CARING BEHAVIOR AMONG GEN Z.

IN THE 21ST CENTURY: A NURSING

STUDENTS PERSPECTIVE

Group B30:

DIANNA S. DUMA
BAI AEESSA M. MAYASA
NOUF U. MOHAMAD
EUREKA PEARL P. PAIRAT

A Thesis presented to the Faculty of College of Health Sciences in Partial

Fulfilment of the Requirements for the Degree of
Bachelor of Science in Nursing

COLLEGE OF HEALTH SCIENCES

NOTRE DAME UNIVERSITY
COTABATO CITY
 CHAPTER I

INTRODUCTION

According to Cuevas (2008). Hospitals offer an extensive array of medical

services and employ highly competent and knowledgeable staff to ensure the provision of

top-tier healthcare. In the healthcare industry, prioritizing patient satisfaction is

paramount. Gen Z, in their increased exposure to educational technologies, is the most

recent generation of pupils to enroll in schools. Both groups are distinguished by their

willingness to embrace technology and their prowess at multitasking. (Dimock, 2019).

Amid the ongoing national emphasis on healthcare reform, it's crucial for

healthcare institutions to assess their performance and gauge patient contentment. The

concern regarding patient care results isn't limited solely to clinical healthcare practices.

Financial administrators within healthcare establishments now recognize the significance

of patient satisfaction and its influence on the organization. The integration of new

technology in patient care underscores the ongoing necessity to consistently measure both

nursing care outcomes and patient satisfaction. (Hall, 2008).

According to Sr. Delacion (2019). Notre Dame Hospital and School of

Midwifery, Cotabato City. A descriptive correlational and comparative study was

conducted to describe the relationship between the caring behavior of staff nurses in

terms of caritas processes and the level of satisfaction of patients as well as significant

difference in the levels of caring behavior of staff nurses when grouped according to age

and length of service or experience.

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 2
 The purpose of this study is to investigate and understand the caring behavior of

nursing students to the pediatric patients, adult patients and geriatric patients within the

context of their education and clinical duty. Ultimately, the findings will contribute to

enhancing nursing education, ensuring that students are better equipped to provide

compassionate and patient-centered care, thereby improving them to understand more

about caring behavior towards patients in clinical setting.

Review Related Literature

This chapter contains relevant literature and concepts providing insights and

comprehensive background to the present investigation.

Gender

Sexualization of touch is different for male and female nurses; to date, female

nurses’ touch is seen as natural and maternal (Kelly et al. 2018).

According to Yi et al., (2018) Men, with the drive to feed the family, have been

traditionally assumed to lack the competency to care for or care about others. Male nurses

often consider the learning process of caring as awkward, although these men were

primarily motivated to enter nursing because of their desire to care for others. A study on

male nurses has suggested that the number of nurses who resigned from the profession

was approximately four times as frequent as female nurses, especially during the first

four years after graduation Moreover, social stigma renders the male nurses in a

vulnerable situation when providing intimate care to women clients.

This confirms the image of nurses as feminine, subordinate, and altruistic

providers of love and care. Caring behavior stems from having special affection or

concern for the recipient. This has led to the belief that female nurses are more caring and
Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 3
therefore, they do not require support in providing caring skills. Most of the literature

focuses on male nurses’ experiences of intimate care and touch. It indicates that men and

women as initiators and recipients of care may misinterpret touch, overshadowing the

potential benefits of providing basic care and comfort. (Liu et al., 2028).

Pediatric Patients

According to Shefali (2022). End-of-Life care and experiencing death of infants,

children, and teenagers remain one of the most difficult and traumatic events for nurses

and nursing students, potentially leading to personal and professional distress. Although

efforts have been made to alleviate stressors in these settings, improvements remain slow.

Pediatric nursing students are providing care for the pediatric patients within the

context of their families. Safety is a priority when dealing with this vulnerable groups of

population. For the majority of these students, this is their first encounter with a pediatric

patient, so they had no or minimal experience in providing developmentally appropriate

care for a pediatric patient. Simulation has the potential to enhance pediatric nursing

education and safeguard the patient’s safety. (Bultas 2011).

