Emergency triage nurses' perceptions of caring behaviors and the safety of the patient during triage encounters: a grounded theory study.

BACKGROUND: Triage is a dynamic process prioritising the patient coming to the emergency department. Caring behaviour and patient safety during the triage process are essential for ensuring a good care experience and treatment outcome. OBJECTIVE: To describe triage nurses' perceptions on caring behaviors and patient safety in the triage area. DESIGN: Strauss and Corbin's Grounded theory method was used to develop the model. METHODS: The study was conducted in the emergency department in northeastern Slovenia. Semi-structured interviews were used for data collection, and 19 triage nurses were selected by theoretical sampling, guided by emerging categories between November 2021 and July 2022. The data analysis was conducted according to Strauss and Corbin's coding framework. RESULTS: The analysis of the interviews generated one category: The process of creating a caring and safe triage encounter for the patient, together with two categories that explain the key phenomenon: (1) Triage caring and (2) Safety in the triage process. Within the category "Triage caring", four subcategories were developed: (1) Assurance of triage nurses' presence, (2) Connectedness, (3) Respectful attitude, and (4) Knowledge and skills. The category Safety in the triage process consists of three identified subcategories: (1) Conception and perception of safety, (2) Factors influencing patient safety, and (3) Improving the triage safety. CONCLUSIONS: The triage nurses' perceptions about caring for the patient and his safety in the triage area show that caring and safety are inseparably linked and coincide when triaging a patient. Namely, caring for the patient means ensuring the patient's safety at the same time. IMPLICATIONS FOR THE NURSING FIELD: A better understanding of the importance of triage nurses' caring behavior and patient safety emerges from the findings, highlighting the challenges faced in a busy emergency department where nurses must balance providing care and responding to patients' needs while ensuring safety. Findings in the study show that patient care and safety are inseparably linked and coincide when triaging a patient. Moreover, applying caring behaviour during triage encounter results in greater patient safety. NO PATIENT OR PUBLIC CONTRIBUTION: The study's design, evaluation of the findings, and execution did not need the involvement of patients or the general public. Participants were triage nurses working in the emergency department. Triage nurses were interviewed about their perceptions of triage nurses on caring behaviors and patient safety during triage encounter.

The relationship between self-compassion and caring behaviour in nurses: A cross-sectional study.

AIM: To examine the relationship between self-compassion and caring behaviour in nurses. BACKGROUND: Self-compassion can influence nurses' ability to cope with stress and their job performance. High levels of self-compassion may play a role in nurses' coping with compassion fatigue and burnout. This may make the concept of self-compassion in nurses an important variable for effective care. METHODS: This is a cross-sectional study. Study data were collected between March and May 2022 from 331 nurses at a hospital in the city of Antalya, Turkey. A personal information form, the Self-Compassion Scale (SCS), and the Caring Behaviour Inventory-24 (CBI-24) were used to collect data, and the program SPSS 23.0 was used in data evaluation. Descriptive statistical methods, Pearson correlation analysis and multiple linear regression analysis were used in the analysis of data. The STROBE checklist was followed for this cross-sectional study. RESULTS: The nurses' mean scores were 3.50 ± 0.61 on SCS and 5.21 ± 0.56 on CBI-24. A positive correlation was found between the nurses' self-compassion levels and caring behaviour. Also, the SCS sub-dimension of mindfulness, working in intensive care and working willingly in the nursing profession significantly predicted caring behaviour. These variables explain 19.4% of the variance of caring behaviour. CONCLUSIONS: The nurses' self-compassion levels were medium and their caring behaviour was at a high level, and caring behaviour was higher in those who worked in intensive care, those who were working willingly in the nursing profession, and in those with high scores on the self-compassion sub-dimension of mindfulness. IMPLICATIONS FOR NURSING AND HEALTH POLICY: It is important to strengthen nurses' self-compassion skills to develop their caring behaviour. In particular, giving nurses in clinics mindfulness-based education will help them to increase their awareness concerning their own lives and to develop their caring behaviour.

Trends in the representation of specialties caring for patients with diabetes in the Czech Republic.

