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Journal ArticleDOI

Patients’ and nurses’ perceptions of respect and human presence through caring behaviours: A comparative study

TL;DR: A better understanding of caring behaviours that convey respect and assurance of human presence to persons behind the patients and may contribute to close gaps in knowledge regarding patients’ expectations is provided.
Abstract: Although respect and human presence are frequently reported in nursing literature, these are poorly defined within a nursing context. The aim of this study was to examine the differences, if any, in the perceived frequency of respect and human presence in the clinical care, between nurses and patients. A convenience sample of 1537 patients and 1148 nurses from six European countries (Cyprus, Czech Republic, Finland, Greece, Hungary and Italy) participated in this study during autumn 2009. The six-point Likert-type Caring Behaviours Inventory-24 questionnaire was used for gathering appropriate data. The findings showed statistically significant differences of nurses' and patients' perception of frequency on respect and human presence. These findings provide a better understanding of caring behaviours that convey respect and assurance of human presence to persons behind the patients and may contribute to close gaps in knowledge regarding patients' expectations.

Summary (4 min read)

Introduction

  • The concepts ‘respect’, ‘human presence’ and ‘caring’ are frequently mentioned but poorly defined in the nursing literature, while research evidence suggests that unarticulated similarities exist among a number of nursing sub-concepts such as human presence and caring.
  • Caring and human presence have many overlapping components8,9 in the sense that they both appear to involve interpersonal sensitivity, expert nursing practice and an intimate reciprocal relationship between the patient and the nurse.
  • 13 Research has also revealed an incongruence between patients’ and nurses’ perceptions of caring and the importance of nursing behaviours that convey caring.
  • The concept of respect has been studied in different settings, such as in forensic psychiatric studies on nurse–patient relationships.
  • As a result, little knowledge exists that identifies how nurses develop, maintain and express respect for the patients they are caring for.

Study design and setting

  • A multi-centre descriptive and correlational design was adopted.
  • Six countries (Cyprus, Czech Republic, Finland, Greece, Hungary and Italy) were involved in this study.

Participants

  • The nQuery Advisor statistical software was used to determine the appropriate sample size for this study.
  • Both the patient and nurse samples were recruited from hospitals chosen by each partner country according to availability and proximity.
  • The inclusion criteria for patients are as follows: hospital stay for at least 2 days (48 h) in a surgical general ward (in order to have received nursing care and be able to judge it), evidence of cognitive awareness, ability to communicate in their native language and willingness to participate in the study.
  • Questionnaires with missing data were removed, and a total of 1537 questionnaires were used for analysis.

Measure

  • The six-point Likert-type (1¼ never to 6¼ always) Caring Behaviours Inventory (CBI)-24 was used in this study.
  • It is based on Jean Watson’s Transpersonal Caring Theory23 and has contributed to the validation of that theory.
  • CBI-Assurance of Human Presence (eight items), CBI-Knowledge and Skill (five items), CBI-Respectful Deference to Others (six items) and CBI-Positive Connectedness (five items), also known as It measures four factors.
  • Each English-translated version was compared with the originals in an international meeting involving the study partners; agreement was established on the semantic and content equivalence of each item.
  • A pilot study among 30 clinic nurses from each participating country preceded the main data collection to test the questionnaires in terms of clarity of instructions and content.

Data collection procedures

  • The main data collection was carried out from September to November 2009.
  • Contact persons, appointed by each country partner, were responsible for distributing the CBI-24 accompanied by a demographic data sheet and a cover letter explaining the aims and the voluntary nature of the study and assuring about the anonymity of the collected data.
  • Patients and nurses meeting the inclusion criteria were verbally invited to participate in the study.
  • Patients who agreed to participate were given the questionnaire and instructed to return it sealed in an envelope to a closed box specifically prepared in each country (located at the ward nursing manager’s office), on the day of their discharge from the hospital.
  • Verbal reminders to nurses for returning the questionnaires were made 1 and 2 weeks after their distribution in order to increase the response rate.

