An international cross-cultural study of nursing students' perceptions of caring

Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring

BACKGROUND

Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process.

OBJECTIVES

The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring.

DESIGN

A multi-centre, cross-sectional observational study was conducted.

SETTING

The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy.

PARTICIPANTS

A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year).

METHODS

Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire.

RESULTS

Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones.

CONCLUSIONS

This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.

Final-year nursing students' perceptions of humanistic education in nursing: a cross-sectional descriptive study

BACKGROUND

Humanistic education is an important part of nursing education. Final-year nursing students' perceptions of nursing humanistic education are under-investigated. This study aimed to examined final-year nursing students' perceptions of nursing humanistic education in both school and hospital.

METHODS

This was a cross-sectional descriptive study conducted from May to June 2022 among 107 final-year nursing students with a self-designed questionnaire.

RESULTS

Final-year nursing students recognized the importance of humanistic education, scoring above 4.0 on a 1-5 scale, while their initiative to enhance humanistic qualities was relatively low. Students' satisfaction with the number of humanities courses offered was only 3.7 ± 0.862. Moreover, 62.6% of students believed there was a need to enhance humanistic environmental development including corridor culture. The "monotonous teaching format" (63.6%) and "teaching methods" (64.5%) have emerged as focal points that students identified as needing attention and improvement.

CONCLUSIONS

In the future, nursing humanistic education can be enhanced by increasing the proportion of humanities, improving teaching methods, stimulating students' learning motivation, and strengthening the construction of humanistic environment.

Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study

BACKGROUND

Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic.

METHODS

In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview.

RESULTS

In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves.

CONCLUSION

The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.

Undergraduate nursing students' experiences of practicing caring behaviours with standardised patients

RATIONALE

Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis.

AIM

The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient.

METHOD

A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience.

RESULTS

One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient.

CONCLUSION

When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences.

An application of the caritative caring approach – nursing students’ experiences of practising caring and uncaring encounters by simulation at a clinical training centre

Purpose

Nurses’ lack of competence to be caring affects patients’ health and patients describe a desire for more individual and compassionate care. Nursing education tends, however, to focus less on the caring approach in nursing practice and more on developing knowledge in psychomotor skills. The aim of this study was to describe nursing students’ experiences of simulating caring and uncaring encounters founded on the caritative perspective at a Clinical Training Centre (CTC).

Method

A qualitative, inductive approach using a qualitative latent content analysis. Written reflections of 49 students were analysed.

Findings

By intertwining reflection with acting and observation, the students experienced that they achieved an open mind and gained an understanding of how important it was to treat the patient based on a caring approach. To act, first uncaring and thereafter caring, gave them an awakening. The students were touched and an overwhelming feeling of suddenly understanding human uniqueness and vulnerability appeared.

Conclusions

To simulate caritative caring and uncaring encounters at the CTC enhanced students’ knowledge and understanding about caring and strengthened their prerequisites to acquire a caritative ontological basic view and attitude which in the long run may lead to an increased feeling of patient well-being in the encounter.

Mediating effects of emotional intelligence on the relationship between empathy and humanistic care ability in nursing students: A cross-sectional descriptive study

Patient-centered nursing holistic care is of utmost important to the nursing profession, and humanistic care cultivation has become a global nursing education concern. This study aimed to examine the relationship among emotional intelligence, empathy and humanistic care ability in nursing students, and to determine whether positive emotional intelligence could mediate the relationship between empathy and humanistic care ability. This study used a cross-sectional, descriptive design. A total of 323 nursing students was enrolled from one medical university in Heilongjiang Province, China. The emotional intelligence questionnaires, empathy scale and humanistic care ability scale were used to quantify participants' responses. There was no significant difference in gender, residence, single-child family and leader experience of nursing students' humanistic care ability. However, the significant differences were found in grade (t = 4.55, P < .01) and major interests (t = 7.06, P < .01). Obviously, there was positive correlation between positive emotional intelligence and empathy (R = 0.37, P < .01), and positive correlation between humanistic care ability and emotional intelligence (R = 0.62, P < .01), and empathy (R = 0.57, P < .01). Furthermore, emotional intelligence (β = 0.21, P < .01) had a significant mediating effect on the relationship between humanistic care ability and empathy. Nurse educators should improve the empathy of nursing students by developing and implementing emotional intelligence programs, in order to improve their humanistic care ability.

