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To develop a comparative meta-theory of nine caring theories by explicating their assumptions, operative mechanisms and consequences for nursing.
Qualitative meta-theoretical document analysis.
Canonical texts were analysed using an intra-source strategy. Paginated statements were extracted and coded across assumptions, metaparadigm anchors (person, health, environment, nursing and care) and mechanisms linking caring intention to clinical action. Synthesis produced a typology and meta-theoretical propositions.
Caring functioned as a generative principle that reorganised person, health, environment and nursing and care into distinct practice architectures. Six mechanism-based subfamilies were identified: transpersonal caritas; phenomenological and embodied clinical wisdom; ethical and relational caring; cultural and contextual caring; systemic and organisational caring; and operationalisable caring. Ten propositions linked assumptions to mechanisms and expected effects.
The caring school is best understood as an ordered set of non-equivalent caring mechanisms rather than a single doctrine, supporting translation to practice design, education and congruent evaluation.
Mechanism-based comparison can reduce conceptual ambiguity and improve alignment between caring interventions and intended outcomes.
This study addresses the under-specification of how caring theories work. It provides a comparative typology and propositions that make mechanisms explicit, informing nursing education, theory development and caring-based practice in diverse settings.
No EQUATOR reporting checklist is available for meta-theoretical discursive analyses; the manuscript follows Journal of Advanced Nursing guidance for discursive papers.
This study did not include patient or public involvement in its design, conduct, or reporting.
To investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID-19 pandemic. We also examined the influence of the nurses’ socio-demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID-19 pandemic.
Caring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID-19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.
Cross-sectional, descriptive study.
A purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short-form 24-item Caring Behavior Inventory from May–August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.
The majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of ‘assurance of human presence’ while lowest in the ‘knowledge and skills’ in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.
Based on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses’ demographic characteristics predicted their professional quality of life and caring behaviours.
The importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID-19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.
Millions of patients receive general anaesthesia every year with either propofol total intravenous anaesthesia (TIVA) or inhaled volatile anaesthesia (INVA). It is currently unknown which of these techniques is superior in relation to patient experience, safety and clinical outcomes. The primary aims of this trial are to determine (1) whether patients undergoing (a) major inpatient surgery, (b) minor inpatient surgery or (c) outpatient surgery have a superior quality of recovery after INVA or TIVA and (2) whether TIVA confers no more than a small (0.2%) increased risk of definite intraoperative awareness than INVA.
This protocol was co-created by a diverse team, including patient partners with personal experience of TIVA or INVA. The design is a 13 000-patient, multicentre, patient-blinded, randomised, comparative effectiveness trial. Patients 18 years of age or older, undergoing elective non-cardiac surgery requiring general anaesthesia with a tracheal tube or laryngeal mask airway will be eligible. Patients will be randomised 1:1 to one of two anaesthetic approaches, TIVA or INVA, using minimisation. The primary effectiveness endpoints are Quality of Recovery-15 (QOR-15) score on postoperative day (POD) 1 in patients undergoing (1) major inpatient surgery, (2) minor inpatient surgery or (3) outpatient surgery, and the primary safety endpoint is the incidence of unintended definite intraoperative awareness with recall in all patients, assessed on POD1 or POD30. Secondary endpoints include QOR-15 score on POD0, POD2 and POD7; incidence of delirium on POD0 and POD1; functional status on POD30 and POD90; health-related quality of life on POD30, POD90, POD180 and POD365; days alive and at home at POD30; patient satisfaction with anaesthesia at POD2; respiratory failure on POD0; kidney injury on POD7; all-cause mortality at POD30 and POD90; intraoperative hypotension; moderate-to-severe intraoperative movement; unplanned hospital admission after outpatient surgery in a free-standing ambulatory surgery centre setting; propofol-related infusion syndrome and malignant hyperthermia.
This study is approved by the ethics board at Washington University, serving as the single Institutional Review Board for all participating sites. Recruitment began in September 2023. Dissemination plans include presentations at scientific conferences, scientific publications, internet-based educational materials and mass media.
Introducción. La punción arterial para el análisis gasométrico provoca dolor de intensidad variable. Este dolor podría alterar la dinámica ventilatoria y, por tanto, los parámetros respiratorios de la muestra sanguínea. Objetivos. Determinar la posible relación entre el dolor inducido por la punción arterial y los parámetros obtenidos del análisis gasométrico de estas muestras de sangre. Como objetivos secundarios, obtener la prevalencia del dolor provocado en la muestra estudiada y la posible asociación con el número de intentos. Metodología. Estudio transversal que incluyó 100 muestras arteriales de 61 pacientes durante el primer semestre de 2024. La intensidad del dolor, reportada mediante la escala NRS-11, fue la variable principal de estudio. Se analizó la asociación de esta variable con variables gasométricas (por ejemplo, pH, pO2, pCO2 y lactato) y con otras variables sociodemográficas y relacionadas con punción arterial. Resultados. La edad fue de 69,43 ± 13,07 y el 68% eran hombres. Respecto a la variable principal de resultado, la puntuación media del dolor fue de 4,03 ± 2,61. La intensidad del dolor no mostró asociación con ninguna variable gasométrica. Sin embargo, el número de intentos de obtener con éxito una muestra arterial mostró significación. Tras ajustar por otras variables, cada intento adicional aumentaba el dolor en 1,14 puntos. Discusión. No se encontró asociación entre el dolor de la punción arterial y los parámetros del análisis gasométrico, por lo que los resultados pueden interpretarse de forma robusta en situaciones en las que no es posible un manejo adecuado del dolor.
ABSTRACT
Introduction. Arterial puncture for gasometrical analysis causes pain of varying intensity. This pain could alter the ventilatory dynamics and therefore the respiratory parameters of the blood sample. Objectives. To determine the possible relationship between the pain induced by arterial puncture and the parameters obtained from the gasometrical analysis of these blood samples. As secondary objectives, to obtain the prevalence of pain caused in the sample studied and the possible association with the number of attempts. Methodology. Cross-sectional study involving 100 arterial samples from 61 patients during the first half of 2024. Pain intensity reported by the NRS-11 was the main study variable. The association of this variable with gasometrical variables (for example: pH, pO2, pCO2, lactate) and with other variables of different nature (sociodemographic and related to the arterial puncture itself) was analyzed. Results. The age was 69,43 ± 13,07 and 68% were men. Regarding the main outcome variable, the mean pain score was 4.03 ± 2.61. Pain intensity showed no association with any of the gasometric variables. However, the number of attempts to successfully obtain an arterial sample showed significance. After adjustment for other variables, each additional attempt increased pain by 1.14 points. Discussion. No association was found between arterial puncture pain and gasometric analysis parameters, so the results can be robustly interpreted in situations where adequate pain management is not possible.
Rev Enferm;39(5): 52-60, 2016 May. . [Artículo]
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