Date of Award


Degree Name

Doctor of Nursing Science

Dissertation Committee

Mary P. Quayhagen DNSc, RN, Chairperson; Mary Ann Hautman, PhD, RN; Marsha D.M. Fowler, PhD, RN


Coping mechanism, Humanism, nursing, psychology, Stress management


Using a stress-coping theoretical framework, this path analytic study revealed personal influences and outcomes of caring by nurses from a patient's perspective. Rating the amount of humanistic caring from a specific nurse who had the greatest effect on them during their current hospital admission, this sample of 120 adult, hospitalized, medically-treated patients, between 25 to 65 years of age indicated that a moderate amount of caring tended to be beneficial. The personal factors which influenced these ratings included the desire to be kept informed, age, and pain perceptions. Younger patients, individuals who desired more cognitive control over health care, and those reporting severe pain had more positive evaluations of nurses, while those with lower self-esteem levels tended to perceive more threat and psychological distress from these interactions. Following positive caring experiences with nurses, most patients reported minimal threat, increased availability of alternative coping options, and use of coping strategies which improved their ability to cope effectively. Other personal factors, such as age, levels of self-esteem, and pain, influenced patients' outcomes following encounters with nurses. Younger patients, who tended to desire more cognitive and behavioral control over health care, reported a greater range of alternatives to deal with nurse encounters. On the other hand, low self-esteem individuals and those with severe pain used more emotion-focused coping strategies which resulted in less effective coping outcomes. Overall, caring, along with coping strategies and decreased psychological distress levels, explained over 40% of the variance of hospitalized patient perceptions of being able to cope effectively following their encounters with nurses. The study implies that future research of personal characteristics of patients may enhance our understanding of their perceptions of caring by nurses, use of coping strategies, and resultant outcomes. Continued study of nursing attitudes and interpersonal competence is also warranted. In addition, increased emphasis could be placed on educational program inclusion of the unique caring role of nurses, as well as ways to improve resources and rewards for caring within the profession and health care system.

Document Type

Dissertation: Open Access



Included in

Nursing Commons