The increasing prevalence of diabetes mellitus (DM) leads to the differentiation of the registration of diabetics in individual specialties. Objective of this paper was the evaluation of changes in the representation of expertise providing care for patients with DM (pDM) in the Czech Republic, based on data analysis from the National Register of Paid Health Services (NRHZS) 2010-2021. In the entire pDM group, the number of patients treated by a diabetologist (DIA) increased from 491,490 (57.0 %) to 537,430 (50.4 %), with a general practitioner (GP) from 27,719 (3.2 %) to 181,330 (17.0 %) and by internist (INT) from 172,918 (20.0 %) to 161,291 (15.1 %). In 2021, 57.9 % DIA, 17 % GP, 12.2 % INT were treated from the group treated with antidiabetics (813,873). In 2021, 84,345 were treated with insulin alone (87.2 % DIA), 129,127 were treated with a combination of insulin and non-insulin antidiabetics; 115,604 (91.6 %) in DIA, 322 (0.3 %) in GP and 7,983 (6.3 %) in INT. 603,331 treated only with non-insulin antidiabetic drugs, of which 281,929 (46.7 %) DIA, 137,744 (22.8 %) GP and 85,273 (14.1 %) INT. For other specialties, 98,385 (16.3 %) persons. 185,838 patients without reported DIA/GP/INT control, of which 80,144 without therapy. The increasing prevalence of DM and changes in reimbursement conditions are reflected in the dynamic development of the distribution of diabetes care by individual specialties.

Care biography: A concept analysis.

In this article, we investigate how the concept of Care Biography and related concepts are understood and operationalised and describe how it can be applied to advancing our understanding and practice of holistic and person-centred care. Walker and Avant's eight-step concept analysis method was conducted involving multiple database searches, with potential or actual applications of Care Biography identified based on multiple discussions among all authors. Our findings demonstrate Care Biography to be a novel overarching concept derived from the conjunction of multiple other concepts and applicable across multiple care settings. Concepts related to Care Biography exist but were more narrowly defined and mainly applied in intensive care, aged care, and palliative care settings. They are associated with the themes of Meaningfulness and Existential Coping, Empathy and Understanding, Promoting Positive Relationships, Social and Cultural Contexts, and Self-Care, which we used to inform and refine our concept analysis of Care Biography. In Conclusion, the concept of Care Biography, can provide a deeper understanding of a person and their care needs, facilitate integrated and personalised care, empower people to be in control of their care throughout their life, and help promote ethical standards of care.

Meaning-oriented thematic analysis grounded in reflective lifeworld research-A holistic approach for caring science research.

BACKGROUND AND AIM: The aim of the present article is to describe meaning-oriented thematic analysis grounded in reflective lifeworld research and to illustrate how the thematic analysis can be integrated in the research process. The article is a methodological paper, including ontological and epistemological assumptions for lifeworld theory. Research based on lifeworld theory is directed towards lived experiences and meanings in everyday life. Research that is founded on the epistemology of the lifeworld can present existential issues important for caring and qualitative research can in particular contribute to existential knowledge needed to understand the world of the patient. DESIGN: Theoretical paper. RESULTS: Starting with a phenomenon of relevance for caring science, the article argues for lifeworld interviews as a data collection method that can contribute to depth and meaning, and then presents a description of how structures of meaning can be outlined through a meaning-oriented thematic analysis. The research of lived experiences in caring science demands an approach that includes a reflective attitude during the methodological considerations. This article highlights the importance of ontological and epistemological considerations when conducting a meaning-oriented thematic analysis. CONCLUSION: The article places meaning-oriented thematic analysis in a wider research process, considering all aspects from collection of data to the creation of meaning-oriented themes.

Raising nurse educators' awareness regarding caring pedagogical relationships' barriers to foster inclusive simulation settings: Insights from a phenomenological study.

