Journal List > J Korean Acad Community Health Nurs > v.29(2) > 1100759

Kim and Park: A Review of the Korean Nursing Research Literature with Focus on Quantitative Measurement of Caring

Abstract

Purpose

The purpose of this study is to review the quantitative research literature on measuring caring in order to identify overall trends in measuring caring.

Methods

Fifty three papers were selected from four databases including RISS4U, DBpia, KISS, and Korea Med.

Results

The number of measuring caring papers has increased since 2000. Approximately 60 % of the total papers were descriptive and correlative design researches with convenience sampling. Jean Waston’s theory was the most popular conceptual framework, but much of the research tended to be conducted without any conceptual framework. In that kind of research, ‘caring’ terms were used without definition. The most frequently used term for the concept of caring was nurses’ caring behaviors. Also, ‘nurses’ was one of the most popular subjects. Thirty six measuring caring instruments were used. Twenty were developed in foreign countries and translated into Korean. The others were developed originally in Korean. Interpersonal Caring Technique - Communication Skills Scale, based on the interpersonal process model, was the most frequently used tool. Among the translated instruments, Coates’ Caring Efficacy Scale was the most popular. Some instruments were used without validation.

Conclusion

These results provide basic data on measuring caring and indicate directions for further research. In particular, validation studies of measuring caring instruments are needed.

References

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Table 1.
Characteristics of Relevant Studies (N=53)
Variables Categories
n (%)
MD JKAN NRF Non-NRF
Publication year 1989 1 - - - 1 (1.9)
1990~1999 2 (1) 1 3 1 7 (13.2)
2000~2004 1 - 1 (1) 1 3 (5.7)
2005~2009 5 (1) 1 3 - 9 (17.0)
2010~2014 7 (2) 1 6 (1) - 14 (26.4)
2015~2016 7 (2) 3 9 - 19 (35.8)
n (%) 23 (43.4) 6 (11.3) 22 (41.5) 2 (3.8) 53 (100.0)
Design Cross-sectional descriptive/correlation 32 (60.3)
Tool development 3 (5.7)
Tool validation 3 (5.7)
Model construction/path analysis 7 (13.2)
Program development/experimental intervention 8 (15.1)
Sample Nurses 20 (37.8)
  Nurses only 16 (30.2)
  Nurses & nursing students 1 (1.9)
  Nurses & patients 3 (5.7)
Nursing students 6 (1.3)
Family caregivers (or mothers) 18 (34.0)
Patients/ home health care clients 5 (9.6)
Staff in long-term facilities (formal caregivers) 4 (7.5)
Theoretical background Waston's human caring theory 19 (35.8)
Kim's interpersonal caring theory 5 (9.4)
Lawton's appraisal of the care giving process 3 (5.7)
Stress-appraisal-coping theory 3 (5.7)
Morse et al.'s concepts of caring, caring attribute 2 (3.8)
Pallett's conceptual framework for family caregiver burden 2 (3.8)
Others: Bevis's caring process (stage), Mayeroff's on caring, Smith's caring effectiveness model or literature review 19 (35.8)
Concept of caring Caring, caring behaviors
  Nurses' care; caring; caring behaviors; person -centered care; peer group caring behavior 16 (29.1)
  Family members' caregiving; caring behavior; caring performance 8 (14.5)
  Staffs' caring behavior; person-centered care 2 (3.6)
Caregiving experience; caregiving (caregiver) appraisal; caregiver reaction assessment 9 (16.4)
Caring process/ interpersonal caring behavior 6 (10.9)
Caring ability/ competency; caring self-efficacy 7 (12.7)
Caring attitudes; attitudes for care; attitude toward the care 4 (7.3)
Care attributes 2 (3.6)
Care satisfaction 1 (1.8)

()=No. of program development or experimental intervention studies; MD=master's thesis or doctoral dissertation; JKAN=journal of Korean academy of nursing; NRF=journal registered with the national research foundation of Korea (NRF); Non-NRF=Journal non-registrated with the NRF.