Authorizations and ethical issues

  • The widely accepted ethical standard by Beauchamp and Childress27 was followed in this study.
  • According to the ethical policy of each country, approvals from internal review boards and/or ethical committees were obtained by each participating country.
  • Each participant was free to participate, refuse or withdraw at any time, without any consequences.
  • Completed questionnaires were sent by each participating country to the project at University of Technology on February 16, 2015nej.sagepub.comDownloaded from leader country , using safe procedures.
  • In each country, data were protected securely (both in electronic and paper form) and had restricted access.

Data analysis

  • Statistical analysis was centrally performed by the project leader country .
  • The first category incorporated the options ‘never’, ‘almost never’ and ‘occasionally’, whereas the second category incorporated the options ‘usually’, ‘almost always’ and ‘always’.
  • Percentages were calculated to analyse ordinal data (frequency of behaviour reported).
  • Analysis was performed on an item level, using the two factors under study (respect and presence).
  • The chi-square test was initially performed to examine possible differences among patients and nurses on the items of the two factors.

Description of the samples

  • A total of 1565 patients and 1148 nurses, from 88 wards of general surgery from 34 hospitals of six different European countries, participated in this study.
  • Most of the patients (51.2%) were women, had previous hospital experience (76%) and had a planned admission for their current hospitalization (67.7%).
  • Almost 92% perceived their health condition to be between fair and very good.

Respectful deference to others

  • As with Assurance of Human Presence, the majority of patients and nurses positively rated the care received/provided under Respectful Deference to Others.
  • Nevertheless, there was also a marked difference on this item, with the patients reporting less frequent perception of care.
  • An important issue of respect – involving ‘treating patients as individuals’ and ‘meeting their stated and unstated needs’ – was rated lower36 by patients in the positive side of the scale, suggesting differences in perception of what ‘individualized care’ means and confirming a divergence of opinion between patients and nurses.
  • 37 Notably, among the 1565 patients involved, few answers were collected in particular for the item ‘meeting their stated and unstated needs’, probably because the meaning of this item is too complex for the patients to understand.
  • Currently, there is growing research interest on incivilities in health-care settings36,38 in relation to uncivil behaviours of patients, caregivers, supervisors and physicians towards nurses.

Assurance of human presence

  • The test results of the eight items incorporated in the factor Assurance of Human Presence as well as the significant statistical differences between patients and nurses are presented in Table 2.
  • As in the case of Respectful Deference to Others, patients’ percentages are higher on the negative side of the scale than those reported by nurses.
  • There is agreement on the technical aspects of nursing, where patients and nurses similarly rated the item ‘giving medications and treatments on time’ (patients 97.2% vs. nurses 96.4%, p ¼ 0.337).

Discussion

  • The results of this study revealed that there is a lack of convergence between nurses’ and patients’ opinion on the perceived frequency (provided and received, respectively) of respectful behaviours in clinical care and caring behaviours that convey assurance of human presence.
  • In their answers, the nurses expressed their perceptions towards the entire group of patients; however, because of the differences in patient needs, the nurses possibly enacted their human presence differently in terms of frequency among these patients.
  • These last two types of patients have a high requirement for nursing care, so their perceptions were not collected.
  • Nurse shortages, changes in the skill mix and hospital settings may have assured essential levels of care based mainly on technical aspects but took away the opportunity for performing ‘soft’ caring behaviours.
  • A between-country and withincountry approach could better address improvement strategies to ethically manage the public economic resources, in order to provide better care in a cost-effective way.

Implications for practice

  • A mismatch between patients’ and nurses’ perception of the frequency of human presence and respectful behaviours in clinical practice has different implications for the nursing community at different levels.
  • At the individual level, periodically evaluating the congruence between patients’ and nurses’ frequency of perception might prompt nurses to critique their own attitudes and maintain their sensitivity towards patient needs.
  • Also, in times of resource scarcities, organizational strategies might help nurses set relational priorities aiming to address their human presence within the group of patients they care for.
  • At the educational level, specific standards of competence might be discussed and established, supporting students in their achievements with educational and tutorial strategies.
  • On the other side of the ethical relationship, it is necessary to consider not only the patients’ rights but also their duties in the health-care setting in order to ensure a mutual respectful relationship.