Binary logistic regression analysis showed that female intern-nursing students

recorded significantly higher psychological distress than male counterparts in response to

the experience of pandemic-related stress. One possibility is that the master stereotypy

related to the belief that females are labeled more emotionally responsive and reacts

negatively to the unpleasant experiences than males . (Rasha 2020)

As a backup for clinical nurses, nursing students also need to receive humanistic

education and develop humanistic caring skills. In China, humanistic courses are

primarily provided in the form of lectures with very few opportunities for students to

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 4
experience real-world scenarios outside the classroom. Moreover, humanistic education

for nursing students prioritizes providing care for adults instead of addressing the needs

of patients from different age groups, such as children. Such problems in traditional

humanistic education result in unsatisfactory teaching effects. (Fang 2023)

Adult Patients

Developing caring competences is one of the most important aims of

undergraduate nursing education. Individuals who enter nursing must possess caring

behavior and continue to allow growth as they progress through the various educational

levels. Students’ reflection on caring is recommended as a key strategy in the process of

teaching and learning nursing discipline. Students’ periodic self-assessments of their

caring behaviors help them reflect on themselves to better understand the importance of

building caring relationships with the patient during clinical practice. (Ferri et al., 2020)

According to Watson et al., (2020). The longitudinal study highlighted positive

changes between junior and senior nursing students, since, after two years of training,

students were influenced by technical and professional skills as far as their perceptions of

caring. Nevertheless, these results are in contrast with the findings of another study,

implemented in one of Singapore’s largest nursing schools, which indicated a statistically

significant reduction in the overall level of caring behavior in first to final year students,

measured with CBI.16 Other studies did not highlight significant changes among the

student cohorts of different years of Nursing Course.

Geriatric Patients

A Study conducted a review of nurses' attitudes towards older people and

explored the reasons why undergraduate nursing students are not choosing gerontology as

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 5
graduate specialty. This study examined nurses’ and nursing students’ preparedness to

care for older people in lower and middle‐income countries through a scoping review and

also discussed undergraduate nursing students’ attitudes, perceptions and experiences in

aged care setting. However, as searched in databases including Cochrane Library,

PubMed, Embase, PsycINFO and CINAHL, the evidence about comprehensive review of

nursing students' willingness to work in gerontological care and of the influencing factors

is limited. As the ageing population increases, an understanding of nursing students’

desire to work in gerontological nursing and the factors influencing nursing students’

consideration of gerontological nursing work is urgently needed. This understanding can

provide guidance for educational and clinical decision‐making and help formulate

corresponding measures to encourage more students to engage in geriatric nursing care

(Yao Liu, 2021).

Nursing education and practice complement each other to improve care rendered

to patients. Student nurses receive training to take care of the sick in various practice

settings. Geriatric care is one of these settings. People worldwide are managing their

health to live longer. Globally, the population of older people is increasing daily because

of improved technology and diverse ways of sharing information defend older persons as

people 60 years and over. Additionally, the age range for defining an older adult in

Ghana is 60 years because that is the stipulated age for retirement. Nonetheless,

increasing age comes with an increased probability of various health conditions because

of the degeneration of body systems. With the increased life expectancy, the care of older

adults is prone to be a challenge in the future if steps are not taken to put solutions in

place. As stipulated by the WHO, ageism is a global issue that needs to be tackled.

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 6
Ageism, a complex phenomenon of discrimination based on age, involves both positive

and negative perceptions of older adults. The quality of care of the older adult can be

influenced by ageist attitudes held by nurses providing this care. Speaking rudely or

disrespectfully to an older adult and/or rendering fragmented care to them are examples

of ageist behaviors. Currently, care of the older adult patients in Ghana is not in separate

units like the pediatrics unit. They are seen together with the adults and youth in the

general wards. Studies have shown that nurses with specialist training are better equipped

to render care to patients. Looking at the curriculum of most nursing schools, gerontology

is usually not a stand-alone course, but students are expected to learn it in their medical-

surgical nursing classes. Hence, training or education of student nurses regarding the care

of older adults is an area that is not taught in-depth. With the rising number of geriatrics,

the issue of ageism is still under-researched in sub-Saharan Africa. In nursing, it is

important to address the issue of hostile and benevolent ageism as it is expected that

nurses will be given the requisite skills to care for all older adults (Attafuah, 2022).

In Africa, it is theorized that older adults are respected because of the culture of

society. Titles of especially the older adults are very necessary and not calling an

individual with the appropriate title is perceived as a sign of disrespect. The attitude of

student nurses towards caring for older adults needs to be examined and shaped, to meet

the ideals of culture. Studies, which showed negative attitudes of student nurses towards

the care of older adults, have been carried out in various countries while others also

documented positive attitudes. A study showed an almost 50-50 (49-44) ratio for those

with positive attitudes and those with negative attitudes. It is reported a positive attitude

among student nurses towards older adults in a study in Nigeria. They however

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 7
recommended a qualitative study to explore the perception and attitudes of these students.

