Care Climate Research Articles

Caring coaching climates emerge as key factor in promoting high school athletes’ well-being and motivation, complimented by a task-involving climate

ABSTRACT When coaches utilise evidence-based practices, the benefits to athletes often extend far beyond the physical. Achievement goal theory has provided insight into which coaching practices facilitate and which hinder youth development. This investigation assessed whether the perceived motivational climate (caring, task-involving, and ego-involving climates; CCs, TICs, EICs) on high school teams are related to athlete well-being and motivation. Athletes (N = 181; M = 15.71 y.o.) completed a questionnaire mid-season. For both the girls’ and boys’ teams, CCs were negatively linked to shame, psychosocial stress, and depression while TICs were positively linked to state coping appraisals and motivation to continue, after controlling for the nested structure of the data. For athletes on girls’ teams (n = 129), CCs were negatively associated with state stress appraisals and positively associated with feeling that their coach cares about what happens to them, state coping, enjoyment, and motivation to continue. For girls’ teams, TICs were positively associated with enjoyment and negatively associated with state stress and life stress. For boys’ teams, CCs were negatively associated with life stress, while EICs were negatively linked to feeling that their coach cares about what happens to them. These results suggest coaches should create CCs and TICs to elicit adaptive motivational responses and foster greater well-being in youth. More than a third (36.5%) of boys’ teams athletes and 24.0% on girls’ teams reported to some extent that their coach is one of the only adults who cares about them, underscoring the critical role coaches can play during adolescence.

Blood Bonds: Transforming Blood Donation Through Innovation, Inclusion, and Engagement.

The journey of receiving blood as a patient with transfusion-dependent beta thalassemia has profoundly shaped my understanding of the life-saving power of blood donation. This personal experience underscores the critical importance of blood donors, not just for individual recipients but for the broader community, enhancing public health, productivity, and well-being. There are several challenges to securing a blood donor pool in current health care climate. Solutions that focus on the engagement of donors, clinicians, and patients are key to improving the donor pool and utilizing the blood supply in a judicious manner.

Perceived autonomy support in individuals with Parkinson’s disease requiring emergency care: a cross-sectional pilot study

BackgroundIndividuals with Parkinson’s disease (PD) report a diminished perceived functional autonomy as their condition progresses. For those seeking emergency care, it is unknown whether the patient-physician relationship is instrumental in respecting patient autonomy. This study evaluated patient autonomy ideals in individuals with PD requiring emergency care and the perceived support for autonomy from emergency department physicians.MethodIndividuals with PD (n = 36, average age 78.1 years) were surveyed using the Ideal Patient Autonomy questionnaire (IPA) and the Health Care Climate Questionnaire (HCCQ). A multivariable regression analysis assessed whether patients’ Hoehn and Yahr stage and IPA questionnaire results predicted HCCQ items.ResultsThe IPA questionnaire revealed that individuals with PD in need of emergency care emphasize the significance of medical expertise (IPA ‘doctor should decide’ theme 0.71) in decision-making and their desire to be fully informed about all potential risks (IPA ‘obligatory risk information’ theme 0.71). The average HCCQ values showed a decreasing trend across Hoehn and Yahr stages 1 to 5: 6.19, 6.03, 5.83, 5.80, and 5.23, respectively. HY scale values also influenced HCCQ items related to the physician’s role.ConclusionIn our cohort, individuals with Parkinson’s disease tend to rely on medical expertise for decision-making and prioritize complete risk information during emergency care. However, this autonomy support diminishes as functional disability levels increase.

Improving Patient Safety and Care Quality Through a "Speaking-Up" Climate: The Mediating Role of Situation Monitoring.

