Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
CHILD Research Group, Jönköping University, Jönköping, Sweden.
Scand J Caring Sci. 2021 Dec;35(4):1123-1133. doi: 10.1111/scs.12927. Epub 2020 Oct 30.
To maintain patients' dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers' non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.
The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson's Theory of Caring.
An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.
The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson's Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson's Theory of Caring were observed and coded in the interaction.
DISCUSSION/CONCLUSION: The CBCS is a theory-based instrument that contributes to research on healthcare providers' behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers' caring behaviour with the intended outcome of patient well-being.
为了维护患者的尊严和福祉，减轻痛苦，医疗保健提供者必须采取关怀行为。然而，每年患者委员会都会收到越来越多的患者和重要他人对医疗保健提供者关怀不足行为的投诉。在医疗保健服务中，定义和衡量言语和非言语关怀行为以及非关怀行为对于解决这些投诉至关重要。然而，没有发现任何研究将关怀理论纳入医疗保健提供者与患者之间的互动中。
本研究旨在基于斯旺森关怀理论开发和测试关怀行为编码方案。
采用行为编码的仪器开发过程，包括从瑞典一所大学的一门本科护理课程中收集的 38 个视频记录的观察数据。观察数据涉及本科护理学生与标准化患者之间的互动。
关怀行为编码方案（CBCS）包含 17 个言语行为和 8 个非言语行为编码，根据斯旺森关怀理论分为关怀和非关怀两类。评估了内容和表面效度。在 INTERACT 软件中进行了定时事件序列连续编码。该编码者与既定的黄金标准（k=0.87）达成了极好的一致性，且平均组内信度（k=0.82）也非常出色。斯旺森关怀理论的所有领域都在互动中被观察到并被编码。
讨论/结论：CBCS 是一种基于理论的工具，有助于研究医疗保健提供者的行为互动。它使用言语和非言语关怀和非关怀行为编码来评估关怀理论和实践的一致性。CBCS 可以为关注改善医疗保健提供者关怀行为的干预措施的开发和测量做出贡献，以提高患者的幸福感为预期结果。