Table 2.
Measurement Tools of Caring of Relevant Studies (N=53)
Tools Study
ID n Total n
TD: Korean tools (n=3) Tool of caring to evaluate quality of nursing care [TCEQ] A1 3 6
Intra-operative caring behaviors [CBM] A2
Tool for measuring the care satisfaction of home health nursing [TCS] A3
VD: not Korean tools(n=3) Caregiver reaction assessment [CRA-K] B1 3
Person-centered care assessment tool [P-CAT] B2
Peer group caring interaction scale [PGCIS] B3
Non-TD/VD: Korean tools (n=13) Developed for using in their studies by authors C1~C6 6 24
Interpersonal caring technique-communication skills [ICTC] Tool of caring to evaluate quality of nursing care [TCEQ] C7~C11 C12~C15 5 4
Attitudes for elderly care [AEC] C16~C18 3
Tool to measure maternal behavior for health promotion for preschool C19~C21 3
children with disabilities [MBCD]
Caring behaviors of caregivers of patients with stroke [CBPS] C22, C23 2
Intra-operative caring behaviors [CBM] C24 1
Geriatric care helper's care fulfillment C25 1
Non-TD/VD: not Korean tools (n=17) Coates's caring efficacy scale [CES] C26~C28 3 23
Korean revised caregiving appraisal scale [K-RCAS] C29~C31 3
Arthur's caring attributes, professional self-concept. and technological C32, C33 2
influences scale [CAPSTI]
Wolf's caring behaviors inventory for elders [CBI] C34, C35 2
Nkongho's caring ability inventory [CAI] C36 1
Parenting competency of the parenting sense of competence scale [PC-PSOC] C6 1
Nelson & Waston's caring factor survey [CFS] C37 1
Cronin & Harrison's caring behaviors assessment tool [CBA] C38 1
PGCIS & organizational climate of caring questionnaire [OCCQ] C39 1
Person-centered care assessment tool [P-CAT] C40 1
Orbell's care work satisfaction scale [SAT] and strain scale [STR] C41, C42 2
Steffen et al.' caregiving self-efficacy [CSE] Szmukler et al.' experience of caregiving inventory [ECI] C42 C43 1 1
Otero et al.' professionals' shared competences in multidisciplinary dementia C44 1
care [PSCMDC]
Shyu's caregiving resources of family caregiving factors inventory [CR-FCFI] C45 1
Caregiving experiences C46§ 1
- Positive=Nolan et al.'carers assessment of satisfaction index [CASI]
- Negative experience=Korean version of Zarit burden interview [ZBI-K]
Caregiving experience C47§ 1
- Positive=Patients' contribution to the family [PC], You and your child [YY]
- Negative=Burden assessment scale [BAS], Care scale [CS], Kang's burden
scale [KBS]

TD=tool development study; VD=validation study;

No. of tools (total tools used in relevant studies=36);

Multiple responses;

§ C46 or C47 used 2 or 5 tools for measuring caregiving experiences but it analyzed that one tool was used.

