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Abstract
RationaleTo 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.AimThe aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.MethodAn 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.ResultThe 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/ConclusionThe 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.
Highlights
The behaviours of healthcare providers affect how patients participate in and experience care situations
Discussions were held between the authors of how to best capture the caring phenomena in healthcare providers’ caring- and noncaring behaviour through Swanson’s Theory of Caring (12, 13)
The result provides an example for instrument development process of a behavioural coding scheme based on a middle range theory of caring
Summary
The behaviours of healthcare providers affect how patients participate in and experience care situations. The same phenomena have been reported in other high-income countries with an increasing amount of complaints to the patient boards, which receive complaints from patients and significant others regarding healthcare providers’ noncaring behaviour and lack of professional competence (2, 7). These complaints demonstrate a need for strategies to increase and enhance healthcare providers’ awareness of their own verbal and nonverbal caring behaviours in order to maintain patients’ dignity and well-being and alleviate suffering (2, 3)
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