Development of Thai Nurses’ Caring Behavior Scale

This study aimed to develop a Thai nurses’ caring behavior scale and test its psychometric properties. Construction of the Thai Nurses’ Caring Behavior Scale (TNCBS) consisted of two phases. Phase I involved identifying the meaning and dimensions of Thai nurses’ caring behaviors; generating an item pool; providing the format for measurement; review of items for content validity by experts; testing for internal consistency and stability; and, examining face validity. Information from these activities lead to development of a 63 item instrument, consisting of 6 dimensions (effective communication; respect; support; being with; doing for; and, utilizing professional knowledge and skills), that used a 4 point Likert-like format response pattern. Phase II involved testing the psychometric properties of the TNCBS. Seven hundred and fifty eight professional nurses from 10 institutions, including one university teaching hospital, two regional hospitals, three general hospitals and four community hospitals, responded to the 63 item scale. Explanatory factor analysis with varimax rotation was used to analyze the scale’s construct validity and found to be acceptable. Due to redundancy of some items, the final version of the TNCBS was reduced to 57 items. Cronbach’s alpha coefficient of the overall scale was 0.98 and that of the six subscales was 0.86 to 0.93. The results indicated acceptable validity and reliability of the final version of the scale.

Family Strength in Caring for a Stroke Survivor at Home

This hermeneutic phenomenological study explored the meaning of family strength when caring for a stroke member at home. Family strength is considered to be the competency of a family when faced with a stressful life event that can be viewed through a continuous man-environmental interaction process. Six family units were purposively recruited and screened using the Family Hardiness Index (four with high-level of hardiness, and two with moderate-level of hardiness). Data were collected through in-depth interviews, field observations and field notes, and analyzed using Braun and Clarke’s thematic analysis method. Findings revealed families with high-hardiness continuously strove to overcome caregiving hardships and had hope for the stroke member’s long existence, while families with moderate-hardiness demonstrated less effort to overcome caregiving hardships and held no hope for the stroke member’s long existence. Primary caregivers among families with high-hardiness revealed more self-development incarer role than did those of families with moderate-hardiness. Families with high-hardiness shared caregiving and family task responsibilities, while families with moderate-hardiness lacked collaboration regarding caregiving and family tasks. In addition, family strength emerged from families overcoming caregiving hardships through: hope for the stroke member’s long existence; development, accumulated experiences of “can do” family members; and, establishment of shared caregiving and family task responsibilities. Consideration of views and abilities of the family unit to provide homecare for a stroke member can enhance nurses’ understanding of different developmental experiences of home caregiving families. In addition, such knowledge can facilitate adoption of meaningful nursing interventions to support the families.