Table 3.
Measurement Tools of Caring of Tool Development or Validation Studies (N=6)
Tools Study ID Theoretical Background Concept of caring Sub-domain (factors) Sample Sampling method No. of items Scale Rating Validity & Reliability T/RT
Tool of caring to evaluate quality of nursing care [TCEQ] A1 Waston's theory Nurses' caring behaviors Accessibility & availability; emotional support & giving information; providing a protective environment (3 factors) 374 patients s(-), c 27 L5 s, mean=94.77 (30~135) P(+); V1(+); V2(+) IT(+); R1=.96
Intra-operative caring behaviors [CBM] A2 Waston's theory Nurses' caring behaviors Holistic needs fulfillment; consideration; protective environment; cautiousness; concern; information; physical comfort (7 factors) 137 regional anesthesia patients s(+), c 33 L5 i, mean=4.00 (3.35~4.42) P(+); V1(+); V2(+); IT(+); R1=.96(.73~.92)
Tool for measuring the care satisfaction of home health nursing [TCS] A3 Waston's theory Care satisfaction Allowance for existential-phenomenological forces; formation of humanistical altruistic system of values; cultivation of sensitivity to self and to others; development of helping-trust relationship; promotion of interpersonal teaching-learning; instillation of faith-hope; systematic use of the scientic problem-solving method for decision making; provision for supportive, protective, and corrective mental, physical, sociocultural, and spiritual environment; assistance with gratification of human needs; promotion and acceptance of the expression of positive and negative feelings (10 factors) 166 clients of home health nursing care s(-), c 56 L4 i, mean=3.58 (3.12~3.73) P(-); V1(+); V2(+); V3(+); V4(+); IT(+); R1=.98; R2=.90
Caregiver reaction assessment [CRA-K] B1 Literature review Caregiver's experiences Disrupted schedule; lack of family support; health problems; financial problems; caregiver self- esteem (5 factors) 248 cancer patient's caregiver s(-), c 24 L5 i, mean=1.26~2.73 P(+); V1(+); V2(+); V3(+) V4(+): V5(+); IT(+); R1=.81(.52~.75); RO=.84; T/RT(+/+)
Person-centered care assessment tool [P-CAT] B2 Literature review Staffs' care performance 3 factors (in original) → 2 factors (in revised): Personalized caring; organizational & environmental support 458 staff in long-term care facilities s(+), c 13 L5 i, mean=3.83 (3.41~4.30) P(+); V1(+); V2(+); V5(+); IT(+); R1=.86 (.84, .77); RO=.88; T/RT(+/+)
Peer group caring interaction scale [PGCS] B3 Waston's theory, Noddings, Hughes Caring behaviors Modeling & assistance behavior; Communication & sharing behavior (2 factors) 218 nursing students s(+), c 16 L6 s, mean=61.62 P(+); V1(+); V2(+); V3(+); V4(+); V5(+); IT(+); R1=.91; R2=.85; RO=.94; T/RT(+/+)

A1~A3=Development studies; B1~B3=Validation studies; Sampling method (s=sampling rationale, c=convenient sampling); Scale (L4~6=4~6 point Likert scale); Rating (s=sum, i=mean of items, f=frequency); Validity & Reliability, T/RT (P=pilot study, V=validity, V1=content, V2=constuct or factor analysis, V3=convergent, V4=discriminant, V5=criterion, IT=item analysis, R=reliability, R1=Cronbach's ⍺, R2=Guttman's split-half coefficient, RO=Cronbach's ⍺ of the original tools, T/RT=translated and re-translated).

