The caring dimensions inventory (CDI): content validity, reliability and scaling

Caring is an elusive phenomenon but this should not prevent the development and validation of reliable quantitative tools for studying this concept in large samples of nurses. The present paper reports on the content analysis of a questionnaire called the Caring Dimensions Inventory (CDI). The CDI was content validated in terms of existing conceptualization of caring and research in this area and also in terms of a nursing taxonomy and its representation in popular United Kingdom nursing publications. The CDI was administered to a large sample of nurses working in Scotland and data were obtained from 1430 qualified and student nurses. The internal consistency of the CDI items related to perceptions of caring was established and the scalability of a sub-set of CDI items was demonstrated. The CDI scale was related to the constructs of age and sex of respondents. Possibilities for further analysis and development of the CDI are discussed.     

透析病人主要照顾者照顾性行为评估表的信效度研究

[目的]翻译"透析病人主要照顾者照顾性行为评估量表"(caregiving to adults on dialysis,LC-GADs),评价其信度、效度及文化相关性,提供一种有效方便的透析病人照顾性行为评估的中文版问卷.[方法] 应用专家小组评定法进行问卷文化相关性、语言一致性及内容效度的评价.对136例透析病人的主要照顾者应用问卷调查对其结构效度进行评价.对其中30例主要照顾者进行重测,进行重测信度评价.[结果]问卷中所有条目均具有较好的文化相关性,其中1个条目被重新修订.中文版LC-GADs有较好的信度和效度,内容效度指数(CVI)为0.975.问卷的信度和效度Cronbach's α分别为0.93和0.86,重测信度为0.80和0.76.因子分析显示中文版LC GADs具有与原英文版量表一致的结构效度.[结论]中文版LC-GADs是一种具有较高信度和效度的评估透析病人照顾者专用行为评估量表,可以为以后广大护理同仁在研究透析病人照顾者行为相关方面提供可靠的数据支持.     

Consciousness, coma, and caring for the brain-injured patient

In this article, a preliminary conceptual framework is presented for exploring nursing interventions and research aimed at improving care of the unconscious brain-injured patient during the early subacute phase of brain injury. The cue-response framework presented is derived from multidisciplinary sources and has specific clinical relevance to critical care nurses caring for unconscious brain-injured patients. A key aspect of this framework is the attention focused on the timing of nursing interventions in response to how nurses interpret the physical, physiological, and secondary cues they observe when caring for comatose patients. A case exemplar is used to present one example of how this framework may be used in the clinical setting.     

Acts of caring: nurses caring for nurses

Caring behaviors displayed toward nurses by nurse managers and nurse peers play a significant role in establishing relationships that promote a healthy work environment. A qualitative study was done to identify behaviors perceived to be caring toward nurses. The theoretical background used for the study was Nursing as Caring by Boykin and Schoenhofer. Data were collected from focus groups consisting of registered nurses currently employed in the practice setting. Content analysis was used for the analysis. The overarching category that was identified was tending to a caring environment. The following emergent categories were also found: caring through helping and supporting, caring through appreciating, and acknowledging unappreciated caring. The findings suggest that nurses demonstrate caring behaviors toward their colleagues by coming to know them on both a professional and a personal level. These behaviors form the foundation for an environment that supports a consistent demonstration of caring.     

Nurturing and caring for self

As instruments of healing, nurses commonly provide therapeutic counseling, but often do not heed their own advice for self-care. To give to others, nurses need to nourish all aspects of self. The self extends far beyond the needs of the physical body. Therefore, giving of the self requires self-nurturance of the physical, mental, emotional, and spiritual aspects. This article describes how to nurture and care for the self.     

Nursing ethics,caring and culture

Recent years have witnessed the publication of numerous articles that draw a critical alignment between ethics and caring. In essence, this theme suggests that caring is a moral pursuit centred on the beneficent attention of one person shown to another. Yet, if such language is to have real poignancy, it must be geared towards an inclusive agenda that meets the needs of all within the community. Research evidence suggests that this is not always the case, especially in terms of the care offered to members of minority ethnic groups. This article will focus on the findings of a qualitative research study that explored the expectations and perceived experiences of nursing care among members of the Pakistani community in Bradford, West Yorkshire, UK. The findings suggest that nurses should develop a more informed narrative that readily reflects the needs of the Pakistani community.     

The inclusion of positive aspects of caring in the Caregiver Strain Index: Tests of feasibility and validity

Background and objective

Positive aspects of caring are commonly cited by carers and can potentially mediate carer strain. However, in outcome assessment for carers, it is still common practice to focus on the negative aspects of caring. This study explored the feasibility and validity of including positive items in a commonly used outcome measure—the Caregiver Strain Index (CSI).

Methods

Five positive items were inserted into the CSI. The resulting ‘CSI+’ questionnaire was included in a postal survey of carers in the Netherlands. Feasibility was assessed through completion rates for the CSI+ and individual items. Validity was assessed through tests of the association of the positive items and the CSI+ scores with relevant characteristics of the care (construct validity) and related scales (convergent validity). Factor analysis was carried out the CSI+ scale.

Results

The addition of the positive items did not noticeably affect the feasibility of the CSI, but did appear to improve the convergent validity of the measure. The multivariable analysis and factor analysis suggests that positive aspects of care could be grouped into ‘coping’ factors and ‘attitudinal’ factors.

Conclusion

These findings support the use of positive items in outcome assessment for carers and provide some support for the use of the CSI+ as an instrument for doing this.     

Concepts of caring and caring as a concept

If caring is to be retained as the "essence" of nursing, and if research in this area is to advance, then the various perspectives of caring must be clarified, the strengths and the limitations of these conceptualizations examined, and the applicability of caring as a concept and theory to the practice of nursing identified. Examination of the concept of caring resulted in the identification of five epistemological perspectives: caring as a human state, caring as a moral imperative or ideal, caring as an affect, caring as an interpersonal relationship, and caring as a nursing intervention. Two outcomes of caring were identified: caring as the subjective experience and as the physiologic responses in patients. The authors concluded that knowledge development related to caring in nursing is limited by the lack of refinement of caring theory, the lack of definitions of caring attributes, the neglect to examine caring from the dialectic perspective, and the focus of theorists and researchers on the nurse to the exclusion of the patient.     

A charter for caring

The Charter of the Royal College of Nursing commits its membership 'to promote the science and art of nursing'. Nursing is essentially synonymous with caring. The caring role is central to nursing but shared with patients themselves, their relatives and with other health professions. It consists of acts of helping and assisting with daily living activities which may be simple or complex. Giving help may involve not only acting for or doing something for another but guiding, supporting, teaching and providing the right environment for another. The art of helping is built on a scientific basis. Knowledge of underlying scientific principles is needed as a basis of judgement for nursing action. The implications of this view of the primary role of the nurse for education, efficiency and specialization in nursing are reviewed.