Limitations

  • And although every effort was made to achieve a high level of validity (use of the same protocol by all partners, sample estimation and group meetings), some limitations must be taken into consideration when interpreting the findings.
  • First, the lack of randomization and the use of a convenience sampling method might have affected the generalizability of the findings.40.
  • Also, because patients and nurses were selected on the basis of their proximity to researchers, they might have had common perceptions on caring behaviours, and this might have introduced a selection bias.
  • Second, the variability in education level among nurses in Europe may have also influenced the study findings.
  • Finally, the use of self-completed questionnaires might have led to a self-report bias.

Conclusion

  • Contemporary nursing is in the middle of continuous anti-theses between caring as a humanistic profession; the limited economic and human resources and the legal, political and technological frameworks of healthcare systems.
  • This article might trigger the ongoing debate about the nature of caring and how nursing puts caring into practice through behaviours that address the specific needs of the person being cared for and convey the values of respect and human presence.
  • Caring is a complex process involving the actions and interactions of patients as well as those of nurses; therefore, exploring the patients’ perspective together with at Cyprus University of Technology on February 16, 2015nej.sagepub.comDownloaded from nurses’ views, coming to some agreement towards a shared definition of nursing phenomena and concepts and then translating them into practice, is of utmost importance.

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Article
Patients’ and nurses’
perceptions of respect and
human presence through
caring behaviours:
A comparative study
Evridiki Papastavrou
Cyprus University of Technology, Cyprus
Georgios Efstathiou
Cyprus University of Technology, Cyprus
Haritini Tsangari
University of Nicosia, Cyprus
Riitta Suhonen
University of Turku, Finland
Helena Leino-Kilpi
University of Turku, Finland; Hospital District of South-Western Finland, Finland
Elisabeth Patiraki
National and Kapodistrian University of Athens, Greece
Chryssoula Karlou
National and Kapodistrian University of Athens, Greece
Zoltan Balogh
Semmelweis University, Hungary
Alvisa Palese
University of Udine, Italy
Marco Tomietto
University of Verona, Italy
Darja Jarosova
University of Ostrava, Czech Republic
Anastasios Merkouris
Cyprus University of Technology, Cyprus
Abstract
Although respect and human presence are frequently reported in nursing literature, these are poorly
defined within a nursing context. The aim of this study was to examine the differences, if any, in the
perceived frequency of respect and human presence in the clinical care, between nurses and patients.
Corresponding author: Evridiki Papastavrou, Department of Nursing, Cyprus University of Technology, 30 Archbishop Kyprianos
Str. 3036 Lemesos, Cyprus
Email: e.papastavrou@cut.ac.cy
Nursing Ethics
19(3) 369–379
ª The Author(s) 2012
Reprints and permission:
sagepub.co.uk/journalsPermissions.nav
10.1177/0969733011436027
nej.sagepub.com
at Cyprus University of Technology on February 16, 2015nej.sagepub.comDownloaded from

