Nurse managers' perceptions and experiences of caring behavior for clinical nurses: a multicenter survey

BACKGROUND

Humanistic care management is a necessary measure to improve the motivation and initiative of clinical nurses and is the foundation to improve the quality of nursing. Understanding the current status and identifying the influencing factors that promote or hinder humanistic care behaviors is essential. This study investigated the current status and experiences of nurse managers' caring behaviors toward clinical nurses.

METHODS

We conducted a mixed-methods study with an explanatory sequential design. A survey on the nurse managers' caring behaviors in 101 hospitals from 23 provinces and four municipalities in China was investigated (n = 2022). Then, semi-structured interviews were conducted to obtain information about the participants' experiences associated with the performance of caring behaviors (n = 27).

RESULTS

Survey data demonstrated that the nurse managers' overall caring behaviors were moderately good. The total scoring rate was 88.55%, and the overall score was 161.19 ± 20.68. Qualitative data revealed that the capacity of nurse managers and clinical nurses, opportunity, and motivation to implement humanistic care are key influencing factors of caring behaviors.

CONCLUSIONS

The results suggested that intrinsic motivation, organizational support, and the humanistic care capabilities of clinical nurses and nurse managers are vital to implementing care behaviors. Thus, successful humanistic care management requires a concerted effort at the individual and organizational levels.

[Towards recognition of the role of analgesia nurse clinician, a Quebec perspective]

Recognition of the role of the analgesia nurse clinician will ensure that people suffering from pain receive quality care and are more satisfied with their care. What's more, the length of their hospital stays is likely to be reduced, as is the associated economic impact. The deployment of analgesia nurse clinicians requires the concerted support of various organizational, professional and political bodies.

[Nursing at the heart of advanced practice]

The posture of the advanced practice nurse (APN) is based on clinical leadership. Their missions contribute to improving the quality of care provided to patients and their families, as well as to deploying the skills of health professionals. It bases its clinical approach on nursing sciences. The RPN can be a lever for the development of the nursing discipline by conducting research or studies based on an epistemological approach.

The effectiveness of daily humanistic care in pharmaceutical care of patients with type 2 diabetes

Although the current methods of pharmaceutical care have demonstrably improved pathogenic condition and humanistic health outcomes of patients with type 2 diabetes, lacking humanistic care limits its reach and effectiveness. The purpose of this study was to evaluate the effectiveness of daily humanistic care reminders in pharmaceutical care of patients with type 2 diabetes. A total of 1200 patients with type 2 diabetes were recruited. The control group received only pharmaceutical care, whereas the intervention group received extra humanistic care from clinical pharmacists. Biochemical data, levels of quality of life, satisfaction, and self-care behavior and relationships between humanistic care and glycemic control were collected before and after 12-month intervention. Humanistic care increased levels of quality of life, satisfaction, self-efficacy and self-care behavior score, decreased blood pressure, glycosylated hemoglobin A1c (HbA1c), blood lipid, fasting blood glucose, postprandial 2-h blood glucose (PPG), inflammation, and insulin resistance after 12-month follow up. Humanistic care showed a positive correlation with glycemic control and negative relationship with HbA1c in patients with type 2 diabetes. There was a positive correlation between humanistic care and glycemic control (R = 0.641, P < .01) and a negative relationship between humanistic care and HbA1c in patients with type 2 diabetes (r = -0.482, P < .01). In conclusion, humanistic care could improve the control of overall clinical outcomes and enhanced medication adherences, which play an important role in the management of patients with type 2 diabetes.

Nursing Students and Nurses' Recommendations Aiming at Improving the Development of the Humanistic Caring Competency

BACKGROUND

Most nursing education programs prepare their students to embody humanism and caring as it is expected by several regulatory bodies. Ensuring this embodiment in students and nurses remains a challenge because there is a lack of evidence about its progressive development through education and practice.

PURPOSE

This manuscript provides a description of nursing students' and nurses' recommendations that can foster the development of humanistic caring.