AIM: The purpose of this paper was to shed light on the main barriers to caring pedagogical relationships within simulation centers from the perspective of nursing students and offer targeted strategies to reduce these barriers. BACKGROUND: A caring pedagogical relationship is a powerful strategy to foster students' learning within simulation settings. However, the development of this relationship could be hindered if nurse educators are not aware of its barriers. Hence, this could affect students' learning and well-being within this academic context. According to our knowledge, no previous research has addressed the question of the barriers to caring pedagogical relationships within the context of simulation. DESIGN: This study employed a descriptive phenomenological method, entitled Relational Caring Inquiry, to collect and analyze data gathered from 19 students enrolled in an undergraduate nursing program. RESULTS: This paper focuses on one eidos-theme that emerged from our data analysis and interpretation entitled "Educator's conscientization regarding barriers to the development of a caring pedagogical relationship". According to data analysis and interpretation, this eidos-theme was the most emphasized by research participants. It emerged from the following themes: (a) educators' dehumanizing practices, (b) disruptive and stressful academic context, (c) lack of educators' experiences and (d) educators' disinterest in students' learning. CONCLUSIONS: Leaving caring pedagogical relationships' barriers unaddressed has shown adverse impacts on students' learning process and their mental and physical well-being. This paper brings to light the main barriers to caring pedagogical relationships and invites educators, managers and nurse leaders to be aware of these obstacles and collectively engage in humanizing nursing education. In other words, we emphasize the impact of these barriers on students' apprenticeship and suggest political actions to build caring and inclusive simulation environments. STUDY REGISTRATION NUMBER: CERSES-19-050-D.

Spirituality, Religiosity, Caring Behavior, Spiritual Care, and Personalized Care Among Student Nurses: A Descriptive Correlational Study in the Philippines.

This study sought to determine the student nurses' spirituality, religiosity, caring behavior, spiritual care, and personalized care. Further, it sought to determine the relationship between spirituality, religiosity, and caring behavior in student nurses' spiritual care and personalized care. The study used a descriptive correlational design using convenience sampling to collect data from 1248 student nurses in the Philippines from December 2023 to February 2024. We collected data using the Spirituality and Spiritual Care Scale rating scale and the Caring Behaviors Inventory. The study revealed that the mean scores of the students in their "spirituality" and "religiosity" were 4.08 (SD = 0.98) and 2.99 (SD = 1.26), respectively. Student nurses had sufficient confidence and skills in spiritual care, caring behavior, and personalized care. The students' age had a weak and negative association with the students' spirituality and religiosity. Students from University A had higher levels of spirituality and religiosity than students from University B, University C, and University D. Students in the 4th year level were more religious than 3rd year students. Students who had their last clinical exposure in the Admission and emergency room reported poorer caring behaviors than those who had previous clinical exposure in the Medical-surgical ward, Obstetrics and gynecology, Intensive Care Units, and Community. There is no significant relationship between a student nurse's spiritual care and caring behavior. This trend is similar to caring behavior and personalized care. The students' age predicts their personalized care.

The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors.

BACKGROUND: Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying. PURPOSE: This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying. METHODS: A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis. RESULTS: Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001). CONCLUSION: This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

"I Felt Like I Mattered": Caring is a key ingredient of collaborative care for chronic illness.

OBJECTIVES: To identify perceptions and experiences related to caring science and collaborative care in intervention participants of the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) study, a randomized, multi-site clinical trial for patients with chronic heart failure and reduced health status. METHODS: Forty-five participants completed semi-structured, telephone interviews with a focus on intervention components, impact of the intervention on participants' lives, and recommendations for intervention change. Data were analyzed using an inductive content analysis approach focusing on the presence and frequency of text to identify patterns, categories, and themes across participants without an a priori code book. The validity of the identified categories was enhanced through triangulation. RESULTS: Three themes were identified: (1) intervention providers' caring/helping attitude and caring/helping communication; (2) care team availability to respond to concerns or questions; and (3) help with understanding and navigating the healthcare system. DISCUSSION: Patients highly value caring attitudes and communication, availability, and empowerment to understand and navigate healthcare systems. These attitudes and behaviors may be important mediators of the success of collaborative care programs. These are consistent with the theory of caring science, a framework that is relevant more broadly to patient-centered and team-based care models.

The Association Between Grandchild Care and Biological Aging Among Middle-Aged and Older Adults in China.

