Moral sensitivity and caring behavior in nursing interns: the mediating role of empathy

Background

The main purpose of this study is to analyze the relationship between moral sensitivity, empathy, and caring behaviors and to explore the mediating effect of empathy on moral sensitivity and caring behaviors of nursing interns.

Methods

A cross-sectional survey was conducted from August to September 2022 in which 261 nursing interns from two Grade 3A Hospitals in Xi'an participated. The questionnaires used in the survey include the General Information Questionnaire (GIQ), the Moral Sensitivity Questionnaire-Revised Version translated into Chinese (MSQ R-CV), the Chinese version of the Jefferson Empathy Scale (JSE), and the Chinese version of the Caring Behavior Inventory (C-CBI). The obtained data were analyzed through descriptive statistics, a one-way analysis of variance (ANOVA), and Pearson's correlation coefficient, and the mediating effect of empathy was tested through structural equations.

Results

The overall mean of moral sensitivity of nursing interns in two Grade 3A Hospitals in Xi'an is 40.84 ± 8.73, the overall mean of empathy is 100.51 ± 21.56, and the overall mean of caring behavior is (113.81 ± 21.05). Statistical analysis showed that there is a positive correlation between moral sensitivity and caring behavior of nursing interns (r = 0.376, p < 0.01), between their empathy and moral sensitivity (r = 0.336, p < 0.01), and between their empathy and caring behavior (r = 0.394, p < 0.01). The empathy of nursing interns has a mediated effect on the relationship between moral sensitivity and caring behavior. The mediated effect value was 0.14, accounting for 31.82% of the total effect.

Conclusion

The moral sensitivity of nursing interns can have a direct impact on predicting the caring behavior and indirect influences their caring behaviors mediated by empathy, with the latter effect being mediated by empathy. Therefore, nursing educators and hospital administrators should adopt targeted interventions to improve the moral sensitivity and empathy of nursing interns, which can further prove to be beneficial in improving their caring behaviors, leading to enhanced quality of nursing care and reduced nurse-patient conflicts and finally to a stabilized nursing team.

Assessment of Nurses' Caring Behaviors from the Perspective of Covid-19 Patients

Caring behaviors are an important focus of nurses' physical and technical aspects of caring. By identifying and comprehending the nurses' caring behaviors from the perspective of the patients, as well as taking into account the elements influencing caring behaviors during the Covid-19 pandemic, we may plan to offer nursing care and caring behaviors based on the needs of the patients. In this cross-sectional study, purposive sampling was used to collect data from both the Demographic Questionnaire and the Nurses' Caring Behavior Questionnaire. The results showed that the respectful relationship field had an average score of 33.57, the professional knowledge and skill field at 15.35, and the overall mean score for the questionnaire was 43.92, with the mean score from the questionnaire being higher than the real mean score. It may be concluded that this component of nurses' behavior is seen favorably by patients in the Covid-19 ward. Additionally, the patients in the Covid-19 ward thought the mean score from the questionnaire on professional knowledge and skills was good because it was higher than the real mean score. The questionnaire's overall score was likewise greater than its mean overall score. Overall, it can be concluded that patients in the Covid-19 ward have a positive opinion of the nurses' level of caring behaviors. These results indicate that it is possible to achieve ideal caring and full patient satisfaction by planning and considering future outlook in order to educate and empower nurses in terms of correct caring behaviors, and to provide quality caretaking.

Nurse and Patient Assessments of COVID-19 Care Quality in China: A Comparative Survey Study

During the COVID-19 pandemic, the quality of nursing care was a concern due to nurses' overwhelming workload. A cross-sectional design was conducted to compare perceptions between nurses and patients about the quality of nursing care for COVID-19 patients and to explore factors associated with these perceptions. Data were collected during the COVID-19 pandemic from 17 March to 13 April 2020 in five hospitals in Wuhan, China. Perceptions of care quality were assessed among nurses and patients using the Caring Behaviors Inventory. Nurses rated the quality of caring behaviors higher than patients. Both nurses and patients rated technical caring behaviors at high levels and rated the item related to "spending time with the patient" the lowest, while patients rated it much lower than nurses. Nurses' sex, participation in ethical training organized by the hospital, professional title, being invited to Wuhan, and length of working experience in years were significantly associated with nurses' self-evaluated caring behaviors. Moreover, inpatient setting and communication mode were significantly associated with patients' self-evaluated caring behaviors.

The Association between Caring Behavior and Death Anxiety among Iranian Nurses Working in Covid-19 Wards

Introduction

Nurses who are at the forefront of the fight against Covid-19 have faced problems such as anxiety and stress due to the high contagiousness of this disease and the challenges of providing services to infected patients. Death anxiety and the resulting fear following the Covid-19 pandemic can affect caring behaviors and the quality of nursing care services.

Objective

The present study was conducted with the aim of determining the association between caring behaviors and death anxiety among Iranian nurses working in COVID-19 wards.

