General aim

The general aim of this project is to apply McGaghie et al.’s (2002) inner resources for compassionate care model to better understand the processes involved in undergraduate nurses’ compassionate care, the relative importance of compassionate care in predicting professional quality of life (which includes burnout, compassion fatigue and compassion satisfaction), well-being and quality care and, according to these data, to study possible ways of intervention in Nursing Degree curricula. .

Specific aims

Specific Aim 1. Conduct validation studies of the instruments of interest to the project. Most of the measures included in this research have been widely used and validated (i.e., Short-ProQOL, SWLS, S-SCS, etc.). However, this objective is very important because there are not Spanish validation studies of all of them, neither longitudinal validations have been carried out. Additionally, gender invariance studies will be necessary. Both Classical Test Theory (including confirmatory models) and Item Response Theory will be used. 

Specific Aim 2. Test the theoretical models, based on McGaghie et al.’s (2002), that relate inner resources to compassionate care and its outcomes. As described, our model will also support (integrate) other useful theoretical models, such as the professional quality of life model of Beth Stamm, and recent evidence on the relations to well-being and quality care. The model (or particular models) that derive are complex and processual, for that reason, require complex (multivariate) statistical models and large sample sizes. Taking this into account, nursing students from two different universities (UV and UIB) will be surveyed, therefore conforming a large sample of nursing students. The longitudinal design of the project opens the possibility to test both cross-sectional models, as well as specific longitudinal models to study in detail trajectory, mediation, and moderation processes such as those already discussed in the hypotheses. This objective will be achieved in different stages. First, the bivariate relationships between the variables of interest must be studied. Then theoretical models and sub-models (depending on the different specific areas of research) will be estimated and tested. As a final step, one (or several) general models based on McGaghie et al.’s (2002) structure will be estimated and tested. Longitudinal models will also be tested. All variables describe in the literature review and hypotheses will be measured in all waves. Therefore, path or panel models will be estimated to better understand the causal effects of the variables. For example, cognitive, affective and moral resources together with awareness of self and others are key variables affecting professional quality of life where it is difficult to establish causal precedence. However, these variables will be available in our data, allowing us to delve deeper into causal effects. 

Specific Aim 3. A primary objective is to include a gender perspective to understand the different potential processes in compassionate care of men and women. Analyses and models generated under specific aim 2 will consider direct and moderating gender effects by applying, where necessary, multigroup routines. This will offer evidence in gender differences in several points, including: measurement invariance of the instruments used across genders; latent mean comparisons (in inner resources, compassion and compassionate care, professional quality of life, well-being and quality care); gender differences in predictive paths (in the relations among variables of interest); etc. 

Specific Aim 4. The project aims at study trajectories of inner resources, compassionate care and professional quality of life, well-being and quality care during the training of undergraduate nurses. This aim focuses on how the variables understudy evolve in the Degree. For example, we will obtain evidence on how training improves students’ inner resources along the Degree years. In the same line, we will offer evidence on how, through the clinical practices that the students develop, they improve their skills for compassionate care, at the same time that they start to suffer from burnout and compassion fatigue. Within this aim, evidence on how initial levels affect to change rates will also be considered. For this purpose, latent growth curve modeling will be used.

Specific Aim 5. Pilot implementation of most important outcomes. In order to further validate our research results, a brief training will be carried out in those inner resources that the theoretical models point as the better predictors of compassionate care. For this purpose, we will use one of our dissemination strategies, the Closing Sessions, to provide participants with brief workshops focused on resources such as resilience, self-efficacy, affective resources, etc., depending on outcomes of Specific Objectives 2, 3 and 4. These workshops will take place during the Closing Sessions of the project at the two participating universities (UV and UIB), in which the cohort of measured students will be invited to participate, as well as authorities from the universities and other representatives of the State Association of Nursing Students (Asociación Estatal de Estudiantes de Enfermería, AEEE), the National Conference of Nusing Deans (Conferencia Nacional de Decanos de Enfermería, CNDE) and the administration (Conselleria de Sanitat and IbSalud) to share with them the main results of the study and offer them resources to improve compassionate care, both with in situ activities (workshops) and through compilations of bibliographical references, videos, courses, podcast, etc. that may be of relevance. Workshops efficacy for inner resources improvement will be also evaluated and reported.