Background and Objectives: Substantial evidence documents grandchild care is associated with self-reported health, life satisfaction, and depressive symptoms among middle-aged and older adults. However, little is known about the relationship between grandchild care and biological aging, especially in China, which emphasizes the unique cultural value of family. The current study sheds light on the biological consequence of grandchild care by examining the link between grandchild care and biological aging among middle-aged and older adults in China, and how gender and spousal involvement in caregiving affect this link. Research Design and Methods: In a representative sample of Chinese adults aged 45-80 from the third wave of China Health and Retirement Longitudinal Study in 2015 (n = 3,384), we calculate biological age using Klemera-Doubal Method, and Ordinary Least Square models are used to examine the correlation between grandchild care and biological aging. Results: High intensity of involvement in grandchild care is related to biological aging, and caring for grandchildren alone predicts greater biological aging. Compared with grandfathers, grandmothers lose more from grandchild care regardless of whether their husbands are involved in the care. Discussion and Implications: Providing grandchild care should be a way to cope with age-related role discontinuity or loss, rather result in extra stress or burden for grandparents. Reducing the intensity of caregiving or increasing family support may attenuate the extent of biological aging.

Nurses' Perception of Caring and Attitudes toward Caring for Dying Patients: Exploring the Relationship Using a Descriptive Cross-Sectional Design.

This study examines the association between nurses' perception of caring and attitudes toward caring for dying patients in end-of-life care units. We used a descriptive cross-sectional design with convenience sampling. Data were collected from May to June 2021 through self-reported questionnaires from 303 Spanish nurses (mean age = 48 years, 78.9% female). Participants completed the Caring Dimension Inventory (CDI-25) and the Frommelt Attitudes Toward Care of the Dying scale. Demographic and training information were collected. Data were analyzed using Stata 16.0. Attitudes toward Care of the Dying Patient were significantly higher in nurses with palliative care training (ß = 2.829, p = 0.018) and those who scored higher on the psychosocial (ß = 0.789, p = 0.0001) and technical dimensions (ß = 0.487, p = 0.011) of the CDI-25. Multivariate analysis identified the psychosocial dimension of the CDI-25 scale (ß = 0.783, p = 0.0001) and palliative care training (ß = 2.686, p = 0.017) as the only significant variables associated with Attitudes toward Care of the Dying Patient. Overall, nurses exhibited a positive attitude toward caring for dying patients. Our results could potentially help nursing directors identify those with the necessary qualities and training for optimal end-of-life care and to further plan training courses to provide optimal care in end-of-life situations.

Mindful self-compassion program based on Watson's theory of human caring in nursing students: A randomized controlled study.

AIMS AND BACKGROUND: This study investigated the impact of the Mindful Self-Compassion Program, based on Watson's Theory of Human Caring Model, on the physical and mental health of nursing students. The essence of nursing is care and compassion. While there are studies on compassion in nursing care, nurses' self-compassion is an underrecognized concept in the literature. METHODS: The study employed a randomized controlled design and involved 80 seconds-grade nursing students from a university in Turkey between December 2021 and June 2022. The intervention group received an online program consisting of six weekly sessions, while the control group did not receive any intervention. The data were collected using the Promotive and Protective Health Behaviors Scale, Watson Caritas Self-Rating Score, Brief Resilience Scale, and Self-Compassion Scale before, at the end of, and 5 months after the program. RESULTS: In both the post-test and follow-up test, the intervention group exhibited an increase in health-promoting and protective behaviors, self-care perception, psychological resilience, and self-compassion compared to the control group. CONCLUSION: Therefore, it is recommended to use the program to improve the physical and mental health of individuals in nursing practice areas. Additionally, it would be beneficial to include the program in the nursing education curriculum. Our findings provide evidence supporting the use of the program for nursing students and nurses.

The Caring Life Course Theory: Opening new frontiers in care-A cardiac rehabilitation example.

