Assessing and Measuri~g Caring in Nursing and Health Science

Jean Watson, RN, PhD, HNC, FAAN

~ Springer Publishing Company

1

Copyright © 2002 by Springer Publishing Company, Inc.

All rights reserved

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means. electronic, mechanical, photocopying, recording. or otherwise, without the prior permission of the publisher.

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01 02 03 04 05 / 5 4 3 2 1

Library of Congress Cataloging.in·Publication Data

~alSon.Jean, 1940-

Assessing and measuring caring in nursing and health science I Jean "ValSon.

p. em.

Includes bibliographical references and index. ISBN 0-8261-2313-9

1. Nursing. 2. Caring. L Tille.

RT42.W382002

610.73-dc21

2001041127 CIF

Printed in the United States of America by Sheridan Books

18

Caring Professional Scale

(Swanson, 2DOO)

The Caring Professional Scale (CPS) was an investigator-developed (Swanson, 2000) paper-and-pencil questionnaire used in an NIH, NINR research grant (R29 01899) to study how consumers rate health care pro,<;ders on their practice relationship style. It was developed as a means to evaluate both the nurse and as a ''lay of evaluating the care received from the physician, midwife, and/or nurse at the time a woman was miscarrying

a child.

The conceptual-theoretical basis of the scale emerged from Swanson's

Caring Theory, an original middle range theory, which was developed over a series of clinical research studies in the area of women's health (Swanson, 1991 ) . The CPS consists of 1:\110 factor analytically derived su bscales: Compassionate Healer and Competent Practitioner. These items were derived from Swanson's original theory categories of:

~. Knowing

• Being with

• Doing for

• Enabling

• Maintaining belief

The definition of caring that is grounded in both theory and empirical findings is: Caring is "a nur-turing way of relating to a valued other toward wh om one fee Is a personal se nse of commi tmen t and responsibil iry" (Swan-

son, 1991).

The actual scale consists of 14 items constructed on a 5-point Likert-

type scale. Sample items include: Was the provider who just took care of

203

204

Summary of Each Instrument for ~GfUring Care

you comforting? ... Informative? ... Technically skilled? ... Support-

ive? An attentive listener? ... Clinically competent? ... Aware of your

feelings? etc. (Swanson, 2000a). Aside from the empirical de~elopment and evolution of Swanson 's Theory, the Caring Professional Scale reliability and validity were established by correlating the CPS with the empathy subscale of the Barret-Lermart Relationship Inventory (r== .61, P < 0.001), which supports criterion validity (Swanson, 2000a). Cronbach's alpha estimates for internal consistency were used to rate the multiple providers: advanced practice nurses (.74 to .96). nurses (.97), and physicians (.96).

The sample used for the tool development and testing was a group of 185 women who were participants in a study exploring the effects of caring (nurse counseling based on Swanson's Caring Theory), measurement (early versus delayed), passage of time on integration of loss (miscarriage impact). and emotional well-being (moods and self esteem). The CPS was developed by the investigator as one strategy to monitor caring as the intervention/process variable (Swanson, 2000b).

This instrument is unique in that it is designed to be used for assessing a variety of health professionals on the caring relationship; it is empirically and theoretically derived by the investigator. and has been used in a federally funded clinical research investigations whereby caring was the intervention. The findings from Swanson's intervention study provide evidence that caring was effective as an intervention modality for reducing emotional disturbance, anger, and depression for women who have miscarried (Swanson, 2000b).

Finally, the original theory from which the CPS emerged has been found from Swanson's recent meta-analysis (Swanson, 1999) to validate the generalizability, or transferability, of Swanson's Caring Theory beyond the perinatal contexts from which it was originally derived. It stands as a promising caring measurement that has both theoretical and empirical validity and clinical relevance across settings, populations, and health care professionals. This instrument is copyrighted and the author request that she be contacted for permission and advice regarding its use. Table IB.l provides an overview of key properties of the i nstrurnen t in a matrix forma t,

, """"
~ ..... ~ .2 , ~:E ~ cl r- d <:>
M -< 0 e l::: i:l 0', fJ a
c IlJ c .~ "§ ._ t"t Z Co :::; , Z ""
• '- c· E .... ..., ;:; ~""""'" .~ ~ E ,... 0
+g ";;; 0 :c "i=i ..:.!. ~ ~~ .~ Z C() ::J OJ ~ ;z: c::<
oJ a ... '" <0 eO ,_ .~ J:: > .... U 0 X Z
~ a ... 0.'" • <:> 3: ~
'" ~ ~ '" c '" ....... :--. .
~ 0:-:. Z 0 M e, 13 vel :c '" ..., ~
'" 0 ..., .~ - c;, 3: '" 0
oJ ;: 0 '" ::: ~:::! l" :..
j G .s .;J ~ a v >=.i -E ~ Ii; v -< C'-I <2 c IU Z on
(f) .. w '" Z 0:: => '" ~ c,
... 1
c , r-
r.: ~ ..., , '" .Q 0 ,
.:: E .'" E v e , .s ;:l
a. ..., c '-' ~
v '- c§ '" .:=-=-= ,...
0 !: 0 M -e
'-' ... OJ) oJ r: <.> c
u 0 '" ~ i:: .5 0 .:: ~ u v '" v ...
c v .~ '" ... ... E ..., ..., <U v C
0 ;::: ..., ;: r: ;::: e .:: > '" '" ...
U E-< c:::l ~ U E-< a. -c 1: '" c E
(f) '" .c '" 205

•

206

Summary of Each Instrument for Measuring Care

CARIt'l'G PROFESSIONAL SCALE* l

DIRECTIONS: Circle the number under the words that best describe the way you
experienced your health care provider.
Yes, Mostly About Occasionally NO,Not Not
Definitely Half and at J\.ll Applicable
Half
Was the Health Care Provider that just took care of you:
1. Emotionally 1 2 3 4 5 N/A
distant?
2. Comforting? 1 2 3 4 5 N/A
3. Positive? 1 2 3 4 5 N/A
4. Abrupt? 1 2 3 4 5 N/A
5. Insulting? 1 2 .3 4 5 N/A
6. Informative? 1 2 .3 4 5 N/A
7. Clinically 1 2 3 4 5 N/A
competent?
8. Understanding? 1 2 3 4 5 N/A
9. Personal? 1 2 3 4 5 N/A
10. Caring? 2 3 4 5 N/A
II. Supportive? 2 .3 4 5 N/A
12. An attentive 2 3 4 5 N/A
listener?
13. Centered on 2 .3 4 5 N/A
you?
14. Technically 2 3 4 5 N/A
skilled?
15. Aware of 1 2 3 4 5 N/A
your
feelings?
15. Visibly 2 .3 4 5 N/A
touched by
your
experience?
17. Able to offer 1 2 3 4 5 N/A
you hope?
18. Respectful 2 .3 4 5 N/A
of you?
©Swanson, '2001. *©KristenM. Swanson. Reprinted by permission of the author.