Table 4.
Measurement Tools of Caring of non-Development and Validation Studies (N=47)
Tools (n=No. of study) Study ID Sampling method Sample & sample size No. of items Scale type Rating Validity & reliability Original reliability Remarks or T/RT
Developed for using in their studies by authors (n=6) C1 s(-); c 73 PT & 73 NR 12 L7 s; f p(+); V1(+); R1(+)=.76~.83 N/A Semantic
C2 s(-); c; r(-) NR e=27, c=0 10 f V1(+); R1(-) N/A
C3 s(+); c 260 F 72 L4 i p(+); R1(+)=.91 N/A
C4 s(-); c 57 NR 33 L5 i p(+); V1(+); R1(+)=.90 N/A
C5 s(-); c; r(-) NR e=18, c=14 20 L7 i V1(+); V2(+); R1(+)=.96 N/A Semantic
C6 s(+); c 291 F 25 L4 i p(+); V1(+); V2(+) R1(+)=.87 N/A
Interpersonal caring technique-communication skills [ICTC] (n=5) C7~C11 all=s(+); c C7=369 NR; C8=252 NRST; C7~C10=50 all=L5 all=i all=R1(+)=.93~.97 all=yes  
C9=207 NRST; C10=174 NR; C11=10 C11=P(+); C11=V1(+)
C11=100 F
Tool of caring to evaluate quality of nursing care [TCEQ] (n=4) C12~C15 C12~14=s(-) C12=244 PT 27 C12=L5 i all=R1(+)=.95~.98 C12,13,15=yes A1
C15=s(+); all=c C13=340 PT & 295 NR C13~15=L7 C13=P(+) C14=no
C14=656 NRST; C15=162 NR
Attitudes for elderly care [AEC] (n=3) C16 C16=s(+), r(-) C16=SF e=18, c=18; C16,17=17 C16,17=L5 C16,17=s all=R1(+)=.84~.96 C17,18=yes C18=Semantic
C17 C17=s(+), r(+) C17=NR e=25, c=25; C18=200 C18=20 C18=L7 C18=i C16=no
C18 C18=s(-); all=c
Tool to measure maternal behavior for health promotion for preschool children with disabilities [MBCD] (n=3) C19~C21 C19=s(+); all=c C19=371 M; C20=371 M; C19=15 all=L4 C19=no all=R1(+)=.83~.86 C19,20=yes
C20,C21=s(-); C21=364 M C20,21=19 C20,21=i C19=V2(+) C21=no
Caring behaviors of caregivers of patients with stroke [CBPS] (n=2) C22, C23 all=s(-); all=c C22=68 F C22=39 all=L4 C22=i C22=R1(-) C23=yes C3 
C23=70 F C23=64 C23=f C23=R1(+)=.97; all=V1(+) C22=no
Intra-operative caring behaviors [CBM] (n=1) C24 s(+); c 162 PT 33 L5 i R1(+)=.97 yes A2
Geriatric care helper's care fulfillment (n=1) C25 s(+); c 112 STAFF 23 L4 i R1(+)=.87 yes
Caring efficacy scale [CES] (n=3) C26 all=c; C26=s(+) C26,28=NRST all=30 all=L6 all=i all=R1(+)=.91~.92 all=yes C26 uses C27
C27 C28 C27,28=s(-) e=23~28, c=23~29++ C27, C28=V1(+) C27,
C26,28=r(-) C27=422 NR C28=T/RT(+/+)
Korean revised caregiving appraisal scale [K-RCAS] (n=3)  C29 C30 C29,30=s(-) C29=103 F C29,C30=27 all=L5 C29=i C29=P(+); C29=V1(+) all=yes Korean version§
C31 C31=s(+) C30=F e=21, c=20++ C31=22 C30,C31=s C29=R1(+)=.39~.87
c; r(-) C31=210 F C30=V2(+), R1(+)=.81
C31=R1(+)=.79
Caring attributes, professional self-concept. and technological influences scale [CAPSTI] (n=2) C32,C33 all=s(-); all=c C32=560 NR C32=60 all=L5 all=i,s all=V1(+); C33=V2(+) C33=yes C32=T/RT(+/+)
C33=324 NR & 372 NRST C33=42 C32=f all=R1(+)=.91~.94 C32=no C33 uses C32
Caring behaviors inventory for elders [CBI] (n=2) C34,C35 all=s(+); all=c C34=430 NR all=42 all=L4 all=i; s all=V1(+); all=R1(+)=.96 all=yes C34=T/RT(+/+)
C35=156 NR C35 uses C34

C1~C25=Korean tools; C26~C47=Translated tools;

Multiple responses;

Program development or intervention study (total=8);

§ not a Korean article; Sampling method (s=sampling rationale, c=convenient sampling, rr=random sampling, r=randomization of intervention study); Sample sample size (PT=patients including home health care clients, NR=nurses, F=family caregivers, M=mother, NRST=nursing students, Staff=formal caregivers in long-term facilities, e=experimental group, c=control group); Scale-L4~7=4~7 point Likert scale; Rating (s=sum, i=item mean, f=frequency); Validity & Reliability (P=pilot study, V1=content validity, V2=construct validity or factor analysis, R1=cronbach's ⍺; Original reliability (N/A=not applicable, yes=reliability of original tools, No=not reported); T/RT=translated and re-translated