In healthcare settings, a climate that encourages speaking up among staff is believed to enhance patient safety and quality of care. However, the specific mechanisms of this relationship remain underexplored. Particularly, there is a need to understand how components of teamwork, such as situation monitoring, can be linked to the impact of a speaking-up climate on relevant outcomes. This study aimed to investigate the direct and indirect effects of a speaking-up climate on patient safety and quality of care using situation monitoring as a potential mediator. This cross-sectional study used survey data from 380 staff nurses who provided direct patient care at three Korean hospitals. Structural equation modeling was utilized to test a hypothesized mediation model using Mplus 7.0. Our data analysis confirmed the partial mediation model. As hypothesized, a speaking-up climate directly improved patient safety (β = 0.384, p < 0.001) and quality of care (β = 0.393, p < 0.001). Also, we found that indirect effects of a speaking-up climate on patient safety (β = 0.224, p < 0.001) and quality of care (β = 0.186, p = 0.005) through situation monitoring were significant. These results indicate that situation monitoring was found to significantly mediate the relationship between a speaking-up climate, patient safety, and quality of care. Our study demonstrates that the positive impact of a speaking-up climate extends beyond improving nurses' speaking up. Further, fostering a speaking-up climate can significantly improve patient safety and quality of care, and situation monitoring has a critical role in this relationship. These findings contribute to understanding how encouraging a speaking-up climate could benefit patient safety and care quality in healthcare organizations.

Medical Students' Views of the Future in a Rapidly Changing World.

Physicians have long been considered valued members of a solid US health care system. Significant changes in medical education, health care, and society at-large suggest that current medical students may face a different future. To help guide educators and policy makers, we set out to understand medical students' perceptions of the future of health care and their place in it. In year one of a longitudinal study, we conducted in-depth interviews of Case Western Reserve University medical students. A multidisciplinary team performed iterative thematic analyses and sampling until reaching saturation on major themes. Eleven medical student participants described social and health care issues as major influences on their professional futures. Concerns included health care system failings, unsustainable costs, climate change, demographic shifts, disinformation, and public distrust in health care. Students looked forward to team practice and using technology, data, and artificial intelligence in care delivery. They hoped for greater access and equity in health care, with a focus on prevention and social, behavioral, and environmental drivers of health. Most students expected to be employed rather than in private practice and sought time/flexibility for professional and personal interests. Paying off medical school debt and advocating for patients and change were priorities. Many saw primary care as important, but fewer envisioned it as their career path of choice. Medical students envision a future shaped by health care systems and social issues. These findings can inform those helping students prepare for uncertainty and rapid change in their careers, their lives, and the lives of their patients.

Using Physical Education Interventions to Prevent Bullying at School: A Systematic Review

ABSTRACT This systematic review aims to summarize relevant studies that have evaluated an intervention to prevent bullying and its consequences, in order to highlight main strategies to prevent these episodes. A systematic review of PubMed, ERIC, Education Database, Scopus, SPORTDiscus, and FECYT databases was performed until April 20, 2022. From a total of 410 studies initially found, 12 were included in the qualitative synthesis. These 12 studies presented several interventions. Promising interventions included targeting bullying perpetrators, victims, and bystanders simultaneously, as well as building a perceived caring climate and increasing children’s resilience. Summary conclusions found that targeting bullying perpetrators, victims, and bystanders simultaneously can prevent disruptive attitudes and bullying by focusing on social and emotional learning and a positive school climate, which can be helpful in providing physical education teachers with a central role in preventing bullying.

Auditoría Interna de Enfermería: una mirada que asegura

In 2020, the Nursing Department of the British Hospital of Montevideo implemented the Internal Nursing Audit (INA), based on the ISO 9001:2015 Standard, to improve the quality and safety of care. The IEA evaluated comprehensive care, patient safety, and internal climate, categorizing findings into strengths, compliance, opportunities for improvement, observations, and nonconformities, through observational audits and electronic checklists. Between 2020 and 2023, the sectors audited increased from 6 to 25, identifying outstanding practices in medication administration and personalized care, while improving areas such as technology training and documentation. The EIA has been instrumental in continuous improvement and quality of care, contributing to patient-centered care and staff satisfaction.

