Caring Behavior of Nurses at Dr. Amando. D. Cope Memorial Hospital, Tabaco City: Its Impact on Patient Care

Caring Behavior of Nurses at Dr. Amando. D. Cope Memorial Hospital, Tabaco City: Its Impact on Patient Care

Modesto Papa Fucio, Romelet Angel B. Bayonito, Jean Fernandez Delos Santos, Raquel Abrera Lau

Camarines Sur Polythecnic Colleges, Camarines Sur, Philippines

^*Corresponding Author

DOI: https://doi.org/10.51244/IJRSI.2025.121500038P

Received: 24 February 2024; Accepted: 27 February 2025; Published: 06 April 2025

ABSTRACT

The study investigated the caring behavior of nurses in one private hospital in Tabaco City and its impact on patient care. It aimed to formulate a plan to enhance the caring behavior of nurses within the hospital. This research delves into the demographic characteristics, caring behaviors, and the determinants shaping these behaviors among nurses. The findings revealed that the workforce, primarily youthful and female, predominantly possesses Bachelor’s degrees and reports an average monthly income of approximately Php 35,000. It highlights empathetic and emotionally supportive caring actions that significantly bolster patient care quality. It points out that intrinsic—like personal commitment, effective communication, and resilience—and extrinsic factors, including staffing ratios and institutional practices, are pivotal in shaping these caring behaviors. The demographic details of nurses, except for work experience and salary, do not significantly affect their natural caring tendencies. However, these factors should not be considered unimportant. To nurture and improve these crucial caring behaviors, the study suggests implementing mentorship programs, providing ongoing professional education, teaching effective stress management techniques, and regularly evaluating staff workloads and the number of staff. The hospital should promote a culture of compassionate care through strategic measures to significantly increase patient satisfaction and outcomes.

Keywords: Caring Behavior; Patient Care; Nursing Practice; Healthcare Quality

INTRODUCTION

In contemporary healthcare settings, the significance of caring behavior in nursing practice cannot be overstated. Rooted in the core values of empathy, compassion, and professionalism, the essence of nursing lies in the genuine care and support nurses provide to their patients. Over the years, the concept of caring behavior has evolved, influenced by changing healthcare landscapes, advancements in technology, and shifting patient needs and expectations. As such, understanding the trajectory of caring behavior in nursing practice in the present time is imperative for optimizing patient outcomes and fostering a supportive healthcare environment.

In the landscape of modern healthcare, the role of nursing extends far beyond the traditional realms of medical assistance. Nurses are often considered the cornerstone of patient care, providing not only clinical support but also emotional and psychological comfort to individuals during times of vulnerability. Central to the concept of nursing is the notion of caring behavior – a fundamental aspect that encompasses empathy, compassion, and attentiveness toward patients’ needs.

Nursing involves independent and collaborative care for people of all ages, whether individuals, families, groups, or communities, and regardless of their health status, across all environments. This field encompasses health promotion, illness prevention, as well as the care of the sick, disabled, and those nearing the end of life. Nurses play a climactic role in healthcare, often as unsung champions in medical facilities and emergencies. They are frequently the first to identify health crises. They are crucial in the frontline efforts of disease prevention and the provision of comprehensive primary healthcare, which includes health promotion, prevention, treatment, and rehabilitation (World Health Organization, 2022).

Caring behavior lies at the core of nursing practice, influencing patient outcomes, satisfaction, and overall quality of care. Nurses who actively engage in caring behaviors not only attend to patients’ physical needs but also address their emotional and psychological well-being (Watson, 2008). This holistic approach is pivotal in enhancing patient experiences and facilitating healing processes.

As stipulated in RA 9173 or The Philippine Nursing Act of 1991 (2002), nurses have the obligation to provide nursing services to individuals, families, and communities across various healthcare settings. This encompasses a broad range of nursing care, including but not limited to care during conception, labor, delivery, and all stages of life from infancy through old age. As independent practitioners, nurses take on a pivotal role in health promotion and disease prevention. Furthermore, as essential healthcare team members, nurses work in conjunction with other healthcare professionals to deliver comprehensive care. This includes curative, preventive, and rehabilitative services, aiding in health restoration, easing suffering, and when recovery is not possible, towards a peaceful death.

This study aimed to critically examine the nuances of caring behavior exhibited by nurses within the timeframe of the present day. It also delved into the intricacies of nursing care within the confines of one private hospital in Tabaco City exploring the multifaceted dimensions of caring behavior exhibited by its nursing staff and its profound impact on patient well-being. With an ever-evolving healthcare landscape characterized by technological advancements and administrative pressures, the essence of human-centered care often risks being overshadowed. By shedding light on the nuances of caring behavior, this research endeavors to not only unravel the intricacies of nursing practice but also advocate for a patient-centric approach that transcends mere clinical intervention.

Furthermore, this study endeavors to identify the factors influencing the expression of caring behavior among nurses, including organizational culture, educational preparation, and personal attribute by investigating the caring behavior of nurses in one private hospital in Tabaco City and its impact on patient care which aimed to formulate a plan to enhance the caring behavior of nurses within the hospital. Specifically, it aimed to achieve the following objectives: (1) Determine the profile of the respondents in terms of age, sex, educational attainment, length of work experience and monthly income; (2) Identify the caring behavior of nurses in one private hospital in Tabaco City in terms of Empathy and Emotional Support, Communication and Information Sharing, Respect for Patient Dignity and Autonomy,  Physical Care and Comfort, Patient Advocacy, Empowerment and Education & Continuity of Care and Follow-up; (3) Evaluate the factors affecting the caring behavior of nurses in one private hospital in Tabaco City, along with (a) Intrinsic factors such as Empathy and Compassion, Personal Values and Beliefs, Communication Skills, Self-Efficacy & Resilience and Coping Mechanism, & (b) Extrinsic Factors such as Work Environment, Staffing Levels and Workload , Organizational Policies and Practices & Interdisciplinary Collaboration; (4) Explore the impact of the caring behavior of nurses in one private hospital in Tabaco City on patient care; (5) Test the significant relationship between the profile of the respondents and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City; (6) Test the significant relationship between caring behavior and the factors affecting the caring behavior of nurses in one private hospital in Tabaco City; (7) Formulate a plan that can be proposed to enhance the caring behavior of nurses in one private hospital in Tabaco City.