AIM(S): To operationalize the Caring Life Course Theory (CLCT) as a framework for improving cardiac rehabilitation (CR) engagement and informing ways to address disparities in rural, low socio-economic areas. METHODS: A secondary analysis of data collected from 15 CR programmes to identify CR patterns through the CLCT lens using a mixed-methods approach. All analytical processes were conducted in NVivo, coding qualitative data through thematic analysis based on CLCT constructs. Relationships among these constructs were quantitatively assessed using Jaccard coefficients and hierarchical clustering via dendrogram analysis to identify related clusters. RESULTS: A strong interconnectedness among constructs: 'care from others', 'capability', 'care network' and 'care provision' (coefficient = 1) highlights their entangled crucial role in CR. However, significant conceptual disparities between 'care biography' and 'fundamental care' (coefficient = 0.4) and between 'self-care' and 'care biography' (coefficient = 0.384615) indicate a need for more aligned and personalized care approaches within CR. CONCLUSION: The CLCT provides a comprehensive theoretical and practical framework to address disparities in CR, facilitating a personalized approach to enhance engagement in rural and underserved regions. IMPLICATIONS: Integrating CLCT into CR programme designs could effectively address participation challenges, demonstrating the theory's utility in developing targeted, accessible care interventions/solutions. IMPACT: Explored the challenge of low CR engagement in rural, low socio-economic settings. Uncovered care provision, transitions and individual care biographies' relevance for CR engagement. Demonstrated the potential of CLCT to inform/transform CR services for underserved populations, impacting practices and outcomes. REPORTING METHOD: EQUATOR-MMR-RHS. PATIENT CONTRIBUTION: A consumer co-researcher contributed to all study phases.

Validation of the Chinese version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' in family caregivers of elderly patients with cancer: A study protocol.

AIM: This study aims to translate the English version of the 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)' into Chinese and validate its psychometric properties in the family caregivers of elderly patients with cancer. DESIGN: A methodological study. METHODS: Based on the Brislin translation model, the original scale will be translated and back-translated, the Delphi expert consultation method will be adopted for cross-cultural adaptation, and the pilot will be carried out in 20-30 family caregivers of elderly patients with cancer. Then, a dual-centre prospective study will be conducted by recruiting 371-542 family caregivers of elderly patients with cancer to validate the psychometric properties of the Chinese version of CAFCPCS. RESULTS: The scale's content validity will be evaluated using the Delphi expert inquiry method, and the face validity will be evaluated using a pre-experiment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to assess structural validity, while internal consistency reliability and split-half reliability will be used to assess reliability. PATIENT OR PUBLIC CONTRIBUTION: Public involvement is of great significance for this study. Participants will be used in a pre-test to give feedback on whether the contents of the clinical pilot version of CAFCPCS after expert consultation can reflect real problems and whether the sentences can be well understood. Based on their opinions, the research group will further refine the scale.

Does fear of compassion effect nurses' caring behaviours? a cross-sectional study.

Aims: The aim of this study is to determine the levels of nurses' fear of compassion for others, fear of compassion from others, and fear of self-compassion and to examine the effect of fear of compassion on caring behaviors. Design: A cross-sectional, quantitative design was used. Participants and research context: The study was conducted between October 2022 and April 2023 with 304 nurses working in two public hospitals. Data collection tools were the "Fears of Compassion Scales" and the "Caring Behaviors Inventory." Data were analyzed using a t test, one-way ANOVA, Pearson correlation analysis, and stepwise multiple regression model. Ethical considerations: Ethics committee approval of the research was obtained from the non-invasive ethics committee of Kütahya Health Sciences University (Reference No: 25.05.2022/2022/06-19). The principles of the Declaration of Helsinki were followed in the study. The purpose of the research was explained to all participants, and their verbal/written informed consent was obtained. Results: The mean scores of nurses on fear of compassion for others and from others were at a moderate level, and their scores on fear of self-compassion were close to a moderate level. It was found that the level of nurses' fear of compassion was related to their sociodemographic and professional variables. Fear of self-compassion, fear of compassion for others, and fear of compassion from others explained 33.5% of the total variance in caring behaviors. Conclusions: Nurses' caring behaviors were shown to be more associated with fear of self-compassion than fear of compassion for others. Fear of compassion may be one of the barriers to compassionate care. Interventions that will reduce nurses' fear of compassion may be one way to provide compassionate care. It is recommended to conduct awareness studies on self-compassion and accepting compassion from others in nurses.

