Background
The cornerstone of the nursing profession is caring, and it’s far one of the traits required to offer patient care [
1]. Nursing academics have spent decades researching care theories because they are important in the nursing sector [
2,
3]. Mosby’s Medical Dictionary defines caring conduct as “Actions characteristics of concern for the well-being of a patient, inclusive of sensitivity, comforting, attentive listening, honesty, and non-judgmental acceptance” (p. 107; [
4]). Conceptually, Caring behavior has two primary additives. The instrumental behavior encompasses technical and physical activities. The second one is expressive behavior, which incorporates psychological and emotional conduct, including displaying emotional compassion to patients and instilling loyalty, optimism, and self-confidence in them. Earlier research [
5] has shown that a caring attitude is an essential predictor of high-quality nursing care and favorable results for patients and nurses. One study reported a favorable correlation between patients’ perceptions of caring attitude and self-efficacy in people with cardiac disease. Furthermore, boosting patients’ perception of nurses’ caring attitude may improve their self-efficacy and health [
6]. Additional studies revealed that the more patients perceived nurses’ caring conduct, the more satisfied they had been with their hospitalization [
7]. Further research determined that nurses were enthusiastic about developing caring relationships with the patients, which would increase their work satisfaction [
8]. Due to fast technological innovation and growing competition, hospital managers always strive to enhance the quality of care [
9]. Nurses account for most of the healthcare personnel in hospitals, and their caring conduct condierably influence on patients’ outcomes [
10]. However, previous literature indicates that neither the degree of caring behavior perceived by patients nor the nurse’s self-perceived caring conduct was increased [
5].
Psychological capital (PC) was defined as an individual’s positive psychological growth state in circumstances of positive psychology [
11], which is made up of self-efficacy, optimism, hope, and resilience four core psychological abilities [
12]. It is well-accepted that individuals’ psychological capital has a substantial impact on how an individual effectively functions at work [
13]. Furthermore, earlier research has emphasized the relevance of psychological capital and humanistic care skills among mental health practitioners in improving wellness, coping, and patient relationships [
7]. Additionally, previous research has shown that nurses with more PC perform better in their nursing roles (
14‐
15). Performance appraisal refers to the assessment of nurses ‘efficiency in the work place and extend to the achievement of institutional goals [
16].
Additionally, humanistic care ability (HCA) is critical in patient-centered care. It includes respecting patients’ humanity, recognizing their uniqueness, and preserving their dignity [
14]. Positive psychological capital is expected to influence person-centered care competency, which is a humanistic care method that reduces negative features while amplifying positive aspects [
18]. In psychiatric care, the quality of the therapeutic relationship has a major influence on patient outcomes [
19].
It is becoming increasingly vital to focus on and develop mental health workers’ humanistic care skills, as well as to include the “patient-centered” service paradigm and humanistic care in clinical settings. Addressing individual needs and backgrounds is critical to patient-centered mental healthcare [
15]. Maintaining dignity entails treating individuals with respect regardless of their mental health status. It entails respecting their choices, privacy, and secrecy. Maintaining dignity improves rehabilitation outcomes and interactions with clinicians [
17]. However, little is known on how psychological capital affects caring attitude among mental health nurses. Examining psychological capital and caring abilities might reveal the importance of positive psychological qualities in improving patient-centered care and humanistic mental healthcare practices in Saudi Arabia.
To advance our knowledge of the relationship between psychological capital and humanistic care abilities, the authors employ Watson’s theory of human caring [
20] and psychological capital theory [
21]. Watson suggests ten carative factors as a framework for organizing structure and emphasizing nursing phenomena. Instillation of faith-hope and promotion and acceptance of the expression of positive and negative feelings are the two factors. According to studies by [
22,
23], has shown that applying Watson’s theory of human caring into the practice of humanistic care may improve nurses’ self-confidence, time management, work engagement, and beneficent behaviors. The adoption of Psychological Capital (PC) theory in this study is justified by the findings of [
14], which established a positive correlation between psychological capital and humanistic care ability among nurses. This aligns with the core principles of Watson’s theory of human caring, which emphasizes the importance of psychological and emotional well-being in providing compassionate and effective care.
