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Backgound In the evolution of nursing as a science, considerations were presented inthe definition of "care‖ and ―caring" in the literature." Special emphasis is given to therelationship between nursing and care as well as in determining the dimensions,characteristics and behaviors that make it as a central concept in nursing. Oncologynursing is a nursing specialty that responded early to the challenge in defining such acomplicated and significant concept.Aim The aim of this study was to examine the caring behaviors as perceived bynurses patients and their caregivers.Methodology: A descriptive correlational study was conducted with cross-sectionalcomparisons, for the three study groups (patients, caregivers, nurses), in medicaloncology clinics of three cancer hospitals in the Attica area. A qualitative research ofnurses‘ caring behaviors using three focus groups followed.The study sample: For the descriptive study a convenience sample of N = 138 pairs of patients receiving chemotherapy and their family caregivers, with a response rate of78.8%, and N = 72 nurses with a response rate of 68% was used. The focus groupswere conducted with a purposeful sampling of 18 nurses with socio-demographiccharacteristics similar to those of participants in the quantitative study.Instruments: For the quantitave study were used 1. A social and professional form. 2.The Caring Behaviors Inventory (CBI). 3. The Symptom Assessment Scale ShortForm (MSAS-SF) MSAS-SF for patients and their family caregivers. 4. The NurseStress Index NSI. The statistical program of SPSS 17.0. was used for data analysis. Inthe qualitative study, a formed interview guide was used and deductive contentanalysis was the method of analysis.Results: There was not any statistically significant difference between patients andtheir family caregivers. Nurses, patients and their caregivers agreed on the scoring in the first two most highly rated caring behaviors, ―Knowing how to give shots, IVs,etc‖ and ―Giving the patients‘ treatments and medications on time‖. Also all threegroups agreed on the two lowest rated caring behaviors ―Including the patient inplanning his or her care‖ and ―Talking with the patient‖.Associations between patients, family caregivers and nurses rating with all CBIsubscales showed a) no statistically significant difference between patients and theirfamily caregivers in any of CBI subscales b) statistically significant difference wasfound between patients and nurses in ―Knowledge and skill‖ (p=0,010), ―Respectfuldeference to others‖ (p=0,001) and ―Positive connectedness‖ (p=0,004). c)assosiations between family caregivers and nurses were found statistically significantdifference in subscale ―Knowledge and skill‖ (p=0,007), ―Assurance of humanpresence‖ (p=0,003), ―Respectful deference to others‖ (p=0,001) and ―Positiveconnectedness‖ (p=0,003).Associations of patients‘ symptoms and their caring behaviors showed that a) Caringbehaviors of subscale ―Knowledge and skill‖ rated lower when they had higher Total MSAS score (r-0,34 p

Purpose: Although, within cancer nursing the concept of caring is central, there are limited studies comparing nurses', patients' and caregivers' views of care, especially in non-Anglo-Saxonic cultures. We explored and compared perceptions of caring behaviours by cancer patients, their caregivers, and nurses in Greece, as well as associations with demographic variables. Methods: A descriptive correlational study with cross-sectional comparisons was conducted in three cancer hospitals in Attica, with a convenience sample of 138 patients receiving chemotherapy and their family caregivers and 72 nurses. Participants completed the Caring Behaviour Inventory-24 (CBI-24). Results: All groups perceived "Knowledge and skill" as the most important CBI sub-scale. There were no statistically significant differences between patients' and caregivers' perceptions of care. Overall, nurses rated their caring behaviours lower than patients and caregivers (. p

The Ministry of Health of Cyprus (approval no: Y.Y. 5.14.02.4(2)) and the Cyprus National Bioethics Committee (approval no: EEBK/EΠ/2008/1) reviewed and approved the research protocol as Cyprus was the coordinating country for the research study. Abstract BACKGROUND: Patients' decisional control over care is the ability or power for patients to decide what their involvement will be in healthcare decisions. There is evidence of limited agreement between the perceptions of patients and the perceptions of nurses and/or caregivers with regard to the degree of patient involvement in the planning and performance of their care. AIM: To analyse and compare patients' and nurses' perceptions of patients' decisional control over their own care. METHOD: A multisite cross-sectional comparative survey design was employed. Data were collected from hospitalised surgical inpatients (n = 1315) and their caregivers (n = 960 nurses) in five European countries. The Individualised Care Scale part B was used for collecting data from both the patients and nurses. Ethical standards were followed throughout the study. RESULTS: Significant between-country differences were found between patients and nurses. In all countries, both patients and nurses regarded that decisional control over care had been actualised (ICS-B: M = 3.75-4.47 and 3.48-4.33, respectively), but there were significant differences in their perceptions regarding four of the six items of the decisional control factor of the ICS-B. CONCLUSIONS: The results show that there are disparities between patients' and nurses' perceptions of patient involvement in care, probably due to cultural issues that need further exploration. CLINICAL RELEVANCE: The disparities between patients' and nurses' perceptions on patients' decisional control over their care should be taken into consideration as a potential cause of patient dissatisfaction with nursing care. The study was funded by the Cyprus University of Technology (EX 11/2008).

