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Sunday, September 26, 2010
Title: Impact of Intentional Caring Behaviors On a Labor and Delivery Unit
Discipline: Women’s Health (WH), Professional Issues (PI), Newborn (NB), Childbearing (CB), Advanced Practice (AP)
Learning Objectives:
Submission Description:- Participants will list four intentional caring behaviors.
- Participants will describe variables that impact nurses and patients perceptions of caring.
- Participants will discuss implications of research findings for their own practice.
Problem Statement/Hypothesis:
Jean Watson’s Theory of Human Caring describes caring as the foundation of nursing and the nurse as the conduit of caring. Caring is the core value of nursing and the ability to provide quality care with a cohesive team is integral to nursing job satisfaction. The study’s intent is to offer nurses physical caring behaviors that prompt their purposeful attention to caring relationships with patients and with each other.
Literature Review:
Research has identified humanistic constructs of caring and love as part of a powerful healing relationship. In a busy, chaotic environment, the nurse may be so focused on accomplishing tasks as a matter of necessity that mindful attention cannot be given to the caring relationship. Literature also suggests peer cohesion and work pressure are among the reasons nurses report leaving their jobs.
Sample:
The study sample is a convenience sample of 72 Labor & Delivery responding nurses and 184 patients greater than 18 years of age.
Methodology:
A quasi-experimental design with pre and post intervention surveys of nurses and patients was used in a 318 bed community hospital Labor & Delivery Unit. The following data collection tools were included Caring Factor Survey-Care Provider Version (CFS-CPV), Caring Factor Survey for patients (CFS) based on the Ten Caritas Processes, and the Anticipated Turnover Scale (ATS).
Data analysis & Interpretation:
Several of the ten caring process scores improved (p<.05) including the total CFS-CPV score. Nurses’ intent to leave their current job did not change significantly suggesting that the ability to perform caring in a work environment is only one of several factors in deciding to stay. Using the Pearson r, no correlation was found between the CFS-CPV total and the ATS total pre or post intervention. Two-way ANOVA between intentional caring behaviors and pre/post CFS-CPV total scores identified only centering prior to the patient encounter as having a significant interaction effect over time (p<.05). This implies centering alone may lead to a relationship focus rather than task orientation. While pre/ post CFS total scores were generally high (>4.0), a significant difference in total score was not found. Two-way ANOVA examining the interaction of demographics and time identified several variables to significantly change using an alpha of .05. Asians (npre12, npost7), Catholics (npre12, npost15), and those experiencing their first admission to the hospital (npre17, npost20) experienced increased caring over time. Pre/post total CFS scores decreased for Black-nonhispanic (npre26 npost24), those having unscheduled Cesareans (npre27, npost21) and patients with poor pain control (npre6, npost5). For Black-nonhispanic patients, results suggest cultural barriers impede the caring relationship. Patients reporting poor pain control did not perceive any difference in their caring experience, suggesting that pain interferes with the success of caring interventions.
Implications for Nursing Practice:
Centering prior to a patient encounters promotes nurse caring and improves the caring experience in some patients. Further research is needed to determine: additional variables impacting intent to stay, Black-nonhispanic patients’ perceptions of caring behaviors, and exploration of the relationship between pain and perception of caring.
