Nurse practitioners' perceptions of their caring behaviors

Describing compassionate care: the burn survivor's perspective

Compassion is vital in burn care. Its delivery could be considered a professional duty and a characteristic of care that affects patient satisfaction. However, the description of compassionate care is underexplored in the burn care literature. This study investigates the concept of compassionate care and how it is described from the perspective of the burn survivor. A qualitative design with two focus groups at the Phoenix Society for Burn Survivors' World Burn Congress was used to examine views of compassionate care directly through 31 burn survivors' accounts to better understand the concept and its delivery within the context of burn care. Discussions were recorded and transcripts were analyzed for prominent themes and descriptive components. Participants were primarily Caucasian (77%), female (60%), with an average age of 47.6 years and an average TBSA burn of approximately 49% sustained approximately 12 years ago. Qualitative data analysis yielded primary themes of: 1) respect the person (subthemes were: establishing an empathic connection, restoring control through choice, providing individualized care, and going above and beyond), 2) communication (subthemes: interpersonal and informational), and 3) provision of competent care. The three primary themes were components of compassionate care; it was not defined by a single characteristic, behavior, or skill but might be best understood as the convergence of the three themes. Implications of findings and barriers to the provision of compassionate care are also discussed.

The Relationship Between Surgical Patients and Nurses Characteristics With Their Perceptions of Caring Behaviors

The purpose of this European survey was to examine the relationship of surgical patients’ and nurses’ personal characteristics with their perceptions of caring behaviors. Caring Behaviors Inventory (CBI) was completed by convenience samples of 1,659 patients and 1,195 nurses from six countries of Europe. The results showed that the older the patients, the more positive were their evaluations of CBI. Those with planned admission and good/very good health conditions gave higher ratings compared to those with an emergency and poor health conditions. Type of admission, age, and health conditions explained 5.2% of CBI variance. Nurses with more work experience and experience in the unit gave significantly higher ratings compared to nurses with less experience. Nurses’ total experience and gender explained 2.3% of the variance of perceived care. Therefore, in a multinational surgical environment, caring behaviors may be influenced by other variables, better captured by using different research methods.

Cross-cultural validation and psychometric properties of the Greek version of the Caring Behaviors Inventory: a methodological study

RATIONALE

Translation, adaptation and cross-cultural validation of instruments or scale to measure concepts of interest among different populations can facilitate sharing of knowledge and advance cross-cultural research globally, especially in countries with diverse populations.

AIMS AND OBJECTIVES

This is a two-phase study aiming to: (1) translate, adapt and cross-validate the 24-item English version of Caring Behaviors Inventory into Greek; and (2) evaluate the psychometric properties of the Greek version (CBI-GR).

METHODS

A descriptive correlational design was used to conduct the study. The procedure involved professional translators, committee approach, and a sample of nurses and patients. The psychometric evaluation of the CBI-GR used a sample of 245 Greek and Cypriot medical-surgical nurses. Data analyses comprised internal consistency reliability (Cronbach's alpha coefficient), stability (test-retest) reliability, item analysis and confirmatory factor analysis.

RESULTS

The Cronbach's alpha for the overall CBI-GR was 0.92 and ranged from 0.76 to 0.87 for the subscales. Correlation coefficients between test and retest for the overall CBI-GR was r = 0.83 and ranged from r = 0.69 to 0.78 for its subscales. Confirmatory factor analysis of the scale supports its four-factor structure and the model indexes were adequate: X(2) (239) = 515.54, P < 0.001; comparative fit index = 0.91; incremental fit index = 0.91; and Tucker Lewis index = 0.90; parsimony normed fit index = 0.73; parsimony comparative fit index = 0.79; and root mean square of approximation = 0.07.

CONCLUSIONS

The CBI-GR is comparable with the original 24-item English version of the CBI and it is suitable to measure nurse caring among Greek-speaking nurses. Further psychometric testing of the instrument among nurses and patients is warranted.

Applying Watson's nursing theory to assess patient perceptions of being cared for in a multicultural environment

BACKGROUND

J. Watson's (2002) caring theory addresses caring relationships among humans and the deep experiences of life itself. M. Leininger (1988) noted that caring is a universal phenomenon, which is likely to be perceived differently by patients and nurses if they come from different cultural backgrounds. Little is known about the patients' perception of "being cared for" in the Kingdom of Saudi Arabia, where most nurses in the workforce come from cultural backgrounds different from their patients.

PURPOSE

This study was designed to explore Saudi patient perceptions of important caring behaviors and those most frequently attended to by staff nurses in a multicultural environment.

