CARE Program and Caring Behaviors Among Nurses of End-Stage Renal Disease Patients on Hemodialysis in a Government Training and Teaching Hospital in the Bicol Region, Philippines

Abstract

Caring is the heart of the nursing profession and the patients and their health status are dynamic and need to be cared for as a unit of body and mind. The caring behavior of nurses needs to improve as the demand for caring is vital in meeting the different needs of the patient. It can be achieved through introduction of a program that is specifically designed to effectively enhance the caring behavior of the nurses. Transpersonal caring as a background conceptual framework was used to explain that an educational training will create an effect on caring behaviors of nurses. Through this, nurse-patient relationship will improve quality health care and increase patient safety in clinical practice. It can be achieved by conducting educational training to improve nurses caring behavior. The CARE program was developed as an intervention for this study. The aim is to investigate the effectiveness of CARE program in improving the caring behavior of nurses caring for ESRD patients undergoing hemodialysis. A one group pre-test post-test design was utilized. Post-tests were done one week and after one month. Convience sampling was used to select participants for the said program. The study population were nurses working on the identified wards and special areas and who meet the inclusion and exclusion criteria. The CARE program for nurses caring for ESRD patients is the independent variable while the caring behavior of nurses is the dependent variable. Nurse variables such as age, sex, highest educational attainment, length of experience and training/s attended related to hemodialysis served as the modified variables. The CBI-24 nurse version was used as the research tool and results were interpreted using appropriate statistical treatment. There were thirty-nine (n=39) nurses who participated, majority were 21-30 years old (43.6%), mostly females, with BSN degrees (82.1%); and with no trainings on hemodialysis (71.8%). Mean scores on caring behavior reported were at 5.31 (pre-test) and 5.66 after one month. The following domains showed: on assurance (pre-test 5.42, post-test 5.72), on knowledge and skills (pre-test 5.47, post-test 5.73), on respectful domain (pre-test 5.31, post-test 5.68), connectedness domain (pre-test 5.04, post-test 5.55). Connectedness was associated with education. The area on giving patient instructions or teaching the patient was highlighted in connectedness. The discussion addresses some possible reasons why the participating nurses prioritized certain caring behaviors. Technical skills and taskoriented are common practice here in the Philippine health setting. Nurses are likely to prioritize their duties due to labor shortage. A one (1) day educational program tailored to improve the caring behavior of nurses was conducted and had a positive result that benefited the participants. The caring behaviors of the participants improved, and the training program gained a positive feedback.