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.     

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.     

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.     

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.     

A 35-item version of the Caring Dimensions Inventory (CDI-35): multivariate analysis and application to a longitudinal study involving student nurses

The present study was designed to investigate the perceptions of caring among student nurses and how these develop throughout the course of a programme of pre-registration nurse education. A 35-item version of the caring dimensions inventory was administered to a cohort of nursing students in a department of nursing in Scotland at entry to the programme, after 12 months and after 24 months on the programme. Caring was largely perceived through a technical dimension, demonstrated by factor analysis, but other dimensions such as intimacy, support and unnecessary and inappropriate aspects of nursing also became apparent as students progressed through the programme.     

Using the caring dimensions inventory as an indicator of person‐centred nursing

Aims. This paper reports findings from a large‐scale quasi‐experimental study that used a measure of caring as a means of evaluating person‐centred nursing and aims to illustrate the synergy between the concepts of caring and person‐centredness. Background. Evidence would suggest that effective person‐centred nursing requires the formation of therapeutic relationships between professionals, patients and others significant to them in their lives and that these relationships are built on mutual trust, understanding and a sharing of collective knowledge. This correlates with the conceptualisation of caring that is underpinned by humanistic nursing theories. Design. A pretest post‐test design was used in this study to evaluate the effect of person‐centred nursing on a range of outcomes, one of which was nurses’ and patients’ perception of caring. Methods. The Person‐Centred Nursing Index was the main data collection tool. The Caring Dimension Inventory and Nursing Dimensions Inventory, were component parts of the Person‐Centred Nursing Index and were used to measure nurses’ and patients’ perceptions of caring. The Person‐Centred Nursing Index was administered at five points in time over a two‐year intervention period. Results. Nurses had a clear idea of what constituted caring in nursing, identifying statements that were reflective of person‐centredness, which was consistent over time. This was in contrast to patients, whose perceptions were more variable, highlighting incongruencies that have important implications for developing person‐centred practice. Conclusion. The findings confirm the Caring Dimension Inventory/Nursing Dimensions Inventory as an instrument that can be used as an indicator of person‐centred practice. Furthermore, the findings highlight the potential of such instruments to generate data on aspects of nursing practice that are traditionally hard to measure. Relevance to clinical practice. The findings would suggest that nurses need to be aware of patients’ perceptions of caring and use this to influence changes in practice, where the prime goal is to promote person‐centredness.     

某三级甲等综合医院新进护士专业自我概念与关怀行为的调查研究

目的：了解本院新进护士的专业自我概念、关怀行为的现状以及两者之间的相关性。方法：对本院符合要求的171名新进护士进行问卷调查,包括一般资料、护理专业自我概念量表和中文版关怀行为量表。结果：自我概念、关怀行为的总体平均分分别为（6.47±0.72）、（3.42±0.44）分。不同自我价值新进护士的自我概念和关怀行为得分具有统计学差异（P〈0.05）,其他一般资料不同的新进护士的自我概念和关怀行为均无统计学差异（P〉0.05）。除关怀行为中的“自我奉献”维度与自我概念中的“综合”和“员工关系”间无相关关系外,其余维度两两间均显著相关（P〈0.05）。结论：本院新进护士的专业自我概念和关怀行为得分处于中上水平,且两者间的关系较为密切。在新进护士的培训过程中,护理管理者应多关注新进护士的专业自我概念提升,改善其关怀行为。     

Perceptions of nursing: a study involving nurses,nursing students,patients and non-nursing students

This paper describes a study of perceptions of nursing by nursing students, qualified nurses (United Kingdom and Spain), patients and non-nursing students. A survey method was used with a longitudinal panel element incorporating a 35-item version of the Nursing Dimensions Inventory translated into Spanish. Data were analysed using principal component analysis, congruence analysis, Mokken scaling, correlation, ANOVA, t-test and Cronbach's alpha. Patients may perceive nursing differently from nursing students, nurses (in the UK and Spain) and non-nurses. These findings are discussed in the context of nurse education and patient care.     

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。     

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。     

Relationships among student and graduate caring ability and professional school climate.

This study represents the second phase in a longitudinal study of the development of caring ability in registered nurses. A nationwide sample of female graduates of US baccalaureate nursing programs was resurveyed 3 years after the phase-one survey taken during nursing school. The purpose of the study was to continue an evaluation of several variables contributing to the development of professional caring ability. Previously validated instruments were used to measure caring ability (Caring Ability Inventory), maternal and paternal care (Parental Bonding Instrument), and the caring climate of the respective nursing schools (Charles F. Kettering Ltd. School Climate Profile). Although parental bonding scores remained unchanged from the initial survey, caring ability scores significantly increased after entry into practice (paired student's t test, P < .001). The strongest predictor of postgraduate caring ability was student caring ability scores (r = .58, P < .001). When student caring ability scores were excluded as a potential predictor during stepwise multiple regression analysis, school climate scores were the strongest predictor of postgraduate caring ability (r = .17, P < .05). This suggests that development of professional caring ability is related to caring school environments. Furthermore, caring ability as a student predicts further development of caring ability after entry into practice.     

The impact of nurse education on the caring behaviours of nursing students

This study aimed to ascertain whether nursing students' perceptions of caring behaviours as part of nursing practice change over a three-year, pre-registration, undergraduate nursing course. Students are expected to have a predisposition to care with nurse education nurturing and developing this into professional caring behaviour. However, there is some evidence that this process inures rather than develops these behaviours. This was a quantitative, single cross section survey of two nursing student cohorts from one Higher Education Institution (HEI) in Wales, United Kingdom (UK). There were two sample groups; sample group A were 80 first year students and sample group B were 94 third year students. Students completed a questionnaire incorporating the caring behaviors inventory (CBI) [Wolf, Z.R., Colahan, M., Costello, A., Warwick, F., Ambrose, M.S., Giardino, E.R., 1994. Dimensions of nurse caring. Journal of Nursing Scholarship 26 (2), 107-111]. The key finding was a statistically significant difference in the means in caring behaviours between first years and third years with third years scoring lower than first years. This was exaggerated for those under 26 and increased further for those under 26 with no previous experience of caring. Caring is a core nursing value and a desirable attribute in nursing students, but the educational process seemed to reduce their caring behaviours.     

