Development and psychometric testing of a new instrument to measure the caring behaviour of nurses in Italian acute care settings

Pediatric Version of the Nurse Caring Behavior Scale: A Cross-Sectional Study in Pediatric Hemato-Oncology Centers

Background and Purpose: Caring is an essential value in nursing, it's crucial in pediatric hemato-oncology: we tested the Nurse Caring Behavior Scale (NCBS) in this setting. Methods: The NCBS is a 14-item validated psychometric questionnaire: caregivers and nurses adapted versions were used. Descriptive statistics and exploratory factor analysis (EFA) were used. Results: The questionnaires were completed by 188 caregivers and 193 nurses. The two data sets were suitable for EFA and fitted with one-solution factor analysis; factor loading showed values >0.40 (>0.60 for caregivers). The mean scores were: 4.5 (range: 1-5) for caregivers and 4.7 (range: 1-5) for nurses. Conclusion: The two validated versions can be used on a wider nurses and caregivers sample and provide an instrument for the development of nursing protocols based on caring.

Patients' perceptions of caring behaviors at referral hospitals in Ethiopia: A cross-sectional survey

Objective

The purpose of this study was to determine patients' perceptions of nurse caring behaviors and to identify factors associated with these perceptions.

Methods

A cross-sectional study was conducted at three referral hospitals in Ethiopia. A consecutive sample of male and female patients (n = 652, response rate 98.8%) was interviewed using the Amharic version of the Caring Behaviors Inventory-16 (CBI-16, including four subscales: Assurance, Knowledge and skill, Respectful, and Connectedness) and the Patient Satisfaction Instrument (PSI). Socio-demographic and clinical factors associated with perceptions of caring behaviors were identified using multiple linear regression analysis.

Results

Patients' perceptions of nurse caring behaviors were high (total Mean = 4.86, SD = 0.72). Behaviors related to the Assurance subscale were rated the highest. The multiple linear regression analysis result showed several socio-demographic and clinical factors statistically significantly associated with patients' perceptions of caring behaviors (total mean scores). Patients who were 40-49 years (B = -0.19, P = 0.012) and single (B = -0.13, P = 0.03) scored lower on total CBI-16 scores. Whereas, patients who had a higher educational level (B = 0.35, P = 0.001), cared for at surgery units (B = 0.11, P = 0.027), and reported having spent more time with a nurse in the past 8-h shift (B = 0.16, P < 0.001) were more likely to have higher perceptions of the care they received. The CBI-16 was positively correlated with satisfaction with received care, as measured with the Patient Satisfaction Instrument (r = 0.62, P < 0.001).

Conclusion

Hospitalized patients in Ethiopia have overall high perceptions of nurse caring behaviors, especially with regard to physical-based caring, while their expectations of emotional-focused care are lower. We identified patients who were in need of care, patients aged 40-49 years and single. The time spent with nurses plays a pivotal role in patients' perceptions of nurse caring behaviors.

Nursing Administration: Watson's Theory of Human Caring

Watson's human caring theory is widely used in nursing clinical practice, education, and research; however, further discussion on the application of this theory in administration is needed. The authors in this article aim to substruct Watson's theory of human caring for nursing administration. Major elements of the theory-transpersonal caring dimensions, caring competencies, and caring moments-are presented in a model of substruction that links the theoretical basis to methodology. In conclusion, this theory can be used as a framework or a conceptual model in nursing administration within an organization.

Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale

OBJECTIVES

Caregiver self-efficacy-a caregiver's belief in his/her ability to contribute to patient self-care-is associated with better patient and caregiver outcomes in single chronic conditions. It is, however, unknown if caregiver self-efficacy improves patient and caregiver outcomes in multiple chronic conditions (MCCs) because there is no instrument to measure this variable. We developed the 10-item Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) scale for that purpose, and we tested its psychometric characteristics in caregivers of patients with MCCs.

METHODS

In this cross-sectional multisite study, we tested the structural validity of the CSE-CSC scale with exploratory and confirmatory factor analysis, and we tested construct validity by correlating CSE-CSC scores with those of the Caregiver Contributions to Self-Care of Chronic Illness Inventory. We also tested reliability, and precision of the CSE-CSC scale.