METHODOLOGY

The researcher utilized the descriptive and correlational research design to determine the caring behavior of nurses in one private hospital in Tabaco City and its impact on patient care.  Descriptive research evaluates a phenomenon as it exists, and it does not attempt to artificially manipulate any condition (Aggarwal & Ranganathan, 2019). Its appropriateness for the study’s focus on collecting data, organizing the collected data, interpreting the significance of what is described, and analyzing the study’s outcomes. In contrast, the correlational design identifies the connections between independent and dependent variables after an action or event has taken place. Moreover, the correlational research design was used in determining the significant relationship between the profile of the respondents and the internal factors affecting the caring behavior of nurses in one private hospital in Tabaco City and in testing the significant relationship between caring behavior and the factors affecting the caring behavior of nurses in one private hospital in Tabaco City.

The study adopted a total enumeration method, also known as universal sampling, to identify the number of respondents. This approach involved including all nursing personnel, both staff nurses and head nurses, at Dr. Amando Cope Hospital in Tabaco City, resulting in a total of 82 respondents for the study.

The researcher used a questionnaire as the primary tool for collecting the data required for the research. It was a self-made survey questionnaire for the qualitative data, supplemented by informal interviews which determined the caring behavior of nurses in one private hospital in Tabaco City and its impact on patient care. The questionnaire was reviewed to ensure it accurately assessed the intended parameters. Throughout the validation process, five hospital staff members were asked to evaluate the questionnaire, its indicators, and its relevance to the study topic. Based on the feedback received from these participants, the researcher revised the questionnaire before the dry run.

The researcher made a set of questionnaires distributed among the nurses in Dr Amando Cope Hospital in Tabaco City. In the set of questionnaires, it is composed of four (4) parts. The first part determined the profile of the respondents; the second part identified the caring behavior of nurses in one private hospital in Tabaco City; the third part evaluated the factors affecting the caring behavior of nurses in one private hospital in Tabaco City; and the fourth part explored the impact of the caring behavior of nurses in one private hospital in Tabaco City on patient care.

A Permit to distribute the questionnaire was secured from the hospital administrator and was approved. The researcher personally handed out the questionnaires to the respondents. After a brief introduction, a short explanation of the study was done by the researcher. The accomplished questionnaires were 100 percent retrieved by the researcher with the help of some staff.

The collected data on the caring behavior of nurses caring behavior of nurses in one private hospital in Tabaco City and its impact on patient care was presented in a quantitative format, utilizing the percentage technique, weighted mean, and chi-square test of independence, and Pearson correlation coefficient.

RESULTS AND DISCUSSIONS

Profile of the Respondents

Table 1 shows the age distribution of 82 nurses at a private hospital in Tabaco City: 43.9% under 25, 36.6% between 25-34, 15.9% between 35-44, and 3.7% between 45-54 years old. This indicates a predominantly young workforce, with 80.5% under 34, highlighting the blend of fresh perspectives and varying levels of experience within the nursing staff.

Table 1: Distribution of Respondents in Terms of Age

Indicator	Frequency	Percentage	Rank
Under 25 years old	36	43.9	1
25 – 34 years old	30	36.6	2
35 – 44 years old	13	15.9	3
45 – 54 years old	3	3.7	4
Total	82	100

The age distribution highlights the need for strategies to enhance nurse retention and job satisfaction, considering the younger workforce’s disposition for job transitions. Implementing mentorship and leadership development programs, utilizing the expertise of more seasoned nurses, can support the professional growth of younger staff. The age distribution of nurses at a private hospital indicates a predominantly young workforce, emphasizing the need for targeted strategies for nurse retention and satisfaction. Such strategies include mentorship and leadership programs, leveraging the experience of older nurses to foster professional growth among younger staff members. (Arsat et al., 2022; Hegazy et al., 2021; Kohnen et al., 2024)

It is also evident that 69.51% (57) of nurses were female, and 30.49% (25) were male, highlighting the typical gender imbalance in nursing globally. While the profession has been traditionally female dominated, there’s a growing emphasis on enhancing gender diversity and inclusivity. Effective strategies to attract and retain male nurses are important for creating a balanced and diverse workforce, ensuring everyone is valued and respected (Morris, 2022). Understanding the gender composition of nurses is vital for effective workforce planning and management. It helps identify disparities in representation and career progression, necessitating policies and initiatives tailored to the needs of both male and female nurses. Fostering an inclusive environment that promotes equal opportunities in leadership and professional growth is key to leveraging the full potential of the nursing staff improving job satisfaction and retention. Moreover, gender diversity in nursing enhances patient care, as nurses of different genders offer varied perspectives and experiences, leading to more personalized and culturally sensitive care. Encouraging cross-cultural competency and communication among nurses can significantly improve patient outcomes and satisfaction. (Červený et al., 2022; Flaubert et al., 2021c; Henshall et al., 2022)

Table 2 shows the educational attainment of nurses at a private hospital in Tabaco City: 91.5% hold a bachelor’s degree, 6.1% have MAN Units, and 2.4% possess a master’s degree. This highlights a predominantly well-educated nursing staff equipped to provide high-quality patient care. The mix of educational backgrounds, from bachelor’s degrees to advanced qualifications, reflects a diverse skill set within the team. The diversity in educational qualifications among nurses suggests opportunities for career progression, specialization, and leadership within the field.