How Do Nursing Students Perceive Substance Abusing Nurses?

Substance abuse among nurses was recognized by nurse leaders and professional nursing organizations as a growing threat to patient safety and to the health of the abusing nurse more than 30 years ago. Although numerous studies on nurse impairment were published in the 1980s and 1990s, there was minimal focus on student nurses' perceptions about impaired nurses and less research has been published more recently, despite a growing rate of substance abuse. A quasi-experimental study to explore the perceptions of student nurses toward nurses who are chemically dependent was conducted using a two-group, pretest–posttest design. The Perception of Nurse Impairment Inventory (PNII) was completed by student nurses at the beginning of their junior course work, prior to formal education about substance abuse. The PNII was repeated after the students received substance abuse education. The PNII was also completed by a control group of sophomore student nurses who did not receive the formal substance abuse education. A repeated measures analysis of variance was used to measure the differences between the two groups of students. Students who received the education chose more compassionate responses on the PNII and were more likely to respond that an impaired nurse's supervisor is responsible for supporting and guiding the impaired nurse to access professional care. Discrepancies in study findings about the efficacy of education for effecting positive attitudes of student nurses toward impaired nurses may be related to the length and type of the education.     

Nurses' and physicians' perceptions of nursing authority

This study compared perceptions of 163 nurses and physicians of the current and ideal status of the decision-making authority of professional nurses. Each nurse and physician agreed or disagreed with 25 items, in two contexts, in the Authority in Nursing Roles Inventory (ANRI). Items in the ANRI describe a variety of nursing roles, functions, and behaviors in health and patient care. The results of the study were statistically significant overall both between and within professional groups. Disparities in several specific areas were revealed. The findings support the premise that in spite of expanded nursing roles emphasizing nursing authority, there are disagreements between nurses' and physicians' perceptions of the current and ideal authority of nurses as well as areas of dissatisfaction within each professional group. Implications of continuing conflicts between nurses and physicians as barriers to professional nursing role enactment, as well as strategies to address the problem, are discussed.     

Nursing to care or caring to nurse: a qualitative investigation of perceptions of new recruits

This article discusses the perceptions of nine student nurses at the commencement of a 3-year diploma programme in nursing. In particular, it focuses on new recruits' perceptions of nursing. As part of a larger longitudinal study which examines the impact of the nursing curriculum on perceptions of health, data were collected from a sample of students concerning their perceptions of nursing, health, illness and the course. Content analysis of indepth interviews identified four themes concerning perceptions of nursing. These were caring, nurture, healing and self-development. These themes are discussed in relation to the student nurses life experiences and in the context of a notion of health as a central goal for nurse education. The students' perceptions of nursing at the commencement of the course suggest that nursing may be a moral choice as an occupation underpinned by the desire to do something worthwhile, whilst the relationship between nursing and health was not explicit.     

Perceptions and expectations of Baccalaureate-prepared nurses in Jordan: Community survey

The overall purpose of this paper is to describe the process of utilizing community participation for curriculum design to develop a new school of nursing. A brief Community Needs Assessment Survey was carried out in order to explore community perceptions and expectations of Baccalaureate-prepared nurses in Jordan. The sample consisted of 152 participants who were staff nurses, nurse administrators, nurse supervisors, nurse educators, physicians, pharmacists and consumers of services. Data were collected through a self-administered survey form using open-ended questions. Participants were asked to describe their perceptions of nursing and nurses, the desired professional skills and personal characteristics of the Baccalaureate-prepared nurse, important curriculum contents and to provide suggestions or comments for improving the preparation of Bachelor of Science in Nursing (BSN) nurses. The findings indicated that nursing was viewed as a caring profession where nurses care for the person both in sickness and health. Several professional skills and personal characteristics emerged as being important for the BSN nurse, including clinical competence, the desire to continue learning, communication skills, ethical and moral character, critical thinking, assessment skills, and computer and English-language skills. The participants provided the desired curriculum contents and suggestions related to the expected skills. Implications for nursing education were discussed.     

Nurse faculty perceptions of readiness for practice among new nurses graduating during the pandemic

BackgroundThe COVID-19 pandemic caused major changes in nursing education, namely a shift to remote learning and significant reduction of clinical practice experience. It is not known how these changes will affect new graduate nurses transitioning to practice.PurposeTo provide guidance to transition-to-practice programs, this study quantitatively described and compared nurse faculty perceptions of readiness for practice among students who graduated pre-pandemic and those who will graduate during the pandemic.MethodsA convenience sample of 116 nurse faculty across North Carolina completed surveys online. Surveys collected information on demographics, professional experience, and teaching changes experienced during the pandemic. The Nursing Practice Readiness Tool was used to measure perceptions of readiness for practice.ResultsNurse faculty reported a wide range of changes due to the pandemic, with limitations in clinical learning prevalent. There was a statistically significant decrease in practice readiness scores for the total scale, six subscales, and all tool items at p < 0.001 for all paired comparisons.ConclusionsWhile there was an overall significant decrease in scores for all competency areas, further analysis of the tool subscales and items can provide guidance for clinical nurses working with new graduates and nurse faculty working with continuing students.