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.     

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。     

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。     

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.     

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.     

Dimensions of Nurse Caring

Dimensions of nurse caring were elicited through nurse and patient responses on the revised Caring Behaviors Inventory (CBI), a 43-item instrument. Subjects included 278 nurses and 263 patients and former patients. An exploratory factor analysis using the principal components method with varimax rotation was used to identify CBI dimensions; a five factor solution resulted. The five dimensions of nurse caring were respectful deference to others, assurance of human presence, positive connectedness, professional knowledge and skill, and attentiveness to the other's experience     

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。     

护士关怀能力培养的效果研究

目的探讨关怀试点病房护士关怀能力培养的效果。方法采取关怀能力培养策略对关怀试点病房护士进行关怀能力培养。抽取护士676名进行调查,用关怀能力评价量表比较总体调查对象与常模、关怀试点病房与非试点病房护士的关怀能力差异。结果与国外常模比较,研究对象关怀能力在认识和耐心维度方面得分偏低,勇气维度方面得分偏高;关怀试点病房护士关怀能力在认识和勇气维度方面得分均高于非试点病房护士,耐心维度比较差异无统计学意义。结论护士总体关怀能力偏低;关怀能力培养策略能有效提高护士的关怀能力;护士关怀能力培养策略在内容、形式方面仍待完善。     

The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments.

The development and testing of a multidimensional instrument to assess the reactions of family members caring for elderly persons with physical impairments, Alzheimer's disease, and cancer is reported. Forty items were administered to a sample of 377 caregivers of persons with physical impairments and Alzheimer's disease. Five dimensions of caregivers' reactions were identified through exploratory factor analysis. Using confirmatory factor analysis on an independent sample (N = 377), these dimensions were tested for factorial invariance across spouse and nonspouse caregivers and between caregivers of persons with cancer and those caring for persons with Alzheimer's disease. The subscales also had a high level of factorial invariance across a three-wave panel study (N = 185). The subscales appeared consistent with first order tests of construct validity.     

Family Caring and Caring in Nursing

Knowledge concerning family caring is developing within the caregiving literature while knowledge of caring is growing separately in the nursing literature. Both nurses (identified with caring) and family carers (identified with caregiving) experience a division of the affective and the instrumental dimensions of caring. Moreover, a historical perspective reveals that caring in nursing and family caring are faced with a common dilemma: caring in a society that undervalues caring. It is suggested that nurses, in the process of reconciling the dimensions of caring for their profession, consider family caring as a unified experience as well.     

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.     

Dimensions of caring: a qualitative analysis of nurses' stories

The purpose of this qualitative, phenomenological study is to describe dimensions of caring as they relate to and clarify the practice of professional nursing. Nurses are unique caregivers, and their work at the bedside and in the community matters. What nurses do as they care for patients is multi-dimensional, complex, and essential. Two hundred stories written by nurses were analyzed using Giorgi's methodology for existential phenomenology. Their stories indicate that nursing goes far beyond technical skills. Seven dimensions of caring that define professional nursing practice were found: caring, compassion, spirituality, community outreach, providing comfort, crisis intervention, and going the extra distance. The nurses' stories demonstrate that the dimensions of caring that define professional nursing practice are universal. Documentation of nurse's stories facilitates reflective and thoughtful practice, while clarifying the essential components of nursing.     

Working under pressure: a pilot study of nurse work in a postoperative setting

Postoperative services provide an excellent setting to study nursing work due to the patients' needing highly technical, yet highly comforting, care. The current study examined nursing work in postoperative services in an attempt to discern how nursing work is structured. Observations of nursing interactions in a 14-bed postoperative unit of a large Swedish university hospital found that nursing work in this setting is highly intensive and multidimensional. The need to provide nursing interactions that are caring and respectful of patients, while at the same time ensuring a high level of technical capacity, was obvious throughout all stages of patient stays in this unit. Furthermore, although each interaction is necessarily time-limited there is a caring relationship sustained with each patient. There is a pattern of caring that emerges that can be encapsulated as a "contingent routine." Nursing work cannot be broken down into "dimensions of caring." The work is high-pressure and involves, by necessity, multitasking. There are many dimensions of nursing care, but, usually, these are supplied simultaneously.     

Epidemiology,diagnosis and treatment of Clostridium difficile infection

Clostridium difficile infection (CDI) is considered to be the main cause of bacterial infectious diarrhea in nosocomial settings. Since the beginning of the new century a continuous rise in the incidence of severe CDI has been observed worldwide. Even though some CDI cases are not associated with previous antibiotic exposure, this remains as the principal risk factor for the development of CDI. The rate of recurrences represents perhaps one the most challenging aspect on the management of CDI. There are several microbiological tests available, but glutamate dehydrogenase antigen test can be selected as the first screening step in a diagnostic algorithm, with positive samples then confirmed using a toxin(s) test, to distinguish toxinogenic from nontoxinogenic CDI. Although metronidazole and vancomycin are and have been the mainstay treatment options for CDI, there are some unmet medical and therapeutical needs. Usually oral metronidazole is recommended for initial treatment of nonsevere CDI and vancomycin for treatment of severe disease. Fidaxomicin may be considered in patients who cannot tolerate vancomycin, although more data are needed. For treatment of a nonsevere initial recurrence of CDI, oral metronidazole should be used, but for treatment of subsequent recurrences or more severe cases fidaxomicin may be helpful.     

