Caring as a Characteristic of Nursing Jobs: Is Caring a Critical Component?
Ask almost any nurse and they will tell you that they entered the nursing profession to care for patients. In fact, a recent study found that “opportunities for caring” for patients was one of two dominant themes reported (Eley et al., 2012). Several caring theories have been developed in nursing to guide the study of caring within the discipline. One in particular that has been used to guide the study and design of health care systems is Swanson Caring Theory (Swanson 1991, 1993). Swanson’s model posits that nurses demonstrate caring for patients when they care for and about them, and that nurses’ caring behaviors help to improve patients’ well-being. There is some evidence suggesting a positive relationship between caring and the outcomes of care, but, unfortunately, we know very little about the degree to which nurses’ jobs promote caring, or the degree to which the environments within nurses work support their ability to care for and about their patients.
The Job Characteristics Model (JCM), developed by Hackman and his colleagues (Hackman and Lawler, 1971; Hackman and Oldham, 1976), has been used extensively in business. Briefly, the JCM proposes that 5 perceived characteristics of work (task variety, significance, and identity, and autonomy and feedback from work) give rise to 3 mediating critical psychological states (experienced meaningfulness, experienced responsibility, and knowledge of results) that are linked to outcomes including general and growth satisfaction and performance. While the JCM remains one of the most influential approaches used to guide job design research, it has not been as widely studied or used in health care and nursing (see, e.g., Edgar, 1999; Mohammed, 2004; Richards, 2000; Tonges et al., 1998); however, several studies have found statistically significant relationships between the 5 characteristics of the JCM, the critical psychological states, and nurses’ job satisfaction (Roedel and Nystrom, 1988; Holiday and Bullard, 1990; Tonges, 1997).
We therefore propose to extend the JCM by developing and testing an instrument to assess the presence of Caring as a characteristic in a nurse’s job content that gives rise to Experienced Caring for Patients as a new psychological state nurses may feel in their work. We will integrate aspects of Hackman and Oldham's Job Characteristics Model with Swanson’s Caring Theory to examine the extent to which nurses perceive Caring as an aspect of their jobs associated with 5 caring processes -- knowing, being with, doing for, enabling, and maintaining belief --- and the amount of variance this characteristic and its related psychological state explain in nurses’ work-place well-being.
Based on Swanson Caring Theory and related research, we will derive specific items that pertain to Caring as a characteristic of nurses’ jobs. The instrument comprised of these items will be evaluated for content validity by a panel of experts. We will carefully define Caring and Experienced Caring for Patients and hypothesize the nature and extent of the relationships between these constructs and other relevant variables. After any necessary revisions, the instrument will be completed by a random sample of acute care staff nurses. Using these data, we will examine the factor structure using exploratory factor analysis, evaluate internal consistency reliability, and analyze the correlations between nurses’ perceptions of the presence of Caring in their job content and Experienced Caring for Patients and between Experienced Caring for Patients and measures of nurses’ affective responses to their jobs, including general and growth satisfaction, burnout and stress.
The results of this study will provide evidence upon which nurse executives may base the design and redesign of nurses’ jobs to promote positive perceptions of the work and work environment and higher levels of work-place well-being. Moreover, study findings can highlight the job behaviors, practices and activities that are needed to more strategically and purposefully build caring into the work of nursing.

2020-01-16

2022-01-31