METHODS

A questionnaire survey was used to explore discrepancies between the perceived importance of caring behaviors and how frequently those caring behaviors were attended to by staff nurses. A probability sample of 393 patients was drawn from three hospitals in three different regions of Saudi Arabia. The Caring Behaviors Assessment instrument of S. N. Cronin and B. Harrison (1988) was used in data collection.

RESULTS

Patients rated overall caring behaviors as important (97.2%) and frequently experienced (73.7%). The discrepancy between the importance of and frequency of attendance to caring behaviors by nurses was statistically significant (t = -4.689, p = .001).

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The caring behaviors based upon Jean Watson's theory were valued by Saudi patients irrespective of their cultural differences with the caregiver. However, the frequency of caring attended to by nurses in teaching/learning and helping/trust behavior subcategories were rated lower. Such is most likely the result of culture differences and language barriers existing between patients and nurses in Saudi Arabia. Results showed that the carative factors in Jean Watson's theory were also applicable to patients in Saudi Arabia and that nursing professionals should base their care on such theory to meet patient needs.

Nurses' Experiences of Feeling Respected—Not Respected

Feeling respected—not respected is an experience integral with the ways nurses choose to describe the quality of their work environments and with the quality of care they provide to patients and families. The purposes of this study were to enhance understanding of nurses' experiences of feeling respected—not respected, and to provide new knowledge about quality of work-life related to feeling respected—not respected. The Parse research method was used to answer the research question, What is the structure of the lived experience of feeling respected—not respected? Participants were 37 nurses in staff and leadership roles at a large teaching hospital. The structure, feeling respected—not respected is affirming—not affirming attentiveness with diverse affiliations arising with assuredness—unassuredness, is discussed in light of the humanbecoming theory, related literature, leadership, and future research.

Caring communications: how technology enhances interpersonal relations, part I

It can help improve communication, collaboration, conflict resolution in healthcare by creating a foundation of caring capabilities.

Toward a predictive model of patient satisfaction with nurse practitioner care

PURPOSE

(a) To determine if caring behaviors of nurse practitioners (NPs), gender of NPs, setting (urban or rural), and age, gender, ethnicity, education, and income of patients were predictors of patient satisfaction; (b) to determine which of these characteristics was the best predictor(s) of patient satisfaction; and (c) begin to develop a conceptual model for explaining patient satisfaction with NP care.

DATA SOURCES

Responses to the Caring Behaviors Inventory (CBI) and a demographic inquiry by 348 NPs in Louisiana and completion of the Di'Tomasso-Willard Patient Satisfaction Questionnaire (DWPSQ) and a demographic inquiry from 817 patients in Louisiana served as data sources. A predictive modeling design explored which variable(s) is the best predictor of patient satisfaction, and multiple regression was used to determine the equation for the best-fitting line and the optimal model for the best predictor(s) of patient satisfaction.

CONCLUSIONS

CBI mean scores were high for all NPs. No statistically significant difference was found between male NPs' and female NPs' total mean CBI scores and between urban or rural total mean CBI scores. DWPSQ mean scores and subscale scores indicated high satisfaction with NP care. No statistically significant relationships were found between the NPs' CBI mean scores and the patients' DWPSQ mean scores. There were significant relationships between the DWPSQ subscales, including Wait Time and Patient Management. Stepwise linear regression revealed that patients' age group was a predictor of DWPSQ total mean scores.

IMPLICATIONS FOR PRACTICE

NPs need to be aware of developmental differences in all age groups and the differences in perceptions of care. There are many variables to consider when determining patient satisfaction with care, including the patients' sociodemographic and health variables, the healthcare system, and characteristics of the healthcare providers. Awareness of these variables may affect how NPs deliver care and ensure quality care with which the patients are satisfied.

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 behaviors of advanced practice nursing students

The purpose of this project was to provide advanced practice nursing (APN) students with the opportunity to enrich their aesthetic knowing and acquire the meaning of caring in their practice by reflecting on their caring narratives. Students were asked to write about a caring encounter they experienced in their practice. The instructor analyzed and organized that data from each narrative. The instructor shared the data with the students for reflection and discussion. This report focuses on the caring practices of the APN students. Nine themes that embraced physical care, communication, comfort, presence, knowing, acceptance, touch, collaboration, and encouragement were identified. The APN students demonstrated aesthetic knowing as well as other ways of knowing in their caring narratives. Through reflection on the caring experiences and discussion in class, students were able to identify the meaning of caring in their practice.