A convenience sample of 1537 patients and 1148 nurses from six European countries (Cyprus, Czech
Republic, Finland, Greece, Hungary and Italy) participated in this study during autumn 2009. The six-
point Likert-type Caring Behaviours Inventory-24 questionnaire was used for gathering appropriate data.
The findings showed statistically significant differences of nurses’ and patients’ perception of frequency
on respect and human presence. These findings provide a better understanding of caring behaviours that
convey respect and assurance of human presence to persons behind the patients and may contribute to
close gaps in knowledge regarding patients’ expectations.
Keywords
Caring behaviours, international, nursing, presence, respect
Introduction
The concepts ‘respect’, ‘human presence’ and ‘caring’ are frequently mentioned but poorly defined in the
nursing literature, while research evidence suggests that unarticulated similarities exist among a number of
nursing sub-concepts such as human presence and caring.
1,2
All these sub-concepts pose a high level of
abstraction, and although they are included in many national ethical codes
3–5
and international documents,
6
there is little clarity about what they mean. Evidence also suggests that nurses lack knowledge of nursing
codes, adopt a conscious and unconscious use of these codes
5
and fail to proactively use such codes to shape
their moral thinking and instead tend to rely on personal values and experiences.
4
Caring is characterized by Gastmans
7
as a moral attitude in nursing, explaining that both the internal atti-
tude and the external actions of a nurse are encompassed within the notion of caring behaviour, which is
inherent in the moral practice of nursing. The ‘moral value’ and the ethical significance of caring in nursing
are expressed through authentic human presence and the acceptance of the patient as a person in need of
help, which is manifested as ‘respect’.
7
Other authors have placed caring into a cohesive, context-
specific interpersonal process
8,9
defined by an authenticity
10
that is characterized by intimate relationships,
preceded by the nurses’ moral foundation and having consequences for both the patient and nurse.
2
Caring
and human presence have many overlapping components
8,9
in the sense that they both appear to involve
interpersonal sensitivity, expert nursing practice and an intimate reciprocal relationship between the patient
and the nurse.
The focus of respect as expressed in professional codes includes individuality, autonomy, dignity, pri-
vacy and other values and responsibilities. Gallagher
10
goes beyond this range of ‘objects’ and introduces
three components of a meaningful and professional approach to respect in nursing practice, that is, acknowl-
edgement, preservation and engagement.
The nursing literature presents abundant empirical evidence on caring, as shown in meta-synthesis stud-
ies,
1,8
literature reviews
11,12
and more recently in systematic reviews of caring behaviours.
13
Research has
also revealed an incongruence between patients’ and nurses’ perceptions of caring and the importance of
nursing behaviours that convey caring.
14
Although human presence is a concept representative of caring behaviours within the nursing profes-
sion,
15
this is less explored and is often confused with other concepts, such as caring, empathy and support,
or is fragmented into numerous sub-concepts.
1,15–17
Human presence is an interpersonal process character-
ized by sensitivity, holism, intimacy, vulnerability and adaptation to unique circumstances, which results in
enhanced mental well-being for both nurses and patients and improved physical well-being for patients.
Godkin and Godkin
15
offer an interesting approach, suggesting that caring behaviours mature and move
from bedside presence to clinical and healing presence, supporting previous metaphysical ideas of physical,
psychological and spiritual presence.
16
More recently, a meta-synthesis analysis of human presence in
370 Nursing Ethics 19(3)
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nursing identified 14 qualitative studies in which nurses and patients define ‘presence’ as a close physical
proximity that includes availability, attending to patients’ personal needs and sensitive communication.
1,10
However, investigations related to the singular concept of presence remain immature, and the tendency to
combine or confuse the term with caring inhibits useful analysis and understanding of the concept.
Theoretical and empirical literature on respect are even rarer,
10
although the concept has been explored
in relation to other concepts such as dignity
18
and autonomy,
19
and has been described as a human right
10
or
as an antecedent of caring.
10
The con cep t of re spec t has b ee n studied in diff er ent settings , such as in for-
ensic psychiatric studies on nurse–patient relationships.
10,20
Itisdescribedasavirtue–anactionthat
requires exer cis e of moral imagina tion, me anin gf ul en gageme nt and authenticity and not me rely as
an appearance.
10
However, alt hough respect is fundamental to ethical nursing pra ctice, it has not been
adequately explored empirically. As a result, little knowledge e xists that identifies how nurses develop,
maintain and express respect for the patients they are caring for.
21
Evidence is also lacking concerning
patients’ perceptions on nurses’ behaviours t hat convey presence and respect. In addition, no reports are
available concerning nurse–patient interactions on planned care and whether these intera cti ons are based
on presence and respect.
Aims
The aims of this study were to answer the following questions:
1. What are the differences, if any, in the perceived frequency of respectful behaviours in clinical care