Table 2. Distribution of Respondents in terms of educational attainment

Indicator	Frequency	Percentage	Rank
Bachelor’s Degree	75	9105	1
BSN with Master’s Degree Unit	5	6.1	2
Master’s Degree	2	2.4	3
Total	82	100

It underscores the importance of supporting professional development through resources like continuing education and mentorship programs. Nurses with advanced education are ideally suited to lead in evidence-based practice, research, and quality improvement efforts. Promoting their involvement in scholarly activities encourages innovation and lifelong learning, benefiting patients and healthcare organizations alike (Mlambo et al., 2021).

Table 3 shows the work experience of 82 nurses in a private hospital in Tabaco City: 41.5% have 1-5 years of experience, 40.2% have less than one year, 11% have 6-10 years, and a small number have over 11 years. This indicates a workforce with a wide range of experience levels. The prevalence of nurses in the early stages of their careers indicates a need for structured support, mentorship, and opportunities for skill enhancement to foster their professional growth and confidence (Zhang et al., 2022).

Table 3. Distribution of Respondents in terms of Length of Work Experience

Indicator	Frequency	Percentage	Rank
Less than 1 year	33	40.2	2
1 – 5 years	34	41.5	1
6 – 10 years	9	11.0	3
11 – 12 years	3	3.7	4.5
13 years and above	3	3.7	4.5
Total	82	100

Conversely, the presence of highly experienced nurses offers an invaluable resource for mentorship, leadership, and ensuring the continuity of high-quality care. Leveraging the strengths and addressing the needs of both groups through targeted initiatives can significantly benefit not only the nurses but also the patients and the healthcare system as a whole.

The salary data for 82 nurse respondents in a private hospital in Tabaco City reveals that 97.6% earn below Php 35,000 monthly, while a small portion, 2.4%, receives Php 36,000 to Php 40,000. This indicates most nurses face financial challenges with the current pay scale, potentially affecting job satisfaction and retention. Improving compensation is crucial for attracting and retaining qualified nurses. Addressing compensation disparities and offering pathways for professional growth and salary progression can boost morale and engagement among nurses. By understanding salary distribution, healthcare leaders can better plan resources and budgets to ensure fair compensation, vital for retaining a skilled and motivated nursing workforce. (Bimpong et al., 2020; Flaubert et al., 2021b)

Caring Behavior of Nurses in One Private Hospital in Tabaco City

Table 4 portrays the caring behavior of nurses in a private hospital in Tabaco City regarding empathy and emotional support, communication and information sharing, respect for patient dignity and autonomy, physical care and comfort, patient advocacy, empowerment and education, and continuity of care and follow-up.

Table 4. Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	Frequency	Percentage	Rank
1. Empathy and Emotional Support	75	91.5	1
2. Communication and Information Sharing	73	89.0	3.5
3. Respect for Patient Dignity and Autonomy	73	89.0	3.5
4. Physical Care and Comfort	71	86.6	6
5. Patient Advocacy	73	89.0	3.5
6. Empowerment and Education	70	85.4	7
7. Continuity of Care and Follow-up	73	89.0	3.5

The data indicates that 91.5% of respondents value empathy and emotional support. Recognizing and prioritizing the need for empathy and emotional support can guide interventions, policies, and training programs to enhance these skills among professionals and individuals, ultimately contributing to healthier and more supportive communities (McNulty & Politis, 2023).

Meanwhile, 89% of respondents recognize the importance of communication and information sharing, respect for patient dignity and autonomy, patient advocacy, and continuity of care and follow-up. Effective communication in nursing practice is key to comprehending and meeting patients’ needs, leading to more personal and patient-centered care (Webb, 2011/2020). Implementing patient-centered approaches enhances autonomy, dignity, and satisfaction, contributing to better health outcomes and adherence to treatment plans (Stephen Ekpenyong et al., 2021). Advocacy and continuity in care further improve satisfaction trust in healthcare, and reduce errors and readmissions (Nsiah et al., 2019; Chen & Cheng, 2023).

86.6% of individuals prioritize physical care and comfort. This is important for healthcare providers, caregivers, and policymakers, highlighting the need to prioritize interventions and policies that guarantee access to quality healthcare services, proper pain management, and compassionate physical care. Recognizing and addressing physical discomfort and needs helps relieve symptoms and promotes dignity, respect, and holistic care. (Ernstmeyer & Christman, 2022)

86.6% of individuals prioritize physical care and comfort, which is important for healthcare providers, caregivers, and policymakers. This highlights the need to prioritize interventions and policies that ensure access to quality healthcare services, proper pain management, and compassionate physical care (Ernstmeyer & Christman, 2022). Addressing physical discomfort and needs helps to relieve symptoms and promotes dignity, respect, and holistic care. At the same time, 85.4% of respondents recognize the importance of empowerment and education. Education and empowerment can impact individuals’ lives, enabling them to make informed decisions, pursue opportunities, and advocate for themselves and others (Flaubert et al., 2021a).

Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City Intrinsic Factors

The following intrinsic factors influence nurses’ caring behavior at a private hospital in Tabaco City, encompassing empathy and compassion, personal values and beliefs, communication skills, self-efficacy, resilience, and coping mechanisms.

Table 5 highlights how empathy and compassion, key intrinsic factors, influence nurses’ caring behaviors in a Tabaco City private hospital. Empathy, enabling nurses to share and understand patients’ feelings, altruism, and selfless concern for others is crucial for fostering compassionate care. These traits help nurses respond to patients’ needs effectively, especially in difficult situations.

Compassion, reflecting deep sympathy for others’ suffering, significantly influences caring behavior, leading individuals to offer comfort and support and building trust and connection. A genuine desire to positively impact others’ lives is crucial, driving individuals to provide compassionate care despite obstacles. The data highlights healthcare professionals’ strong abilities in empathizing and showing genuine concern for patients, with high scores in communicating empathy and genuine care, suggesting their proficiency in expressing and acting compassionately towards their patients.