Organizational ethical climate: influence on employee meaning and well-being

PurposeThe organizational environment can influence how employees experience meaningfulness. This study examines the mediating role of meaningful work between organizational ethical climates and the affective well-being of employees. We also test for the moderating role of self-regulatory traits in this relationship.Design/methodology/approachPartial least squares – structural equation modelling (PLS-SEM) was employed to test the hypothesized model using responses from 430 working professionals. Recommended robustness checks were conducted before model assessment and hypotheses testing.FindingsThe findings suggest that a caring ethical climate is positively related to affective well-being. Meaningful work dimensions, i.e. unity with others, inspiration and balancing tensions partially mediate the relationship between the caring climate and affective well-being. Integrity with self and balancing tensions fully mediate the negative effect of an instrumental climate on affective well-being. Positive mediation of unity with others and negative mediation of reality were observed between a law and code climate and affective well-being. Moderating effects of self- and other-orientation and self-monitoring were also observed.Research limitations/implicationsThe study presents significant insights, however, a few limitations must be discussed. The study has relied on cross-sectional data which may be addressed in future studies.Practical implicationsIn times when organizations are spending in large amounts in ensuring meaningful work and employee well-being, this study suggests internal mechanisms that can bring positive impact in employees' work life. Leaders should assess how employees perceive the ethical climate of the organization in order to provide better meaningful work opportunities to the workforce.Social implicationsHaving meaningful work and experiencing affective well-being are significant for a collective betterment of society. Meaningful work encourages individuals in identifying how their work if affecting the society. A affectively happy workforce is essential in building a mentally healthy society.Originality/valueThis study contributes to the investigation of organizational factors that help employees find meaning in their work. Based on ethical climate theory, this study highlights how organizations can redesign and modify their ethical climates to provide opportunities for employees to experience meaningful work and improve their affective well-being.

Outpatient oncology settings: the distinctive contribution of supportive design to patient experience and wellbeing

ABSTRACT The concept of patient-centred care is increasingly shaping healthcare practices, particularly within oncology settings. Its implications extend to a hospital's constructed environment and how it is designed, yet few studies have explored patient experience of such sensitive settings, and even fewer have examined outpatient oncology facilities. This study researched how the hospital built environment affects cancer patient wellbeing using in-depth interviews with 24 patients across Australia and Egypt. Analysis of patient-narrated experiences shed light on the potential latent impact of the built environment on patient health-related outcomes, such as pre-treatment anxiety and treatment-induced sensitivities and stresses. Three overarching themes were identified, including the built environment capacity to contribute to incidences of positivity; balancing the unavoidable (necessary) presence in the hospital; and encouraging reasons to return – potentially enhancing treatment compliance. The study further demonstrates how such support may contribute to experiencing a desired climate of patient-centred care, affording additional grounds for patients to cope with the potential burdens of treatment and its side effects.

Association of quality of nursing care with violence load, burnout, and listening climate

BackgroundViolence against nurses is common. Previous research has recommended further development of the measurement of violence against nurses and integration of the individual and ward-related factors that contribute to violence against hospital nurses. This study was designed to address these issues by investigating the associations between violence, the listening climate of hospital wards, professional burnout, and perceived quality of care. For this purpose, we used a new operationalization of the violence concept.MethodsWe sought nurses to participate in the study through social media which yielded 765 nurses working in various healthcare systems across Israel who volunteered to complete a self-administered online questionnaire. 80% of the sample were hospital nurses, and 84.7% were female. The questionnaire included validated measures of burnout, listening climate, and quality of care. Instead of using the traditional binary measure of exposure to violence to capture the occurrence and comprehensive impact of violence, this study measured the incremental load of violence to which nurses are subjected.ResultsThere were significant correlations between violence load and perceived quality of care and between constructive and destructive listening climates and quality of care. Violence load contributed 14% to the variance of burnout and 13% to the variance of perceived quality of care. The ward listening climate moderated the relationship between burnout and quality of care.ConclusionsThe results of this study highlight the impact of violence load among nurses and the ward listening climate on the development of burnout and on providing quality care. The findings call upon policymakers to monitor violence load and allocate resources to foster supportive work environments to enhance nurse well-being and improve patient care outcomes.

