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     

Caring Behaviors Inventory: analysis of responses by hospitalized surgical patients

Hospitalized surgical patients were surveyed to determine the completeness, reliability, and validity of their responses to the 42-item Caring Behaviors Inventory (CBI) and to an abbreviated inventory derived from it. Of 354 patients, 211 completed all 42 CBI items. Item responses were reliable (alpha = 0.980) and each correlated (r = 0.192-0.630) with global nurse caring (GNC). The CBI score (item sum) also correlated with patients' rating of GNC (r = 0.569). All CBI items correlated with the CBI score (r = 0.582-0.863). Forward multiple regression showed 6 items (6, 13, 16, 28, 33, and 41) to explain nearly all variance in the CBI score (R = 0.979). Responses to these 6 items by 318 patients were reliable (alpha = 0.893); their sum was correlated with the CBI score (r = 0.964) and patients' rating of GNC (r = 0.605). This study provides further statistical support for the CBI. It justifies use of a less burdensome 6-item inventory.     

Emergency department nurses’ perceptions of caring behaviors toward individuals with mental illness: A secondary analysis

AimThe aim of this study was to determine emergency department (ED) nurses’ caring behaviors toward individuals with mental illness; and the influence of stigma on their caring behaviors.MethodThis is a secondary analysis of a cross-sectional study with (n = 813) ED nurses working in the United States from March 2021 to April 2021. The Caring Behaviors Inventory-24 item (CBI-24) and the Mental Illness: Clinicians’ Attitudes Scale-4 (MICA v4) were used to collect data.ResultsThe mean CBI-24 score was 4.6 (SD = 0.8). The MICA v4 had an overall sum of 53.4 (SD = 9.2). Caring behaviors and stigma were found to have significant weak inverse relationship (r = - 0.23, p <.001). Age and level of education had a significant inverse relationship with caring behaviors (r = - 0.12; r = -. 19, p <.01 respectively).ConclusionThe results of this study may contribute to the quality, equity, and safety of the emergency nursing care of individuals with mental illness, thereby improving health outcomes. It is recommended that the diversity of nurses and the characteristics of the ED be taken into consideration when designing trainings, providing leadership support, and managing resources to support the care of individuals with mental illness.     

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.     

Development and validation of the Chinese version of the Diabetes Management Self-efficacy Scale

OBJECTIVE: The purpose of this study was to translate the Diabetes Management Self-Efficacy Scale (DMSES) into Chinese and test the validity and reliability of the instrument within a Taiwanese population. RESEARCH DESIGN AND METHODS: A two-stage design was used for this study. Stage I consisted of a multi-stepped process of forward and backward translation, using focus groups and consensus meetings to translate the 20-item Australia/English version DMSES to Chinese and test content validity. Stage II established the psychometric properties of the Chinese version DMSES (C-DMSES) by examining the criterion, convergent and construct validity, internal consistency and stability testing. The sample for Stage II comprised 230 patients with type 2 diabetes aged 30 years or more from a diabetes outpatient clinic in Taiwan. RESULTS: Three items were modified to better reflect Chinese practice. The C-DMSES obtained a total average CVI score of .86.The convergent validity of the C-DMSES correlated well with the validated measure of the General Self-Efficacy Scale in measuring self-efficacy (r=.55; p<.01). Criterion-related validity showed that the C-DMSES was a significant predictor of the Summary of Diabetes Self-Care Activities scores (Beta=.58; t=10.75, p<.01). Factor analysis supported the C-DMSES being composed of four subscales. Good internal consistency (Cronbach's alpha=.77 to .93) and test-retest reliability (Pearson correlation coefficient r=.86, p<.01) were found. CONCLUSIONS: The C-DMSES is a brief and psychometrically sound measure for evaluation of self-efficacy towards management of diabetes by persons with type 2 diabetes in Chinese populations.     

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.     