RESULTS

The 358 enrolled caregivers (mean age 54.6 years; 71.5% female) cared for patients with an average of 3.2 chronic conditions. Structural validity was good, and it showed 2 factors within the scale. Construct validity showed significant correlations between scores of the CSE-CSC scale and the Caregiver Contributions to Self-Care of Chronic Illness Inventory. Reliability coefficients were between 0.90 and 0.97. Measurement error yielded satisfactory results.

CONCLUSIONS

The CSE-CSC scale is valid, reliable, and precise in measuring caregiver self-efficacy in contributing to patient self-care in MCCs. Because caregiver self-efficacy is a modifiable variable, the CSE-CSC scale can be used in clinical practice and research to improve patient and caregiver outcomes.

The development and psychometric testing of three instruments that measure person-centred caring as three concepts - Personalization, participation and responsiveness

AIM

To develop and test the psychometric properties of three instruments that measure Person-centred Caring: as Personalization, Participation and Responsiveness.

DESIGN

A three-phase mixed methods design used two frameworks: content validity determination and quantification; consensus-based standards for selection of health measurement instruments.

METHODS

A narrative literature review identified the domain definition. A systematic review of instruments provided the basis for item pools, which were refined by focus groups (N = 4) of multidisciplinary staff and service users (N = 25) and cognitive interviews (N = 11) with service users. Scale content validity indexes were calculated. Three cross-sectional surveys were conducted between April 2015 and June 2016. The instruments' psychometric properties tested included factor structure, internal consistency and construct validity. Convergent validity was tested, hypothesizing that: Personalization related to relational empathy; Participation related to empowerment; and Responsiveness related to trust.

RESULTS

Scale content validity indexes were ≥0.96 in all instruments. Response rates were 24% (N = 191), 15% (N = 108) and 19% (N = 124). Two factors were revealed for the Personalization and Responsiveness instruments and one factor for the Participation instrument. All had acceptable: reliability (Cronbach's Alpha >0.7); construct validity (>50%); and convergent validity (Spearman's correlation coefficient >0.25, p < 0.05).

CONCLUSION

This study composed definitions and instruments that reflect the multidisciplinary teams' caring behaviours, which have acceptable reliability and validity in the community population. Further psychometric testing of Participation and Responsiveness instruments should be undertaken with a larger sample.

IMPACT

The instruments can be used to monitor the variability of multidisciplinary teams' caring behaviours; research effective interventions to improve caring behaviours; and increase understanding of the impact of caring on health outcomes.

A longitudinal study on caring behaviors of Italian nursing students

AIM AND OBJECTIVE

The aim of this study was to analyze the caring behavioral differences taking place over the nursing academic period.

BACKGROUND

Caring is a core value in nursing education and many of its features can be measured as specific behaviors. The Italian Caring Behaviors Inventory is a tested psychometric questionnaire, useful to this aim. The use of the questionnaire facilitates the student's self-reflection and awareness.

DESIGN

Descriptive longitudinal study.

METHOD

The Italian Caring Behaviors Inventory questionnaire was filled out by 103 undergraduate nursing students at two Italian universities from May 2016 to May 2018 both during the second and the third year course. The questionnaire features 24 items with four caring factors: Factor 1 'Being with', Factor 2 'Doing with competence', Factor 3 'Responding to individual needs', Factor 4 'Providing effective care'. The Wilcoxon signed-rank test was used to assess differences between factors. Multiple regression analyses were conducted in order to evaluate variables associated with the increase or decrease of factors over time.

RESULTS

Results show a significant increase in Factor 2 during the selected period, which is positively associated with delta-Factor 1 and delta-Factor 3 and negatively associated with surgery clerkship during the third year of their course. Moreover, there is a significant decrease in Factor 3 between the second and third academic year and the variable positively associated to this decrease is the delta-Factor 4.

CONCLUSIONS

One of the main risks of nursing education is an asymmetric impact in favour of doing at the expense of being. In this study, we demonstrated that nursing students reported an increase in instrumental caring and a decrease in expressive caring. These results suggest that a specific training in expressive caring in the third term could be a viable answer to this unmet need in nursing education.