Table 5. Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Empathy and Compassion

Indicator	Weighted Mean	Verbal Interpretation	Rank
Ability to understand patient’s feelings	3.59	Highly Affect	3
Demonstration of emphatic responses	3.43	Affect	5
Ability to put oneself in the patient’s shoes	3.54	Highly Affect	4
Display of genuine concern for patient’s well-being	3.60	Highly Affect	1.5
Effective communication of empathy	3.60	Highly Affect	1.5
Average Weighted Mean	3.55	Highly Affect

The respondents highly valued understanding and empathizing with patients, showing an ability to view situations from the patient’s perspective and providing empathic responses. This embodies a comprehensive approach to empathy, crucial for building trust and rapport and can greatly improve patient satisfaction and treatment adherence. Demonstrating genuine concern enhances patients’ sense of support and can positively affect their healing process.

Table 6 presents the factors that influencing nurses’ caring behaviors at a private hospital in Tabaco City, focusing specifically on Personal Values and Beliefs. The information highlights significant ratings in different areas connected to personal values and beliefs in healthcare settings. The findings reveal that respect for disability and a strong commitment to professional integrity received the highest scores. This indicates a marked focus on affording individuals with disabilities the dignity and equality they deserve, alongside a firm commitment to maintaining ethical practices and moral values in healthcare.

Ethical decision-making is highly valued among healthcare professionals, indicating a strong commitment to moral integrity in their practice. The emphasis on consistency and adhering to professional standards highlights the importance of reliability and following established protocols. These findings suggest that personal values significantly influence healthcare professionals’ behavior and decisions, with a strong ethical foundation and compassion being key to developing meaningful patient relationships.

Table 6. Intrinsic Factors Affecting the Caring Behavior of Nurses at Dr. Amando D. Cope Memorial Hospital, Tabaco City in Terms of Personal Values and Beliefs

Indicator	Weighted Mean	Verbal Interpretation	Rank
Alignment with ethical principles	3.49	Affect	7
Consistency in practice	3.51	Highly Affect	6
Respect for disability	3.67	Highly Affect	1
Commitment to Professional Integrity	3.66	Highly Affect	2
Empathy and Compassion in Practice	3.6	Highly Affect	4
Adherence to Professional Standards	3.56	Highly Affect	5
Ethical Decision Making	3.62	Highly Affect	3
Average Weighted Mean	3.59	Highly Affect

Table 7 highlights the importance of adaptability in communication skills among nurses at a private hospital in Tabaco City, suggesting they effectively adjust their communication style to meet varied patient needs and situations, which fosters better understanding and rapport.

Table 7. Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Communication Skills

Indicator	Weighted Mean	Verbal Interpretation	Rank
Verbal Clarity	3.51	Highly Affect	5
Non-verbal Communication	3.05	Affect	6
Empathy and Emotional Intelligence	3.59	Highly Affect	4
Clarity of Written Communication	3.59	Highly Affect	3
Adaptability in Communication	3.6	Highly Affect	1
Assertiveness	3.59	Highly Affect	2
Average Weighted Mean	3.49	Highly Affect

Assertiveness is highly valued in healthcare, second only to adaptability. It enables providers to communicate needs and opinions confidently while being respectful. Empathy and emotional intelligence are also crucial, indicating a priority for responding sensitively to patients’ emotions, which helps build trust. Meanwhile, non-verbal communication has moderate importance, suggesting potential for improvement. Non-verbal cues like body language impact patient views and outcomes significantly.

Table 8 highlights that Tabaco City private hospital nurses exhibit strong self-efficacy, particularly in decision-making confidence. This suggests they believe in their ability to make effective clinical decisions, which is crucial for delivering timely and appropriate care.

Table 8. Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Self-Efficacy

Indicator	Weighted Mean	Verbal Interpretation	Rank
Confidence in decision-making	3.61	Highly Affect	1
Problem-Solving Abilities	3.55	Highly Affect	4
Resilience in Challenging Situations	3.54	Highly Affect	5
Adaptability to Change	3.56	Highly affect	3
Initiative and Proactivity	3.59	Highly Affect	2
Self-Recognition and Time Management	3.52	Highly Affect	6
Average Weighted Mean	3.56	Highly Affect

The initiative, adaptability, and problem-solving abilities are also notably strong among healthcare professionals in Tabaco City, indicating their proactive nature in addressing patient needs and navigating healthcare changes effectively. Their resilience in challenging situations further underscores their ability to maintain quality care amidst adversity, contributing to better patient outcomes and satisfaction. Healthcare professionals in Tabaco City demonstrate strong initiative, adaptability, and problem-solving skills, showcasing their proactive stance in addressing patient needs and managing healthcare changes. Their resilience in adversity highlights their commitment to quality care, leading to improved patient outcomes and satisfaction.

Table 9 highlights nurses’ resilience and coping mechanisms at a private hospital in Tabaco City, emphasizing flexible thinking as their strongest attribute. This ability to adapt and innovate in the face of challenges plays a crucial role in problem-solving and supports their resilience in a demanding healthcare environment.

Flexible thinking is paramount, but a strong sense of purpose and meaning also significantly motivates healthcare professionals, emphasizing their commitment to compassionate care and positive patient outcomes. Problem-solving skills are crucial, ranking third, for effectively tackling challenges in complex healthcare environments. Meanwhile, skills in emotional regulation and self-compassion, though ranking lower, play critical roles in managing stress and preventing burnout, underscoring their importance in maintaining professionals’ emotional well-being.