Development of the Family Nurse Caring Belief Scale (FNCBS)

Measurement of family nursing practice phenomena needs particular attention. This study develops a new instrument, Family Nursing Caring Belief Scale (FNCBS), that measures nurse attitudes regarding provision of family-sensitive care to families in crisis and establishes initial psychometric properties. Classical test theory was used to construct a discriminative, summative instrument for measuring nurse attitudes. Internal consistency reliability in a randomly selected sample (N = 163) of pediatric intensive care unit and neonatal intensive care unit nurses was estimated at .81 (Cronbach's alpha) and .78 (Guttman split half). A four-factor structure was revealed: ethical caring practices, systems orientation to family, child advocacy, and normalizing milieu. The FNCBS demonstrated concurrent (r = .57) and criterion-related validities. The FNCBS demonstrated sound psychometric properties with a child-rearing population of families and has the potential for future use in family nursing research, education, and practice. It requires further assessment before testing with an adult population.     

Caring behaviors as perceived by nurse practitioners

PURPOSE: To investigate nurse pratctitioners' (NPs') perceptions of their own caring behaviors and to examine NPs' demographics as a function of their caring behaviors. DATA SOURCES: Responses to the Caring Behaviors Inventory(CBI) and a demographic inquiry from 348 NPs in Louisiana. CONCLUSIONS: CBI mean scores and subscale scores were high for all 348 NPs. No statistically significant difference was found between male NPs' and female NPs' total mean CBI scores or between urban or rural total mean CBI scores. The interaction between nurse gender and area o practice was not statistically significant. IMPLICATIONS FOR PRACTICE: NPs often work in clinic situations where productivity is the most valued characteristic and where little time is afforded for identifying caring behaviors of the NP and/or establishing a caring relationship with the patient. NPs must be extremely conscious of the need not to "throw out the baby with the bathwater" and sacrifice characteristics that are inherent in nursing for those emphasized in primary care practice. As their responsibilities in the health care setting continue to expand, NPs must continually evaluate and validate their roles to ensure quality care that satisfies patients.     

Validation of CARE‐Q in residential aged‐care: rating of importance of caring behaviours from an e‐cohort sub‐study

Aim and objective. To validate the Caring Assessment Report Evaluation Q‐sort questionnaire in the residential aged‐care setting. Based on this determination, to conclude with what degree of confidence the questionnaire can be used to determine the ranking of the importance of caring behaviours amongst aged‐care nurses and residents in residential aged‐care. Background. Perceptions of caring may be context specific. Caring in residential aged‐care may stand in contrast to the sense of caring understood and practiced in other settings. Design. Self‐administered survey. Methods. Residents from three not‐for‐profit aged‐care facilities, across both high‐care (nursing‐home) and low‐care (hostel care) were surveyed relying on the Caring Assessment Report Evaluation Q‐sort questionnaire. A sub‐sample of registered and enrolled nurses working in residential aged‐care and registered with the Nurses & Midwives e‐cohort study completed the same survey. Results. Although the Caring Assessment Report Evaluation Q‐sort questionnaire showed good internal consistency for the sample of nurses, the results for the residents were more erratic. Both groups displayed large ranges for the inter‐item correlations. The results of the Mann–Whitney U‐test indicated that the nurses rated the Comforts, Anticipates and Trusting relationship as significantly more important than the residents. Both groups rated the Explains and facilitates subscale as least important. All subscales, however, received median scores greater than, or equal to, six (seven‐point, Likert scale) indicating that all were considered important overall. Conclusion. Based on poor Cronbach's alpha coefficients, negative inter‐item correlations and qualitative observations, without further development within the residential aged‐care facility the free response format version of the Caring Assessment Report Evaluation Q‐sort may not be an appropriate measure to use with residential aged‐care residents. More research needs to be conducted into how residents and nurses are interpreting the items in the Caring Assessment Report Evaluation Q‐sort. Relevance to clinical practice. There will always remain a need for nurses to enact behaviours that are meaningful to residents (and patients generally).     