The effects of simulation-based education on undergraduate nursing students' competences: a multicenter randomized controlled trial.

BACKGROUND: Education in nursing has noticed a positive effect of simulation-based education. There are many studies available on the effects of simulation-based education, but most of those involve a single institution, nonrandomized controlled trials, small sample sizes and subjective evaluations of the effects. The purpose of this multicenter randomized controlled trial was to evaluate the effects of high-fidelity simulation, computer-based simulation, high-fidelity simulation combined with computer-based simulation, and case study on undergraduate nursing students. METHODS: A total of 270 nursing students were recruited from five universities in China. Participants were randomly divided into four groups at each institution: the high-fidelity simulation group, the computer-based simulation group, the high-fidelity simulation combined with computer-based simulation group, and the case study group. Finally, 239 participants completed the intervention and evaluation, with 58, 67, 57, and 57 participants in each group. The data were collected at three stages: before the intervention, immediately after the intervention, and three months after the intervention. RESULTS: The demographic data and baseline evaluation indices did not significantly differ among the four groups. A statistically significant difference was not observed between the four methods for improving knowledge, interprofessional collaboration, critical thinking, caring, or interest in learning. While skill improvement differed significantly among the different groups after the intervention (p = 0.020), after three months, no difference was observed (p = 0.139). The improvement in skill in the computer-based simulation group was significantly lower at the end of the intervention than that in the high-fidelity simulation group (p = 0.048) or the high-fidelity simulation combined with computer-based simulation group (p = 0.020). CONCLUSIONS: Nursing students benefit equally from four methods in cultivating their knowledge, interprofessional collaboration, critical thinking, caring, and interest in learning both immediately and over time. High-fidelity simulation and high-fidelity simulation combined with computer-based simulation improve skill more effectively than computer-based simulation in the short term. Nursing educators can select the most suitable teaching method to achieve the intended learning outcomes depending on the specific circumstances. TRIAL REGISTRATION: This clinical trial was registered at the Chinese Clinical Trial Registry (clinical trial number: ChiCTR2400084880, date of the registration: 27/05/2024).

How assisted eating becomes a caring practice in institutional settings: Embodied gestures and stages of assisted eating.

Assisted eating is a basic caring practice and the means through which many individuals receive adequate nutrition. Research in this area has noted the challenges of helping others to eat while upholding their independence, though has yet to explicate how this caring practice is achieved in detail and across the lifespan. This paper provides an empirical analysis of assisted eating episodes in two different institutions, detailing the processes through which eating is collaboratively achieved between two persons. Data are video-recorded episodes of infants during preschool lunches and care home meals for adults with dementia, both located in Sweden. Using EMCA's multimodal interaction analysis, three core stages of assisted eating and their underpinning embodied practices were identified: (1) establishing joint attention, (2) offering the food, and (3) transferring food into the mouth. The first stage is particularly crucial in establishing the activity as a collaborative process. The analysis details the interactional practices through which assisted eating becomes a joint accomplishment using a range of multimodal features such as eye gaze, hand gestures, and vocalisations. The paper thus demonstrates how assisted eating becomes a caring practice through the active participation of both caregiver and cared-for person, according to their needs. The analysis has implications not only for professional caring work in institutional settings but also for the detailed analysis of eating as an embodied activity.

Investigating the caregiving burden and stress of mothers with children with special needs.