Table 9. Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Resilience and Coping Mechanism

Indicator	Weighted Mean	Verbal Interpretation	Rank
Emotional Regulation	3.46	Affect	5
Social Support	3.45	Affect	6
Problem-Solving Skill	3.55	Highly Affect	3
Flexible Thinking	3.61	Highly Affect	1
Self-Compassion	3.51	Highly Affect	4
Sense of Purpose and Meaning	3.57	Highly Affect	2
Average Weighted Mean	3.53	Highly Affect

Extrinsic Factors

The following intrinsic factors influence nurses’ caring behavior at a private hospital in Tabaco City, encompassing work environment, staffing levels and workload, organizational policies and practices, and interdisciplinary collaboration. Extrinsic factors reflect the impact of external elements such as policies, resources, work culture, and societal views on healthcare. Addressing these factors is key to enhancing care delivery and supporting the well-being of both patients and nurses.

Table 10 depicts how extrinsic factors like the work environment impact nurses’ caring behavior at a private hospital in Tabaco City. It emphasizes the positive influence of team and leadership support and safety and security on nurses’ job satisfaction, well-being, and care quality.

Effective leadership enhances nursing staff morale and engagement by offering support, resources, and advocacy, creating a positive work environment. The emphasis on safety and security as a priority highlights the critical need for a safe workplace, including physical safety measures, appropriate staffing, and emergency protocols, contributing to nurse well-being and quality patient care.

Reorganization and acquisition hold the fourth spot, highlighting the profound effects of organizational shifts and mergers on nurses’ work lives. Ensuring clear dialogue, openness, and support throughout these transitions is crucial to lessen upheaval and preserve morale and job contentment.

Table 10. Extrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Work Environment

Indicator	Weighted Mean	Verbal Interpretation	Rank
Team Support	3.6	Highly Affect	1
Workload Balance	3.29	Affect	7
Leadership Support	3.56	Highly Affect	2
Safety and Security	3.55	Highly Affect	3
Professional Development opportunities	3.41	Affect	5
Workplace Culture	3.39	Affect	6
Reorganization and Acquisition	3.48	Affect	4
Average Weighted Mean	3.47	Affect

Balancing workloads, enhancing opportunities for professional advancement, and nurturing a supportive workplace atmosphere are identified as moderate concerns, signaling areas ripe for enhancement. Striking an equilibrium between the demands of the job and available resources, facilitating continuous professional development, and cultivating a positive work environment are key strategies for supporting the well-being and retention of nursing staff.

Table 11 highlights the impact of extrinsic factors like staffing levels and workload on nursing care at a private hospital in Tabaco City. Adequate staffing emerges as the top concern, underscoring its importance in ensuring safe, high-quality care and preventing nurse burnout. The role of support staff is also crucial, offering necessary assistance to nurses, enabling them to concentrate on patient care, and reducing burnout risks. Prioritizing these factors is vital for maintaining nurse well-being and enhancing patient care outcomes.

Table 11. Extrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Staffing Levels and workload

Indicator	Weighted Mean	Verbal Interpretation	Rank
Staffing Adequacy	3.41	Affect	1
Patient-to-Nurse Ratio	3.34	Affect	4
Workload Distribution	3.37	Affect	3
Overtime and Extra Shifts	2.87	Affect	6
Stress level due to Workload	3.18	Affect	5
Availability of Support Staff	3.41	Affect	2
Average Weighted Mean	3.26	Affect

Workload distribution is crucial, ranking third in importance for nursing staff. It highlights the need for a fair share of tasks to prevent nurse burnout, enhance job satisfaction, and minimize errors. Although moderate concerns about patient-to-nurse ratios and workload stress were raised, these areas suggest potential for improvement. High patient-to-nurse ratios and significant workload stress can deteriorate nurse well-being and performance, underscoring the necessity for effective workload management and stress support mechanisms.

Overtime and extra shifts are least favored, suggesting they’re seen as undesirable for solving staffing issues, potentially leading to nurse fatigue, burnout, and reduced job satisfaction. This highlights the need to tackle the root causes of staffing shortages instead of depending on these temporary measures.

Table 12 presents the impact of extrinsic factors on nurses’ caring behavior at a private hospital in Tabaco City, focusing on organizational policies and practices. It shows that support for professional development is the most valued aspect, indicating that nurses prioritize opportunities for learning, skill improvement, and career progression. Investing in professional development is not merely beneficial for the nurses but also enhances patient care and organizational efficiency.

Table 12. Extrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Organizational Policies and Practices

Indicator	Weighted Mean	Verbal Interpretation	Rank
Clarity and Accessibility of Policies	3.37	Affect	7
Fairness and Equity in Policy Distribution	3.41	Affect	5
Consistency in Policy Application	3.38	Affect	6
Transparency in Decision-making Process	3.5	Highly Affect	2
Flexibility of Policies to Adapt to Changing Needs	3.45	Affect	3
Support for Professional Development	3.51	Highly Affect	1
Alignment of Policies with Organizational Values	3.41	Affect	4
Average Weighted Mean	3.43	Affect

Transparency in decision-making is the second priority, highlighting the value of open, clear communication and accountability within organizations. This fosters trust and engages employees, contributing to a positive culture. Ranked third is policy flexibility, underlining the need for adaptive and responsive organizational policies to navigate changes and challenges effectively. Fairness and equity in policy implementation and alignment with organizational values are acknowledged as moderately important, indicating potential areas for enhancement.

Fair and equitable policies bolster morale, satisfaction, and retention by aligning with organizational values, thereby ensuring integrity in implementation. Improvement is needed where clarity and accessibility of policies are lacking, as well as in their consistent application. Making policies clear, accessible, and consistently applied is crucial to ensure employee understanding, compliance, and fairness and minimize confusion, disputes, and inequities.

Table 13 highlights how interdisciplinary collaboration influences nurses’ caring behavior at a private hospital in Tabaco City, particularly emphasizing the significance of collaborative decision-making. This suggests that combining expertise from various healthcare disciplines through teamwork is crucial for enhancing problem-solving, innovation, and patient care.