between patients and nurses?
2. What are the differences, if any, in the perceived frequency of behaviours assuring human presence
between patients and nurses?
Methods
Study design and setting
A multi-centre descriptive and correlational design was adopted. Six countries (Cyprus, Czech Republic,
Finland, Greece, Hungary and Italy) were involved in this study.
Participants
The nQuery Advisor statistical software was used to determine the appropriate sample size for this study.
The estimations required (for a 90% power level to be achieved, a ¼ 0.01) at least 223 completed question-
naires from patients and 150 completed questionnaires from nurses.
Both the patient and nurse samples were recruited from hospitals chosen b y each partner country
according to availability an d proximity. The inclusi on criteria f or patients are as follows: hospital stay
for at least 2 d ays ( 48 h) in a surgical g eneral ward (in order to have received nursi ng car e and be able
to judge it), evidence of cognitive awareness, ability to communicate in their n ative language and will-
ingness to partic ipate in t he stud y. A tota l of 1971 qu estionnaires were distributed to patients and 1659
were returned (response rate ¼ 84, 17%). Questionnaires with missing data were removed, and a total of
1537 questionnaires were used for analysis.
Nurses were also recruited in terms of proximity. The inclusion criteria for nurses were as follows: being
registered as nurses, willingness to participate, with at least 1 year of work experience, with direct contact
with patients and working in the same surgical department where the patients are confined. A total of 1567
Papastavrou et al. 371
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questionnaires were distributed, and 1195 were returned (response rate ¼ 76, 26%). Questionnaires with
missing data were removed and 1148 were eligible for the analysis.
Measure
The six-point Likert-type (1 ¼ never to 6 ¼ always) Caring Behaviours Inventory (CBI)-24 was used in this
study. This instrument is a short version of the CBI developed primarily by Wolf et al.
22
It is based on Jean
Watson’s Transpersonal Caring Theory
23
and has contributed to the validation of that theory. The CBI-24 is
used to explore the perception of the frequency of caring behaviours as practised by nurses/received by
patients (the higher the mean of responses, more frequently the caring behaviours are perceived). It has been
used in different clinical settings (oncology and surgical departments)
24
and can be administered (the same
version without changes) to both patients and nurses. It measures four factors: CBI-Assurance of Human
Presence (eight items), CBI-Knowledge and Skill (five items), CBI-Respectful Deference to Others (six
items) and CBI-Positive Connectedness (five items).
24,25
Preliminary authorizations to the use of the CBI were requested and obtained from its author (Wolf, per-
sonal contact, 2008). Agreements were also obtained for the copyright of each translated version, and the
author agreed to any modifications that the research group has considered necessary.
The instrument was translated into the participating countries’ languages by forward-and-back transla-
tion processes
26
and submitted to a national panel of experts for assessment of content validity. Each
English-translated version was compared with the originals in an international meeting involving the study
partners; agreement was established on the semantic and content equivalence of each item. Further advice
was obtained by the author on the administration process and on other queries that arose during the meeting.
A pilot study among 30 clinic nurses from each participating country preceded the main data collection to
test the questionnaires in terms of clarity of instructions and content. No changes were required at this stage.
Data collection procedures
The main data collection was carried out from September to November 2009. Contact persons, appointed by
each country partner, were responsible for distributing the CBI-24 accompanied by a demographic data
sheet and a cover letter explaining the aims and the voluntary nature of the study and assuring about the
anonymity of the collected data. Patients and nurses meeting the inclusion criteria were verbally invited
to participate in the study. Patients who agreed to participate were given the questionnaire and instructed
to return it sealed in an envelope (provided) to a closed box specifically prepared in each country (located
at the ward nursing manager’s office), on the day of their discharge from the hospital. Similarly, nurses were
asked to return the completed questionnaires, sealed in an envelope (provided), in a closed box located at the
ward manager’s office. Verbal reminders to nurses for returning the questionnaires were made 1 and 2
weeks after their distribution in order to increase the response rate.
Authorizations and ethical issues
The widely accepted ethical standard by Beauchamp and Childress
27
was followed in this study. The Minister
of Health of Cyprus (Y.Y. 5.14.02.4(2)) and the Cyprus National Bioethics Committee (EEBK/EP/2008/1)
approved the research protocol, as Cyprus was the coordination point for the project. According to the ethi-
cal policy of each country, approvals from internal review boards and/or ethical committees were obtained
by each participating country. Each participant was free to participate, refuse or withdraw at any time, with-
out any consequences. The return of completed questionnaires from both nurses and patients was considered
as consent for participation. Completed questionnaires were sent by each participating country to the project
372 Nursing Ethics 19(3)
at Cyprus University of Technology on February 16, 2015nej.sagepub.comDownloaded from