The Strain of Care for Delirium Index: a new instrument to assess nurses' strain in caring for patients with delirium

This study evaluated content validity, internal consistency and construct validity of the Strain of Care for Delirium Index (SCDI), a newly constructed instrument to measure the strain nurses experience in caring for patients with delirium. Content validity, evaluated by eight experts, reduced the initial pool of items from 38 to 28. Using a convenience sample of 190 nurses, Cronbach's alpha for the 28-item version was 0.88. Using non-linear principal components analysis another eight items were eliminated and a four-factor structure was identified. The proportion of variance explained by the remaining 20 items was 61.51%. Preliminary psychometric evaluation of the SCDI supported content validity, internal consistency and construct validity; however additional psychometric evaluation is warranted.     

The Hopkins Rehabilitation Engagement Rating Scale: development and psychometric properties

OBJECTIVE: To conduct an initial investigation of the psychometric properties of the Hopkins Rehabilitation Engagement Rating Scale (HRERS), a 5-item, clinician-rated measure developed to quantify engagement in acute rehabilitation services. DESIGN: We used a cross-sectional design to conduct correlational and multivariate analyses to establish the measure's internal consistency, interrater reliability, construct validity, and criterion validity. SETTING: Acute inpatient rehabilitation in 3 metropolitan hospitals. PARTICIPANTS: A total of 206 subjects with spinal cord injury, ischemic or hemorrhagic stroke, amputation, or hip or knee replacement. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The HRERS, Positive and Negative Affect Schedule, Brief Symptom Inventory, Levine's Denial of Illness Scale, Craig Handicap Assessment and Reporting Technique, and FIM instrument. RESULTS: The HRERS has good internal consistency (alpha=.91) and interrater reliability (intraclass correlation coefficient, .73) and represents a unidimensional construct. It correlated negatively with symptoms of depression (r=-.24, P<.01), higher ratings of denial of illness (r=-.30, P<.001), and self-rated negative affect (r=-.23, P<.01), and correlated positively with self-rated positive affect (r=.36, P<.001) and level of functioning 3 months postdischarge (r=.22, P<.01). CONCLUSIONS: The HRERS is a valid and reliable measure of rehabilitation engagement that relates to intermediate-term functional outcomes.     

Registered nurses'' experiences of caring for the elderly in different health-care areas

Caring for elderly patients is an undertaking for a majority of Swedish nurses in different health-care sectors. The purpose of the study was to understand how nurses experienced the meaning of caring for elderly patients after 2 years as Registered Nurses. Interviews were conducted with 20 nurses 2 years after graduation. Data were analysed with a phenomenological-hermeneutic method and resulted in two themes: (i) providing the elderly with a sense of trust; and (ii) commitment to elderly patients. Each theme was made up of four subthemes, expressing both positive and negative aspects. Caring for the elderly means that the core of caring is in focus. Nurses need a supportive context for their care of the elderly, especially when they experience that they or their staff cannot provide the optimal quality of care for the patients.     

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.     

A Chinese version of the Caring Assessment Report Evaluation Q-sort scale for measuring patients' perception on nurses' caring behaviours: Reliability and validity assessment

A reliable and valid instrument for understanding patients' perceptions of nurses' caring behaviour as well as assessing the quality of nursing care is necessary. The purpose of this study was to assess the reliability and validity of a Chinese version of the Caring Assessment Report Evaluation Q-sort (CARE-Q) Scale for the measurement of patients' perceptions of nurses' caring behaviours. The study sample comprised 250 patients from a medical centre in central Taiwan. Content validity, construct validity, internal consistency and stability reliability were assessed. The Content Validity Index of the Chinese version of CARE-Q was 0.90. Cronbach's alpha indicated good internal consistency reliability. Stability reliabilities for the six subscales ranged from 0.83 to 0.92. The results reveal that the Chinese version of the CARE-Q scale for the measurement of patients' perceptions on nurses' caring behaviours indicates high reliability (internal consistency and stability) and good content validity.     

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.