Comparative Assessment of Nurse Caring Behaviours and Patient Satisfaction between Chronic and Acute Patients following Surgical Treatment

Zhangrou Rao

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China.

Hui Shi *

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China.

Jing Hu

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China.

Lanping Hu

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China.

Manjuan Xu

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China.

Regis Ernest Mendame Ehya

Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan-430071, Hubei, P. R., China and Gabonese Scientific Research Consortium B.P 5707, Libreville, Gabon.

Guy-Armel Bounda

Gabonese Scientific Research Consortium B.P 5707, Libreville, Gabon and Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China. Pharmaceutical University, 639# Longmian Avenue, Nanjing-211198, Jiangsu, P. R. China.

*Author to whom correspondence should be addressed.


Background: Patients suffering from chronic disease tend to have a quality of life significantly different from patients surgically treated due to post-traumatic injuries. Thus, both groups might perceive nurse caring behaviours and patient satisfaction differently, valuing distinct technical and quality features of their hospital care.

Objective: The present study aimed to assess nurse caring behaviours perceived by two distinct groups of patients followed post-traumatic surgeries, and its correlation to patient satisfaction.

Methods: Clinical data of patients admitted in orthopaedics trauma and microsurgery’s department between January 2022 and February 2023, and treated for diabetic foot ulcer or traumatic injury of foot and/or ankle, due to traffic accident and crush injury, were analysed. The study enrolled 50 patients, and 25 patients were controlled randomized in each group (diabetic foot ulcer cohort vs trauma cohort). Nurse caring behaviours inventory-24 (CBI-24), patient satisfaction index (PSI), Numeric rating scale for pain, and hospital length of stay were recorded, analysed and compared between both groups.

Results: The mean age differed significantly between diabetic foot ulcer and trauma cohort patients (53 vs. 38, respectively, p < 0.001), while body mass index and aetiology side were not significantly different between both groups (p > 0.05, both). The overall mean score of CBI-24 did not significantly differ between DFU and trauma cohort (4.77±0.5 vs 4.96±0.5, respectively). However, both groups significantly differed in all technical caring behaviours (p < 0.001). Technical professional subscale of PSI and mean hospital length of stay were found statistically different between both groups. Moreover, CBI-24 and PSI were significantly correlated within each group (p < 0.05).

Conclusion: Significant difference was observed in CBI-24 and PSI subscales between both groups, with a significant correlation between the two concepts within each group. Patients undergoing diabetic foot ulcer surgical treatment are more likely to highly perceive technical caring behaviours, while patients with traumatic injury of foot and/or ankle, due to traffic accident and/or crush injury tend likely to value quality of caring behaviours.

Keywords: Clinical nursing care, caring behaviours inventory, patient satisfaction, quality of care, diabetic foot ulcer, trauma

How to Cite

Rao , Zhangrou, Hui Shi, Jing Hu, Lanping Hu, Manjuan Xu, Regis Ernest Mendame Ehya, and Guy-Armel Bounda. 2023. “Comparative Assessment of Nurse Caring Behaviours and Patient Satisfaction Between Chronic and Acute Patients Following Surgical Treatment”. Asian Journal of Research in Nursing and Health 6 (1):218-26.


Download data is not yet available.


Bergbom I, Nåden D, Nyström L. Katie Eriksson's caring theories. Part 1. The caritative caring theory, the multidimensional health theory and the theory of human suffering. Scand J Caring Sci. 2022;36(3):782-790.

DOI: 10.1111/scs.13036. Epub 2021 Oct 5. PMID: 34609017.

Näsman Y. The theory of caritative caring: Katie Eriksson's theory of caritative caring presented from a human science point of view. Nurs Philos. 2020;21(4):e12321. DOI: 10.1111/nup.12321. Epub 2020 Sep 24. PMID: 32974999.