leader country (Cyprus), using safe procedures. In each country, data were protected securely (both in elec-
tronic and paper form) and had restricted access.
Data analysis
Statistical analysis was centrally performed by the project leader country (Cyprus). Data were analysed
using SPSS v16 for windows (SPSS Inc., Chicago, IL, USA). Preliminarily, CBI-24 internal consistency
was assessed: Cronbach’s a was 0.94 for the nurses’ sample and 0.96 for the patients’ sample. Demographic
data were analysed using descriptive statistics, such as frequencies, percentages and means and standard
deviations (SDs). For the purpose of analysis, ordinal data (Likert-type scale) were combined into two cate-
gories. The first category incorporated the options ‘never’, ‘almost never’ and ‘occasionally’, whereas the
second category incorporated the options ‘usually’, ‘almost always’ and ‘always’. The first category was
considered as showing a negative practice/experience towards presence and respectful behaviours (less fre-
quently practised by nurses/experienced by patients), and the second category was considered as showing a
positive practice/experience (more frequently practised by nurses/experienced by patients). Percentages
were calculated to analyse ordinal data (frequency of behaviour reported). Analysis was performed on
an item level, using the two factors under study (respect and presence). The chi-square test was initially
performed to examine possible differences among patients and nurses on the items of the two factors. How-
ever, because in all tests, a number of cells in the contingency table have an expected count of <5, it seemed
more appropriate to use the Fisher’s exact test for testing differences.
28,29
Results
Description of the samples
A total of 1565 patients and 1148 nurses, from 88 wards of general surgery from 34 hospitals of six different
European countries, participated in this study.
Patients: The patients’ mean age was 54.4 (SD ¼ 16.7) years, and the mean days of hospitalization was
9.7 (SD ¼ 11.9) days. Most of the patients (51.2%) were women, had previous hospital experience
(76%) and had a planned admission for their current hospitalization (67.7%). The majority of the
patients had a secondary (40.6%), primary (24.7%), college (20.6%) or university (12.7%) education,
and a small minority was not educated at all (1.5%). Most of the patients had undergone some kind of
surgery (80.8%). Almost 92% perceived their health condition to be between fair and very good.
Nurses: The nurses’ mean age was 38.1 (SD ¼ 10.2) years, and their mean working experience was 15.5
(SD ¼ 10.3) years, while their experience in the surgical unit was 9.4 (SD ¼ 8.5) years. The majority
of the nurses worked on a full-time basis. Most of them were women (91.9% female nurses and 8.1%
male nurses). With respect to nursing education, 41.5% reported as having a diploma in nursing
(3 years), 27.6% had a bachelor of science in nursing, 2.7% had a master’s degree and 27.9% reported
as having a 2-year nursing education.
Respectful deference to others
As presented in Table 1, differences of opinion between nurses and patients are statistically significant on all
items included in the factor Respectful Deference to Others (p < 0.001), with the exception of the item
‘attentively listening to others’. Although the tendency of both patients and nurses was to answer towards
the positive side of the scale, it is interesting to note that the percentage of patients who gave negative
Papastavrou et al. 373
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Journal ArticleDOI
TL;DR: The Modele humaniste des soins infirmiers (MHSI-UdeM) as mentioned in this paper is a modele humaniste des infirmieres humanistes, which is a humanistière humaniste, humanist, and humanist.
Abstract: Comme a bien des endroits dans le monde, le Quebec n’echappe pas aux reformes de son systeme de la sante, lesquelles peuvent malheureusement entrainer des obstacles a la qualite des soins, de meme qu’une certaine deshumanisation, et ce, tant au regard des soins a la clientele, qu’au niveau organisationnel, pour les professionnels de la sante. C’est ainsi que le « Modele humaniste des soins infirmiers - UdeM » (MHSI-UdeM) souhaite offrir une perspective novatrice visant l’amelioration de la qualite et de la securite des soins, de la satisfaction et du bien-etre de la clientele ainsi que celui des infirmieres. Tout en respectant leurs influences theoriques, les auteurs presentent leur vision des concepts centraux de la discipline de meme que des concepts cles du Modele, cherchant ainsi a les rendre plus comprehensibles, accessibles et applicables dans la pratique quotidienne des infirmieres. Cet article vise a faire connaitre le Modele a la communaute infirmiere, a promouvoir son implantation dans toutes les spheres d’activites de la profession infirmiere en plus d’en montrer son applicabilite et ses retombees en recherche infirmiere. Il apparait que ce modele s’avere prometteur dans l’actualisation et le developpement d’interventions de soins humanistes aupres de la clientele.

