Oncology patients' and professional nurses' perceptions of important nurse caring behaviors

Background  

Caring is the essence of nursing. Caring to be meaningful needs to be based on mutual agreement between nurses and patients as to what constitutes nurse caring behaviors. As a result, healthcare professional can enhance patients' satisfaction of care by providing appropriate caring behavior. However, previous research that combined multiple types of patients, nurses and institutions demonstrated disagreement in prioritizing important behaviors. This paper reports a study that aimed at determining the caring behaviors which oncology patients and oncology nurses perceive to be the most important.     

The importance of nurse caring behaviors as perceived by Swedish hospital patients and nursing staff

The present study identified patient (n = 81) and nursing staff (n = 105) perceptions of the most and least important nurse caring behaviors. Using a Swedish version of the CARE-Q instrument, patients ranked as most important competent clinical know-how, while the nursing staff ranked expressive/affective behaviors as most important to make patients feel cared for. The results show significant differences (p less than 0.05) between the two groups in the rating of 29 of the instrument's 50 specific behaviors and in five out of six subscales combining individual items. Thus, patient perceptions of important nurse caring behaviors differ from staff perceptions. These results are similar to those from other studies of hospitalized patients' perceptions of caring. The staff's results are in accordance with studies of professional nurses' perceptions of caring. The findings support conclusions by other authors.     

What makes nursing satisfying: a comparison of college students'' and registered nurses'' views

This paper reports a study of nurses' perceptions of the positive and negative features of the work environment and their contribution to satisfaction with nursing. The concept of a 'work space' was developed to describe nurses' mental images of the features of their work environment. Eighty-four final-year student nurses and 75 registered nurses rated questionnaire items designed to examine perceptions of opportunities for professional development, sources of satisfaction, difficulties, time constraints and problematic interactions with other hospital personnel. There was general agreement among nurses about the aspects of their work that they found satisfying, but student nurses were more pessimistic than registered nurses that nursing would give them opportunities for recognition of their worth. Students returning from practica in critical care wards reported more stressful interactions with other personnel than students returning from general ward practica. Structural equation modelling of the causal relations between sources of satisfaction with nursing revealed that recognition and self-perceptions of work as a nurse were the strongest predictors of overall satisfaction with nursing. Caring for patients contributed only indirectly through its influence on nurses' feelings about themselves. The data indicate the significance of personal and social implications of nursing careers.     

Nurses' perceptions of care and caring

Care and caring have been identified as inherently difficult concepts to define, but many authors believe that care is the central and unifying core of nursing. It is vital that nurses understand what care is, with the current issues about measuring and justifying exactly what they do for patients in order to be clear about what good care is. If nurses are to constantly improve the care they give, they need to be clearer about how to care for patients. Nurses need to make sure that they are giving the patients what they want and not what the nurses want. This review of the literature explores nurses' perceptions of care and compares it with what patients want in terms of care. It also highlights some important and interesting differences between what patients and nurses perceive as good care.     

Perceptions of caring by nurse educators.

The purpose of this paper is to report on nurse educators' perceptions of caring behaviors. A review of the literature indicated a lack of consensus between nurses and patients of exactly what constitutes caring behaviors. Since subjects in previous studies were based on nurses educated at various levels, it was hypothesized that a more homogeneous sample of nurses with advanced education might provide different findings. Using the Larson CARE-Q, 110 nurse faculty, managers, and clinical specialists/practitioners were asked to indicate what they believed were the most and least important caring behaviors. Because the 72 educators' findings were similar to those of 38 other nurses with advanced education, their responses were combined. A clear difference between the perceptions of nurses and patients was obtained, and the data support the results of previous studies--nurses have a tendency to consider comfort and trusting relationship items as most important while patients perceive behaviors associated with physical care as most important. No significant differences were found between educators according to type of programs or functional groups, and few differences were found according to age, years of experience, or clinical areas.     

师生所认同的临床护理教师有效特征的比较研究

目的探讨临床护理教师与实习护生所认同的，临床护理教师有效特征。方法运用美国Brown（1981）设计的临床教师特征量表（CTCI），对68名临床护理教师与77名临床实习的护生进行问卷调查及对临床护理教师有效特征进行评估。通过统计分析，比较教师与学生的有效特征分数。结果20条项目评分的均值大于3分，临床护理教师与护生对临床教师有效特征总评分经相关检验差异有统计学意义；真诚对待患者及关怀患者、信任尊重学生、知识丰富并能将知识传授给学生被认为是临床护理教师前3项最有效特征。有效特征3项分类方差分析，在本专业能力、师生关系和个性中差异有统计学意义。结论探讨，临床护理教师与实习护生所认同的临床教师有效特征，是为了更好地促进临床护理教学，协调师生关系，有助于临床带教质量的全面提升。     

Are we meeting their needs.

The aim of this pilot study is to discover the student nurses' learning needs and perceptions during their operating department allocation and whether we are meeting those needs. Also, what influence their perceptions have had upon selecting perioperative nursing as a career. The study focuses upon semi-structured interviews with student nurses and their accounts of their experiences of being learners in the operating department. During their allocation, students are able to view surgery and to assist in the recovery of patients and to understand what a surgical patient experiences. They are exposed to the roles and responsibilities of operating department nurses. However, little is known about how students perceive these experiences. In this study two groups of students from the same year were interviewed to determine their perceptions and needs during the allocation and whether their learning needs had been met.     

