The effect of the training of presence in care (TPinCare) on the care-oriented patient-nurse interaction and the caring behaviors of nurses working with oncology patients: A randomized controlled trial

AimThe aim of this study is to investigate the effects of “The Training of Presence in Care-TPinCare” of nurses working with oncology patients on care-oriented patient-nurse interaction and caring behaviors.BackgroundHelping the individual to realize, protect and maintain his/her existence can be considered as the basis of "good nursing care". Presence is a way of care for the nurse and patient that fosters human-to-human bonding and deep contact experience and healing.DesignThis is a randomized controlled study.MethodData were collected between January 2019 and May 2019. The sample selection consisted of 52 nurses working with oncology patients, 26 interventions and 26 controls in accordance with the criteria of inclusion, exclusion and exemption by randominization and blinding. The data were collected by using the "Nurses Introductory Features Form", "Caring Behaviors Scale − 24 " and "Caring Nurse-Patient Interaction Scale". The training was applied to nurses in the intervention group. In data analysis used SAS 9,4 program; statistically Mean score, t test, Repeated Measures ANOVA. In the context of these effect sizes, the power of the study was calculated to be 0.99 for each scale. This study was conducted in line with the principles of the Declaration of Helsinki.ResultsAccording to the control group of nurses in the intervention group, there were no statistically significant differences in the mean scores of caring behaviors at different measurement times. A statistically significant difference was found in favor of the intervention group for caring nursing patient interaction general, sub-dimensions of "importance”, “competence” and “practicality", in nursing interventions (p < 0.05). Although the pretest mean scores of the nurses in the intervention group were lower compared with the control group, it was found that the posttest mean scores increased and the level of follow-up was maintained by a little increasing or decreasing. It was determined that there was no significant change in the posttest and follow-up scores of the nurses in the control group according to the pre-test mean scores.ConclusionsThis study showed that TPinCare has a positive effect on nurses working with oncology patients with respect to care quality perception and viewing “importance”, “competence” and “practicality", of attitude and behaviours related to care-focused patient nurse interactions. In this context, it can be suggested to continue the trainings which will contribute to caring behaviors and patient-nurse interactions of nurses and to support them with institutional contribution.     

Cancer patient and staff ratings of caring behaviors: relationship to level of pain intensity

This study explored differences in the perceived importance of nursing caring behaviors between patients with cancer pain and oncology nurses and to explore the relationship between level of pain intensity and the importance of various nursing caring behaviors. The study included 50 matched cancer patient-staff pairs from oncology inpatient units of 3 hospitals in northern Taiwan. The Brief Pain Inventory-Chinese version (BPI-C) and the Caring Assessment Report Evaluation Q-sort (CARE-Q) were used for data collection. Results revealed that cancer pain patients ranked "being accessible," "monitors and follows through," and "anticipates" as being the most important nursing caring behaviors; the nursing staff ranked "being accessible," "explains and facilitates," and "monitors and follows through" as being the most important behaviors. No correlations were found between cancer pain patients and staff rankings of the perceived importance of various caring behaviors. The self-reported level of pain intensity by patients was significantly positively correlated with the patient rating of the "anticipates" behavior. Patient self-reported level of pain interference was significantly positively correlated with the "monitors and follows through" behavior and significantly negatively correlated with the "explains and facilitates" behavior. Staff perception of both a patient's level of pain intensity and pain interference was significantly positively correlated with staff rating of the "being accessible" behavior. Results demonstrated that greater patient-staff communication is needed for staff to more accurately provide caring interventions to make patients with cancer pain feel cared for.     

