Högskolan i Skövde

Generally, the students' development of caring behaviors increased while participating in the Caring Behavior Course, the CBC. Using a structured observational behavioral coding scheme can assist educators in assessing caring behavior both in education and in practice.

Background: In today's complex healthcare organisations there is an increasing recognition of the need to enhance care quality and patient safety. Nurses' competence in demonstrating caring behaviour during patient encounters affects how patients experience and participate in their care. Nurse educators are faced with the challenge of balancing the demand for increasingly complex knowledge and skills with facilitating students' abilities essential to becoming compassionate and caring nurses. Aim: The aim was to describe undergraduate nursing students' development of caring behaviour while participating in a caring behaviour course. Method: This pilot study used a quantitative observational design. At a university in Sweden, video-recorded observational data from twenty-five students were collected in the first and last weeks of a full-time five-week Caring Behaviour Course (the CBC). In total, 56-min video-recorded simulation interactions between a student and a standardised patient were coded by a credentialed coder using a timed-event sequential continuous coding method based on the Caring Behaviour Coding Scheme (the CBCS). The CBCS maps the five conceptual domains described in Swanson's Theory of Caring with related sub-domains that align with Swanson's qualities of the Compassionate Healer and the Competent Practitioner. The CBCS contains seventeen verbal and eight non-verbal behavioural codes, categorised as caring or non-caring. Results: Between the two simulations, most verbal caring behaviours increased, and most non-verbal caring behaviours decreased. Statistically significant differences between the simulations occurred in the sub-domains Avoiding assumptions and Performing competently/skilfully in the quality of the Competent Practitioner. Most observed caring behaviours aligned with the Compassionate Healer. Conclusion: Generally, the students' development of caring behaviours increased while participating in the CBC. Using a structured observational behavioural coding scheme can assist educators in assessing caring behaviour both in education and in practice, supporting caring as the universal foundation of nursing and a key to patient safety.

Motivation & Aim

Although school of nursing curricula often refer to caring as the central core in nursing practice, students often have a gap in understanding and knowing how to intertwine caring in all aspect of nursing practice. Thus, nursing curricula often tend to focus more on developing psychomotor skills and knowledge, referred to as doing, with less concentration on how one interacts with patients. Even though there has been extensive research on simulation in nursing education there are limited studies focusing on the intentional and visible incorporation of compassionate and competent caring behavior in simulations. Therefore, the aim was to describe undergraduate nursing students’ experiences of practicing caring behaviors with a standardized patient. 

Method

A sample of forty-eight fourth semester undergraduate nursing students enrolled in a five-week caring behavior course at a Swedish university, were at the first and last week individually video-recorded during two caring behavior simulations with a standardized patient. After observing each of their video-recordings, students completed individual written reflection on their own verbal and nonverbal caring behavior. The written reflections were analyzed using qualitative content analysis. 

Conclusion

Simulated encounters with standardized patients that visibly intertwine caring with nursing practice facilitates nursing students’ learning of compassionate and competent caring behaviors

The learning experience made the students aware of the impact of practicing caring in nursing practice, recognizing that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters

Video-recorded caring behavior simulations provide a feasible educational learning didactic, facilitating students’ learning to apply caring behaviors

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.

This study examines undergraduate nursing students’ experiences of participating in a Caring Behavior Course using various learning didactics. Twenty-five students participated in one of five focus group interviews with data analyzed according to qualitative content analysis. The main theme to emerge, an insightful and sudden awakening that caring is not only theoretical words, was further explained with three themes and nine subthemes. The Caring Behavior Course demonstrates effective learning didactics to develop awareness of values that influence caring behaviors and can contribute to patient well-being, particularly relevant for the care challenges in the time of COVID-19 and beyond.

Rationale

To maintain patients’ dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare 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.

Aim

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 behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.

Result

The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.

Discussion/Conclusion

The CBCS is a theory-based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well-being.

Background: Knowledge of living with childhood cancer, through the trajectory, is sparse. Aim: The aim of this study was to follow young children's health and functioning in everyday life through their cancer trajectory. Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis. Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children's trajectories in relation to diagnosis but individual patterns were seen for each child. Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.

Purpose: The aim of this study was to illuminate parents' lived experiences of losing a child to cancer. Method: Interviews and a narrative about parents' experiences of losing a child to cancer were gathered from six parents of children whom had participated in a longitudinal study across the child's illness trajectory. The analysis of the data was inspired by van Manen's hermeneutic phenomenological approach. Results: One essential theme emerged: Like being covered in a wet and dark blanket, as well as six related themes: Feeling conflicting emotions, Preparing for the moment of death, Continuing parenting after death, Recollecting and sharing memories, Working through the sorrow and New perspectives in life. Conclusion: There is a need for good palliative care. If not, there is a risk that the parent will perseverate and blame themselves for not being a good parent during the suffering child's last time in life. Meetings with the parents six months and two years after the child's death might facilitate healing through the grief process. 

Purpose: A dramatic improvement in outcomes of survival rates of childhood cancer has been seen. Caring science research is central in providing skills and knowledge to the health care sector, but few overviews of the content of published research have been carried out. The aim of this review was to investigate the content and methodology of published studies in paediatric oncology relevant to caring science, and also to compare possible differences in content and method of the published studies from the nursing and psychosocial perspectives. Method: A systematic literature review was performed of 137 published articles on paediatric oncology relevant to caring science in Sweden. Results: The results show that most of the studies were descriptive or comparative ones with a quantitative design. Most of them focused on parents (43%) or children (28%). Most of the studies investigated wellbeing (88%), using questionnaires (54%) or interviews (38%). Several different measurement instruments had been used. While the results were often clearly presented, the clinical implications were more diffuse. The most acknowledged research fund was the Swedish Childhood Foundation (75%). Conclusions: To reflect the children' perspectives in paediatric oncology require that future researchers take on the challenge of including children (even young ones) in research. The use of a limited number of agreed measurement instruments is desirable. The biggest challenge for the future is to make a shift from explorative to intervention studies. There is an urgent need to transform research results into clinical practice. (C) 2014 Elsevier Ltd. All rights reserved.