Furthering caring through nursing education

The nursing students' main quest is for self actualization by attributing meaning to life through caring. To assist student nurses in this quest, the nurse educator needs to plan educational interventions according to an anthropological model that posits care and caring as innate human attributes. Further, the structural essence of what professional nursing caring entails should also be posited as a point of departure for curriculum planning. The author proposes such models. The main implications include that the nursing curriculum must increasingly attend to the emotional needs of nursing students. Curricular content and teaching strategies toward this goal are suggested.     

Effects of clinical practice environments on clinical teacher and nursing student outcomes

The purpose of this study was to use a cross-sectional survey design, with an integrated theoretical perspective, to examine clinical teachers' (n = 64) and nursing students' (n = 352) empowerment, teachers' and students' perceptions of teachers' use of empowering teaching behaviors, students' perceptions of nurses' practice behaviors, and students' confidence for practice in acute care settings. In this study, teachers and students were moderately empowered. Teachers reported using a high level of empowering teaching behaviors, which corresponded with students' perceptions of teachers' use of such behaviors. Teachers' empowerment predicted 21% of their use of empowering teaching behaviors. Students reported nurses as using a high level of professional practice behaviors. Students felt confident for professional nursing practice. The findings have implications for practice contexts related to empowering teaching-learning environments and self-efficacy.     

Predictors of nurses' perceptions of barriers to research utilization

AIM: To identify predictors of nurses' self-reported barriers to using research findings in clinical practice. BACKGROUND: Several studies have shown that nurses perceive barriers to research utilization but to our knowledge predictors of nurses perceptions of barriers to research utilization have not been identified before. METHODS: Three questionnaires were answered by 833 nurses: the Barriers Scale, the Quality Work Competence questionnaire and a questionnaire including questions on professional issues. RESULTS: Dissatisfaction with support from immediate superiors for participating in research and/or development projects, having no academic degree and unclear and unrealistic workplace goals were identified as factors increasing the risk of perceiving barriers to the use of research findings in clinical practice. CONCLUSIONS: The results imply that head nurses, nursing managers and other health care leaders should create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT: To support research utilization and evidence-based care health care leaders, head nurses and nurse managers should create clear and realistic goals for the work place including demands on evidence-based care. It is also important for head nurses and nurse managers to create strategies for supporting nurses' professional development and possibilities to implement research findings in clinical practice.     

Student nurse attitudes towards homeless clients: a challenge for education and practice

The purpose of this research was to describe attitudes of nursing students (and paramedic officers) towards marginalized clients. Convenience quota sampling in a major health faculty was employed. Students participated on a voluntary basis. A 58-item Likert scale, developed by the authors, assessed the student nurses' attitudes. In general, attitudes towards homeless clients were neutral; detailed analyses, however, revealed that student nurses would decline to care for homeless clients in various situations. Personal experience with homeless patients and positive attitudes of nurses significantly contributed to increased quality of care and equality of treatment for homeless clients. Certain student nurse behaviors warrant immediate attention to prevent marginalized patients from being exposed to unfair, inaccessible and biased nursing care. Based on our results, we recommend that further research attention be paid to the role of ethics education and faculty behaviors, as faculty members serve as role models for professionalization.     

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.     

How accurately do nurses perceive patients' needs? A comparison of general and psychiatric settings

This paper examines to what extent nurses' perceptions of patients' needs correspond to the patients' views of their own needs. A questionnaire was designed to assess patients' emotional and physical needs in general medical wards and in acute psychiatric wards. Sixty patients, 30 psychiatric and 30 general, together with their 'key' nurses, took part in the study. Results indicate that, despite there being no evidence of appreciable disagreement between the 'average' psychiatric nurse and the 'average' psychiatric patient, there is little evidence that individual nurses and their patients, whether psychiatric or general, agree. The nurses' inability to perceive patients' needs on an individual basis is consistent with other studies which suggest that nurses use stereotypes when perceiving patients' needs. Implications for nursing care are discussed.     

Concepts in nurse education

This paper reports a case study of student and senior nurses at the Royal Free Hospital, London, England Qualitative methods were used to investigate the perceptions of nursing upon which students and senior nurses based their activities on the wards Differences were identified between the ways in which students and senior nurses 'saw' their day-to-day tasks Analysis showed that these differences were based upon differing levels of conceptualization Student nurses were found to operate with low levels of conceptualization and were thus unable to categorize or group the patients, procedures or problems confronting them Senior nurses, on the other hand, operated with a high level of conceptualization and were able to perceive similarities in objects, events and processes and to differentiate these into categories, classes or patterns This allowed them to prioritize lines of action and to respond to situations in a rational and effective way The problem for nurse education, then, is how best to enable students to develop a professional level of conceptualization Strategies are identified by which senior nurses might enable student nurses to develop concepts in relation to their nursing activities on the wards     

Attitudes and normative beliefs of nursing students as predictors of intended care behaviors with AIDS patients: a test of the Ajzen-Fishbein theory of reasoned action.

Few investigators have studied nurses' or nursing students' responses to caring for AIDS patients. The purpose of this exploratory study was to test the Ajzen-Fishbein (1980) Theory of Reasoned Action in a student nurse population about AIDS patient care. This theory offers an approach to explaining individuals' intentions to engage in certain behaviors as determined by two components: attitudes toward the behavior and subjective norms. Forty-six second-year baccalaureate nursing students completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (alpha reliability range was .69-.85) prior to and following an instructional unit on caring for AIDS patients. Consistent with the theory, students' attitudes and subjective norms were found to be significant predictors of intentions to care for AIDS patients in their clinical experience (R2 = .29, F[1, 43] = 6.63, p less than .003). In addition, qualitative data resembled those in previous reports of fear of contagion among health professionals. The effects of the instructional unit about caring for AIDS patients resulted in significant changes in both attitudes and subjective norms.