Providers' and consumers' perspective of nurses' caring behaviours

The primary purpose of this article is to discuss the development and testing of a scale designed to examine nurses' caring behaviours. A pilot study was conducted with a convenience sample (n = 81) of 42 nurses (providers) and 39 patients (consumers). The setting was two community hospitals in the New England Region. The respondents were able to assign a rank of the items (nurses' caring behaviours) with a spread of mean values from 3.5 to 16.7. There was agreement on the most caring behaviour, 'The nurses treat me as an individual', on the behaviour in the middle range of caring, 'The nurses comfort me by their silent presence', and on the least caring behaviour, 'The nurses did not talk about how my illness might affect my life'. The Wilcoxon two-sample rank-sum test was used to test the difference in rank of the 20 items between the providers and the consumers. There was a significant difference between the providers and the consumers in the ranking of nine of the 20 items. The consumers valued behaviours that recognized their individual perspective as well as that of their family and behaviours that helped them anticipate and prepare for change. The providers placed a greater emphasis on the behaviours that were more geared towards the comforting aspects of care by encouraging patients to express and vent their feelings. These findings allow clinicians to be sensitized to their caring behaviours by increasing their realization of how behaviours are perceived by patients. The instrument needs minor revision and then further testing is indicated.     

Gender and perceived nurse caring in nurse-patient dyads.

The effect of nurse gender on nurse and patient perceptions of nurse caring was explored. Members of nurse-patient dyads (N = 145), equally distributed among the four possible gender combinations, completed matching forms of the Caring Questionnaire immediately following a shift. Perceptions of nurse caring that actually occurred during the preceding shift, as well as usual preferences about nurse caring, were measured. Results of two-factor ANOVAS showed no significant differences in actual caring according to nurse gender from either the nurse or the patient perspective. Expectations of certain nurse caring behaviours, however, were significantly lower for male nurses from both nurse and patient perspectives. The results suggest implications for nursing practice, education and further research.     

Nurse caring behaviours

The purpose of this research paper is to examine caring behaviours and how they relate to nurses practice from the psychiatric and general nurses' views. Whether this caring is influenced by the nurses' age, gender or qualification is also examined. The convenience sample used were nurses ( n =118) of all grades and experience in a general hospital and in a psychiatric hospital. The Care-Q instrument was used. The response rate was 66%. Statistical analysis included rankings of sub-scale and individual items and the chi-square test of association. The results show that nurses ranked physically based caring behaviours higher than affective behaviours. They emphasized monitoring and comforting behaviours but paid less attention to anticipatory behaviours. Gender appeared to have the greatest influence on what caring behaviours were valued. Male nurses were less likely than female nurses to be accessible, forming trusting relationships or performing comforting behaviours. The results challenge both nurses and nurse educators to examine caring behaviours in nursing practice.     

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 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<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.     

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.     

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.     

Nursing students' perceptions of the importance of caring behaviors

Title. Nursing students’ perceptions of the importance of caring behaviours Aim. This paper is a report of a study to determine the nursing students’ perceptions of the importance of caring behaviours. Background. Caring has been considered as the essence of nursing. It is believed that caring enhances patients’ health and well‐being and facilitates health promotion. Nursing education has an important role in educating the nurses with adequate caring abilities. Method. Ninety nursing students (response rate 75%) responded to a questionnaire consisting of 55 caring behaviours adapted from items on Caring Assessment Questionnaire (Care‐Q). Behaviours were ranked on a 5‐point Likert‐type scale. The caring behaviours were categorized in seven subscales: ‘accessibles’, ‘monitors and follows through’, ‘explains and facilitates’, ‘comforts’, ‘anticipates’, ‘trusting relationship’ and ‘spiritual care’. Data were collected in Iran in 2003. Findings. The students perceived ‘monitors and follows through’ (mean = 4·33, SD = 0·60) as the most and ‘trusting relationship’ (mean = 3·70, SD = 0·62) as the least important subscales. ‘To give patient’s treatments and medications on time’ and ‘to do voluntarily little things…’ were the most and least important caring behaviours, respectively. ‘Explains and facilitates’ statistically and significantly correlated with age (r = 0·31, P = 0·003) and programme year (r = 0·28, P = 0·025). Gender had no statistically significant influence on students’ perceptions of caring behaviours. Conclusion. Further research is needed, using longitudinal designs, to explore nursing students’ perceptions of caring behaviours in different cultures, as well as evaluation studies of innovations in curriculum and teaching methods to improve learning in relation to cultural competence and caring concepts.     

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.     

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.     

