed‐side caring, which makes it easier for them to find time for caring in situations that arise when nurses’ skills, expertise and authority are called upon. Conversely the consultancy function entails short‐term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses’ possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.     

实习护生护理关爱行为及影响因素分析

目的 通过护理实习生护理关爱行为的自评,调查关爱行为现状及其影响因素.方法 采用关爱行为问卷和影响因素问卷对正在实习的100名护生进行问卷调查.关爱行为问卷采用台湾学者Lee-Hsieh制定的关爱行为测量问卷的初始条目,根据大陆的文化背景增删后形成.影响因素问卷为自行设计.结果 本组实习护生自评关爱行为得分(4.11±0.42)分,真诚、同情、尊重维度得分(4.19±0.39)分.职业关爱行为维度得分(4.02±0.49)分,不同性别、不同学历、不同选择护理专业方式的护生自评平均得分差异有统计学意K(P＜0.05).逐步回归显示临床学习环境和个人职业态度是护生关爱行为的影响因素.结论 实习护生关爱行为有待进一步提高,建议护理教育者加强对护生临床实习环境的改善和职业态度的培养.     

A longitudinal study into the perceptions of caring among student nurses using multivariate analysis of the Caring Dimensions Inventory

A longitudinal study involving student nurses' responses to the Caring Dimensions Inventory (CDI) was carried out to investigate the development of perceptions of caring. This study continues previously reported work in which the development of the CDI was described. The current study was designed to see if the CDI could detect changes in perceptions of caring among student nurses as they progressed through their training. Data were collected on the same subjects at three points, each a year apart, throughout the study. A cohort of 168 student nurses entering training was recruited into the present study and data from the CDI was analysed using exploratory factor analysis. A four factor structure for perceptions of caring throughout the study was supported, with some evidence for a five factor structure at 24 months into the programme of nurse education. A professional and technical factor increased in congruence with a similar factor, identified in a previous study, throughout the present study and was used to provide factor scores for individual students. There was a statistically significant and moderately sized correlation between the score on this factor and the age of the student nurses. The five factor solution yielded a factor of accountability. Professional and educational consequences of the study are discussed along with the problem of attrition in longitudinal studies.     

Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beijing, China

Aims. The aims of the study were to develop an understanding of caring in nursing from the perspective of cancer patients and attempt to identify the concept of caring in the Chinese cultural context. Background. Caring as a concept remains elusive, the acceptable definitions of the term care have not been reached. The expressions, processes and patterns of caring vary among cultures, but there is a lack of Chinese culture‐based study about caring in nursing. Methods. A qualitative research design was used and 20 cancer patients were interviewed using a semi‐structured interview guide. A qualitative content analysis was used to identify themes in the data. Results. Three themes emerged from the data, which suggested that caring is delivering care in an holistic way: nurses’ caring attitudes and their professional responsibility for providing emotional support, nurses’ professional knowledge and their professional responsibility for providing informational support and nurses’ professional skills and their professional responsibility for providing practical support. The caring behaviour of nurses as perceived by cancer patients involved the provision of emotional, informational, and practical support and help based on patients’ needs. A model of caring in nursing was formulated. Conclusions. Caring in nursing as perceived by cancer patients involves nurses having qualified professional knowledge, attitudes and skills in oncology and providing the informational, emotional and practical supports and help required by cancer patients. Relevance to clinical practice. Caring is manifested in nursing actions through nurse–patient communication process. Patients have their inner expectation for nurses’ caring behaviour and attitudes and nurses’ performance of caring or uncaring behaviour has a direct influence on the feelings of patients. It is necessary for all nurses to continue improving their oncology professional knowledge, attitudes and skills as well as their abilities of offering informational, emotional and practical support and help for their cancer patients.     

护理本科生对护理关怀认知的研究

目的探讨护理本科生对于护理关怀的认知水平及影响因素,为护理本科生关怀能力的培养提供理论依据。方法采用方便抽样对北京某高校护理学院二、三、四年级157名护理本科生进行问卷调查。结果护理本科生在专业技术方面得分高于其他维度,二年级护理本科生在专业技术方面得分高于三、四年级,差异有统计学意义（F=4．679,P〈0．05）。护理本科生对护理关怀重要性的认同、对护理课程的兴趣（社会心理方面、专业技术方面、正确的情感投入）均呈现正相关（P〈0．05）。不同年级护理本科生对关怀行为的认知单项得分比较差异均有统计学意义（P〈0．05）。结论护理本科生对护理关怀行为的认知水平有待提高,学校应通过加强人文关怀教育,运用多种教学手段提高学生对于护理课程的兴趣,帮助学生全面理解关怀的内涵,提高护理本科生护理关怀行为的认知水平。     

