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Abstract: The purpose of this study was to replicate and expand on Persky, Nelson, Watson, and Bent (2008) study of characteristics related to nurses who were effective in Watson's Caritas framework. Previous research suggests that poorer work environments are associated with higher levels of caring. This surprising finding warrants further investigation. Registered nurses were recruited from a mid-sized community-based hospital in the Midwest portion of the United States of America (N = 20). Each completed the health environment survey (HES). Ten patients that had received primary care from the nurse completed the caring factors survey (CFS). Two hundred nurse/patient dyads were used to determine the relationship between the CFS and HES. Six of the 13 HES scales were positively associated with CFS scores. As nurses' positive perceptions of the work environment increased, patients' perceptions of caring increased. Our findings contrast Persky et al.'s. Further research is needed examining factors influencing the relationship between job environment and patient perceptions of caring.
Keywords: caring, job environment, nursing, job satisfaction, Caritas
As healthcare continues to rapidly change in the United States and around the world, the pressure to understand the relationship between system factors and patient outcomes is growing. With the increase in the volume of research in this area, our understanding of the significant contributions that nursing makes to these outcomes is becoming more refined (Aiken, Clarke, Sloane, Lake, & Cheney, 2008). An important complement to systems-level studies are those that examine individual-level characteristics which contribute to patient outcomes and satisfaction. Such studies are of interest because they can help to focus recruiting and training efforts at the individual level in nursing settings. Studies like that conducted by Persky et al. (2008) is one such example.
Persky et al. (2008) set out to develop a profile of characteristics that described the nurses who were 'effective' within Watson's Caritas framework (Watson, 2005; Watson, 2010). In order to understand how these characteristics operated within the care setting, they measured unit-based employee job satisfaction and patients perceptions of caring. One of the main findings of the study was that the nurses who were most effective in Watson's Caritas framework were those that were least satisfied in their jobs. This finding, due to its surprising nature, bears further examination. In...