METHODS

Interpretive phenomenology was selected as the study's methodological approach. Participants (n = 26) were recruited from a French-Canadian university and an affiliated university hospital. Data was collected through individual interviews. Data analysis consisted of an adaptation of Benner's (1994) phenomenological principles that resulted in a five-stage interpretative process.

RESULTS

The following five themes emerged from the phenomenological analysis of participants' recommendations: 1) pedagogical strategies, 2) educators' approach, 3) considerations in teaching humanistic caring, 4) work overload, and 5) volunteerism and externship.

CONCLUSION

The findings suggest the existence of a challenge when using mannikins in high-fidelity simulations with the intention of developing humanistic caring. The findings also reaffirm the importance of giving concrete and realistic exemplars of humanistic caring to students in order to prevent them from making "communication" synonymous to "humanization of care".

Accumulation of Secondary Metabolites of Rhodiola semenovii Boriss. In Situ in the Dynamics of Growth and Development

Rhodiola semenovii Boriss. (Regel and Herder) might be a promising replacement for the well-known but endangered Rhodiola rosea L. In this research, the metabolic profile of R. semenovii, including drug-active and stress-resistant components, was studied in the context of source–sink interactions in situ in the dynamics of growth and development. Gas chromatography with mass spectrometric detection and liquid chromatography methods were used. The data obtained allow for assumptions to be made about which secondary metabolites determine the level of stress resistance in R. semenovii at different stages of ontogeny in situ. For the first time, an expansion in the content of salidroside in the above-ground organs, with its maximum value during the period of seed maturation, and a significant decrease in its content in the root were revealed in the dynamics of vegetation. These results allow us to recommend collecting the ground component of R. semenovii for pharmaceutical purposes throughout the seed development stage without damaging the root system.

Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ?

Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.

Turkish Validity and Reliability Study of Humanistic Practice Ability of Nursing Scale

BACKGROUND

Nurses should have humanistic qualities to identify what the patient needs with an effective care plan and meet these needs. The aim of this study is to conduct the Turkish validity and reliability study of the Humanistic Practice Ability of Nursing Scale.

METHODS

This methodological study was carried out with 300 nurses online (e-mail, WhatsApp, Facebook, and Instagram) between April 02, 2021, and May 15, 2021. A questionnaire prepared via docs.google.com/forms was sent to the nurses. The scale was translated into Turkish, and then, the content and construct validity of its Turkish version was obtained through exploratory factor analysis and confirmatory factor analysis. The reliability of the scale was tested by performing item analysis and internal consistency analysis.

RESULTS

The analysis revealed that the content validity index of the scale was 0.96. In the exploratory factor analysis performed within the scope of the Turkish adaptation of the scale, the rate of the total variance explained was 59.63%. Factor loadings of all the items ranged between 0.47 and 0.79. While Cronbach's Alpha value was 0.93 for the overall Humanistic Practice Ability of Nursing Scale, it ranged from 0.71 to 0.89 for its subscales. The exploratory factor analysis and confirmatory factor analysis revealed no necessity of making any revision or modification in the scale. Therefore, the 29-item and five-dimension structure of the Humanistic Practice Ability of Nursing Scale was used in its Turkish version. Goodness-of-fit index values were obtained after the CFA was performed.

CONCLUSION

The Turkish version of the Humanistic Practice Ability of Nursing Scale can be used as a valid and reliable measurement tool to assess nurses' humanistic practice ability.