护理本科生对护理关怀行为的认知及其影响因素

目的探讨护理本科生对护理关怀行为的认知及其影响因素,为培养护生的关怀理念、关怀能力及关怀行为提供依据。方法采用关怀维度测量表（caring di mensions inventory,CDI）对4个年级210名护生集中进行问卷调查。结果护生CDI测量结果总分为（74.43±13.61）分,属于中等程度,且随着年级升高呈现下降趋势。得分最高的5项依次为：真诚对待患者,把患者视为整体的人,为患者保密,观察患者的用药效果,指导患者有关自我照顾的事宜;得分最低的5项依次为：与患者分享你的个人问题,探究患者的生活方式,与患者同座,保持患者家属的知情,把患者需要放在首位。护生每学期参加社会活动次数、对护理关怀重要性的认同、对护理课程的兴趣等因素与关怀行为的认知呈显著正相关（P〈0.01）。结论护理本科生对护理关怀行为的认知水平有待提高,应对护生加强整体护理内涵及护理观念的教育,且重视学校、社会、家庭和临床的共同参与。可以通过增加学生社会活动的次数、促进学生对护理关怀重要性的认同及提升学生对护理课程的学习兴趣等措施来提高护生护理关怀行为的认知水平。     

The ‘caring experience’: Testing the psychometric properties of the Caring Efficacy Scale

The purpose of the study was to undertake rigorous psychometric testing of the Caring Efficacy Scale in a sample of Registered Nurses. A cross‐sectional survey of 2000 registered nurses was undertaken. The Caring Efficacy Scale was utilized to inform the psychometric properties of the selected items of the Caring Efficacy Scale. Cronbach's Alpha identified reliability of the data. Exploratory Factor Analysis and Confirmatory Factor Analysis were undertaken to validate the factors. Confirmatory factor analysis confirmed the development of two factors; Confidence to Care and Doubts and Concerns. The Caring Efficacy Scale has undergone rigorous psychometric testing, affording evidence of internal consistency and goodness‐of‐fit indices within satisfactory ranges. The Caring Efficacy Scale is valid for use in an Australian population of registered nurses. The scale can be used as a subscale or total score reflective of self‐efficacy in nursing. This scale may assist nursing educators to predict levels of caring efficacy.     

Caring behaviours and stress perception among student nurses in different nursing programmes: A cross-sectional study

Caring is central to providing high-quality nursing. Little research exists concerning the relationship between caring behaviours and stress perception among student nurses. This study aimed to explore this relationship among student nurses in different nursing programmes. A sample of 792 student nurses from three nursing education programmes in one academic institution completed Chinese versions of the Caring Behaviors Scale and the Nurse Stress Checklist to assess participants' caring behaviour and psychosocial responses to work-related stress, respectively. We found a statistically significant negative correlation between caring behaviour and stress perception among participants. The three most frequently reported caring behaviours were related to ‘knowing the patient’: (a) recognising that each patient holds unique values, (b) taking a patient's chief complaints seriously, and (c) stating that the family's best interests should be respected regarding health decisions. Completion of work, time limitations, and lack of personal interactions were sources of stress. Nursing education curricula involve the fundamentals of caring and the preparation of nursing students for clinical practice. The study recommends that nursing faculty and administrators should educate students in stress management in order to foster, support, and promote caring behaviours among nursing professionals.     

Assessing nurse-patient interactions from a caring perspective: report of the development and preliminary psychometric testing of the Caring Nurse--Patient Interactions Scale

While there is a large body of literature regarding caring in nursing and some measurement tools addressing the concept have been developed, limitations of existing instruments constrain theory-driven research on nurse-patient interactions. The purpose of this paper is to describe the development and initial psychometric evaluation of the Caring Nurse-Patient Interactions Scale in a sample of 332 nurses and nursing students. The tool intended to facilitate research on the links between caring and patient outcomes. A content validity approach involving 13 expert nurses resulted in a 70-item tool sub-divided into 10 nursing carative factors. Alpha coefficients between sub-scales varied from .73 to .91 and sub-scales inter-correlations ranged from .53 to .89. Pearson correlation coefficients ranged from --.02 to .32 between the sub-scales and social desirability suggesting low to moderate bias. Results of the contrasted group approach partially supported the hypotheses while all differences were in the expected direction. Results suggest that the scale has strong potential for use in research, clinical and educational settings.     

