Exploring Nurses’ Personal and Professional Values and Care Quality: A Convergent Mixed-Methods Analysis

Abstract

Background: Professional standards and the Codes of Ethics from the International Council of Nurses and American Nurses Association are frameworks driving professional practice and are linked to positive patient and nursing outcomes. Objective: To describe qualitative themes extracted from narrative responses on how nurses’ personal values influence nursing care and converge with quantitative results assessing personal values, professional values, and the practice environment, a key component of nurse satisfaction and subsequent care quality. Methods: A convenience sample of nurses across 19 sites within a large nonprofit healthcare system was surveyed. Quantitative measures included the Short Schwartz’s Value Survey for personal values, the Nurses Professional Values Scale-3 for professional values, and the Practice Environment Scale of the Nursing Work Index, assessing practice settings. Concurrently, nurses were asked, “How do your values influence the care you provide?” Responses were examined using a descriptive qualitative method for thematic analysis. Results: The sample included qualitative (n = 408) and quantitative (n = 671) responses. Six qualitative themes emerged: patient-centered care, professionalism/integrity of practice, advocacy, dissonance, golden rule/ethics of reciprocity (religiosity), and perseverance. Themes converged with the mean personal values of achievement, self-direction, universalism, benevolence, tradition, and conformity, and diverged with hedonism, security, and stimulation. All professional values factor means and work environment subscale means converged. Conclusions: Findings highlight convergence and divergence between qualitative and quantitative responses from nurses, offering new insights into the themes of dissonance, perseverance, and religiosity. The findings present valuable opportunities to enhance recruitment and retention strategies.