Scand J Caring Sci; 2012; 26; 372–380 Patient satisfaction as an outcome of individualised nursing care Background: The association between individualised nursing care and patient satisfaction has been previously found. However, there is a lack of studies examining this association between individualised care and patient satisfaction in a cross-cultural study. Aims: This study examines the association between individualised care and patient satisfaction in a sample of general surgical patients from five European countries. Methods: A cross-sectional design and survey method were used to collect data from general surgical patients (N = 1315, response rate 78%) in 72 inpatient wards in 26 general acute hospitals’ in 2009 using self-completed questionnaires the Individualised Care Scale and the Patient Satisfaction Scale. Data were analysed using descriptive statistics, Pearson correlation coefficients and multiple stepwise regression analyses. Results: Surgical patients reported that the care they received was only moderately individualised overall, but individuality was taken into account well in patients’ clinical situation and decisional control over care. Patients were satisfied with their care, mostly with the technical aspects of care and least with the information given. There were between-country differences in patients’ perceptions of individuality in care and patient satisfaction. A positive correlation between the level of individualised care received and patient satisfaction was found, confirming that individualised nursing care delivery influences patients’ satisfaction with care and demonstrating that this quality of care indicator might be able to be used as a predictor of patient satisfaction, one outcome of care. Conclusion: The findings of this study strengthen previous results and further reporting the existence of a relationship and the positive correlation between individualised care and patient satisfaction. The results can inform administrative decisions and policy on introducing nursing approaches to care that would increase patient satisfaction.

Aim. The aim of this study was to compare patients’ and nurses’ perceptions of individualised care in five European countries, the Czech Republic, Cyprus, Finland, Greece and Hungary. Background. Individualised nursing care has been studied from both patients’ and nurses’ perspectives, but to date, there are no studies comparing these perspectives internationally. Methods. A cross-sectional comparative survey design was used. Data were collected from nurses (n = 960; response rate, 79%) and patients (n = 1315; response rate, 78%) in 71 surgical units from 26 acute hospitals in 2009. Data were collected using two Individualised Care Scales (ICS-Nurse and ICS-Patient) and analysed statistically using descriptive and inferential statistics. Results. Differences in patients’ and nurses’ assessments of individualised nursing care were found between each country. Nurses, compared with patients, assessed that they supported patient individuality more often. The Meannurses ranged from 3·61 (SD 0·90, Greece)–4·31 (SD 0·53, Hungary), and the Meanpatients ranged from 3·05 (SD 1·09, Greece)–3·79 (SD 1·00, Cyprus). To a large extent, the care provided was individualised as defined by the Meannurses 3·75 (SD 0·92, Greece)–4·36 (SD 0·49, Hungary) and the Meanpatients 3·41 (SD 0·95, Greece)–4·18 (SD 0·79, Cyprus). In Cyprus and Finland, patients’ assessments of the individuality in their care corresponded well with nurses’ assessments. Clear between-country differences in both patients’ and nurses’ assessments were found in both subscales of the ICS. Conclusions. An in-depth analysis of the European between-country differences is required to define the causes of differences that may be due to the differing content of education, the organisation of nursing work, ideology and values assigned to individualised care and health care systems and processes in each country. Relevance to clinical practice. Obtaining both patients’ and nurses’ assessments of individualised care may facilitate the further development of individualised nursing care and be used to help to harmonise European health care processes and nursing care.

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients’ and nurses’ perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026–1037. Abstract Aim. This paper is a report of an international study of patients’ and nurses’ perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers’ perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses’ caring actions when compared to nurses’ views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients (n = 1659) and their nurses (n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses’ and patients’ responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses’ and patients’ views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses’ responses were higher compared to patients (P

The purpose of this European survey was to examine the relationship of surgical patients' and nurses' personal characteristics with their perceptions of caring behaviors. Caring Behaviors Inventory (CBI) was completed by convenience samples of 1,659 patients and 1,195 nurses from six countries of Europe. The results showed that the older the patients, the more positive were their evaluations of CBI. Those with planned admission and good/very good health conditions gave higher ratings compared to those with an emergency and poor health conditions. Type of admission, age, and health conditions explained 5.2% of CBI variance. Nurses with more work experience and experience in the unit gave significantly higher ratings compared to nurses with less experience. Nurses' total experience and gender explained 2.3% of the variance of perceived care. Therefore, in a multinational surgical environment, caring behaviors may be influenced by other variables, better captured by using different research methods. This study was funded by the Cyprus University of Technology.

