Perceptions of caring behaviours among patients, nurses, nursing students: mixed methods systematic review

BACKGROUND: The foundation and core value of the nursing profession is caring. Worldwide, it is expected that nursing education will cultivate caring behavior amongst nurses to fulfill the health needs of a patient. Three earlier reviews related to caring behavior were identified. However, these reviews were conducted over ten years ago and other literature has since been published. Therefore, it is timely to synthesise the most recent evidence related to the perceptions of patients, nurses, and nursing students of caring behaviours exhibited by nurses. METHODS: A mixed methods systematic review was conducted in accordance with Joanna Briggs Institute (JBI) guidelines. MEDLINE, Web of Science, Scopus, and Cumulative Index of Nursing in Allied Health Literature (CINAHL), PsycINFO, and Embase were searched to identify original peer reviewed studies published from January 2009 onwards. All records were systematically screened for eligibility based on their title, abstract, and full text by all three authors. Eligible studies were critically appraised for methodological quality using the Mixed Methods Appraisal Tool. Both qualitative and quantitative studies were reviewed and data separately extracted for each type of study. The findings were narratively synthesised using a convergent integrated approach. The thematic synthesis of qualitative data and narrative summary of quantitative data was integrated to provide the overall findings of the review. RESULTS: From 4130 records identified, 44 studies were included (19 qualitative, 23 quantitative, and two mixed methods study). The studies covered several hospital specialty areas. Two themes, physical care with sub-themes of knowledge and skills; comfort; and assurance, and expressive care with sub-themes of connectedness; being respectful; trusting relationships, and teaching and learning emerged from the analysis. CONCLUSIONS: In this review, deficits in knowledge and training requirements of both nurses and student nurses have been identified. For nurse leaders, the review findings will bring insight to those who develop nursing policies to ensure that caring behaviours are incorporated into guidelines and job descriptions for registered nurses. CLINICAL TRIAL NUMBER: Not applicable.