Quality of caring interactions between nurses and patients during the COVID-19 pandemic: A cross-sectional survey with nurses and patients in acute and community care

Aims: To describe the characteristics and quality of caring interactions between nurses and patients during the earlier phases of the COVID-19 pandemic in acute and home care settings.

Background: Nurse-patient interaction (NPI) plays an important role in effective, person-centered care delivery and has been impacted by the COVID-19 pandemic.

Methods: The survey was part of a multimethod study and used a cross-sectional design. It included both nurses and patients receiving care during the first wave of the COVID-19 pandemic (March-June 2020) at a university-affiliated tertiary care hospital and two large public home care agencies. Data were collected from July to October 2020, using the Individualized Care Scale (ICS), patient and nurse versions. The ICS is a 5-point Likert-type scale divided into two dimensions: ICS-A and ICS-B with 17 items each. The ICS-A subscale assesses patients' or nurses' perceptions of patient individuality as supported by specific nursing activities. The aim of the ICS-B subscale, conversely, is to assess perceptions of how individuality is maintained in the care either provided or received. Inferential statistics were used for comparisons between settings and populations. The study followed the STROBE checklist for cross-sectional studies.

Results: The survey was completed by 443 nurses and 295 patients. Patients' perception of "nurses support their individuality" was moderate (ICS-A 3.42, range 1-5), as was their perception of "nurses provide individual care to patients" (ICS-B 3.89, range 1-5). Nurses' own perception of supporting individuality was found to be high (ICS-A 4.30, range 1-5), as was the mean score of their actual provision of individual care (ICS-B 4.21, range 1-5), which was statistically significantly higher than the ratings of patients. Nurses working in home care rated individuality and individual care statistically significantly higher than those working in acute care.

Conclusion: The findings suggest that during the earlier phases of the pandemic, Swiss nurses perceived their support of patient individuality and individual care to be higher than their European peers had prior to the pandemic and higher than patients did. However, those engaged in the provision of care within a hospital setting perceived the level of individuality and individual care to be lower than those engaged in the provision of care within a home care setting.

Implications for nursing and health policy: It is evident that nurses' efforts and contributions to the quality of care require organizational recognition and support. Their commitment should be recognized and supported by leadership and policymakers.