Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students

Abstract

Caring Behavior Coding Scheme based on Swanson's Theory of Caringdevelopment and testing among undergraduate nursing students 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.

Development of caring behaviour in undergraduate nursing students participating in a caring behaviour course

“…The Caring Behaviour Coding Schema (CBCS) [21] is based on Swanson's Theory of Caring. The CBCS maps five conceptual domains further defined by related sub‐domains: Maintaining Belief, Knowing, Being With, Doing For and Enabling.…”

“…Additionally, Lavoiec et al [20] highlighted that most instruments used during simulations focus on knowledge, psychomotor skills, or behaviour as separate components. However, Mårtensson et al [21] developed the Caring Behaviour Coding Scheme (the CBCS) that assesses knowledge, psychomotor skills, and behaviour simultaneously. The CBCS was used in this study to describe undergraduate nursing students' development of verbal and non‐verbal caring and non‐caring behaviours while participating in a caring behaviour course using a student‐centred learning approach and a variety of learning didactics.…”

Narrative Education Combined With Experiential Teaching in the Development of Empathic Competence of Undergraduate Nursing Students: Pre-Test Post-Test Design

“…Zhang et al, 2021; Zhu et al, 2021). While research has shown that empathy for nursing staff can be acquired through education, and narrative education can enable nursing students to improve their empathy through hands-on experiences or simulations (Mårtensson et al, 2021; Petty, 2017). Most studies have focused on narrative education courses rather than integrating narrative education methods into existing curricula, which may increase the academic burden on students and waste faculty resources (C.-D. Huang et al, 2021; Petty, 2017; Xue et al, 2023).…”

The meaning of reflection for understanding caring and becoming a caring nurse

“…According to Eriksson [ 12 ], human beings are inherently caring, while for Olshansky [ 13 ] and Boykin & Schoenhofer [ 14 ], caring is not necessarily an innate trait in nurses, but more a process and an outcome that occurs over time and involves mastering caring behaviour. Several studies support the idea that caring can be learned and emphasise that the core aim of nursing education is to develop nursing students’ caring competencies [ 15 , 16 , 17 ]. Among many recommendations, nursing education is suggested to focus on strengthening the caring identity of students, enabling them to match their idealistic caring vision with that agreed upon by the nursing profession [ 18 , 19 , 20 ].…”