An international cross-cultural study of nursing students' perceptions of caring

Abstract

Background: Single studies suggest that nursing students perceive caring as more an instrumental than expressive behaviour and indicate some differences between caring perceptions in junior and senior nursing students. However, there are limited studies investigating caring perceptions in nursing students across multiple cultures.Objective: To determine perceptions of caring in Slovene, Croatian, Chinese and Russian nursing students and explore whether there are statistically significant differences in perceptions of caring between countries and between first and third-year nursing students. Design:A cross-sectional descriptive study design was used. Settings and participants:The study included 604 nursing students enrolled in first and third year in seven different nursing faculties in four countries: Slovenia; China; Croatia; and the Russian Federation. Methods:The 25-item Caring Dimension Inventory (CDI-25) was used to measure caring perceptions. We also included demographic questions regarding age, gender, country, year of study and type of study. Demographic data were analysed using descriptive analysis while a two-way analysis of variance (ANOVA) adjusted for unequal sample sizes was performed together with a post hoc analysis of the results. Results:The results of two-way ANOVA showed that both main effects (country and year of study) were statistically significant, as well as their interaction at the .05 significance level. The main effect for country was F(3, 596)=3.591, p<.0136 indicating a significant difference in CDI-25 between Slovenia (M=108.9, SD=9.2), Russian Federation (M=107.1, SD=8.2), China (M=102.8, SD=9.7) and Croatia (M=110.0, SD=8.6). Conclusions:Perceptions of caring in nursing students differs across countries, probably due to different educational systems, curricula, cultural differences and societal values.

Perceptions of Caring Behavior Among Undergraduate Nursing Students: A Three-Cohort Observational Study

“…This finding is in agreement with the study of Watson et al, 36 but is in contrast with the results of other studies which highlighted a reduction or no difference in caring level during the Nursing Degree Programme in nursing students. 16,27,37,38 In our sample, the CBI-24 dimensions "Responding to individual needs" and "Being with", obtained the highest scores (M = 5.20 and M = 4.85) among the students of first year, indicating good perception of expressing caring. At the end of third year, 3 of the 4 CBI-24 dimensions, statistically significant increased: "Being with" (F = 6.85, p = 0.001); "Doing with competence" (F = 75.42, p < 0.001) and "Providing effective care" (F = 13.75, p < 0.001), suggesting that both components of caring, expressive and instrumental, were perceived by students as prominent in the relationship with patients.…”

“…The distribution of gender and age in our sample is similar to other studies that investigated nursing students' perceptions of caring behaviors. 16,38,49 The total mean score of CBI-24 was 4.82 in the first year, 5.12 in the second and 5.26 in the third year cohort of students. These data indicate that students already perceived caring at high level at the end of the first year and, successively, over the three years of the course, they perceived an increase of caring level, in a statistically significant way.…”

“…27,37 A recent international cross-cultural study, which investigated the changes of caring perception between first-and third-year nursing students of different countries (Slovene, Croatian, Chinese and Russian Federation), found statistically significant differences only among Slovene students. 38 Many authors highlight that caring is composed of two principal components: instrumental and expressive behaviors, which are differently emphasized by studies. 38 In general, nursing students perceive that instrumental behavior is more prevalent than expressive in caring.…”

“…38 Many authors highlight that caring is composed of two principal components: instrumental and expressive behaviors, which are differently emphasized by studies. 38 In general, nursing students perceive that instrumental behavior is more prevalent than expressive in caring. 18,20,27,36,37 Nevertheless, as suggested by a recent study, more emphasis on expressive behaviors is needed during nursing education, in order to complete learning and training on caring.…”

“…18,20,27,36,37 Nevertheless, as suggested by a recent study, more emphasis on expressive behaviors is needed during nursing education, in order to complete learning and training on caring. 38 Regarding student gender and caring behavior, research is limited and with inconsistent results. 18 Students' reflections on caring are recommended as a key strategy in the process of teaching and learning nursing discipline.…”