Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Cynthia D. Connelly, PhD, RN, FAAN; Ruth A. Bush, PhD


Acute Care setting, nurse-patient relationship, nursing, patient care technology, perception


Background: Technological devices are increasingly used in healthcare and their proliferation has providers questioning the impact on the patient-provider relationship. Technological device integration has been studied in the primary care setting, less extensively in the acute care setting. The impact of device use on the nurse-patient relationship in acute care setting required further study, particularly with nursing's history of holistic practice incorporating caring and presence. Objectives: The study purpose was to explore the patient's perceptions of nurse caring and presence when technological devices were used in care delivery in the acute care setting. Specific aims were: 1) to describe the levels of nurse technological competency as caring and patient perceptions of caring and nurse presence, 2) to examine the relationships between patient and nurse demographics and levels of nurse technological competency as caring and patient perceptions of caring and nurse presence, and 3) to explore qualitatively the perceptions of the nurse and patient of technological device use in care delivery. Methods: A mixed methods, descriptive, concurrent embedded design with convenience sampling was conducted in early 2014 with 112 nurse and 115 patient participants. Study measures included the Technological Competency as Caring in Nursing Instrument, the Caring Behaviors Inventory-24, and the Presence of Nursing Scale. Qualitative data was derived from semi-structured interviews with a smaller subset of participants. The setting was a community adult acute care hospital in the southwestern United States. Descriptive and inferential statistics were conducted using SPSS version 22. Results: Nurses rated their technological competency as caring high, with a mean score of 82.71. Demographically, Asians reported a significantly higher mean score (M = 86.04) than other races. Patients rated overall nurse caring behaviors high (M = 5.44) with the positive connectedness subscale having the lowest mean score (M = 5.16). Gender and pain significantly influenced patient caring scores -- males rated overall caring, assurance of human presence, and positive connectedness higher than females. Positive connectedness was inversely related to pain occurrence. Patients rated nurse presence high (M = 115.82); age was positively correlated and significantly predicted presence scores. Qualitative themes included safety, learning and balance. Conclusions: This study examined ratings of nurse technological competency as caring, patient perceptions of caring and nurse presence in the context of an increasingly pervasive high technology environment. Safety, learning, and balance were themes which emerged when providers and patients reflected on how technology and device use was operationalized during care delivery.

Document Type

Dissertation: Open Access



Included in

Nursing Commons