It is reported that students over the years prefer to work in general adult wards and

pediatric wards at the expense of the older adults. Hostile ageism deters the care of older

adults and the desire to specialize in gerontological nursing among current and future

nurses. It is disturbing that the older adult population is growing but interest in the

attitude of health personal towards this group is not rising simultaneously. The quality of

nursing care older adults will receive is highly reliant on the training of today’s student

nurses. Student nurses have had contact with older persons and it is necessary to assess

their perception of older adults care as well as their attitude towards care of the older

adults. The authors also sought to identify any students with an interest in career

progression in the field of geriatrics (Rathnayake, et al., 2021).

Theoretical Framework

This study is anchored on Jean Watson's Philosophy and Science of Caring, she

defines humans as cannot be treated as an object and that humans cannot be separated

from self, others, nature, and the larger universe. The theory encompasses the whole of

nursing and that emphasis is placed on the interpersonal process between the caregiver

and care recipient. In particular, the theory focuses on the centrality of human caring and

on the transpersonal caring relationship, caring moment and healing consciousness which

should be the nurse's guide toward implementing caring behaviors into their own nursing

practice (Sr. Elisea L. Delacion, 2019).

According to Watson's theory, "Nursing is concerned with promoting health,

preventing illness, caring for the sick, and restoring health." It focuses on health

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 8
promotion, as well as the treatment of diseases. According to Watson, caring is central to

nursing practice, and promotes health better than a simple medical cure. The nursing

model also states that caring can be demonstrated and practiced by nurses. Caring for

patients promotes growth; a caring environment accepts a person as he or she is, and

looks to what he or she may become. She devised 10 caring needs specific curative

factors critical to the caring human experience that need to be addressed by nurses with

their patients when in a caring role.

As curative factors evolved within an expanding perspective, and as her ideas and

values evolved, Watson offered a translation of the original curative factors into clinical

caritas processes that suggested open ways in which they could be considered.

Conceptual Framework

The diagram below explains the direction of the study where the independent

variables are the Nursing Students' perspective in caring behavior which is categorized as

patient-centered care. The students demographic profile may also be a contributory

benefit to achieve the goals. Both variables may have a direct cause to the effects of

patient's wellness and rehabilitation in a clinical setting.

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 9
 INDEPENDENT VARIABLES DEPENDENT VARIABLES
Perceptions of the participants in the
caring behavior in terms of.

a) pedriactic patients; Caring Behavior among Gen Z

b) adult patient; and

c) geriatric patients;

Demographic Profile of the Participants.

a) age and

b) gender

Figure 1. The Schematic Diagram Showing the Variables of the Study

Statement of the Problem

This study aims to explore the insights of nursing students in this essential area

and quantify the perspective in caring behavior of nursing students at Notre Dame

University College of Health Sciences. Specifically, this study sought to answer the

following questions:

1. What are the demographic profile of the participants in terms of

a. age

b. gender

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 10
2. Are there differences in the perceptions of the participants in the caring behavior

in terms.

a. pediatric,

b. adult, and

c. geriatric patients

3. Are there differences in the perceptions of caring behaviors between the two genders in

nursing students?

Significance of the Study

The following can benefit from the study:

Nursing Education. This will equip student to deliver more thorough and efficient

care to variety of patient demographic to promote collaborative and integrated approach

to healthcare.

Nursing Student. This study will be able to help student nurses identify and

understand more about caring behavior given to a patient in admittance to hospital

setting.

Future Researchers. The study will provide them a tool and basis of necessary

information which will add to the background on their future research.

Scope and Limitations

This study aims to understand the Level IV Nursing Students' Perspective of Caring

Behavior toward Patient in Notre Dame Hospital during their clinical exposure.

Additionally, this study shows the relationship between the caring behaviors of nursing

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 11
students and the level of satisfaction experienced by patients with the nursing care they

received during hospital confinement.

Moreover, the study was limited to eight (8) sections of level IV nursing students in

Notre Dame University who only have clinical exposure to Notre Dame Hospital.

Therefore, the findings should have been interpreted with caution and in a quantitative

manner.

Furthermore, the study relied solely in a generalized tool of questioner. In

conclusion, the study's finding should have been interpreted within context of its scope

and delimitation.

Definition of Terms

The following variables are described as used in this study.

Caring Behavior. Refers to kindness, support, and a willingness to help or provide

comfort to those in need.

Gen Z. This refers to the nursing students that participated in the research study.

Patient. Refers to a person who needs medical support and attention.

Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 12
Caring Behavior Among Gen Z. In The 21st Century: A Nursing Student Perspective 13