Table 13. Extrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Interdisciplinary Collaboration

Indicator	Weighted Mean	Verbal Interpretation	Rank
Communication Between Disciplines	3.45	Affect	5
Respect for Other Discipline	3.54	Highly Affect	3
Collaborative Decision-Making	3.57	Highly Affect	1
Conflict Resolution Skills	3.46	Affect	4
Inter-professional Trust	3.4	Affect	6
Resource Sharing and Allocation	3.55	Highly Affect	2
Average Weighted Mean	3.43	Affect

Resource sharing and allocation are crucial, highlighting the importance of interdisciplinary collaboration to optimize patient care. Leveraging diverse strengths and resources ensures efficient healthcare delivery. Additionally, respect for other disciplines is vital, underscoring mutual appreciation for various expertise. This respectful collaboration builds trust, enhances teamwork, and improves patient care, creating a positive workplace environment. Conflict resolution skills are crucial for fostering interdisciplinary collaboration and addressing conflicts from differing perspectives, priorities, or approaches among healthcare professionals. While communication and trust between disciplines are important, there’s room for improvement to enhance collaboration and conflict management effectively.

Impact of the Caring Behavior of Nurses in One Private Hospital in Tabaco City on Patient Care

Healthcare professionals’ caring behavior, marked by empathy, compassion, and attentiveness, significantly improves patient outcomes. It strengthens the patient-provider bond, fosters trust, and boosts care satisfaction. Table 14 details how nurses’ empathy, compassion, and attentiveness in a Tabaco City private hospital enhance patient care.

The findings show that 80.5% acknowledge the compassionate and kind treatment patients receive from nurses, underscoring the pivotal role of empathy and compassion in enhancing nursing care. Such attributes strengthen the therapeutic bond between nurses and patients, fostering trust and comfort and significantly impacting patient satisfaction and outcomes. This emphasis on kindness and compassion aligns with patient-centered care principles, addressing the comprehensive needs of patients and proving to boost both their care experience and health results. Essentially, these results highlight how crucial compassion and empathy are in elevating the quality of nursing care.

Table 14. Extrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City in Terms of Interdisciplinary Collaboration

Indicator	Frequency	Percentage	Rank
1. The nurses treat with kindness and compassion	66	80.5	3
2. The nurses showed genuine concern for my well-being	70	85.4	1
3. The nurses provided emotional support during difficult times	65	79.3	4
4. The nurses respected my dignity and privacy	69	84.1	2

The data shows that 85.4% of respondents believe nurses genuinely care for their well-being, highlighting the vital role of empathy and compassion in nursing. This sense of care strengthens the nurse-patient relationship, increases patient engagement in treatment, and improves health outcomes. Demonstrating genuine concern also aligns with core nursing values such as empathy, compassion, and a patient-centered approach.

The data demonstrates the significant role of empathy, dignity, and emotional support in enhancing patient experiences in nursing care. 84.1% of respondents acknowledged that nurses honored their dignity and privacy, underlining the critical nature of respecting patient rights and autonomy to bolster patient-centered care. This respect improves the care experience and adheres to ethical norms and professional nursing standards, emphasizing dignity, respect, and confidentiality.

Furthermore, 79.3% appreciated receiving emotional support from nurses during challenging periods, illustrating the vital aspect of nursing in attending to patients’ emotional and psychosocial needs. Emotional support aids in mitigating feelings of anxiety and isolation, promoting overall well-being and resilience. This element of care is key to the holistic approach of nursing, which integrates the physical, emotional, and psychological components of health, highlighting the indispensable qualities of empathy, compassion, and effective communication in nursing practice.

Relationship Between the Profile of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

According to chi-square test results, table 15 shows no significant link between nurses’ ages and intrinsic factors influencing their caring behavior in a Tabaco City private hospital.

Table 15. Relationship Between the Age of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	Computed X2 Value	p-value	Decision on Ho	Interpretation
Empathy and Compassion	1.87	0.931	Accepted	Not Significant
Personal Values and Beliefs	2.387	0.496	Accepted	Not Significant
Communication Skills	5.726	0.455	Accepted	Not Significant
Self-Efficacy	7.521	0.275	Accepted	Not Significant
Resilience and Coping Mechanism	3.053	0.802	Accepted	Not Significant

The high p-values obtained from both the Pearson Chi-Square and Likelihood Ratio tests suggest that any observed differences in the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City across different age groups are likely due to random variation rather than a systematic relationship between age and intrinsic factors. In other words, the distribution of intrinsic factors does not vary significantly based on age categories in this sample.

Table 16 illustrates the relationship between the sex of the respondents and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City.

The chi-square test result suggests no significant relationship between sex and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City.  This suggests that the differences observed in the data are probably attributable to random variations instead of a meaningful association between the variables.

Table 16. Relationship Between the Sex of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	ComputedX2 Value	p-value	Decision on Ho	Interpretation
Empathy and Compassion	2.356	0.308	Accepted	Not Significant
Personal Values and Beliefs	0.587	0.444	Accepted	Not Significant
Communication Skills	3.421	0.181	Accepted	Not Significant
Self-Efficacy	3.357	0.187	Accepted	Not Significant
Resilience and Coping Mechanism	3.5	0.174	Accepted	Not Significant

Table 17 presents the relationship between the educational attainment of the respondents and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City.

Table 17. Relationship Between the Educational Attainment of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	Computed X2 Value	p-value	Decision on Ho	Interpretation
Empathy and Compassion	4.792	0.309	Accepted	Not Significant
Personal Values and Beliefs	1.25	0.535	Accepted	Not Significant
Communication Skills	2.062	0.724	Accepted	Not Significant
Self-Efficacy	3.968	0.41	Accepted	Not Significant
Resilience and Coping Mechanism	1.528	0.822	Accepted	Not Significant

The results from the chi-square test show no significant link between educational attainment and intrinsic factors affecting nurses’ caring behavior in a private hospital in Tabaco City. Both the Pearson Chi-Square and the Likelihood Ratio tests yielded p-values above the 0.05 significance level, indicating that the observed differences are likely due to chance rather than a real association. Thus, while there appears to be no meaningful connection between the variables, it’s important to interpret these findings cautiously, especially because of possible issues with low expected counts.