Spirituality, Security, Compassion, and Play: Innovative Ways Group Psychotherapy Addresses Human Suffering

ABSTRACT We are surrounded by trauma, grief, pandemics, health care inequality, poverty, climate change, and social injustice, not to mention increases in suicide, depression, and loneliness. How can group therapists address these issues and thrive? The current special edition focuses on how groups foster compassion, provide spiritual healing, and address human suffering in effective and innovative ways. Instead of focusing on symptom reduction alone, group therapists and researchers are exploring ways that group therapy can provide healing and resources to people including health care providers, and those who are on the front lines. The current special edition will highlight how spiritual interventions, compassion and attachment-focused interventions, and group interventions can engender positive outcomes for diverse group members that include parents of inner-city children to first responders. If there ever was a time for us to focus on compassion, faith, and forgiveness, it is now.

Causal Model of Autonomous Motivation to Modify Dietary Behavior among People with Early-stage Chronic Kidney Disease

Dietary behavior is significant for delaying chronic kidney disease progression but is difficult to modify. Autonomous motivation is one of the key concepts that seem to be useful for behavior modification. Thus, this descriptive cross-sectional study was purposed to develop and test a causal model of autonomous motivation to modify dietary behavior among people with early-stage chronic kidney disease. Participants comprised 308 people with early-stage chronic kidney disease from ten tertiary hospitals in Thailand. Data collection employed a demographic and health information form, the Regulation of Eating Behaviour Scale: Autonomous Motivation Subscale, the General Causality Orientation Scale: Autonomy Orientation Subscale, the Health Care Climate Questionnaire Short-Form, the Importance Domain of the Aspiration Index: Intrinsic Life Aspiration Subscale, the Importance Domain of the Aspiration Index: Extrinsic Life Aspiration Subscale, and the Basic Need Satisfaction in General Scale. Data were analyzed through descriptive statistics and structural equation modeling using M-plus.The results showed the final model explained 57% of the variance in autonomous motivation to modify dietary behavior. Intrinsic life aspiration, autonomy support from healthcare providers, and autonomy orientation had a positive direct effect on autonomous motivation and an indirect effect through basic psychological need satisfaction. Basic psychological need satisfaction had a positive direct effect on autonomous motivation. On the other hand, extrinsic life aspiration had neither a direct nor an indirect effect on autonomous motivation. Nurses can use these findings to design and test nursing interventions by integrating autonomy orientation, autonomy support from healthcare providers, and intrinsic life aspirations for enhancing autonomous motivation to modify the dietary behavior of this population.

Effects of caring climate on career commitment for preschool teachers: the mediating roles of interpersonal trust and cooperative learning

ABSTRACT Preschool teachers in Taiwan face pedagogical and emotionalchallenges that shape their job satisfaction, commitment, and socialidentity. Understanding their views on professional developmentand organizational commitment in early childhood education is critical. This study aims to examine the relationship between caring climate and career commitment and test the multiple mediating effects of interpersonal trust and cooperative learning in this relationship. A survey was conducted in Taiwan to test preschool teachers’ attitudes toward career commitment and other related factors. The questionnaire consisted of four latent factors: caring climate, career commitment, interpersonal trust and cooperative learning. We used partial least squares to analyze the sample data and examine the reliability and validity in the multiple mediation model. The results of the multiple mediating analysis indicated that interpersonal trust and cooperative learning fully positively mediated the association between caring climate and career commitment. Preschool teachers’ career commitment is influenced by their perceptions of caring climate in workplaces. Their positive attitudes toward kind interactions and teamwork with colleagues in preschools actively support sustainable development of their career paths.