33 citations


Cites background from "Patients’ and nurses’ perceptions o..."

  • ...Pourtant, plusieurs études (82-87) rapportent qu’une pratique inspirée du caring peut amener des avantages perçus par la personne soignée, par exemple la diminution de l’anxiété et l’augmentation des connaissances face à sa situation de santé....

    [...]

  • ...En ce qui concerne la valeur ajoutée pour l’infirmière, des écrits (19, 38, 64, 66, 67, 81, 86-88) dévoilent que cette dernière peut notamment se sentir valorisée au travers d’une relation de caring, être satisfaite des soins prodigués et donner un sens à sa pratique....

    [...]

References
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Book
01 Jan 1979
TL;DR: The principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues and three cases to exemplify some of the conflicts in ethical decision-making are discussed.
Abstract: Morality and ethical theory types of ethical theory the principle of respect for autonomy the principle of nonmaleficence the principle of beneficence the principle of justice professional-patient relationships ideals, virtues and conscientiousness.

13,200 citations

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TL;DR: This new edition of Ann Bowling's well-known and highly respected text is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services.
Abstract: This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

2,602 citations

Book
01 Jan 1989
TL;DR: In this article, the authors provide an overview of the research process in qualitative and quantitative research and its use in nursing practice, including preliminary steps in the Research Process Scrutinizing Research Problems, Research Questions, and Hypotheses Finding and Reviewing Studies in the Literature Examining the Conceptual/Theoretical Basis of a Study Part I: Overview of Nursing Research Introducing Research and Its Use in Nursing Practice Comprehending Key Concepts in Qualitative and Quantitative Research Understanding the Research process in QualIT Understanding the research processes in Q&Q Understanding Q&
Abstract: Part I: Overview of Nursing Research Introducing Research and Its Use in Nursing Practice Comprehending Key Concepts in Qualitative and Quantitative Research Understanding the Research Process in Qualitative and Quantitative Research Reading Research Reports Understanding the Ethics of Nursing Research Part II: Preliminary Steps in the Research Process Scrutinizing Research Problems, Research Questions, and Hypotheses Finding and Reviewing Studies in the Literature Examining the Conceptual/Theoretical Basis of a Study Part III: Designs for Nursing Research Scrutinizing Quantitative Research Design Scrutinizing Qualitative Research Design Examining Specific Types of Research Evaluating Sampling Plans Part IV: Data Collection Examining Data Collection Methods Evaluating Data Quality and Measurements Part V: Data Analysis Analyzing Quantitative Data Analyzing Qualitative Data Part VI: Critical Appraisal and Utilization of Nursing Research Critiquing Research Reports Using Research in Evidence-Based Nursing Practice

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Journal ArticleDOI
TL;DR: The Principles of Biomedical Ethics by Beauchamp and Childress is a classic in the field of medical ethics and has been vigorously defended against the various criticisms that have been raised.
Abstract: The Principles of Biomedical Ethics by Beauchamp and Childress is a classic in the field of medical ethics. The first edition was published in 1979 and “unleashed” the four principles of respect for autonomy, non-maleficence, beneficence, and justice on the newly emerging field. These principles were argued to be mid-level principles mediating between high-level moral theory and low-level common morality, and they immediately became very popular in writings about medical ethics. Over the years Beauchamp and Childress have developed this approach and vigorously defended it against the various criticisms that have been raised. The 5th edition of this book is, as all the …

1,839 citations

01 Jan 1988
TL;DR: Watson's Theory of Human Care draws from the works of Western and Eastern philosophers, approaching the human care relationship as a moral idea that includes concepts such as phenomenal field, actual caring occasion, and transpersonal caring.

800 citations

Frequently Asked Questions (1)
Q1. What contributions have the authors mentioned in the paper "Patients’ and nurses’ perceptions of respect and human presence through caring behaviours: a comparative study" ?

The aim of this study was to examine the differences, if any, in the perceived frequency of respect and human presence in the clinical care, between nurses and patients. Ac. cy Nursing Ethics 19 ( 3 ) 369–379 a The Author ( s ) 2012 Reprints and permission: sagepub. Com Downloaded from A convenience sample of 1537 patients and 1148 nurses from six European countries ( Cyprus, Czech Republic, Finland, Greece, Hungary and Italy ) participated in this study during autumn 2009.