The cultivation of caring presence in nurses : a systematic review

Abstract

Caring presence is crucial in quality healthcare since it promotes trust, honesty and boosts esteem for both the patient and the nurse; therefore, contributing to a high level of holistic care. Prior to this study, no research synthesis was available on cultivating caring presence. Such a synthesis will be very helpful in order to develop strategies for the cultivation of caring presence and to identify gaps. The purpose of this study was to critically review available research-based literature on strategies to cultivate caring presence in nurses and, to synthesise research-based literature on how caring presence is cultivated in nurses. A systematic literature review was conducted, using an explorative and descriptive design. The five steps for a systematic review as adapted from the Academy of Nutrition and Diabetics Manual (academy of nutrition and dietetics) (2016) were followed. These steps included formulating a focused review question, gathering and classifying the evidence, conducting a critical appraisal, summarising evidence and drafting conclusions. After the execution of the first two steps, a sample of 19 studies was obtained, and was eligible for critical appraisal after which 17 studies were finally included. Studies that met the inclusion criteria were retained for data extraction, analysis and synthesis. These studies included qualitative studies (n=4), literature reviews (n=5), a meta-synthesis (n=1), case reports (n=3) and text and opinion (n=3). Five main themes, with or without sub-themes, emerged from the synthesis. The main themes included that caring presence in nursing can be cultivated through critical thinking skills and awareness, holistic care, awareness of the concept of presence and types of presence, fostering personal and professional growth and, the cultivation of caring presence through reflection. This systematic review answered the review question which is: what strategies lead to the cultivation of caring presence in nurses in order for them to enact caring presence, improve their wellbeing and, to frequently improve the wellbeing of the patients. Strategies to cultivate caring presence in nursing emerged in the form of themes, sub-themes and conclusions synthesised from the available literature. The limitation, that evidence on how these strategies cultivate presence could not be found, is acknowledged. However, valuable suggestions through which caring presence can be cultivated in the clinical settings and in nursing education could be made, as well as recommendations for nursing practice, education and research.