The influence of psychological climate for caring and perceived insider status on the relationship between managerial caring and positive employee well-being

Learning the factors that positively impact employee well-being is not a new stream of study. The care and support provided by managers can influence employees’ motivation and overall well-being. The positive emotional environment created by a caring climate can significantly impact how individuals feel and function in their professional lives. Additionally, perceived insider status, which reflects a sense of belonging and integration, can positively affect self-esteem and well-being. Social identity theory posits that positive well-being occurs when individual employees feel that they are surrounded by a climate of care signaled by the direct manager and overall employee acceptance within the organization, which ultimately influences their overall positive well-being. This study collected data from 197 employees working in the service sector in different industries within the United Arab Emirates (UAE) through survey questionnaires using a convenience sampling technique. Partial least squares structural equation modeling(PLS-SEM) version 4 was used to analyze the dataset and test the hypotheses. The results indicate that managerial caring relates positively to positive employee well-being. Furthermore, a psychological climate of care and perceived insider status seriallymediate the relationship between managerial caring and positive employee well-being. Thus, this study offers new insights into the importance of managerial care in employees’ positive well-being within their organizations, as well as the caring model among managers and employees. Managers who show and develop an atmosphere of care toward employees enhance their positive well-being.

Validation of the Korean Version of the Health Care Climate Questionnaire among Cancer Survivors

Healthcare professionals should support autonomy in their patients in order for them to maintain the motivation to cope actively with their conditions. The Health Care Climate Questionnaire (HCCQ) is useful for assessing patients’ perceptions of the autonomy support provided to them. We aimed to validate the psychometric properties of the Korean version of the HCCQ (HCCQ-K) among Korean cancer survivors. This study evaluated the factor structure, concurrent validity, and internal consistency. Data from 367 cancer survivors were analyzed using confirmatory factor analysis (CFA), Pearson’s correlations, and Cronbach’s α values. The CFA validated that the single-factor structure of the HCCQ-K had an excellent fit that was consistent with that of the original English version. Concurrent validity was confirmed by moderate correlations between the HCCQ-K and both psychological well-being and self-management. Reliability was verified by satisfactory internal consistency, with a Cronbach’s α value of 0.91 and strong item-total and inter-item correlations. The HCCQ-K is therefore a valid and reliable tool for assessing autonomy support provided by healthcare professionals to Korean cancer survivors. The HCCQ-K may help healthcare professionals understand their patients’ needs for autonomy support and develop strategies to motivate active coping behaviors.

Transition shock among nursing interns and its relationship with patient safety attitudes, professional identity and climate of caring: a cross-sectional study

BackgroundNursing interns often experience lots of challenges during their clinical nursing internships, which can adversely affect career decisions and result in a squandering of nursing education resources. Patient safety attitudes, professional identity and climate of caring may affect nursing interns’ clinical experience. However, more evidence is requested to validate these relationships for nursing educators to develop effective education programs and facilitate interns’ successful transition.MethodsThis was a cross-sectional study, which used a convenience sampling method to recruit 387 nursing interns during December 2022 to April 2023 in university affiliated hospital in Hunan province, China. Data were collected using standardized scales. Spearman correlation and multiple regression analysis were employed to examine the relationship between transition shock, patient safety attitudes, professional identity, and climate of caring.ResultsNursing interns experienced transition shock at a moderate level and the highest levels of transition shock in response to overwhelming practicum workloads, with the second being related to the conflict between theory and practice. Transition shock was negatively correlated with patient safety attitudes, professional identity and climate of caring among nursing interns.ConclusionsNursing managers and educators need to value the transition shock experienced by nursing interns. Our study suggests that developing a strong sense of professional identity and a positive attitude toward patient safety can be effective in reducing the level of transition shock among nursing interns. In addition, a caring climate within the nursing unit can significantly enhance the overall experience of nursing interns. This can be achieved by enhancing the support of clinical mentors, providing patient safety-focused education, and facilitating team communication among nurses.