Table 18 illustrates the relationship between the length of work experience of the respondents and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City.

Table 18. Relationship Between the Length of Work Experience of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	Computed X2 Value	p-value	Decision on Ho	Interpretation
Empathy and Compassion	2.699	0.952	Accepted	Not Significant
Personal Values and Beliefs	2.875	0.579	Accepted	Not Significant
Communication Skills	27.732	0.419	Rejected	Significant
Self-Efficacy	29.049	0.239	Rejected	Significant
Resilience and Coping Mechanism	3.721	0.881	Accepted	Not Significant

The chi-square test indicates no significant link between nurses’ work experience length and their caring behavior’s intrinsic factors at a private hospital in Tabaco City. The chi-square and Likelihood Ratio tests yielded p-values above the 0.05 threshold, suggesting the observed differences could be due to chance rather than a real connection. Thus, while it seems there’s no meaningful relationship between work experience and intrinsic factors, it’s important to interpret these findings cautiously because of possible concerns with low expected counts.

Table 19 illustrates the relationship between the monthly salary of the respondents and the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City.

Table 19. Relationship Between the Monthly Salary of the Respondents and the Intrinsic Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Indicator	Computed X2  Value	p-value	Decision on Ho	Interpretation
Empathy and Compassion	0.099	0.952	Accepted	Not Significant
Personal Values and Beliefs	1.246	0.264	Accepted	Not Significant
Communication Skills	0.175	0.916	Rejected	Significant
Self-Efficacy	0.285	0.867	Rejected	Significant
Resilience and Coping Mechanism	1.452	0.484	Accepted	Not Significant

The chi-square test results show no significant link between monthly salary and intrinsic factors, as both the Pearson Chi-Square and Likelihood Ratio tests yielded p-values above the 0.05 significance threshold. This implies the observed differences are likely due to chance rather than a real connection between monthly income and intrinsic factors impacting nurses’ caring behavior at a private hospital in Tabaco City.

Relationship Between Caring Behavior and the Factors Affecting the Caring Behavior of Nurses in One Private Hospital in Tabaco City

The correlation analysis between caring behavior assessment and factors influencing caring behavior reveals a moderately strong positive correlation (r = 0.473, p < 0.001). This suggests that there is a significant association between the caring behavior and the factors affecting the caring behavior. Specifically, individuals who score higher on the assessment of caring behavior tend to also report higher levels of factors influencing caring behavior, and vice versa.

This finding implies that certain factors contribute to the manifestation of caring behavior in individuals. Understanding and addressing these factors could be crucial for fostering and promoting caring behavior among healthcare professionals, which can ultimately enhance patient care outcomes and overall satisfaction.

Formulated Plan to Enhance the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Caring behavior lies at the heart of nursing practice, forming the cornerstone of patient-centered care and fostering positive patient outcomes. In the dynamic healthcare landscape, where patient needs are increasingly complex and diverse, nurturing a culture of caring among nurses is paramount in one private hospital in Tabaco City which recognizes the significance of enhancing caring behavior among its nursing staff to uphold excellence in patient care delivery. By prioritizing the development of caring competencies, the hospital aims to strengthen patient satisfaction, improve clinical outcomes, and bolster its reputation as a provider of compassionate healthcare services. Moreover, fostering a caring culture can enhance staff morale, job satisfaction, and retention, ultimately contributing to a more cohesive and resilient healthcare workforce. The formulated plan is illustrated in Table 20.

General Objective

The proposed plan is formulated to enhance the caring behavior of nurses in one private hospital in Tabaco City, to ensure the delivery of high-quality, patient-centered care. Through targeted interventions and supportive initiatives, the plan seeks to cultivate a culture of compassion, empathy, and respect among nursing staff, thereby enriching the healthcare experience for patients and their families. By equipping nurses with the necessary knowledge, skills, and resources to embody caring in their practice, the hospital aims to elevate the standard of care delivery, promote positive patient outcomes, and foster a nurturing environment conducive to professional growth and fulfillment. Through collaborative efforts and continuous improvement, the plan endeavors to position the one private hospital in Tabaco City as a beacon of excellence in compassionate healthcare delivery within the Tabaco City community and beyond.

Table 20. Formulated Plan to Enhance the Caring Behavior of Nurses in One Private Hospital in Tabaco City