The study’s findings may guide nursing managers to adopt interventions aimed at increasing PC among mental health nurses in Saudi Arabia to promote high-quality, ethical, and humanistic treatment. Assessing caring abilities using a validated test can also provide a baseline for existing care behaviors. Overall, the study has the potential to significantly improve mental health nurses’ care capacity, quality of care, and patient outcomes. Our study aims to investigate the association between PC and humanistic care ability (HCA) among mental health nurses in Saudi Arabia.
Research Hypothesis
There is a positive correlation between psychological capital and humanistic care ability among mental health nurses.
Methods
Study design and setting
A descriptive correlational research design was used in this study. The study followed the STROBE checklist, which provides guidelines for reporting cross-sectional studies. This study was conducted at a government mental health complex in Riyadh, Saudi Arabia. This is a specialized mental health medical facility that includes both mental illness and addiction related disorders clinics that provide free treatment services, in addition to preventive and rehabilitative programs. More than 600,000 different services (e.g., treatment, rehabilitative, preventive) for more than 100,000 patients were provided by the complex during year 2023.
Study population
The G*Power software version 3.1.9 was operated to estimate the required number of respondents [
24], with a power of 0.95%. Using the formula for sample size calculation:
$${\text{n}}\, = \,\frac{{{z^2}*p*\left( {1 - p} \right)/{e^2}}}{{1 + \,\frac{{{z^2}*p*\left( {1 - p} \right)}}{{{e^2}*N}}}}$$
where p the estimated proportion in population = 0.5, N population size = 1000, e margin of error = 3.1% (0.031), and z is the standard normal value with confidence level 95% = 1.96.
Mental health nurses who work in the targeted mental health facility and provided their consent to participate were considered for recruitement. However, nurses with other specialties, those who were unwilling to participate, and/or nurses who were away due to illness or personal leave, and interns were omitted from the study. A total of 500 licensed mental nurses who voluntarilty agreed to participate were included in the study resulting in a response rate of 100%.
Instruments
1)
Socio-demographic information that includes age, gender, marital status, educational level, level of experience, and professional title. Additional question was included to this section that was about practice environmental satisfaction.
2)
Psychological capital questionnaire [PCQ] [
25,
26], is a 24-item questionnaire designed to evaluate the PsyCap aspects. The PCQ has four dimensions: optimism, resiliency, hope, and efficacy. They take about 10–15 min to complete. The overall score was between 24 and 144. Scores between 6 and 11 indicate a very low level on this subscale; between 12 and 17 indicate an allowable level; between 18 and 23 indicate a moderate level; between 24 and 29 indicate a high level; and between 30 and 36 indicate a very high level. Higher scores are correlated with greater psychological capital. Our investigation found that the scale has a Cronbach’s α coefficient of 0.94, indicating higher internal consistency.
3)
The Caring Ability Inventory (CAI), developed by Nkongho [
27], was used to evaluate humanistic care abilities and includes 37 items measuring three dimensions (cognition, courage, and patience). Items are scored using a 7-point Likert scale, with higher scores indicating more caring qualities. This scale has been utilized in numerous academic and therapeutic settings [
27,
28]. The total score ranges from 37 to 259. The higher the CAI score, the greater the degree of humanistic care abilities [
29]. Scores below 203.1 indicate a low level, 203.1-220.3 scores indicate a medium level, and scores above 220.3 indicate a high level of caring abilities [
30]. The tool showed good internal consistency with Cronbach’s α of 0.96 for this study.
Data collection
The current study utilized an online methods for data collection, research instruments were transformed into an online format a survey platform (Google Forms), Following formal approval from relevant authorities, email invitations containing the survey link were sent to participants. Data collection done from June 2023 to September 2023. After the collection completion period, the responses were donloaded and analyzed statistically.
