Effectiveness of an Online Caring Curriculum in Enhancing Nurses' Caring Behavior.

BACKGROUND: A hospital in Taiwan implemented a framework of caring in clinical practice. After the pilot study, the current study was conducted to implement and evaluate the effectiveness of the program. METHOD: One hundred four nurses from two hospitals were recruited for the intervention (n = 50) and comparison (n = 54) groups in a mixed-method, quasi-experimental pre- and postintervention design. Audiovisual materials based on the authentic caring and uncaring experiences of nurses and patients were created as the curriculum content. Role modeling and reflective practice were used as learning strategies. Both groups of nurses and patients completed a pre- and postintervention evaluation of nurse caring behaviors, using the SHARE (Sense patients' needs before they ask, Help patients out, Acknowledge patients' feelings, Respect the dignity and privacy of patients, Explain what is happening) caring behavior measurement. A focus group interview was conducted. RESULTS: The intervention group exhibited higher frequency of caring behavior than the comparison group (p < 0.001). CONCLUSION: Authentic experiences, reflective practice, and online videos were effective teaching strategies in enhancing nurse caring behavior in an online continuing education program.

Nurse preceptor training needs assessment: views of preceptors and new graduate nurses.

BACKGROUND: In Taiwan, regulatory bodies mandate that preceptor training programs comprise six mandatory topics used by all teaching hospitals. These programs have little empirical justification. This study explores the training needs of preceptors from the viewpoints of both preceptors and preceptees. METHOD: Investigators used qualitative methods to conduct 17 focus group interviews with 63 preceptors and 24 preceptees from five hospitals in Taiwan. A constant comparative method was used to analyze the data and extract themes and subthemes from participants' experiences. RESULTS: Seven themes were extracted from both preceptor teaching experiences and preceptee learning experiences. Analysis of the empirical data showed that the six mandated topics do not meet the needs of preceptors. This study also documented the concept of "nurses eating their young" for the first time in Taiwan. CONCLUSION: The findings of this study may serve as a reference for redesigning preceptor training programs in Taiwan.

Validation of self-directed learning instrument and establishment of normative data for nursing students in taiwan: using polytomous item response theory.

BACKGROUND: Little research has investigated the establishment of norms for nursing students' self-directed learning (SDL) ability, recognized as an important capability for professional nurses. An item response theory (IRT) approach was used to establish norms for SDL abilities valid for the different nursing programs in Taiwan. PURPOSES: The purposes of this study were (a) to use IRT with a graded response model to reexamine the SDL instrument, or the SDLI, originally developed by this research team using confirmatory factor analysis and (b) to establish SDL ability norms for the four different nursing education programs in Taiwan. METHODS: Stratified random sampling with probability proportional to size was used. A minimum of 15% of students from the four different nursing education degree programs across Taiwan was selected. A total of 7,879 nursing students from 13 schools were recruited. The research instrument was the 20-item SDLI developed by Cheng, Kuo, Lin, and Lee-Hsieh (2010). IRT with the graded response model was used with a two-parameter logistic model (discrimination and difficulty) for the data analysis, calculated using MULTILOG. Norms were established using percentile rank. RESULTS: Analysis of item information and test information functions revealed that 18 items exhibited very high discrimination and two items had high discrimination. The test information function was higher in this range of scores, indicating greater precision in the estimate of nursing student SDL. Reliability fell between .80 and .94 for each domain and the SDLI as a whole. The total information function shows that the SDLI is appropriate for all nursing students, except for the top 2.5%. SDL ability norms were established for each nursing education program and for the nation as a whole. CONCLUSIONS: IRT is shown to be a potent and useful methodology for scale evaluation. The norms for SDL established in this research will provide practical standards for nursing educators and students in Taiwan.

Using the ADDIE model to develop online continuing education courses on caring for nurses in Taiwan.

BACKGROUND: A hospital in Taiwan committed to implementing a framework of caring in clinical practice. This study was conducted to develop online courses on caring for the hospital's nurses. METHOD: The ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model was applied to develop and evaluate this caring curriculum. Concrete caring and uncaring behaviors were identified through patient and nurse interviews. These were used to make 72 instructional videos and five live-action movies. Evaluation tools included quizzes, self-evaluations, focus group interviews, and a measurement of caring behavior. Patients used the same instrument to evaluate the nurses. RESULTS: Nurses' self-evaluations showed positive results. No significant difference was found between pre- and postcourse patient evaluations. CONCLUSION: This study shows the usefulness of ADDIE and provides a model for how research data and results can be used to inform administratively mandated organizational change. It also provides evidence on the effects of caring education.