BACGROUND: This research was conducted to examine the caregiving burden and stress situations of mothers with children with special needs. METHODS: The research, which is descriptive and correlation-seeking, was conducted between September 2022 and September 2023 in special education and rehabilitation centers in a city in eastern Turkey. The population of the research consists of the mothers of 2072 children who received education in the specified Special Education and Rehabilitation Centers between the specified dates. The sample size was determined to be 324 individuals based on the known sampling method. "The Personal Information Form, the Zarit Caregiving Burden Scale, and the Perceived Stress Scale were used to collect the data for this study. The data was analyzed using the SPSS package software. For the interpretation of the data, percentages, means, standard deviations, one-way variance analysis, independent groups t-test, Pearson correlation, and simple linear regression were used. FINDINGS: Among the mothers, 44% were aged 30-39, 87.0% had a child with a disability, and 51.9% had a child with an intellectual disability. The mean total scores of the mothers were 26.71 ± 8.80 for the Zarit Caregiving Burden Scale and 27.00 ± 11.35 for the Perceived Stress Scale. There is a difference between the mothers' age, education level, income level and the type of disability of their child and the Zarit Caregiving Burden scale score average; It was determined that there was a significant difference between the place of residence and the number of disabled children they had and the average score of the Perceived Stress Scale. A positive correlation was found between Zarit Caregiving Burden Scale scores and Perceived Stress Scale scores of the mothers (p < 0.05). APPLICATION TO PRACTICE: The study revealed that mothers with children with special needs experienced higher levels of stress as their care burden increased. Providing economic assistance and informing and training mothers about the care of children with special needs were recommended to reduce the care burden of mothers with children with special needs.

The role of Empathy in the relationship between emotional support and caring behavior towards patients among intern nursing students.

BACKGROUND: The empathic relationship between nursing students and patients allows them to understand and address caring behavior for patients. Appropriate emotional support equips them to overcome the complexities and difficulties inherent in patient care. This support cultivates resilience and self-awareness, enabling students to manage their emotions effectively and establish meaningful connections and caring with their patients. OBJECTIVES: To investigate the role of empathy in the association between emotional support and caring behavior toward patients among intern nursing students at Alexandria and Damanhur University. SUBJECTS: The study subjects were 200 intern nursing students in their internship years of 2022-2023, randomly selected from an equal sample size from Alexandria and Damanhur University, Egypt. TOOLS: A questionnaire of social information& academics from students, the Toronto Empathy Questionnaire, the Caring Dimension Inventory, and the Multidimensional Scale of Perceived Social Support are used to collect participants' data. RESULTS: Empathy was associated with caring behavior and emotional support among nursing students (P < 0.001), and higher levels of empathy indicated increased levels of caring behavior and emotional support. The caring behavior significantly increased when intern nursing students received more emotional support and among those who were not working in private hospitals (p < 0.001,&p = 0.023 respectively). Empathy acts as a mediating role in the relationship between emotional support and caring behavior. IMPLICATIONS: Implementing strategies to assist interns in navigating challenges and promoting a culture of support can facilitate the cultivation of caring behaviors. Shedding light on the interconnectedness of empathy, emotional support, and caring behavior can inform the design of interventions to strengthen empathy as a pathway to improving patient outcomes. CONCLUSION: Empathy is a mediating factor in the relationship between emotional support and caring behavior. This suggests that interventions promoting empathy may serve as a pathway to enhancing caring behavior among nursing students and strategies for improving patient care outcomes by strengthening empathy skills among healthcare professionals.

Can internship programs affect nursing students' critical thinking disposition, caring behaviors, and professional commitment?

BACKGROUND: Nursing students are given opportunities to develop critical thinking disposition, caring behaviors, and professional commitment through clinical training. Therefore, nurse educators should move away from traditional methods toward new ones, such as internship programs in clinical training. This study assessed the effect of nursing internship programs on senior undergraduate nursing students' critical thinking disposition, caring behaviors, and professional commitment. METHODS: This quasi-experimental study was conducted using a pretest-posttest design but with no control group. The study sample included 46 senior students enrolled in nursing internship programs. A demographic questionnaire, the Critical Thinking Disposition Inventory (CTDI), the Caring Assessment Report Evaluation (Care-Q), and the Nursing Professional Commitment Scale (NPCS) were used to collect data before and five months after the nursing internship programs were implemented. RESULTS: The study findings revealed that the senior nursing students' caring behaviors improved, but the total scores of critical thinking disposition and professional commitment did not change significantly after the nursing internship programs (p > 0.05). CONCLUSION: According to the results, nurse educators are recommended to adopt strategies to improve the effectiveness of internship programs on critical thinking disposition and professional commitment among senior undergraduate nursing students.