A theoretical framework of caring in the Chinese context: a grounded theory study

Aim. This paper is a report of a study describing the components of nurse caring in the Chinese cultural context. Background. The expressions, dimensions and patterns of caring vary in different cultures. Caring is deeply embedded in the Chinese culture and nurses are told to care for patients as if they were related by blood. However, to put caring in a professional and practical context, it must extend meaning with a deeper philosophical inspiration that is transcendent and described to guide nursing practices. Methods. A grounded theory research design and the Delphi method were adopted. First, a total of 16 individual non-structured interviews were conducted with noted scholars on nursing education, clinical nursing, nursing administration, medical education and the humanities between January 2006 and June 2007. All interviews were audio recorded, transcribed and analysed using constant comparative data analysis. Secondly, 20 experts with the same inclusion criteria were recruited to conduct a two-round Delphi study to enrich and validate the theoretical framework of caring. Experts were asked to score 0 = disagree or 1 = agree for each listed item and its description in a scale. Consensus was considered when 90% or more agreement was reached. Data were collected from May 2007 to February 2009 and calculated for the agreement rates using SPSS version 11.0. Results. Four attributes of caring including attitude of caring, knowledge of caring, ability of caring and perceptions of caring were determined, along with 8 associated subcategories and 22 statements. Among them, caring attitude is central for presenting care in daily practice. Professional knowledge of nursing, the humanities and social science give the basic theoretical guidance for nurses to exhibit caring behaviour. In the education process, perceptions of giving and receiving care are the key factors for cultivating care. Conclusions. The framework could be interpreted as a list of teaching objectives and could contribute to the further development of an integrated approach for teaching care in nursing curricula. It would also be beneficial for applying and evaluating care in the practice of clinical nursing and nursing education in the Chinese culture.