肿瘤科护士关怀照护行为现状调查

目的调查肿瘤科护士关怀照护行为现状。方法采用关怀行为量表,对115名肿瘤科护士进行问卷调查。结粜肿瘤科护士关怀照护行为得分为（59．64±11．82）分。3个维度的得分从高到低为：协助患者度过疾病不平顺的过程（2．00±O．43）分、了解患者需求（I．99±0．47）分、患者权益的维护（I．97±0．44）分。不同学历和工作性质的护士整体关怀照护行为差异具有统计学意义（P〈0．05）;不同职称、工作年限以及工作性质的护士“协助患者度过疾病不平顺的过程”维度得分差异具有统计学意义（P〈O．Ol或P〈O．05）。结论肿瘤科护士协助患者度过疾病不平顺关怀照护行为较好,维护患者权益的关怀照护行为较差。低学历、低职称以及合同制护士的关怀行为亟待提高。     

Knowledge,attitudes, and practice behaviors (KAPb) of nurses and the effectiveness of a training program in psychosocial cancer care

Purpose

Psychosocial distress in oncology patients may significantly interfere with their health outcomes and quality of life. Nurses work closely with their patients and are in the best position to screen for distress and provide timely intervention. It is thus important for nurses working in oncology settings to be equipped and prepared to address distressing psychosocial issues. The present study aims to investigate the impact of a training program in psychosocial care on nurses’ knowledge, attitudes, and clinical practice behaviors.

Methods

A total of 180 nurses working in medical oncology and radiation oncology departments at the National University Cancer Institute Singapore underwent a training program in psychosocial care as part of their continuing nursing education curriculum. One hundred fifty four of these nurses completed a self-designed questionnaire on nurses’ knowledge, attitudes, and practice behaviors (KAPb) at all four time points: baseline, post-training, and at 6 and 12 weeks post-training, respectively.

Results

The self-designed KAPb questionnaire proved adequate for this study. Positive gains on applied knowledge and practice behaviors were sustained over a 12-week period. There were no changes in theoretical knowledge. A decreasing trend in attitudes was noted, although this was specific to the participants’ attitudes toward the importance of emotional concerns as compared to physical concerns in cancer treatment. Enrolled nurses seemed to have higher starting levels of theoretical knowledge than their registered counterparts were. There were no other differences on demographic variables in relation to the efficacy of the training program.

Conclusions

The training program was successful in improving the applied knowledge and practice behaviors of nurses in providing psychosocial care for cancer patients. However, further refinement to the program, with particular attention to nurses’ existing training and years of clinical nursing experience, would enhance staff empowerment and care improvement.     

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.     

肿瘤科护士人文关怀能力的调查研究

目的了解肿瘤科护士人文关怀能力及相关因素。方法采用护生人文关怀能力量表对52g肿瘤科护士进行问卷调查。结果肿瘤科工作年限〉5年的护士人文关怀能力得分高于工作年限≤5年的护士（P〈0．01）,护士的人文关怀能力与外界关怀程度成正相关。结论肿瘤科护士的人文关怀需进一步加强,加强外界对护士的关怀可能有助于其人文关怀能力的培养。     

Oncology patients' and oncology nurses' perceptions of nurse caring behaviours

Previous research on patients' and nurses' perceptions of nurse caring behaviours has documented significant differences in the ranking of important behaviours. However, these samples have included a variety of medical-surgical patients and nurses and different types of institutional settings, all of which may have affected the results. The present study sought to determine if patients and nurses from one subspecialty area and one institution would have more concordant perceptions of caring. Forty-four oncology patients and 49 oncology nurses completed the Respondents Perceptions of Caring Behaviour Scale (RPCBS). Results showed that overall mean patient rankings were highly correlated with mean nurse rankings (Spearman's correlations coefficient 0.94, P<0.0001). The Wilcoxon two-sample rank sum test was used to test the difference in rank of the 20 items between the patients and nurses. There was a significant difference in rank in only six of the 20 items. These data suggest that oncology patients and nurses have more concordant perceptions of caring than previously investigated groups. Implications for practice and further research are discussed.     

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.     

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.     

Examining relationships between socio-demographics and self-efficacy among registered nurses in Australia

Background

Self-efficacy in nursing is the nurses’ perception of their abilities to show caring orientations, attitudes, and behaviours and to develop caring relationships with patients. Self-efficacy is associated with years of experience, higher levels of job satisfaction and changes to nursing practices that conform with best practice. There is currently a paucity of evidence and no Australian studies were found examining the relationships between socio-demographic variables and self-efficacy in Australian nurses.