Data analysis
The acquired data was processed, tabulated, and statistically analyzed using the Statistical Package for Social Sciences (SPSS V23.0). The independent samples t-test was employed to assess the disparities between mean scores of the research variables. The relation between two continuous variables was evaluated using the Pearson correlation coefficient test. Finally, the researcher developed a simple linear regression model to estimate the effect of psychological capital on CAI [
31].
Ethical considerations
This study received ethical approval from the institutional review board of Shaqra University with reference number ERC_SU_S_202300049. Informed consent was obtained from all study participants who agreed to participate before proceeding to the survey. A web-based survey created with Google Forms was used to collect data. Mandatory completion of all questions was enforced to avoid missing data. Participants were not able to submit multiple responses from the same account. All the data collected from the participants was kept anonymous and confidential to protect their privacy.
Discussion
The present study aimed to examine the relationship between psychological capital and humanistic care abilities among mental health nurses.
According to current study results, most of the participants were female, married, had an bacholar degree and more than two third had six years of experience or above and were a senior nurses. These results are consistent with a study done by [
32] who found that, most participants were female, married, and had an undergraduate degree or above, and contradicting with our study results diploma nurses accounted for more than half.
The results showed that, more than one third of the respondents have high level of psychological capital, while the highest PCQ sudimention score was regarding self efficacy and hope. In the same vein [
33,
34], reported that, most of the participants have high level of total PC and its subdimention. Also, Our findings indicate that over two-thirds of the respondents have very high level of humanistic care abilities, which is inconsistent with previous studies by [
2,
14,
35] who reported low level of humanistic care ability among participants.
Moreover, there is a positive correlation between PC, age categories, educational level and professional title among respondents. In the same vein [
14], reported that significant differences in psychological capital scores across professional titles, marital status, department and years of work. Additionally, there is a positive correlation between HCA, age groups and years of experience among respondents. Consistent with [
14] stated that, nurses with more professional experience had higher humanistic care abilities. In contrast [
36] reported that, none of the social-demographic variables in his study predicted the humanistic care ability of mental health workers.
There is a positive correlation between psychological capital and humanistic care abilities among mental health nurses. This finding compatible with [
14] who reported that, psychological capital was positively correlated with humanistic care ability, a high level of psychological capital enhances an individuals’ active engagement in work [
37]. Previous study [
33] notes that psychological capital is positively correlated with humanistic care ability and its two dimensions (cognition and patience). Additionally [
17] stated that psychological capital was positively associated with humanistic care abilities among mental health workers.
Regarding the effect of psychological capital on humanistic care abilities, the current study results revealed that psychological capital significantly predicted CA, the mean score of psychological capital significantly affects the mean score of CA, when the mean score of psychological capital increases, the mean score of CAI will increase. These results may be due to Nurses with more psychological capital having more enthusiastic in caring for patients. This result was supported by [
14,
35] who confirmed that psychological capital improved nurses’ ability to provide humanistic care.
Limitations of the study
The study will ignificantly improve mental health nurses’ care capacity, quality of care, and patient outcomes. However, our study still cannot confirm cause and effect relationships, the finding may lack generalizability as the study was conducted within a single setting. To address these limitations, future research could adopt a longitudinal design and replicating the study across diverse settings and national studies to enhance results generalizability was recommended.
Implications for nursing practice
The study findings reinforce the need to establish and strengthen the psychological capital. In work circumstances, particular interventions might be considered to promote psychological capital and its subdimentions, and therefore contribute to effectiveness of instilling positive resources in their patients and encourage the formation of a positive representation of their work and positive thoughts about their professional advancement. We propose that nursing managers can improve the mental health nurses’ humanistic care abilities by instilling their self-confidence in their workability and developing positive interactions with patients [
38].
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