Care: what nurses say and what nurses do

Caring is neither simply a set of attitudes or theories, nor does it comprise all that nurses do. Nursing care is determined by the way nurses use knowledge and skills to appreciate the uniqueness of the person they are caring for (changing the care noun into a caring verb). The purpose of this article is to present a range of contemporary nurse theorists' ideas on caring and to examine these ideas using the backdrop of nursing as practiced in both Australia and Canada to demonstrate a range of national and international similarities and theoretical beliefs. Caring relationships set up the conditions of trust that enable the one receiving the care to accept the help offered, underpinning the nurse-patient relationship or the therapeutic relationship. Caring is always specific and relational such as that found in the nurse-patient relationship. We believe that caring theory has much to offer nursing practice worldwide. Caring must be considered in the caring context because the nature of the caring relationship is central to most nursing interventions. Nurses need to be able to actually practice caring rather than just theorize about it-using caring theories to inform their practice.     

A pilot study to measure the caring efficacy of baccalaureate nursing students

Caring in professional nursing, often described as the essence of nursing, has gained increasing attention over the past several decades. Many programs claim to be based on a caring philosophy and practice. Despite the expectation that graduates of nursing programs will develop relationships with their patients and practice within a caring framework, evaluation of caring competencies is not well developed. The purpose of this pilot study was to measure the self-reported caring competency of baccalaureate nursing students using the Coates Caring Efficacy Scale (CES) (1). Students from prenursing courses to final semester seniors completed the CES (N = 193). Mean scores in this cross-section of students were higher than those reported by Coates for novice student nurses, but slightly lower than those Coates reported for comparable baccalaureate seniors. Final semester seniors identified their families as making the greatest contribution to their development of caring; only a few reported the influence of the nursing curriculum. This study, while limited to students in one program, provides beginning evaluative data of self-reported caring competencies of nursing students.     

Development of an instrument to measure technological caring in nursing

Twenty-seven statements make up the Technological Caring Instrument (TCI) which was developed to measure technological caring in nursing. In order to establish a database and its reliability and validity, responses were generated from 193 professional nurses who participated in the study. The results indicate that the TCI has a high internal consistency, construct validity, and sufficient split-half reliability. Cronbach's alpha was 0.8129 with split-half alpha of 0.666 for 14 items in Part 1 and 0.828 for 13 items in Part 2. Significant differences were found between factors (F = 97.0199, P = 0.0000). Factor analysis identified eight items with the first factor revealing nine cluster statements with values of 0.51–0.84. The second factor had two cluster statements with 0.75 and 0.74 values. The independent sample t -test results demonstrated the influence of education, area of expertise, and years of experience on the technological caring of registered professional nurses. The utilization and continued investigation of TCI are suggested.     

Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses

AimThe purpose of these studies was to determine the reliability and validity of the 24 item Perspectives on Caring for Older Patients (PCOP) scale and further develop the scale as a useful tool for measuring nurses' perspectives toward caring for older patients.BackgroundAgeism has long been an issue in the U.S. as well as globally and is reflected in the attitudes of nurses caring for older patients. Most research in this area utilizes scales that measure attitudes toward older adults or aging in general which is different from how nurses feel about caring for older patients.MethodsInstrument development studies using the PCOP scale were conducted involving two independent samples for exploratory and confirmatory analyses. Study 1 included nurses and nursing students from six hospitals in the U.S. while Study 2 included students in a baccalaureate nursing program. Exploratory factor analysis was conducted in Study 1, and confirmatory factor analysis using structural equation modeling was performed in Study 2. A test of structural invariance was used to confirm stability of factor structure across samples.ResultsExploratory factor analysis using split samples (Study 1) resulted in a PCOP scale with 12 items, and structural equation modeling confirmed a 9-item factor structure. The test for invariance also showed an excellent fit to the data.ConclusionsThe revised nine-item PCOP scale is a reliable and valid tool for use in measuring nurses' perspectives toward caring for older patients in the U.S. and internationally.     

Caring for and about cancer patients: identifying the meaning of the phenomenon "caring" through narratives

For several decades nurses have been using the terms "caring" and "nursing." Caring, considered to be a universal phenomenon, has been seen as a nursing term, including all aspects of delivering nursing care to patients. Ten registered nurses selected from hematologic, oncologic, and lung medicine wards were asked to narrate one situation in which they had been able to supply good caring and one situation wherein they had not been able to provide good caring for the patient. To identify the meaning of the caring phenomenon as experienced and expressed by nurses working with patients who have cancer, a qualitative analysis using phenomenologic hermeneutics was used. The narrated interviews, tape-recorded and transcribed verbatim, were analyzed, and a theme was interpreted: developing and maintaining a helping-trusting interpersonal relationship. Five subthemes also were identified: creating an interaction with the patient and the next of kin, acting to satisfy the needs of the patient and next of kin, feeling frustration in the role of caring, being affected by time aspects, and developing self and acquiring insight. It is in caring that nurses and patients connect with one another, are fulfilled, and experience growth. If they work actively with this perspective, nurses will feel fulfilled, not frustrated.