A caring relationship with people who have cancer

Title.  A caring relationship with people who have cancer.
Aim.  This paper is a report of a study conducted to elucidate the meaning of a caring relationship with people with cancer.
Background.  A caring relationship becomes the most important focus of caregiving when treatment of the body has reached the limits where cure is no longer expected. Caring as perceived by people with cancer involves nurses having professional attitudes and skills in order to provide good care, including emotional and practical support.
Methods.  A phenomenological hermeneutic approach influenced by Ricoeur was used. Eight nurses working in an oncology unit in Iran were interviewed in 2007 about their experiences of caring relationships with people who have cancer.
Findings.  The findings were interpreted as getting involved in a mutual/demanding close relationship. Closeness demanded nurses to be present, to listen to patients, and to be compassionate. Closeness was also mutual and characterized both caregiving and receiving new insights into values in the nurses' own lives. The close relationship was at times frustrating when they were faced with situations that they could not handle and were out of their control.
Conclusion.  Closeness is an important foundation for caring, and acquires a special dimension in the care of people with cancer and their relatives. It derives from the personal and professional experiences of nurses in their own life stories. Nursing education should include a reflective approach in order to develop caring skills in oncology nursing that are not merely attuned to medical care.     

Senior nursing students' and professional nurses' perceptions of effective caring behaviors: a comparative study.

Care forms the basic core of nursing actions. Traditionally nurses have described the acts of administering to patients as care behaviors. Many nurses find it difficult to define these caring behaviors. It is important that nurses have insight into the specific behaviors that patients perceive to be most important. Several studies have examined and compared nurses' and patients' perceptions of effective care behaviors. The literature supports an incongruence of what nurses perceive and what patients perceive as effective. This study identifies and compares student nurses' and professional nurses' perceptions of effective caring behaviors. The Caring Assessment Report Evaluation Q-sort (CARE-Q) was used to obtain the data. The participants included senior baccalaureate nursing students (n = 30) at Thomas Jefferson University, College of Allied Health Sciences, and professional nurses (n = 30) with 1 or more years experience. The significance of the difference between the groups was tested using the Mann Whitney U test. Results indicate agreement between the students and the nurses in all categories except trusting relationship (p = .06). The ages within the groups varied from 21 to 47 years. The difference in ages between the nurses and the students is significant (p = .0002). Findings provide a better understanding of student nurse perceptions of caring behaviors and provide implications for further research for nurse educators.     

The impact of occupational stress on nurses’ caring behaviors and their health related quality of life

Background

Nursing is perceived as a strenuous job. Although past research has documented that stress influences nurses’ health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied. The aim was to investigate and explore the correlation amidst occupational stress, caring behaviors and their quality of life in association to health.

Methods

A correlational study of nurses (N?=?246) who worked at public and private units was conducted in 2013 in Greece. The variables were operationalized using three research instruments: (1) the Expanded Nursing Stress Scale (ENSS), (2) the Health Survey SF-12 and (3) the Caring Behaviors Inventory (CBI). Univariate and multivariate analyses were performed.

Results

Contact with death, patients and their families, conflicts with supervisors and uncertainty about the therapeutic effect caused significantly higher stress among participants. A significant negative correlation was observed amidst total stress and the four dimensions of CBI. Certain stress factors were significant and independent predictors of each CBI dimension. Conflicts with co-workers was revealed as an independent predicting factor for affirmation of human presence, professional knowledge and skills and patient respectfulness dimensions, conflicts with doctors for respect for patient, while conflicts with supervisors and uncertainty concerning treatment dimensions were an independent predictor for positive connectedness. Finally, discrimination stress factor was revealed as an independent predictor of quality of life related to physical health, while stress resulting from conflicts with supervisors was independently associated with mental health.

Conclusion

Occupational stress affects nurses’ health-related quality of life negatively, while it can also be considered as an influence on patient outcomes.

