Do Nurses' Intrapersonal Characteristics Influence Work Performance and Caring Behaviors?

Purpose:

Quality and safety of patient care is non-negotiable in healthcare. International studies recognize the link between nurses’ work performance and the educational background of nurses as well as physical and psychosocial working environments. These links impact on the quality and safety of patient care. In addition, physical and psychosocial working environments also influence nurses’ caring behaviors executed during patient care delivery. Evidence highlights that nurse caring behaviors determine a consistent proportion of patient satisfaction with aspects such as pain management. It also is a key motivational factor influencing recruitment and retention of nurses which have implications for finance and quality. However, competence is not only about technical skill but also about the underlying characteristics of practitioners which influence how they execute their competence. Less evidence is available about the influence that nurses’ intrapersonal characteristics may have on their work performance and caring behaviors.  The purpose therefore was to investigate the influence of selected intrapersonal characteristics of nurses on their work performance and caring behaviors. 

 Methods:

 STUDY DESIGN:  Quantitative, cross-sectional survey, predictive correlation design.

POPULATION: Professional nurses working in medical-surgical units in general hospitals.

SAMPLING: Stratified sampling was done to select the province with the largest number of nurses and the district with the province with the largest number of general hospitals. Hospitals invited to participate were randomly selected providing a sample of nine hospitals. Based on the population size utilizing public and private hospital services in South Africa, the nurse sample included two nurses from public sector to one nurse from private sector. All nurses from all the medical-surgical wards participated providing a sample of 218 participants. In view of research indicating that health workers may overrate the care they provide and that patients and nurses do not necessarily agree on what caring behaviors entail, it was decided to invite patients to complete the caring behaviors inventory. Patients were randomly selected from a sampling frame of patients in the unit where participating nurses worked at the time of data collection. Inclusion criteria were that patients had to be older than 18 years, in hospital for more than 24 hours, not in any discomfort and able to speak and write English, Afrikaans, isiZulu or Sesotho, the languages most used in the province providing a sample of 116 patients.

DATA COLLECTION INSTRUMENTS: Seven validated self-report instruments were used. Nurses completed six  instruments: Demographic information; Schwirians’s Six Dimension Scale of Nursing Practice (6-DSNP) assessing work performance; Nurses Professional Values Scale (NPVS-R) assessing professional values; Core Self-Evaluations Scale (CSES) measuring personality; Situational Test of Emotion Management (STEM) a form of emotional intelligence; Empathy Quotient (EQ-short) to measure empathy; Kanungo Job Involvement  Scale to measure job involvement. Patients were invited to complete one instrument, namely the Caring Behaviours Inventory (CBI) to indicate their perceptions of nurses caring behaviours. The CBI was translated into Afrikaans, isiZulu and Sesotho with the forward-backward translation method.

DATA COLLECTION: Between September 2013 and March 2014 the researcher distributed and collected the nurse questionnaires. Patient questionnaires were distributed and collected by field workers who could each speak two of the identified languages.

DATA ANALYSIS: SPSS 21, AMOS and SAS were used for data analysis.  

ETHICAL CONSIDERATIONS: Ethics approval was obtained from the University Ethics Committee, each of the participating hospitals and their governing authorities, nurse and patient respondents. 

Results:

Statically significant relationships were found between nurses’ demographics and selected intrapersonal characteristics with work performance and caring behaviours.  Only the professional values of nurses had an effect size indicating a practically important influence on work performance and caring behaviours. The importance of professional values (NPVS-R) as predictor for the dimensions of work performance (6-DSNP), is two to three times that of any other predictor that can be added to the equation on a 10% level of significance. 

Conclusion:

Demographics and intrapersonal characteristics of nurses do influence their work performance and caring behaviours. Professional values were the only predictor identified indicating that nurses with high professional values orientation have a 90% chance to positively influence their work performance and caring behaviors. This has clinical relevance for both nurse educators and nursing service managers. Professional values can be taught; therefore it can be developed in the classroom. Professional values are furthermore influenced  through experience over time indicating that in service education or continuous professional development for nurses working in clinical services should not only concentrate on updating clinical skills, but should also provide opportunities to reflect and strengthen professional values. Recommendations are provided for professional nurses, practice, education, management and research.