Perception of nursing students from the Middle East about caring: A descriptive, comparative, cross-sectional study

AIM

To investigate the perception of undergraduate nursing students in different countries in the Middle East about caring.

DESIGN

A cross-sectional, descriptive, comparative design.

METHODS

A total of 1,582 nursing students from six different countries in the Middle East completed the Caring Dimensions Inventory.

RESULTS

The total mean score of caring was 138.8 (± 15.8), indicating a high level of caring. The highest mean score was for nursing students from Egypt (M = 145.37 ± 15.97), whereas the lowest was for nursing students from Palestine (M = 135.36 ± 13.48). The caring perception was more significant for female students than male students, and no significant correlation was found between students' ages and caring scores.

CONCLUSIONS

The high level of caring among nursing students reflects the involvement of caring behaviour in the nursing curricula, which motivates nursing schools to continue stressing the importance of caring and to enhance this behaviour among their graduates.

PATIENT OR PUBLIC CONTRIBUTION

Improving the students' caring competencies as recommended by the study will influence the caregiving quality in the future that will be reflected in nurse-patient caring relationships and raise the patients' and public satisfaction with nursing care.

Humanistic caring ability of midwifery students in China and its associated factors: A multi-centre cross-sectional study

BACKGROUND

Research regarding humanistic caring has proliferated to enable person-centred and holistic care. Empirical evidence investigating the humanistic caring ability is largely derived from studies recruiting general nursing students. Midwifery students, however, remain underrepresented.

OBJECTIVES

To assess the humanistic caring ability of midwifery students in China and investigate its associated factors.

DESIGN

A multi-centre cross-sectional descriptive study.

SETTINGS

Five medical colleges spreading across Eastern, Central and Southern China.

PARTICIPANTS

Secondary vocational, higher vocational and undergraduate midwifery students (N = 303).

METHODS

The Caring Ability Inventory (CAI), the Jefferson Scale of Physician Empathy for Nursing Students (JSPE-NS), the Connor-Davidson Resilience Scale (CD-RISC) and the Professional Identity Scale for Nursing Students (PISNS) were used to measure humanistic caring ability, empathy, resilience and professional identity, respectively. Stepwise multiple linear regression was used to explore associated factors.

RESULTS

The midwifery students' total mean CAI score was 184.63 ± 19.88. In the multiple linear regression analysis, empathy (β = 0.394, p < 0.001), resilience (β = 0.233, p < 0.001) and professional identity (β = 0.161, p = 0.002) were positively associated with the humanistic caring ability of midwifery students. The humanistic caring ability was also influenced by educationl level, perceived concern from peers and recognition of caring ability as a prerequisite for midwifery profession.

CONCLUSIONS

Midwifery students in China have poor humanistic caring ability, which needs to be further improved. Interventions that cultivate the empathy, resilience and professional identity have the potential to advance the humanistic caring ability of midwifery students. Promoting a supportive and caring atmosphere among peers is also important.

Nursing students admitted through the affirmative action system display similar performance in professional and academic trajectories to those from the regular path in a public school in Brazil

Objectives

Affirmative action providing higher education access for socially vulnerable students has been implemented in several countries. However, these policies remain controversial. This study compares the performance of students admitted through the regular path and social quota systems, during and after completion of nursing education, in a public nursing school in Brazil.

Methods

This retrospective cohort study included all students admitted to nursing school at the School of Health Sciences (ESCS), Brazil, between 2009 and 2014, who were followed until May 2020. The first phase involved document analysis from the ESCS academic management system and Brazilian government agencies. In the second phase, a survey was conducted among the alumni. The social quota system criterion was public school attendance across all primary and secondary education levels.

Results

Of the 448 students included in the study, 178 (39.7%) were from the affirmative action and 270 (60.3%) from the regular path systems. Affirmative action students were older at the time of nursing school admission (p < 0.001) and took longer to be admitted to the nursing school (p < 0.001) after completing high school. There were no significant differences in the dropout rates and years to complete nursing school. In the second phase, 108 alumni answered the survey. No significant differences were found in their participation in the undergraduate scientific research program and university extension projects, attending residency programs, getting a master’s degree and doctoral degree, monthly income, teaching activity, joining public service through a government job competition process, participation in management activities in the private and public health sector, and degree of job satisfaction.