     

Caring Behaviors Inventory: a reduction of the 42-item instrument

BACKGROUND: Caring traditionally has been at the center of nursing. Effectively measuring the process of nurse caring is vital in nursing research. A short, less burdensome dimensional instrument for patients' use is needed for this purpose. OBJECTIVES: To derive and validate a shorter Caring Behaviors Inventory (CBI) within the context of the 42-item CBI. METHODS: The responses to the 42-item CBI from 362 hospitalized patients were used to develop a short form using factor analysis. A test-retest reliability study was conducted by administering the shortened CBI to new samples of patients (n = 64) and nurses (n = 42). RESULTS: Factor analysis yielded a 24-item short form (CBI-24) that (a) covers the four major dimensions assessed by the 42-item CBI, (b) has internal consistency (alpha =.96) and convergent validity (r =.62) similar to the 42-item CBI, (c) reproduces at least 97% of the variance of the 42 items in patients and nurses, (d) provides statistical conclusions similar to the 42-item CBI on scoring for caring behaviors by patients and nurses, (e) has similar sensitivity in detecting between-patient difference in perceptions, (f) obtains good test-retest reliability (r = .88 for patients and r=.82 for nurses), and (g) confirms high internal consistency (alpha >.95) as a stand-alone instrument administered to the new samples. CONCLUSION: CBI-24 appears to be equivalent to the 42-item CBI in psychometric properties, validity, reliability, and scoring for caring behaviors among patients and nurses. These results recommend the use of CBI-24 to reduce response burden and research costs.     

Emergency Physicians' and Nurses' Attitudes towards Alcohol-Intoxicated Patients

Background

Emergency physicians and nurses are frequently dissatisfied professionally when treating alcohol-intoxicated patients, and have negative attitudes towards this patient population and alcohol rehabilitation.

Study Objectives

The goal of this study is to examine differences in attitudes between emergency physicians and nurses towards alcohol-intoxicated patients.

Methods

This single-site survey study evaluated emergency physicians' and nurses': 1) attitudes of personal professional satisfaction and dissatisfaction when caring for intoxicated patients; 2) attitudes towards the difficulty in caring for alcohol-intoxicated patients; 3) attitudes towards respect of the alcohol-intoxicated patient; 4) attitudes towards the adequacy of training in caring for intoxicated patients; 5) attitudes towards rehabilitation and counseling of alcohol-intoxicated patients.

Results

Physicians were less satisfied and more dissatisfied than nurses when caring for alcohol-intoxicated patients. Physicians found treating alcohol-intoxicated patients more difficult than nurses did. Physicians were more likely to agree that alcohol-intoxicated patients should be treated with respect. Physicians felt more adequately trained than nurses in caring for alcohol-intoxicated patients. Nurses were more likely to believe that alcohol-related rehabilitation is ineffective compared with physicians. Both nurses and physicians refer alcohol-intoxicated patients to rehabilitation to a similar extent.

Conclusions

Emergency physicians and nurses have similar attitudes but significant differences in the extent of these attitudes towards the care of the alcohol-intoxicated patient.     

Taking the lead - Sharing best practice in intravenous bisphosphonate use in urological cancers

Purpose

Bisphosphonates relieve metastatic bone pain, prevent, reduce and delay skeletal morbidity in metastatic bone disease and are recommended in European guidelines but safety concerns, specifically renal dysfunction and osteonecrosis of the jaw, necessitate specific precautions when administered intravenously. Pan-European guidance for nurses at the forefront of patient-focussed cancer care is required to minimise patient risk.

Methods

A panel of urology and oncology nurses from seven European countries collaborated to decide what constituted best practice for bisphosphonate administration when indicated for prevention of skeletal-related events in patients with advanced urological malignancies.

Results

The panel agreed that urology, oncology, and home-care nurses who are at the forefront of patient-focussed care are well placed to ensure best practice is followed but across Europe nurses have insufficient training on bisphosphonate administration for urological cancers. Based on extensive clinical experience in administering bisphosphonates the panel propose best practice for identifying those patients who could benefit, for example those with bone pain or at risk of fracture, and for minimising risk of adverse events by checking renal function, adjusting dosing, ensuring adequate hydration, and regularly assessing dental health, as well as providing information and support.

Conclusions

Sharing this best practice across Europe could assist nurses who care for patients with urological cancers and bone metastases or indeed those caring for cancer patients in general, to take the lead, or at least be aware of what is the best practice that helps to ensure effective and safe IV bisphosphonates administration to patients under their care.