Perceptions of Familial Caregivers of Elder Adults

This study investigated perceptions of 739 familial caregivers of elder adults to answer the question "is there a significant relationship between appraisal, social distance and the cost of caring for an elder family member?" the cost of caring was analyzed in five dimensions (personal-social restrictions, physical-emotional health, value, care recipient as provocateur and economic cost). Caregivers reported concern for their well-being, feelings of disgust/anger, high social distance and coping by accepting and holding back. Not only were significant relationships found, but caregivers emerged as an at-risk population.     

Intercultural caring-an abductive model

The aim of this study was to increase the understanding of caring from a transcultural perspective and to develop the first outline of a theory. The theoretical perspective includes Eriksson's theory of caritative caring. Texts on caring by the transcultural theorists, including Campinha-Bacote, Kim-Godwin, Leininger and Ray, are analysed using content analysis. The overall theme that resulted from this analysis was that caring is a complex whole. Three main categories of caring emerged: inner caring, outer caring and the goal of caring. Inner caring consists of caring is a relationship, and caring and culture are seen in different dimensions. Outer caring refers to caring affected by educational, administrative and social and other structures. The goal of caring consists of caring leading to change towards health and well-being. The main categories include categories and subcategories that are compared with Eriksson's theory of caritative caring.
A model for intercultural caring is generated abductively. Caring and culture appear in three dimensions: caring as ontology independent of context; caring as a phenomenon emphasised differently in different cultures; caring as nursing care activities is unique. Caring alleviates suffering and leads to health and well-being. This model describes caring from an intercultural perspective as a mutual but asymmetric relationship between the nurse and the patient, including the patient's family and community. The patient's cultural background and acculturation influence caring. The cultural background, cultural competence and organisation of the nurse also influence caring. Caring is seen as a complex whole. This study integrates Campinha-Bacote's, Kim-Godwin's, Leininger's and Ray's views of caring with Eriksson's caritative caring and presents caring from a transcultural perspective in a new way as a model for intercultural caring, which can benefit nursing care, education, research and administration.     

Longitudinal study of emotional intelligence, leadership, and caring in undergraduate nursing students

This study describes the development of emotional intelligence (EI), leadership, and caring in undergraduate nursing students throughout their educational program. A correlational, repeated measures study design was used. Fifty-two nursing students completed four self-report questionnaires on three occasions (T1, T2, T3): BarOn Emotional Quotient Inventory: Short (EQ-i:S), Self-Assessment Leadership Instrument (SALI), Caring Ability Inventory (CAI), and Caring Dimensions Inventory (CDI). Mean scores for Total EI did not change significantly over time (T1, 100.1 ± 13.8; T2, 103.1 ± 13.8; T3, 101.6 ± 14.7). However, EI adaptability was higher at T2 (101.6 ± 13.1) and T3 (101.8 ± 14.1) than at T1 (97.0 ± 12.5; p = 0.03), as was CAI Courage (64.2 ± 9.5, 66.7 ± 9.5, 66.9 ± 8.7; p = 0.04) and the CDI (96.8 ± 18.1, 103.0 ± 7.3, 102.0 ± 10.9; p = 0.02). Changes in EI were positively correlated (r > 0.50, p < 0.001) with changes in SALI, CAI Knowing, and CAI Courage. During the undergraduate program, significant increases occurred in caring and EI adaptability but not in overall EI or leadership.     

妇幼专科医院护士共情能力在正念水平与关怀能力间的中介作用

目的:调查妇幼专科医院护士关怀能力、正念水平及共情能力,并分析其相关性。方法:采用便利抽样法,于2021年6月选取无锡市某三级甲等妇幼专科医院424名护士作为研究对象,采用一般情况调查问卷、关怀能力量表、正念注意觉知量表和杰弗逊共情量表对其进行问卷调查。采用Pearson相关性分析正念水平、关怀能力及共情能力间的相关性,采用Amos 23.0软件建立结构方程模型,并使用Bootstrap法验证共情能力在正念水平与关怀能力间的中介作用。结果:妇幼专科医院护士关怀能力总分为(162.93±19.96)分,正念注意觉知总分为(64.09±13.10)分,共情能力总分为(104.42±17.02)分;Pearson相关性分析结果显示,关怀能力总分及各维度得分与正念注意觉知及共情能力总分及各维度得分呈明显正相关(P<0.01);Bootstrap法验证了共情能力在正念水平与关怀能力间起部分中介作用,中介效应占总效应的45.52%。结论:妇幼专科医院护士关怀能力处于较低水平,共情能力在正念水平与关怀能力间起部分中介作用,医院管理者应关注护士正念水平及共情能力的评估,为提高护士关怀能力提供借鉴...     

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。     

低年资护士核心能力和关怀能力现状及其相关性研究

正护士的核心能力是护士专业价值的集中体现,是建立在护理职责基础之上的知识、技能、态度、价值观的综合优势~([1])。Waston人性关怀理论指出"人性关怀是护理学的本质"~([2]),而良好关怀的结果是护理人员和患者皆达到人格的升华~([3])。低年资护士指从院校毕业后从事临床工作不超过3年的护士~([4])。目前各医院均较重视低年资护士基本技能和专业技能的培训~([5]),