Knowledge, Attitudes and Practices Levels of Clinical Nurses towards Humanistic Caring: the First Nationwide Multi-Centre Cross-Sectional Survey in China
Authors: Chang Hongwei , Xiong Danli , Hu Deying , Yu Ruiying , Liu Yanjin , Dai Dongmei , Lin Zheng , Chen Yongyi , Zhao Guanghong , Tan Rong , Wu Hongyan , Liu Yilan 
Published: August 2024

Abstract

Background
The development of humanistic care in China is being faster. However, patients' satisfaction with nurses' humanistic care is still at a moderate level. There is a lack of a nationwide multi-centre, large-sample cross-sectional survey of nurses' knowledge, attitudes and practices of humanistic care in China. It is not conducive to the identification of gaps in the development of humanistic care.
Method
A multi-centre, large-sample cross-sectional survey was conducted in July-August 2022 in 25 provinces (cities and districts) in China. Convenience sampling was used to recruit nurses who met inclusion and exclusion criteria in tertiary hospitals in these areas. The survey instruments used were a self-designed general information questionnaire and The Knowledge, Attitudes and Practices (KAP) of Clinical Nursing Staff on Humanistic Care Questionnaire designed by Chinese scholar Li Yuqin. The original scale had a content validity index of 0.980(P < 0.001), a Cronbach's α of 0.982(P < 0.001), and a retest reliability of 0.983(P < 0.001). The Cronbach's α for the scale in this study was 0.991(P < 0.001). The questionnaire was collected using Question Star, a widely used questionnaire web-based collection platform in China. In August 2022, we collected a total of 14,305 valid questionnaires, with an effective recovery rate of 99.72%. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses.
Result
The average scores of the knowledge, attitudes and practices indexes of humanistic care of the participating nurses in this study were 80.24%, 83.62% and 87.95%, respectively. There are still deficiencies in the knowledge index, especially regarding the current development of humanistic care, the essence of humanistic care, and the basic requirements for implementing humanistic care. The attitudinal aspect was about the fact that humanistic care can reduce the number of patient hospitalisation days, the starting point of nurses' care and whether nurses' humanistic care should be included in the nursing quality assessment index. In terms of influencing factors, nurses' gender, satisfaction with their work, the importance of self-care, love of nursing, family support for their work, and harmonious relationship with colleagues would have a positive impact on their knowledge, attitudes, and practices of humanistic care. Whether or not they had participated in humanistic care training, satisfaction with their salary, and their title of being an associate nurse positively influenced their knowledge and attitudes toward humanistic care competence. Whether or not they had worked on a humanistic care pilot ward and whether they had a teaching role would also have an impact on the knowledge score. In addition, nurses whose departments were operating theatres and ICUs had poorer caring behaviours.
Conclusion
Chinese clinical nurses have a medium level of knowledge and attitude towards humanistic caring and good behavioural performance. Nurses' humanistic care training needs to be strengthened, and the content can focus on the development status, nature, role, and basic requirements of humanistic care. Hospitals should encourage nurses to actively participate in humanistic care training, and at the same time permeate humanistic care in management to enhance the caring atmosphere in the organisational environment.