Methods

This cross-sectional study was conducted in 2021 in Tehran. The participants consisted of 233 nurses who were purposively selected from university hospitals in Iran. Data collection tools included Demographic Information Form, Death Anxiety Scale, and Caring Dimension Inventory (CDI-25). Data analysis was done using SPSS (version 16).

Results

Most of the participants were female (79.4%), had less than 5 years of work experience (50.6%), and had bachelor's degree (88.8%). Based on the results, the level of death anxiety among nurses was moderate (7.05 ± 3.85) and their caring behavior was at optimal level (103.03 ± 13.15). Among the subscales of caring behavior, physical-technical behaviors with mean of 46.43 ± 6.20 got the highest score, and unnecessary behaviors with mean of 4.39 ± 0.73 got the lowest score compared to other subscales. Based on data analysis findings, caring behavior and its dimensions had no significant correlation with nurses' death anxiety (p = 0.111).

Conclusions

Our results showed that despite having a moderate level of anxiety, nurses try to provide good care behaviors to patients with covid-19. However, reducing nurses' anxiety can improve caring behaviors.

The empathy level and caring behaviors perceptions of nursing students: A cross-sectional and correlational study

PURPOSE

The aim of the study was to investigate the empathy level and caring behaviors perceptions of nursing students.

METHOD

This cross-sectional and correlational study was conducted with 276 nursing students.

RESULTS

The mean Empathic Tendency Scale score was 62.71 ± 5.10 (min. 20 to max. 100), indicating a low level of empathy. The mean of the Caring Assessment Questionnaire was 5.42 ± 0.80 (min. 1 to max. 7), showing a good perception of caring behaviors. There was a positive, low, and significant relationship between empathy and caring behaviors (r = 0.286, p < 0.001).

CONCLUSION

This study revealed that nursing students have low-level empathy and high-level caring behaviors.

PRACTICE IMPLICATIONS

Throughout the educational process, the students' caring competencies, which include empathy and caring behaviors, developed. It is suggested that humanistic and value-oriented pedagogical approaches be incorporated into nursing curricula.

The relationship between nursing students' professional attitudes and caring behaviors: A cross-sectional study

PURPOSE

This study aimed to determine the relationship between nursing students' professional attitudes and caring behaviors.

DESIGN AND METHODS

The research is a cross-sectional, descriptive, and correlational study. The study was conducted with 202 nursing students. The participation rate was 95%.

FINDINGS

The total Instrument of Professional Attitude for Student Nurses mean score was 106.708 ± 20.24 and the Caring Behaviors Inventory-24 mean score of the nursing students was 5.23 ± 0.88. A positive weak correlation was found between total Instrument of Professional Attitude for Student Nurses scores and sub-dimension scores, and Caring Behaviors Inventory-24 total scores of nursing students (p < .05).

PRACTICE IMPLICATIONS

The present study has demonstrated that the professional attitudes of students positively affect caring behaviors.

Mediating Effect of Compassion Competence on the Relationship between Caring Behaviors and Quality of Nursing Services in South Korea

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson’s correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses’ caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary.

Turkish adaptation and psychometric testing of the caring assessment tool-administration

PURPOSE

The purpose of this study was to adapt the Caring Assessment Tool-Administration (CAT-Adm) to Turkish and to test the psychometric properties.

DESIGN AND METHODS

The study was carried out in a cross-sectional and methodological design. The sample consisted of 578 nurses.

FINDINGS

The total score correlation coefficients of the items in the scale ranged from 0.69 to 0.90, and the Cronbach alpha reliability coefficient was 0.98, indicating excellent reliability. The results of the factor analysis confirmed the single-factor structure of CAT-Adm and the scale fit was good.

CONCULATION

In this study, CAT-Adm was determined to be a reliable and valid tool.

PRACTICE IMPLICATIONS

With the use of CAT-Adm, nurses' perceptions of nurse managers' approach can be evaluated.

Professional quality of life and caring behaviours among clinical nurses during the COVID-19 pandemic

AIMS AND OBJECTIVES

To investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID-19 pandemic. We also examined the influence of the nurses' socio-demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID-19 pandemic.

BACKGROUND

Caring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID-19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.

DESIGN

Cross-sectional, descriptive study.

METHODS

A purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short-form 24-item Caring Behavior Inventory from May-August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

The majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of 'assurance of human presence' while lowest in the 'knowledge and skills' in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.

CONCLUSIONS

Based on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses' demographic characteristics predicted their professional quality of life and caring behaviours.

RELEVANCE TO CLINICAL PRACTICE

The importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID-19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.

Relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors

PURPOSE

To examine the relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors.

METHOD

This study used a descriptive and cross-sectional design. The data were analyzed with Pearson's correlation and Linear regression analyses.

RESULTS

The professional behaviors of nursing students were found to increase their desire to become a nurse in the future with "instills confidence through caring" and "supportive learning climate" subscales but to decrease their desire to be an academician in the future.

CONCLUSION

As students' perceptions of clinical instructor caring increased, their status of applying professional behaviors was found to increase, as well.

PRACTICAL IMPLICATION

Descriptive characteristics and clinical instructor caring are related to high professional behaviors in nursing students.

Caring behaviors, moral sensitivity, and emotional intelligence in intensive care nurses: A descriptive study

PURPOSE

To evaluate the relationship of caring behaviors with moral sensitivity, emotional intelligence and descriptive characteristics in intensive care nurses.

METHOD

Descriptive study. The sample of this study consisted of 156 nurses. The data were collected using introductory information form, caring behaviors inventory, moral sensitivity questionnaire, and emotional intelligence scale. The factors affecting caring behavior were determined using stepwise multiple linear regression.

FINDING

It was determined that high education level, working in shifts, as well as appraisal of emotion subscale of emotional intelligence scale and also autonomy, expressing benevolence, and following praxis subscales of moral sensitivity questionnaire were high predictors for caring behaviors.

PRACTICE IMPLICATIONS

Descriptive characteristics, moral sensitivity, and emotional intelligence are related to high caring behavior in intensive care nurses.

The value of caring behavior and its impact on students' self-efficacy: Perceptions of undergraduate nursing students

BACKGROUND

Clinical instructors are the key mediators in helping students conquer clinical experiences by preparing them for clinical workplaces. The caring behavior of instructors plays an important role in the instructor-student relationship.

OBJECTIVE

This study aimed to (a) assess the perception of nursing students of clinical instructors' caring behavior and (b) explore the correlation between their perception of instructors' caring behavior and their self-efficacy.

DESIGN

A quantitative descriptive correlation design was adopted.

SETTING

The sample was collected from the faculty of nursing at a major governmental university for females in the Kingdom of Saudi Arabia.

PARTICIPANTS

A sample of nursing students (N = 200) was recruited.

METHODS

The data were collected using the inventory for nursing students' perceptions of instructor caring (NSPIC) and general self-efficacy (GSE) scale. Descriptive and inferential statistics, such as Pearson r correlation and regression analysis, were used.

RESULTS

The total mean of NSPIC was moderate to high (mean = 3.06, SD = 1.04). The level of GSE among students was high (mean = 3.45, SD = 0.849). NSPIC is significantly correlated with its GSE (r = .282). In addition, GSE turned out to be a major indicator of caring behavior, with P = .021 and R²  = 0.642.

CONCLUSION

Caring relationships between clinical instructors and nursing students enable students to grow as caring professionals. Therefore, nursing programs must have highly qualified clinical instructors to teach and train students and be a good role model in the workplace.

The Turkish version of the Nursing Students' Perceptions of Instructor Caring Scale: An assessment of psychometric properties

PURPOSE

The aim of this study was to determine the psychometric properties of the Turkish version of the Nursing Students' Perceptions of Instructor Caring (NSPIC-Tr) Scale.

DESIGN AND METHODS

Methodological study. The sample of this study consisted of 344 nursing students.

FINDINGS

Its four-factor structure was confirmed with explanatory factor analysis (EFA) and confirmatory factor analysis (CFA) results. The results of CFA showed that the scale's fit index supported the EFA. The scale's Cronbach's alpha internal consistency coefficient had high reliability.

PRACTICE IMPLICATIONS

NSPIC-Tr is a valid and reliable scale for the assessment of Turkish nursing students' perceptions of instructor caring.

Impact of Instructors' Caring on Students' Perceptions of Their Own Caring Behaviors

PURPOSE

The aim of this study was to identify the correlation between instructors' and students' caring behaviors and to explore the impact of instructors' caring on students' perceptions of their own caring behaviors.

DESIGN

A descriptive, nonexperimental design was used in this study.

METHODS

A total of 586 student nurses from four countries (Greece, the Philippines, India, and Nigeria) were recruited to participate in this study during the months of September 2013 to January 2014. Data collection was based on interviews using two standardized questionnaires: the Nursing Students' Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Inferential statistics such as the Pearson r correlation and regression analysis were used to determine correlations between relevant variables.

FINDINGS

Student nurses perceived "instills confidence through caring" (mean = 4.275, SD = 0.755) as the most frequently demonstrated subscale, while "control vs. flexibility" (mean = 3.469, SD = 0.701) was the least demonstrated subscale. The highest self-reported subscale in the CBI was "assurance" (mean = 4.796, SD = 0.949), while "connectedness" (mean = 4.541, SD = 0.985) was the lowest self-rated subscale. The NSPIC correlated significantly with the CBI (r = .587, p < .001). Four of the five subscales in the NSPIC correlated significantly with the CBI when considered individually; the exception was the "Supportive learning climate" subscale (r = .009, p < .40). Among the NSPIC subscales, "instills confidence through caring" explained 32% in the CBI and "appreciation of life's meaning" explained 3% in the CBI.

CONCLUSIONS

Instructors' caring behaviors influenced nursing students' caring behaviors positively. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.

CLINICAL RELEVANCE

The knowledge generated from this study provides direction in developing useful and effective caring strategies and curricular programs for nursing students. Understanding this concept in a cross-cultural context is necessary in order to develop an international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.