Where Has All the Caring Gone?: Patient and Nurse Perceptions of Nursing Caring Behaviors

Monday, 12 July 2010: 2:45 PM

Kathleen Ellstrom, RN, PhD
Pulmonary & Critical Care Section, VHA Loma Linda Healthcare System, Loma Linda, CA
Denise Giambalvo, RN, MS
Nursing Administration, Kaiser Permanente - Anaheim, Anaheim, CA

Learning Objective 1: The learner will be able to discuss the implications of the demographics and data comparing patients and nurses completing the surveys.

Learning Objective 2: The learner will be able to compare results from this study using the Caring Attributes scale to results from studies completed in Asia and Europe.


The aim of this study was to describe and contrast nurse caring behaviors as perceived by Medical-Surgical (MS)/Intensive Care Unit (ICU) staff nurses and MS/ICU patients. Nurse caring behaviors are linked to overall inpatient satisfaction in multiple patient care surveys.


In this cross sectional, two group comparative study data were collected from two integrated health care organizations: public (Site 1) and private (Site 2). Institutional Review Board approval was obtained from both. A cover letter with each survey explained the purpose of the study. Patients and nurses were asked if they would be willing to complete the survey. If they agreed, they were given the survey within a pre-addressed envelope.

Nurse perceptions were assessed by the Caring Attributes, Professional Self-Concept Technological Influences Scale {1-5 Likert scale} and has measured reliability of 0.75. Patient perceptions of nurse caring behaviors were assessed using the Methodist Health Care System Nursing Caring Instrument {1-7 Likert scale}, which has an Intra-Class Correlation of 0.98. Statistical analysis used descriptive statistics, χ2 and T test.


A total of 518 completed surveys were obtained: 258 nurses; 250 patients. There was no difference between Sites (1=6.07; 2=5.89) in patient perceptions of nurse caring behaviors (p=.0.31) or nurse perceptions between Sites (1=4.47; 2=4.41) (p=0.179). There was a significant difference between Sites comparing patient perceptions between ICU and MS (p=0.001); as well as between ICU and MS at each institution: Site 1 p=0.012, Site 2 p=0.025.


While the overall perception scores were not significant between the sites, the scores of the individual questions and ICU/MS are of interest and may provide an opportunity for improvement. The Caring Attributes scale has been validated in Asia and Europe and our results will be compared to theirs.