Theories of caring in nursing, developed over decades, are rooted in the ethical principle of respect for human dignity and an expectation of nurse behavior that demonstrates caritas. This article describes the context and evolution of caring-theory development; presents an overview of caring theories, their components, and studies framed by a caring theory; and examines the current state of caring-theory development. The body of knowledge framed by caring theories, constructs, and models contributes to caring science. Caring science depends on how future research and scholarship are guided, translated, disseminated, and expanded to strengthen caring science and to direct nursing praxis.

The purpose of this study was to develop the caring behaviors inventory for elders (CBI-E), based on the caring behaviors inventory (CBI). Aconvenience sample (N = 36) of elders completed the instrument. Procedures to establish content validity, including item selection and revision, construct validity, reliability, and pilot testing were employed to establish the psychometric properties of the initial version of the 28-item CBI-E. Content validity of the expert type was established with six advanced practice nurses, expert in gerontological nursing. The investigators revised items following expert review; one item was eliminated. Cronbach’s alpha coefficient was .94 for the overall CBI-E. The response scale was modified and several items were revised.

This review aimed to identify methodologically sound studies that evaluated the effect of nurse caring on the satisfaction of hospitalized, adult patients. Quantitative studies were located from electronic databases, with a search strategy that focused on titles, key words, index terms, abstracts, and full text published documents on nurse caring or nursing staff caring, patient satisfaction, and hospitalized adults. The initial search identified 2,709 references. Fifty-two full text citations remained for the next step of critical appraisal; 16 documents were included in the final review. Most of the citations were Level VI in a hierarchy of evidence with low quality. Nurse caring protocols need to be developed and linked causally to the outcome of patient satisfaction with hospitalization.

Few acute care healthcare agencies have tested the effect of a caring-focused program on the satisfaction of hospitalized, adult patients. Caring interventions need to be tested to document the effectiveness of nurse caring on a healthcare outcome, patient satisfaction. This study identified critical elements in interventional studies on nurse caring by determining patterns and caring activities in interventions (programs, protocols, or standards) to develop a caring protocol for a National Cancer Institute Comprehensive Cancer Center (NCICCC). Research, other published articles on caring programs, and instruments were analyzed for patterns and elements indicative of caring behaviors or activities representing nurse caring that could contribute to a caring intervention. Intervention dissemination strategies were also analyzed for incorporation into the program’s implementation in a nursing department of the NCICCC. Content analysis techniques identified patterns and activities in caring interventions and intervention dissemination strategies. Comments and written suggestions on the draft caring protocol were solicited from agency stakeholders (N = 22), including administrators, key nursing staff, and members of the Patient Family Advisory Council. The caring protocol/standard of practice and dissemination strategies were identified.

This three-round Delphi study generated an international standard of care for caring for potential use by nurses and other health care providers in health care agencies and communities. The caring elements, based on related literature, were surveyed from members of the International Association for Human Caring (IAHC) and attendees of the IAHC meeting held in Boca Raton, Florida (USA), in 2000. The standard was constructed from questionnaire responses and provides a starting point for developing a practice model and subject matter for debate among clinicians, educators, and researchers from diverse cultures.and quantitative analysis indicated that student caring behavior significantly improved.