Conclusion

Our results revealed that affirmative action is a policy that contributes to the reduction of inequalities and guarantees the training of nursing professionals with a similar professional qualification received through affirmative action and regular path systems.

Caring in process: A 3-year qualitative longitudinal study of nursing students

AIM

This paper aims to describe caring perceptions and behaviors among student nurses in Italy as they progress through their nursing education.

BACKGROUND

As nursing students are potential nurses of the future, there is an expectation that in addition to appropriate academic qualifications, they will develop appropriate caring behaviors/attitudes. However, there has been some evidence that the educational process does not always modify their caring perceptions/behaviors or that the direction of the change is not always positive.

DESIGN

A qualitative longitudinal design with three data collection points, was performed from October 2013 to October 2016 at the University of Verona, Trento Campus.

METHODS

Semi-structured interviews were conducted at the time of entry into a 3-year bachelor's degree program in nursing and at the end of the second and third years. Observation of the students during their clinical practice was carried out at the end of each of the three years of education. Thirty students commenced the study and 24 finished. Data were analyzed using a phenomenological approach.

RESULTS

The iterative process of analyzing interviews and observations resulted in nine themes collectively from all three stages: establishing a trusting relationship with the patient, satisfying the patient's needs, paying attention, being respectful, being competent, giving time, being concerned with the emotional dimension, acting within context to facilitate caring actions and giving information.

CONCLUSIONS

At the end of the third year the students' concept of caring was enhanced; their initial generic or lay view of caring turned into an intentional, competent, conscious, accountable and realistic caring approach.

Investigation of the relationship between nursing students' disgust sensitivity and caring behaviours

AIM

This study aimed to investigate the disgust sensitivity of nursing students, the factors affecting this sensitivity, their caring behaviors and the relationships between these components.

BACKGROUND

Disgust sensitivity has been conceptualized as the degree of disgust felt in response to various stimuli. Nursing students often encounter recognized disgust triggers in clinical practice, such as feces, mucus, urine, foul-smelling wounds and contact with the dead. The nursing students' disgust sensitivity can affect the way they think and may affect their care behaviors.

DESIGN

The study used a descriptive cross-sectional design and was conducted with nursing students in a Turkish university nursing program (n = 577).

METHODS

The study data was collected through the Disgust Sensitivity Scale-Revised Form and the Caring Assessment Questionnaire.

RESULTS

Of the students in the study, 59.6% stated that they experienced disgust while providing care. A negative relationship was found between students' total scores from the Disgust Scale and the Caring Assessment Questionnaire (p < 0.01). The students' disgust sensitivity level was high and the higher the disgust sensitivity, the fewer caring behaviors they exhibited.

CONCLUSIONS

In light of these findings, it can be said that the caring behaviors of nursing students are negatively influenced by disgust sensitivity. Hence, nurse educators need to evaluate students' disgust sensitivity, help students to identify and address their disgust emotions, deal with disgust management strategies together and be aware of when students need support.

Perceptions of Caring Behavior Among Undergraduate Nursing Students: A Three-Cohort Observational Study

Introduction

Increase in the knowledge of "caring science" among nurses plays a key role in ensuring a correct caring behavior towards patients. Caring training for students is a priority in nursing education, but unfortunately there are limited and conflicting studies which explore this outcome. The purpose of this observational study was to explore the perceptions of caring behaviors by nursing students during their clinical practice training in order to highlight if the level of caring behaviors changes as the nursing course progresses.

Materials and Methods

The Caring Behaviors Inventory-24 (CBI-24) was administered to 331 students, enrolled in the three years of an Italian Nursing Course, who accepted to participate in the study (89.2% response rate). The data were analyzed using SPSS software version 26.0 (SPSS Inc., Chicago, IL).

Results

The total mean score of CBI-24 was 4.82 in the first, 5.12 in the second and 5.26 in the third-year students. The CBI-24 dimensions "Responding to individual needs" and "Being with" obtained the highest scores among the students of the first year. At the end of the first year, our students were already able to perform expressive caring, whereas instrumental caring developed at a high level in the second and third years. We did not highlight any statistically significant difference between the two gender CBI-24 item scores.

Conclusion

In light of our results, we put in evidence that Nursing Degree Programme favours the development in students of both relational and technical components of caring behaviors. We hope that in future students' self-assessment of caring behaviors could be considered an educational outcome for Nursing Programme.