Nursing care of older people: a personal construct theory perspective

This paper outlines the use of the repertory grid technique, with nurses caring for elderly residents, and residents of a nursing home. The method focuses on the individuality of each person's attempt at making sense of her/his caring world. Previous papers have focused on a discussion of the repertory grid technique as a research method and tool for psychiatric nurses, an overview of studies using this technique with nurses and social workers, and applications of personal construct theory (from which the technique is derived) to nursing research. A paper by Rawlinson described content analysis of the role constructs elicited from the nurses. In this study, content analysis of caring constructs elicited by nurses and residents was also undertaken, and the results are presented. Additionally, principal component analysis of the repertory grids was carried out, and three examples are presented. This combined analysis provides an in-depth insight into nurses' perceptions of caring for others; perceptions which guide their caring behaviours. This information can be used by individual nurses to review their caring practice.     

Cancer nurses narrating after conversations with cancer outpatients: how do nurses’ roles and patients’ perspectives appear in the nurses’ narratives?

Aim: The aim of this study was to contribute to knowledge of nursing practice in the cancer care field by exploring cancer nurses’ perceptions of conversations with cancer outpatients. Background: Current practice at cancer outpatient clinics in Norway is that nurses have planned conversations with patients and relatives as a follow‐up after patient–physician conversations about assessment and medical treatment. Little is known about nurses’ experiences of conversations in the ambulatory context. This study reports the experiences of initial patient–nurse consultations. Data were collected in 2006–2007. Design: A qualitative phenomenological hermeneutic study was performed. A purposive sample of 12 cancer nurses was selected for qualitative interviews where nurses were narrating about conversation experiences. Significance and meaning of conversation experiences were analysed within a hermeneutic perspective, inspired by Ricoeur. Anonymity and voluntary participation procedures were followed. Ethical approval for the study was obtained from the Regional Committee for Medical Research Ethics of the region. Findings: There were plots of nurses experiencing conversations as hard work, routine work or artistry. The nurses’ conceptualizations of their roles as an information provider, or patient‐centred caring role were rooted in rules of the nursing community or in humanistic caring ethics. Differences of nurses’ perceptions and experiences of conversations are explained by different attitudes and role appreciations. Conclusion: Cancer nurses’ role appreciation and meaning horizons are guiding their perceptions of patient–nurse communication. Feeling free to act in interplay with patients’ voices, the patients’ perspectives become foreground. There is an educational challenge here in terms of developing methods to help nurses to discover how their mental work and meaning horizons guide conversational practice.     

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.     

‘Caring? It's the little things we are not supposed to do anymore’

Pearcey P. International Journal of Nursing Practice 2010; 16 : 51–56
‘Caring? It's the little things we are not supposed to do anymore’ This study explored the views of twenty‐five qualified nurses in five hospitals to determine what they perceived as dominant values in clinical nursing work. Aspects of a grounded theory approach were used and this study formed the final one of three. The first two studies had student nurse samples and this study aimed to confirm and validate the data from the students' perceptions. The student nurses had implied that nurses communicated and ‘cared’ for patient's much less than they expected. Findings from this study reaffirm the students' perceptions and suggest that nurses may not be as caring as they would like to be. One significant issue to emerge, in conjunction with the realization that nurses were not being as caring as they would have liked, was that it mattered to them that caring was the ‘little things’ not ‘supposed to be done anymore’.     

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.     

护士人文关怀品质测评量表的研制

目的初步研制护士人文关怀品质测评量表,为评价护士人文关怀品质现状提供评价指标。方法通过专家访谈、相关文献的提取和现有测评工具条目的遴选建立量表条目池,经两轮Delphi专家咨询和临床调查对量表条目进行筛选和信效度检验,建立初始量表。结果量表包括4个维度(人文关怀理念、人文关怀知识、人文关怀能力、人文关怀感知)共29个条目,其内容效度(内容效度指数为0.986)、结构效度(4个因子的累积贡献率为55.009%)、内部一致性信度(Cronbachα系数为0.932)、分半信度(分半系数为0.801)均在量表研制的理论允许范围之内。结论该量表具有较好的信、效度,可用于护士人文关怀品质的测评。     

Perceived occurrence and importance of caring behaviours among patients and staff in psychiatric, medical and surgical care

The present study identified, within psychiatric, medical and surgical care, patient and staff perceptions of the occurrence and importance of caring behaviours A Swedish version of the 'CARE-Q' instrument, including 50 caring behaviours, was used for the assessment of importance, and the 'CARE-How often' questionnaire (containing the same behaviours) was used for the determination of occurrence In psychiatric and medical care, but not in surgical care, staff considered several behaviours to occur more frequently than did patients However, in each type of care, the groups agreed fairly well with respect to rankings of behaviours 'Explains and facilitates' occurred rarely, and 'Monitors and follows through' occurred often, according to both patients and staff Overall, patients and staff differed both with regard to perceived levels and rankings of the importance of behaviours Psychiatric patients perceived 'Explains and facilitates' as most important, and somatic patients perceived 'Monitors and follows through' as most important, while staff in both somatic and psychiatric care considered 'Comforts' as the most important subscale Neither patient nor staff perceptions of the occurrence of caring behaviours were well matched with their perceptions of the importance of these Implications for nursing practice and for studying patient satisfaction with care are given