Table 4.
Measurement Tools of Caring of non-Development and Validation Studies (Continued) (N=47)
Tools (n=No. of study) Study ID Sampling method Sample & sample size No. of items Scale type Rating Validity & reliability Original reliability Remarks or T/RT
Caring ability inventory [CAI] (n=1) C36 s(-); c NR 277 37 L7 i R1(+)=.83 no T/RT(+/-)
Parenting competency of the parenting sense of competence scale [PC-PSOC] (n=1) C6 s(+); c 291 F 7 L6 i V1(+); R1(+)=.74 yes C6 uses C20
T/RT(-/-)
Caring factor survey [CFS] (n=1) C37 s(+); c 107 NR 20 L7 s; i V1(+); R1(+)=.94 yes T/RT(+/+)
caring behaviors assessment tool [CBA] (n=1) C38 s(+); c 159 NR & 159 PT 60 L5 i p(+); V1(+); R1(+)=.83~.93 yes T/RT(+/+)
PGCIS & organizational climate of caring questionnaire [OCCQ] (n=1) C39 s(+); c 229 NR PGCIS=16 L6 i p(+); V1(+); yes PGCIS=B3
OCCQ=17 R1(+) PGCIS=.91; OCCQ=.91
Person-centered care assessment tool [P-CAT] (n=1) C40 s(+); c 114 NR 13 L5 i R1(+)=.78 yes B2
Care work satisfaction scale [SAT] and strain scale [STR] (n=2) C41,C42 C41=s(-); C41=374 F SAT all=6 all=L5 C41=i; SAT all R1(+)=.91~.94 all=yes C41=T/RT(+/-)
C42=s(+), c C42=200 F STR all=13 C42=no STR all R1(+)=.94 C42 uses C41
Caregiving self-efficacy [CSE] (n=1) C42 s(+); c 200 F 15 0~100 no V1(+); R1(+)=.89 yes T/RT(+/+)
Experience of caregiving inventory [ECI] (n=1) C43 s(-); c; r(-) F; e=17, c=16++ 66 L4 i R1=.87~.92 yes Korean version
Professionals' shared competences in Multidisciplinary dementia care [PSCMDC] (n=1) C44 s(+); c 201 STAFF 19 L5 i V1(+); R1(+)=.93 yes T/RT(+/+) 
Caregiving resources of family caregiving factors inventory [CR-FCFI] (n=1) C45 s(+); c 87 F 12 L3 i p(+); V1(+); V2(+) yes T/RT(+/+)
R1(+)=.86
Carers assessment of satisfaction index [CASI]; Korean version of Zarit burden interview [ZBI-K] (n=1) C46 s(+); rr(+) 320 F CASI=20 CASI=L3 s R1(+) CASI=.91 yes Korean version
ZBI-K=22 ZBI-K=L5 ZBI-K=.94
Patients' contribution to the family [PC]; You and your child [YY]; Burden assessment scale [BAS]; Care scale [CS]; Kang's burden scale [KBS] (n=1) C47 s(-); c 100 F BAS=7 L4 i p(+); R1(+) BAS=.82 partly yes T/RT(+/-)
CS=8 CS=.84; KBS=.92
KBS=18 PC=.87; YY=.78
PC=9, YY=9

C1~C25=Korean tools; C26~C47=Translated tools; +Multiple responses;

Program development or intervention study (total=8);

§ not a Korean article; Sampling method (s=sampling rationale, c=convenient sampling, rr=random sampling, r=randomization of intervention study); Sample sample size (PT=patients including home health care clients, NR=nurses, F=family caregivers, M=mother, NRST=nursing students, Staff=formal caregivers in long-term facilities, e=experimental group, c=control group); Scale-L4~7=4~7 point Likert scale; Rating (s=sum, i=item mean, f=frequency); Validity & Reliability (P=pilot study, V1=content validity, V2=construct validity or factor analysis, R1=cronbach's ⍺; Original reliability (N/A=not applicable, yes=reliability of original tools, No=not reported); T/RT=translated and re-translated

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