Un malaise flou en héritage : la construction du savoir infirmier enseigné au Québec

Introduction&#160;: A discussion paper based on a teaching experience, and presenting a reflective viewpoint developed as part of the university nursing course Theory in Nursing.Context&#160;: A critical look at the historiography and reference works used in nursing courses.Objectives&#160;: To shed new light on the foundations of the nursing discipline by seeking to better integrate the participation of religious communities in the development of nursing knowledge.Method&#160;: Analysis of articles from Recherche en soins infirmiers and a reflective approach influenced by an interdisciplinary perspective linking nursing science, history, and the contribution of Pierre Bourdieu&#8217;s work.Results&#160;: Observation of the complete absence of contributions to nursing knowledge before Florence Nightingale (1820-1910) and of a century-long silence after her.Discussion&#160;: Analysis of the observed reflex to disavow the legacy of nursing sisters in Quebec through the analysis of three aspects&#160;: the Nightingalian episteme, the historiographical positioning of nurses and historians, and the construction of knowledge based on the experience of the Sisters of Providence at the H&#244;pital Saint-Jean-de-Dieu.Conclusion&#160;: By ignoring the Franco-Catholic origin of the scientific field of nursing, this disciplinary knowledge deprives itself of a powerful nursing model.

Comparing feeling of competence regarding humanistic caring in Belgian nurses and nursing students: A comparative cross-sectional study conducted in a French Belgian teaching hospital

Aim

The aim of the study was to describe and compare feeling of competence regarding humanistic caring in Registered Nurses (RN) and nursing students (NS).

Design

A quantitative comparative cross-sectional research design was used.

Methods

A convenience sample of 196 RN and 47 NS in a teaching hospital in Belgium completed a self-administered questionnaire composed of a sociodemographic survey and the Caring Nurse-Patient Interactions Scale (CNPI-23) developed by Cossette et al.

Results

The four dimensions of the CNPI-23 were compared using the Skillings-Mack test. Both groups scored higher on "humanistic" and "comforting" than on "clinical" and "relational" care and both scored lowest on this last dimension. Linear regressions showed that none of the variables had a statistically significant influence on the CNPI-23 scores, except for NS "state of health," which influenced their feeling of competence regarding "relational care."

Analyse dimensionnelle du construit « formation par la recherche »

Initial nursing training programs in France have been included under the umbrella of university studies since 2009, when the ministry of higher education recognized an undergraduate program in nursing. The formal training system places great emphasis on research, and a teaching unit that enables nursing students to become acquainted with the research process has been introduced. Knowledge construction now involves the use of research approaches, and the interdependent practice&#8211;theory&#8211;research triad is implicitly recognized. Research training programs have thus far received little study. I chose to use Schatzman&#8217;s dimensional analysis method to clarify the meaning and use of the concept. From my results, nine dimensions of the &#8220;research training programs&#8221; construct emerged&#160;: 1) problematization of the situation, 2) different representations, 3) updating or developing knowledge and changing students&#8217; relationship to knowledge and the world, 4) the development of a scientific culture, 5) the development of the reflective process, 6) identity transformation, 7) self-training, 8) writing as a tool for professionalization, and 9) the integration of various dimensions. Lastly, I present a visual representation of the construct that provides an overview of the results and acts as a conceptual basis for trainers and teachers, and as such helps to promote student nurses&#8217; introduction to the research process in undergraduate nursing programs.

Humanistic caring, a nursing competency: modelling a metamorphosis from students to accomplished nurses

BACKGROUND

Most nursing regulatory bodies expect nurses to learn to be humanistic and caring. However, the learning process and the developmental stages of this competency remain poorly documented in the nursing literature.

METHODS

The study used interpretive phenomenology, and 26 participants (students and nurses) were individually interviewed. Benner's (1994) method was adapted and concretised into a five-phase phenomenological analysis to assist with intergroup comparisons.

RESULTS

Critical milestones and developmental indicators were identified for each of the five stages of the 'humanistic caring' competency. Satisfaction and meaning at work seemed closely connected to the development of 'humanistic caring'. Links emerged between the development of 'humanistic caring' and three other competencies.

CONCLUSIONS

Nurse educators might insist on the fact that 'humanistic caring' goes beyond nurse-patient communication and that it is integrated in nursing care. The findings highlight that nurses' working conditions should be improved in order to uphold humanistic caring after graduation.

[From clinical leadership in the home to leadership in the territory: a response to healthcare needs]

The provision of home health care in France is primarily based on the contribution made by private practice nurses. This method of practice requires a specific expression of nursing leadership notably with regard to its clinical component.

