A survey on nurses’ perception of the importance of caring behaviors and factors affecting its provision

Document Type: Original Quantitative and Qualitative Research Paper


1 Faculty of Nursing, Islamic Azad university, Uremia Branch, Uremia, Iran

2 MSc in Nursing, Islamic Azad university, Uremia, Iran

3 RN, MS of Physiology, Supervisor in Imam Khomeini Hospital, Uremia, Iran


Background: Caring is the essence of nursing practice, but has been understood in various countries in a different way. Analysis of nurses’ perception of caring behaviors provides the possibility to nursing teachers and administrators to be able to plan a program to meet all the patients’ needs with an inclusive view.
Aim: to determine nurses’ perception about caring behaviors and the factors that may affect those behaviors.
Method: In this cross- sectional study, 189 Registered Nurses who were selected through Quota sampling from four teaching hospitals of Urmia city were included. Data Collection was carried out using a self-structured three-part questionnaire. Data were analyzed using descriptive tests and multivariate linear regression analysis with SPSS version 16.
Results: The highest caring behavior score was related to writing nursing reports and the lowest score to the helping to patients in their physical activity in daily life. Multivariate regression analysis showed that the sense of responsibility towards patients, sense of personal achievement due to nursing profession, belief in delivering high quality care and  personal problems of nurses explained the variance in caring behaviors.
Conclusion: In order to consider all the patients’ needs, social - emotional aspects of caring is needed to be more emphasized in nursing education and planning. To highlight moral issues, creating moral and enhancing counseling services can lead to increased sense of responsibility, promoted professional ethics and self efficacy which itself resulted in decreased nurses’ personal problems.



1. Swanson K. Empirical development of a middle rang theory of caring. NR.1999; 140 (3):161-6

2. Khademian Z,Vizeshfar F. Nursing student’s perceptions of the importance of caring behaviors. JAN. 2007; 61(4):456-62 (Persian)

3. Murphy F, Jones S, Edwards M, James TL. The impact of nurse education on the caring behaviors of nursing students. NET.2009; 29:254- 64

4. Watson J, Smith MC. Caring science and the science of unitary human beings: a trans- theoretical discourse for nursing knowledge development. JAN. 2002; 37(5):452-61.

5. Karaoz S. Turkish nursing students’ perception of caring.NET. 2005; 25: 31–40

6. Brilowski GA, Wendle MC. An evolutionary concept analysis of caring. JAN. 2005; 50(6): 641–50

7. Wolf ZR, Colahan M, Costello A, Warwick F, Ambrose MS, Giardino ER. Relationship between nursing care and patient satisfaction. MSN.1998; 6(2):99-105

8. Day RA, Field PA, Campbell IE, Reutter L. Students evolving beliefs about nursing: From entry to graduation in a four- year baccalaureate program. NET.2005; 25: 636–43

9. Wilkes LM, Wallis MC. A model of professional nurse caring: nursing students’ experience. JAN.1998; 27: 582–9

10. Farmer E. The older person. In:Schofield I, Tolson D, Arthur D, Davies S, Nolan M. An exploration of the caring attributes and perceptions pf work place change among gerontological nursing staff in England, Scotland and China (Hong kong). IJNS.2005; 42: 197-209

11. Dowlind M. The meaning of nurse–patient intimacy in oncology care settings: From the nurse and patient perspective. EJON.2008; 12(4):319- 28

12. Dingwall R, Allen D. The implications of healthcare reforms for the profession of nursing. NI.2001; 8(2):64–74

13. Foruzi MA, Alizadeh SM, Nuhie E, Nikian Y. Comparison of the importance of caring behaviors as perceived by nurses and patients. JKUMS.1994; 1:181-8.

14. Watson R, Lea HA, Rumeu C, Beunza M, Barbarin B, MacDonald J etal. Differences and similarities in the perception of caring between Spanish and UK nurses. JCN.2003; 12: 85- 92

15. Schofield I, Tolson D, Arthur D, Davies S, Nolan M. An exploration of the caring attributes and perceptions of work place change among gerontological nursing staff in England, Scotland and China (Hong kong). IJNS.2005; 42: 197-209

16. Takase M, MaudeP, Manias E. Impact of the perceived public image of nursing onnurses’ work behavior. JAN.2006; 53(3): 333–43

17. Patistea E. Nurse’s perceptions of caring as documented theory and research. JCN.1999; 8(5): 487– 95

18. Oconnel E, Landers M. The importance of critical care nurse,s caring behaviours as perceived by nurses and relatives. ICCN.2008; 24:349-58.

19. Watson R, Lea A. The caring dimension inventory (CDI): content validity, reliability and scaling. JAN.1997;25: 87- 94

20. Lee A, Watson R, Deary IJ. Caring in nursing: A multivariate analysis. JAN.1998; 28(3);662-71

21. Rafii F, Oskouie F, Nikravesh M. Caring behaviors of burn nurses and the related factors. JISBI.2007; 33: 299 – 305 (Persian)

22. Oskouie FH, Rafii F, Nikravesh M. Major Determinants of caring behavior. HHPR.2006; 7: 6-16

23. McCance T, Slater P, McCormack B. Using the caring dimensions inventory as an indicator of person-centered nursing, JCN.2008;18: 409–17

24. Smith MK, Sullivan JM. Nurses’ and patients’ perceptions of most important behaviors in a long-term care setting. GN.1997; 18(2): 70–3

25. Greenhalgh J,VanhanenV, Kyngas H. Nurse caring behaviors. JAN.1998; 27(5): 927–32.

26. Brunton B, Beaman M. Nurse Practitioners’ perceptions of their caring behaviors. JAANP. 2001; 2(11): 451–6.

27. Larsson G, Windmark PV, Lampic C, Essen LV, Sjoden PO. Cancer patient and staff ratings of importance of caring behaviors and their relations to patient anxiety and depression. JAN.1998; 27(4): 855–64

28. Mary ET, Sandra L. Traditional Models of Care Delivery: What Have We Learned? JNA.2004; 34(6): 291-7

 29. Essen Lv, Sjoden PO. The importance of nurse caring behaviors as perceived by Swedish hospital patients and nursing staff. IJNS.2003; 40: 487–97.

30. Herdman E. challenging the discourses of nursing ageism. IJNS.2002; 39: 105-14

31. Foong AL, Rossiter JC. Socio- cultural perspectives on the image of nursing: the Hong Kong dimension.JAN.1999; 29: 542- 8

32. Salami T, Karimi H, Shahbazi L, Dehganpoor H, Hafezieh A et al. Evaluation of clinical senior nursing student’s skills in intensive care units. JYMSHSSS.2005; 13(3):60-6 (Persian)