Areas of Concern	Specific Objectives	Strategies/ Activities	Persons Involved	Expected Outcomes
1. Caring Behavior   Empowerment and Education	To implement a comprehensive empowerment and education plan aimed at enhancing the caring behavior of nurses with the goal of promoting patient-centered care, improving patient satisfaction, and fostering a culture of compassion and excellence in nursing practice.	Design and facilitate interactive workshops focused on topics such as empathy development, effective communication skills, active listening, cultural competence, and strategies for promoting patient dignity and autonomy.   Organize regular workshops focused on enhancing nurses’ understanding of caring behavior, including topics such as empathy, active listening, and patient advocacy.	HRMO   Training Coordinator   Hospital staff and personnel     Hospital Administrators	Nurses will demonstrate improved awareness and understanding of the importance of caring behavior in promoting patient-centered care.   Nurses will exhibit enhanced communication skills, including active listening, empathetic communication, and effective patient education techniques, leading to improved nurse-patient interactions and satisfaction.
2.  Factors Affecting the Caring Behavior     a. Intrinsic Factors   Personal Values and Beliefs	To develop and implement a targeted plan aimed at understanding and addressing the factors affecting caring behavior, specifically focusing on personal values and beliefs, among nurses, ultimately improving patient satisfaction and fostering a culture of empathy and excellence in nursing practice.	Facilitate values clarification workshops to help nurses reflect on and articulate their personal values and beliefs related to caring for others.   Provide opportunities for self-reflection and group discussion to explore the alignment between personal values and professional practice.	HRMO   Training Coordinator Hospital staff and personnel     Hospital Administrators	Nurses will demonstrate increased awareness of their personal values and beliefs and reflect on how these factors influence their caring behavior in nursing practice.   Nurses will show evidence of aligning their personal values and beliefs with professional nursing practice, leading to more consistent and authentic expression of caring behaviors towards patients.
b. Extrinsic Factors   Work Environment	To develop and implement strategies aimed at addressing work environment factors that influence caring behavior among nurses with the goal of fostering a supportive and conducive work environment conducive to compassionate and patient-centered care.	Conduct a comprehensive assessment of the work environment to identify factors such as workload, staffing levels, physical environment, teamwork dynamics, and organizational culture that may impact nurses’ ability to provide caring behavior.   Develop and facilitate workshops focused on workload management strategies, stress reduction techniques, and time management skills to help nurses cope with the demands of their work environment while maintaining compassionate care.	HRMO   Training Coordinator Hospital staff and personnel     Hospital Administrators	Nurses will experience reduced levels of burnout and stress as a result of interventions aimed at addressing workload and enhancing support mechanisms in the work environment. Nursing teams will demonstrate improved teamwork, communication, and collaboration, leading to a more supportive and cohesive work environment that fosters caring behavior among staff.
3.  Impact of Caring Behavior on Patient Care   The nurses showed genuine concern for my well-being	To enhance the impact of caring behavior on patient care by fostering a culture of genuine concern and empathy among nurses, ultimately improving patient outcomes and experiences.	Develop and deliver training sessions focused on cultivating genuine concern and empathy among nurses towards patients.   Organize workshops aimed at enhancing nurses’ ability to empathize with patients by helping them understand patients’ perspectives, emotions, and needs.   Introduce mindfulness and self-reflection practices to help nurses cultivate self-awareness, empathy, and compassion.   Promote patient-centered care principles throughout the hospital, emphasizing the importance of placing patients’ needs, preferences, and values at the forefront of care delivery.	HRMO   Training Coordinator Hospital staff and personnel     Hospital Administrators	Patients will report higher levels of satisfaction with the care provided by nurses, noting the genuine concern and empathy demonstrated in their interactions.   Patients will experience improved clinical outcomes and recovery rates as a result of the supportive and compassionate care provided by nurses who demonstrate genuine concern for their well-being.

CONCLUSION AND RECOMMENDATIONS

Based on the result of the study, the following conclusions are made:

1. The majority of the nurses in one private hospital in Tabaco City are females, a holder of Bachelor’s degrees, and earn a monthly salary of Php 35,000.00. On the other hand, most are under 25 years old and have 1-5 years of work experience.
2. The nurses in one private hospital demonstrate empathic caring behavior and serve as pillars of emotional support, creating a healing environment where patients feel valued, respected, and supported.
3. The caring behavior of nurses in one private hospital in Tabaco City is highly affected by intrinsic factors along with empathy and compassion, personal values and beliefs, communication skills, self-efficacy, and resilience, and coping mechanisms. On the other hand, the nurses are affected by extrinsic factors along with staffing levels and workload, and. interdisciplinary collaboration. Moreover, caring behavior is affected by extrinsic factors along with organizational policies and practices and the work environment.
4. The caring behavior has an impact on patient care specifically in showing genuine concern for the patient’s well-being, respecting the patient’s dignity and privacy, and treating them with kindness and compassion.
5. It was found that the profile of the respondents such as age, sex, and educational attainment does not have a significant correlation with the intrinsic factors affecting the caring behavior of nurses in one private hospital in Tabaco City, along with empathy and compassion, personal values and beliefs, communication skills, self-efficacy, resilience, and coping mechanisms. On the other hand, the length of work experience and monthly income significantly correlated with the intrinsic factors along with communication skills, and self-efficacy. However, they did not exhibit a significant correlation with empathy and compassion, personal values and beliefs, or resilience and coping mechanisms.
6. The caring behavior exhibited by nurses in one hospital in Tabaco City has a significant relationship with the factors affecting their caring behavior.
7. The formulated plan can be proposed to enhance the caring behavior of nurses in one private hospital in Tabaco City.

Based on the result and conclusions made, the following recommendations are given:

1. Given that the majority of nurses are under 25 with 1-5 years of experience, consider implementing mentorship programs pairing experienced nurses with newer ones to facilitate knowledge transfer and skill development. Additionally, offering opportunities for further education and training could help enhance their skills and career prospects.
2. Encourage and support initiatives that foster a positive work environment, such as regular team-building activities, stress management workshops, and forums for open communication. Recognize and reward nurses who consistently demonstrate empathic caring behavior to reinforce desired behaviors.
3. Conduct regular assessments of staffing levels and workload to ensure that nurses are not overburdened, which could impact their ability to provide quality care. Promote interdisciplinary collaboration through joint training sessions and meetings to improve communication and coordination among healthcare professionals.
4. Develop and implement policies and practices that prioritize patient-centered care, emphasizing respect for patient dignity, privacy, and autonomy. Provide ongoing training and support to nurses to enhance their communication skills and empathy, fostering a culture of compassionate care within the hospital.
5. Invest in professional development opportunities tailored to the specific needs identified, such as communication skills training and resilience-building workshops. Conduct regular assessments to monitor the impact of these interventions and make adjustments as needed to ensure their effectiveness.
6. Continuously monitor and evaluate the factors influencing nurses’ caring behavior to identify areas for improvement. Utilize feedback from nurses and patients to inform decision-making and prioritize initiatives that have the greatest impact on enhancing caring behaviors.
7. The formulated may be implemented to enhance the caring behavior of nurses in one private hospital in Tabaco City, ultimately leading to improved patient outcomes and satisfaction.

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