Developing online continuing education content for enhancing caring among Taiwan nurses.

BACKGROUND: To promote the quality of nursing care, a hospital in Taiwan committed to implementing its SHARE framework for clinical practice. This study was conducted to develop caring content for the SHARE framework in the form of online continuing education videos. METHODS: Five focus group interviews were conducted with 19 exemplary nurses. A constant comparative method was used to extract caring themes that were integrated into the five components of SHARE: S: Sense patient's needs; H: Help patient out; A: Acknowledge patient's feelings; R: Respect patient's dignity and privacy; E: Explain what is happening. RESULTS: Concrete caring behaviors consistent with SHARE were identified. Real-world scenarios were used to produce five videos demonstrating the components of SHARE for use in online caring education. CONCLUSION: This project offers a new strategy for strengthening caring behavior in nurse-patient interactions and may help to establish a model for caring in nursing continuing education in Taiwan.

Measuring peer caring behaviors of nursing students: scale development.

BACKGROUND: Caring is one of the most important domains of nursing research, peer caring among student nurses, and its potential effects on nurse caring behaviors remains largely unexplored. Few tools in the literature target peer caring interactions, and which were either irrelevant to our research purpose or culturally inappropriate for nursing student population in Taiwan. OBJECTIVES: The purpose of this study was to develop a culturally sensitive instrument to measure peer caring behavior from the student perspective and to offer a descriptive answer to "what is peer caring in Taiwan." DESIGN: The study uses both qualitative and quantitative methods in developing the "Peer Caring Measurement (PCM)" questionnaire. SETTINGS: Students from a 5-year associate degree nursing program in a university of technology in southern Taiwan were recruited into this study. PARTICIPANTS: Thirteen first- through fourth-year student volunteers between the ages of 16 and 20 were interviewed to explore caring behavior in student peer-to-peer interactions. Two classes from each of the first, second, third, and fourth year students, a total of 360 students were randomly selected to assess the internal consistency of "PCM", and 47 first-year students were conveniently selected to examine the stability of the tool. METHODS: Interviews were conducted in an unstructured manner. Qualitative data were analyzed by a constant comparative method. The questionnaire survey was used to assess the validity and reliability of "PCM". RESULTS: A 17-item "PCM" was developed; the content validity, construct validity, and reliability of the tool were ensured by expert review, factor analysis, and internal consistency. Three factors, labeled assistant caring, academic caring, and affective caring, accounted for 63.197% of the variance. CONCLUSIONS: The "PCM" addressed the multidimensional construct of peer caring. It was validated in a Chinese language version and can be used in college settings to evaluate student interactions and their peer caring behaviors.

Action research on the development of a caring curriculum in Taiwan: Part II.

This article presents the development, design, implementation, and evaluation of the third-year course of a caring curriculum being developed for a 5-year associate degree nursing program in Taiwan. The course, titled Application of Caring Concepts, was taught to more than 800 students by 16 instructors recruited from various departments. The instructors attended workshops and seminars on caring and then developed the course materials and teaching strategies. Instructional strategies included role modeling, dialogue, discussions, journaling, simulations, readings, and projects that involved students' applying caring skills outside of the classroom. Students were evaluated by patients in clinical practice using the Caring Behavior Measurement, developed in a previous study, and the course was evaluated by qualitative analysis of student feedback. Student responses to course content and instructional strategies were positive. Patients generally indicated that students always or normally performed caring behaviors. The study showed that with an appropriate curriculum and learning strategies, students can learn caring skills.

Development of an instrument to measure caring behaviors in nursing students in Taiwan.

The purpose of this study was to develop a culturally sensitive instrument to measure caring behaviors in nursing students in Taiwan from the patient perspective. The study, involving expert assessment of content validity and face validity, a first test (n = 196), and a second test (n = 192) in medical-surgical patients, and the generation of descriptive statistics, resulted in a 28-item questionnaire, the caring behavior measurement (CBM). The findings suggest the CBM is a valid and reliable assessment tool of caring behaviors in students and practicing professional nurses, as well as offering a descriptive answer to "what is caring in nursing in Taiwan".