This chapter addresses the multiplicity of issues facing health care organizations that prevent them from focusing on their primary service mission of caring and patient-centered care. Some of these issues include quality, safety, lack of coordination and collaboration among nurses, physicians, and other health care providers and units of care, stressful workplace environments, inefficiencies, hospital-physician alignment and reimbursement, and monetization/output/revenue imbalances. The chapter also addresses a historical perspective about the carative or caring and curative traditions in health care that have helped to define the current state of health care systems. It describes a framework for examining the challenges in today’s health care system, organized according to some initiatives proposed in 2003 by a leading health care system chief executive officer (CEO) and a chief medical officer (CMO), a proposal that calls for more accountable care rather than our current ineffective, inefficient, and costly system.
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The Caring Behaviors Inventory (CBI) was the second empirical measurement instrument of caring to be reported in the nursing literature. The first version of the CBI was a Likert-scaled instrument with total scores ranging from 42 to 168. The CBI is one of the earliest to be developed with clarity of conceptual-theoretical basis, along with ongoing testing and refinement of the instrument. It is one of the few instruments in caring that provides supporting evidence for empirical validation of Watson’s transpersonal caring theory. The instrument has been reported to be among those with the shortest length of time; it has consistent language, with easy to understand instructions, and easy to analyze results, which have been used in descriptive, correlational, cross-sectional, predictive, comparative descriptive, and mixed methods design studies. The CBI has been described as useful in determining perceptions of nurse caring in patients and nurses in hospitals and nurse practitioners.
Assessing and Measuring Caring in Nursing and Health Sciences, 3rd Edition:Watson’s Caring Science Guide
The health sciences would not be complete without a caring science. Although all health sciences focus to some degree on caring, when the public thinks about caring, nursing often is foremost in their minds. This book focuses on instruments for assessing caring in the nursing literature but is useful to all in the health sciences or healing professions. It not only brings to the forefront the various conceptualizations of caring but also identifies approaches to the measurement of the concepts that have been derived from multiple perspectives on caring. The various instruments presented capture the multiple essences of caring, which may be viewed as an attitude, an ability, an attribute or characteristic, or a complex of interrelated behaviors. The book provides nursing leaders, students, and scholars with an up-to-date critique and compilation of the most salient and up-to-date instruments to assess and measure caring. It brings together in one source the many approaches to conceptualizing caring and the instruments that have been designed to measure it. The book provides questionnaire development procedures, theoretical underpinnings of instruments, reliability and validity evidence, and descriptions of instruments and their sources. This updated collection encompasses measurements of caring that have relevance in assessing caring among students as well as patients and nurses, thus allowing use in both educational and clinical care research. Some new instruments focus on assessing caring at the administrative/relational-system caring level, address a new a population (e.g., family), and include novel potential techniques such as computerization. This collection of caring instruments offers a story of nursing theory and knowledge development, as nursing scholars search for and experiment with measuring or capturing the elusive phenomenon of human caring, often considered nonmeasurable.
- Go to article: The Caring Behaviors Inventory for Elders: Development and Psychometric Characteristics
The purpose of this study was to develop the Caring Behaviors Inventory for Elders (CBI-E) and to establish its psychometric characteristics further. The 28-item CBI-E was framed by Watson’s theory of human caring. Aconvenience sample (N = 215) of elders and their caregivers (N = 138) completed the instrument. Psychometric analysis included item analysis, test-retest reliability, internal consistency reliability with Cronbach’s alpha coefficients, contrasted groups construct validity, and factorial validity, using principal components analysis with varimax rotation. Preliminary construct validity was established. Five dimensions of the CBI-E were identified: attending to individual needs, showing respect, practicing knowledgeably and skillfully, respecting autonomy, and supporting religious/spiritual beliefs. Additional testing is warranted.
- Go to article: Guiding Principles for Transforming Curriculum Through Integration of Technology as Expression of Caring
Guiding Principles for Transforming Curriculum Through Integration of Technology as Expression of Caring
Challenged by a Summer Academy on humanoid caring robots, members of the Anne Boykin Institute for the Advancement of Caring in Nursing created guiding principles for transforming curricula by integrating technology into nursing education. The guidelines were oriented in academy dialogue on nursing as caring and robotic caring. Articles written for a special topics issue for the International Journal for Human Caring addressed robots in healthcare systems and perspectives on robots as providers of caring interventions. Themes in the articles informed the guidelines. The guidelines might incentivize faculty to integrate humanoid caring robots, a technology exemplar, into nursing curricula.