Why We Have to Develop Instruments of Our Caring Measurement Based on an Indonesian Perspective

Introduction: Caring is the core or focus in nursing as a form of professional nursing practice. The current caring instrument is an original instrument that measures the attitudes or behavior of nurses, has not paid attention to the administrative and environmental aspects of the hospital. The use of an instrument that does not yet contain certain characteristics gives rise to improper measurement results. The purpose of this study was to explain the importance of developing caring measurement instruments with an Indonesian perspective.Methods: Systematic reviews were carried out from database articles on ScienceDirect, Scopus, Google Scholar, SpringerLink, Wiley online, Proquest, and EBSCOhost. Criteria for articles were articles published in the last 10 years, national and international research locations, and in Indonesian and English. 15 references were obtained from 2100 references that met the predetermined criteria. The development of a caring behavior instrument based on an Indonesian perspective does not yet exist.Results: The results found that development on the basis of linguistics, cultural adjustment, and according to the prevalence of disease in a country because the epidemiology of the disease differs on the climate region.Conclusion: Specific caring instruments in an Indonesian perspective is expected that the research results will be more accurate. 

The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross sectional survey

BACKGROUND

In healthcare systems, human resources play a strategic role that has a significant impact on the whole caring process. When the wellbeing of professionals is low their performance decreases, counterproductive work behaviours may became more likely, and as a result the quality of care is compromised. Studies have shown that leadership style is particularly relevant in relation to the quality of work environments in healthcare organizations.

OBJECTIVE

The main purpose of this study is to test a model that investigates the relationships between nurse managers' leadership style and patients' perception of the quality of the care provided by the nurses, through the mediation of the quality of the working environment (in terms of burnout, interpersonal strain and counterproductive work behaviour).

DESIGN

A multi-centre cross-sectional study was conducted.

SETTING

The study was conducted in five hospitals located two in the north, two in the centre and one in the south of Italy.

PARTICIPANTS

Participants were 479 registered nurses (working as staff nurses, while head nurses and nurse managers were excluded) and 829 patients aged 18 years or older, able to read and write Italian and hospitalized for at least 3 days. Severely ill or mentally disabled patients who were not able to fill in the questionnaire were excluded.

METHODS

The data were collected through two different questionnaires, one for the nurses and one for the patients. A multilevel analysis was conducted to examine the hypothesized model.

RESULTS

Results confirmed the hypothesis that, when nurses were satisfied with leadership, they felt less burned-out and strained in interpersonal relationships, they engaged less in misbehaviour, and, in turn, patients were more satisfied with the quality of the care provided by the nurses.

CONCLUSIONS

The results of this study showed that the characteristics of the organizational context, the leadership, and the behaviours of nurses, influenced patients' perceptions of nurses' care. Therefore, managers of healthcare services should take these results into account seriously in order to improve the quality of care provided to patients.

Psychometric testing of the Caring Behaviors Inventory for nursing students

AIM AND OBJECTIVE

To test the psychometric properties of the nursing students' version of the 24-item Caring Behaviours Inventory.

BACKGROUND

Caring is at the heart of nursing and should also be a core value in nursing education. Caring can be manifested through measurable behaviours. The Caring Behaviors Inventory is a valid and reliable measure of nurses' caring behaviours in clinical settings. It has already been used among nursing students, but it needs more psychometric testing.

DESIGN

Cross-sectional validation study.

METHOD

The questionnaire was filled in by 300 undergraduate nursing students at two Italian universities in May 2016. Exploratory factor analysis was conducted using Mplus maximum likelihood with GEOMIN oblique rotation. A multifaceted approach was used to evaluate the model fit. The STROBE checklist for cross-sectional studies was followed.

RESULTS

Four dimensions were identified: "being with," "doing with competence," "responding to individual needs" and "providing effective care." Adequate fit indices and high reliability of the factors were found. Correlations between factors were positive and significant.

CONCLUSION

This study makes it possible to use the same tool to compare the caring practices perceived by students, nurses and patients. Further studies with bigger samples could be stratified to investigate the associations between caring levels and student characteristics. The Caring Behaviors Inventory can be used to call attention to caring in nursing education, helping to make this concept less elusive.

RELEVANCE TO CLINICAL PRACTICE

The effective self-assessment of nursing students' caring behaviours offers opportunities for reflection on their caring practice. This could improve the caring level of their behaviours in clinical practice and help them to become caring nurses in the future.