[Hope in tragedy. When action gives meaning to a life]

The experience of illness causes disorientation, a loss of meaning, and a loss of freedom to act. In other words, the entire field of practical possibilities diminishes, resulting in action being viewed as something impossible. In this case, the question is the following: Can the nurse contribute to maintaining hope for a life that is rich in meaning, adjusted to the limits imposed by the patient’s illness? To explore the answer to this question, we propose a humanistic model of accompaniment that enables nurses to restore hope and power to persons in vulnerable situations. In examining the best-case and the worst-case scenarios that a vulnerable person could be faced with, the accompaniment method proposed places emphasis on the exploration of practical interventions that could foster the best-case scenario and reduce the risk and the consequences of the worst-case scenario. By working on certain pragmatic aspects, we find that life becomes meaningful according to the use we can make of it, taking into account what we can actually do.

Traumatic Brain Injury in Adolescence and the Family Resilience Process: A Case Study

Introduction

The aim of this study was to better understand the family resilience process following a severe traumatic brain injury during adolescence.

Case Presentation

Inspired by the humanistic model of nursing care as a disciplinary perspective, this study used a qualitative and inductive case study design.

Management and Outcome

The data analysis yielded six themes as well as four subthemes that illustrate this family’s resilience process. The most important factors that emerged are (a) family characteristics (i.e., a fighter personality, cultural and spiritual beliefs, presence of hope, keeping a sense of humor), (b) support of family members, (c) support of friends, (d) practicing sports and leisure activities, (e) back-to-school support, and (f) feeling helpful to the adolescent.

Discussion

This study provides interesting avenues with regard to the implementation of strategies to foster the resilience process in families during particularly difficult situations in their lives, such as a traumatic brain injury during adolescence.

Positive deviance and hand hygiene of nurses in a Quebec hospital: What can we learn from the best?

BACKGROUND

Although it is well known that hand hygiene is the most effective measure to prevent health care-associated infections, hand hygiene adherence is low in Quebec, as it is elsewhere. For this study, an innovative framework was used to explore the clinical practice of nurses regarding hand hygiene and the factors that influence it: positive deviance, or the idea that there are people who find better solutions to problems than their peers. This study investigated positive deviance at the level of the care team to shed light on group dynamics.

METHODS

We conducted focused ethnographies on 2 care units-a medical-surgery unit and a palliative care unit-at a Montreal university hospital. Data collection consisted mainly of systematic observations and individual interviews with nurses.

RESULTS

The results show that positive deviance related to hand hygiene is instigated by social cohesion within a care team, created, in this study, by the mobilizing leadership of the head nurse in the medical-surgery unit and the prevailing humanist philosophy in the palliative care unit.

CONCLUSIONS

In health care, it can be useful to apply the positive deviance approach to care teams instead of individuals to better understand the ideologic and structural differences linked to better hand hygiene performance by the nurses.

[Describing undergraduate nurses’ student vision of spirituality as well as their perception of the nurse’s role in this dimension]

In North American society people have diverse cultural and religious affiliations. The nursing profession underlines the importance of including patients’ spirituality in giving holistic care. However, studies suggest that the majority of nurses do not include the spiritual dimension on a regular basis. Therefore, we thought it important to focus on undergraduate nurses’ understanding of spirituality as well as on their perception of the nurse’s role in this area. We conducted a quantitative and descriptive cross-sectional study, which gave us an overall view of the students’ perceptions. Three hundred and forty-five students answered an online survey which included French translations of the Spirituality and Spiritual Care Rating Scale and the Students Survey of Spiritual Care. Analysis of the results indicated that the students’ perception of spirituality is a contemporary one. The majority agree that nurses should include spirituality in their care but do not feel equipped to do so adequately. A comparative analysis showed that the students’ answers differed significantly depending on their cultural affiliation as well as on their affiliation or not with a religion. Recommendations for teaching purposes will also be presented.