Factors associated with care omission and patient safety climate.

To identify the factors associated with the omission of nursing care and patient safety climate. A cross-sectional study developed at a university hospital in the Brazilian Center-West, between September and December 2022. The MISSCARE-Brazil and the Safety Attitudes Questionnaire were applied to a convenience sample of 164 nursing professionals. The most omitted care was walking three times a day or as prescribed (66.5%). The overall score of the Safety Attitudes Questionnaire was 63,8 (SD: 12,6). The level of satisfaction (p<0.018) and the perception of professional adequacy (p<0.018) were associated with the omission of nursing care and the patient safety climate. The study showed a high prevalence of omission of care and unfavorable perception of the patient safety climate, mainly associated with professional adequacy for work performance.

Remote monitoring and teleconsultations can reduce greenhouse gas emissions while maintaining quality of care in cystic fibrosis.

Remote care usefulness and climate change co-benefits should be addressed simultaneously to incentivize political action. To assess the changes in healthcare consumption, lung function and greenhouse gas (GHG) emissions during the COVID-19 pandemic in Dutch cystic fibrosis (CF) care. Retrospective multicentre observational study in five Dutch CF centres. Eighty-one participants were included. Healthcare consumption was described alongside the COVID-19 Stringency Index (2019-2022). Travel related GHG emissions were calculated for every clinic visit. Changes in percentage predicted Forced Expiratory Volume in one second (ppFEV1) were assessed using a paired-samples T-test. Healthcare consumption patterns followed COVID-19 public health measure stringency but returned back to the "old normal". Emission of 5.450, 3 kg of carbon dioxide equivalents were avoided while quality of care was relatively preserved. ppFEV1 declined as expected (ΔMeans 3.69%, 95%CI 2.11-5.28). Remote monitoring of lung function and symptoms and teleconsultations in CF can reduce GHG emissions while maintaining quality of care. As health sectors constitute a large share of national climate change footprints, digital health can partly alleviate this burden by reducing private travel.

Exploring Caring Dynamics in a Private University: Impact on Employee Well-Being at one of the Private University at East Java

The COVID-19 pandemic phenomenon situation makes mental health has become one of the main things of concern throughout the world, including aspects of human resources. The era of working with a new remote system such as Work From Home (WFH) has contributed to affecting employee mental health. Through this research, will explore caring dynamics in a private university: impact on employee well-being at one of the private universities at East Java. The method is quantitative research using AMOS software. Data was collected from 100 respondents using the questionnaires. The results showed Organizational Caring, Managerial Caring, Co-Worker Caring has a significant effect on Climate of Care for Employee, and Climate of Care for Employee has a significant effect on Employee Caring, Attitudes, Behavior, and Well-Being.

Patients Perceived Autonomy Support Affecting Treatment Motivation, Depression, Anxiety and Stress in CHD and Diabetes Mellitus

The study was aimed to investigate the impact of perceived autonomy support on treatment motivation, depression, anxiety and stress among patients of coronary heart disease and diabetes mellitus. Study was completed through correlational research design and 310 patients were selected as sample of study by applying convenient sampling technique. Three questionnaires were utilized as research instruments to measure variables; Health Care Climate Questionnaire (Ryan, 1995), Treatment Motivation Questionnaire (Ryan, 1995), and DASS (Lovibond, 1995). Findings revealed that treatment motivation was positively correlated with perceived autonomy support. Results suggest that there was negative correlation among depression, anxiety, stress and perceived autonomy support. Perceived autonomy support is significant positive predictor of treatment motivation. In addition no difference was investigated between gender on PAS and TM. Level of depression anxiety and stress was reported higher among female as compared to male patients of CHD and DM. It was suggested that treatment motivation must be explored as mediator between PAS and DAS among patients in future.