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Developing a new questionnaire to measure nurse caring behaviours: a mixed method study

Elisa Ambrosi, Federica Canzan, Alessandra Zenere, Mario Grassi, Stefano Tardivo, Luigina Mortari, Luisa Saiani, Elisabetta Zanolin


Rationale, aims and objective: Measuring nurse caring may provide empirical evidence to assist clinicians and administrators in making decisions. The aim of the present study was to develop a new scale, called the CARE-Italy, grounded in the Italian culture, for measuring nurses’ caring behaviours.

Methods: A mixed method approach was applied in developing the instrument. The item generation and scale development were performed through a qualitative phenomenological approach and a focus group with a panel of experts. The provisional instrument was then administered to a convenience sample of 439 nurses and then questionnaire scaling and association analysis were performed. A dual scaling analysis of successive categories was performed to identify preferences on the rating scale. An item selection based on item-scale correlations and item weights was performed. Subjects’ mean scores were computed and standardized in a 100-point scale.

Results: The 20 caring behaviours perceived by nurses to be the most important ones constitute the final version of the CARE-Italy questionnaire. They concern patients’ surveillance, professional relationships with patients, satisfying patients’ and family members’ practical and psychological needs, team consultation and nurses’ emotions.

Conclusions:  A relational and paternalistic caring approach by Italian nurses seems to be suggested. The next step of the research project will be the validation process of the CARE-Italy questionnaire with a Likert scale measuring the occurrence of the 20 caring behaviours in daily practice.


Caring behaviour, caring perception, clinical relationship, dual scaling, measurement, moral imperative, nursing, patient experience, person-centered healthcare, preference data, questionnaire development

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