Although respect and human presence are frequently reported in nursing literature, these are poorly defined within a nursing context. The aim of this study was to examine the differences, if any, in the perceived frequency of respect and human presence in the clinical care, between nurses and patients. A convenience sample of 1537 patients and 1148 nurses from six European countries (Cyprus, Czech Republic, Finland, Greece, Hungary and Italy) participated in this study during autumn 2009. The six-point Likert-type Caring Behaviours Inventory-24 questionnaire was used for gathering appropriate data. The findings showed statistically significant differences of nurses’ and patients’ perception of frequency on respect and human presence. These findings provide a better understanding of caring behaviours that convey respect and assurance of human presence to persons behind the patients and may contribute to close gaps in knowledge regarding patients’ expectations.

The association between individualised nursing care and patient satisfaction has been previously found. However, there is a lack of studies examining this association between individualised care and patient satisfaction in a cross-cultural study.This study examines the association between individualised care and patient satisfaction in a sample of general surgical patients from five European countries.A cross-sectional design and survey method were used to collect data from general surgical patients (N = 1315, response rate 78%) in 72 inpatient wards in 26 general acute hospitals' in 2009 using self-completed questionnaires the Individualised Care Scale and the Patient Satisfaction Scale. Data were analysed using descriptive statistics, Pearson correlation coefficients and multiple stepwise regression analyses.Surgical patients reported that the care they received was only moderately individualised overall, but individuality was taken into account well in patients' clinical situation and decisional control over care. Patients were satisfied with their care, mostly with the technical aspects of care and least with the information given. There were between-country differences in patients' perceptions of individuality in care and patient satisfaction. A positive correlation between the level of individualised care received and patient satisfaction was found, confirming that individualised nursing care delivery influences patients' satisfaction with care and demonstrating that this quality of care indicator might be able to be used as a predictor of patient satisfaction, one outcome of care.The findings of this study strengthen previous results and further reporting the existence of a relationship and the positive correlation between individualised care and patient satisfaction. The results can inform administrative decisions and policy on introducing nursing approaches to care that would increase patient satisfaction.

The aim of this study was to compare patients' and nurses' perceptions of individualised care in five European countries, the Czech Republic, Cyprus, Finland, Greece and Hungary.Individualised nursing care has been studied from both patients' and nurses' perspectives, but to date, there are no studies comparing these perspectives internationally.A cross-sectional comparative survey design was used. Data were collected from nurses (n = 960; response rate, 79%) and patients (n = 1315; response rate, 78%) in 71 surgical units from 26 acute hospitals in 2009. Data were collected using two Individualised Care Scales (ICS-Nurse and ICS-Patient) and analysed statistically using descriptive and inferential statistics.Differences in patients' and nurses' assessments of individualised nursing care were found between each country. Nurses, compared with patients, assessed that they supported patient individuality more often. The Mean(nurses) ranged from 3·61 (SD 0·90, Greece)-4·31 (SD 0·53, Hungary), and the Mean(patients) ranged from 3·05 (SD 1·09, Greece)-3·79 (SD 1·00, Cyprus). To a large extent, the care provided was individualised as defined by the Mean(nurses) 3·75 (SD 0·92, Greece)-4·36 (SD 0·49, Hungary) and the Mean(patients) 3·41 (SD 0·95, Greece)-4·18 (SD 0·79, Cyprus). In Cyprus and Finland, patients' assessments of the individuality in their care corresponded well with nurses' assessments. Clear between-country differences in both patients' and nurses' assessments were found in both subscales of the ICS.An in-depth analysis of the European between-country differences is required to define the causes of differences that may be due to the differing content of education, the organisation of nursing work, ideology and values assigned to individualised care and health care systems and processes in each country.Obtaining both patients' and nurses' assessments of individualised care may facilitate the further development of individualised nursing care and be used to help to harmonise European health care processes and nursing care.

This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. A descriptive comparative survey design was used to analyse a sample of surgical patients (n = 1659) and their nurses (n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients (P0·05) with important differences in the 'assurance of human presence' (P0·001) and the 'respectful deference to others' (P0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' (F = 24·199, P0·001) and patients' views on caring (F = 26·945, P0·001). Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses.