Motivation & Aim
In today's complex healthcare organizations there is an increasing recognition of the need to enhance care quality and patient safety. Simultaneously, patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non-caring behaviors. Defining and measuring both verbal and nonverbal caring and non-caring behavior in healthcare providers’ care delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients. Therefore, the aim was to develop and test a caring behavior coding scheme based on Swanson’s Theory of Caring.
Method
An instrument development process was used for behavioral coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data depicts a six minutes simulated interaction between an undergraduate nursing student and a standardized patient focusing caring in nursing practice.
Result
The Caring Behavior Coding Scheme (the CBCS) entails eight nonverbal and seventeen verbal behavioral codes, categorized as caring and non-caring behaviors in accordance with Swanson’s Theory of Caring. Content validity was examined by Dr. Swanson, face validity was conducted by two clinical-nurses. A timed-event sequential continuous coding was performed in INTERACT®, the coder achieved excellent agreement with the developed gold standard (k = 0.87), and excellent mean inter-rater reliability (k = 0.82). The CBCS adequately captured caring behaviors as all domains in Swanson’s Theory of Caring were rated in the interaction.