Labrague LJ, McEnroe-Petitte DM, Papathanasiou IV, Edet OB, Arulappan J, Tsaras K. Nursing students’ perceptions of their own caring behaviors: a multicountry study. Int J Nurs Knowl. 2017;28(4): 225–32.

DOI: 10.1111/2047-3095.12108

Maghsoud F, Rezaei M, Asgarian FS, Rassouli M. Workload and quality of nursing care: the mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach. BMC Nurs. 2022;21(1):273. DOI: 10.1186/s12912-022-01055-1

World Health Organization. Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020. Geneva: WHO; 2016. Available:

Shen Y, Jian W, Zhu Q, Li W, Shang W, Yao L. Nurse staffing in large general hospitals in China: an observational study. Hum Resour Health 2020;18(1):3. DOI: 10.1186/s12960-020-0446-5

Liu JX, Goryakin Y, Maeda A, Bruckner T, Scheffler R. Global Health Workforce Labor Market Projections for 2030. Hum Resour Health. 2017;15(1):11. DOI: 10.1186/s12960-017-0187-2

World Health Organization. State of the World’s Nursing 2020: Investing in Education, Jobs and Leadership. [Internet] Geneva: WHO; 2020. Available:

Yi J and Kim J. Impact evaluation of nurse staffing policy reform in Korea: A quasi-experimental study. J Nurs Manag. 2022;30(7):3457–65. DOI: 10.1111/jonm.13815

Ozdemir H, Söyüncü Y, Ozgörgen M, Dabak K. Effects of changes in heel fat pad thickness and elasticity on heel pain. J Am Podiatr Med Assoc. 2004;94(1): 47-52. DOI: 10.7547/87507315-94-1-47. PMID: 14729991

IDF Diabetes Atlas 2021. International Diabetes Federation, Brussels, Belgium; 2021.


Frykberg RG, Wukich DK, Kavarthapu V, Zgonis T, Dalla Paola L; Board of the Association of Diabetic Foot Surgeons. Surgery for the diabetic foot: A key component of care. Diabetes Metab Res Rev. 2020;36 Suppl 1:e3251.

DOI: 10.1002/dmrr.3251. Epub 2019 Dec 10. PMID: 31820543.

Wolf ZR, Giardino ER, Osborne PA, Ambrose MS. Dimensions of nurse caring. Image J Nurs Sch. 1994;26 (2):107–11. DOI: 10.1111/j.1547-5069.1994.tb00927.x

Wu Y, Larrabee JH, Putman HP. Caring Behaviors Inventory: a reduction of the 42-item instrument. Nurs Res. 2006;55 (1):18–25. DOI: 10.1097/00006199-200601000-00003

He T, Du Y, Wang L, Zhong ZF, Ye XC, Liu XH. Perceptions of caring in China: patient and nurse questionnaire survey. Int Nurs Rev 2013;60(4):487-93. DOI: 10.1111/inr.12058

Da CJ, Cao FL, Zhang XF, Cui NX, Tian QX, Dong LJ. Translation and validation caring behavior inventory. Chin J Nurs Sci 2017;32:72–75

Jiang W, Jiang J, Zhao X, Liu Z, Valimaki MA, Li X. Nurse and Patient Assessments of COVID-19 Care Quality in China: A Comparative Survey Study. Int J Environ Res Public Health. 2023;20(3): 2717. DOI: 10.3390/ijerph20032717

Hinshaw AS and Atwood JR. A Patient Satisfaction Instrument: precision by replication. Nurs Res 1982;31(3): 170-5, 191.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63 Suppl 11:S240-52.

DOI: 10.1002/acr.20543

Kargar L, Khademian Z, Rambod M. Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study. Acute Crit Care 2021;36(2):118-25. DOI: 10.4266/acc.2020.00752

Papastavrou E, Efstathiou G, Tsangari H, Suhonen R, Leino-Kilpi H, Patiraki E, et al. A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. J Adv Nurs. 2012;68(5):1026-37.

DOI: 10.1111/j.1365-2648.2011.05807.x

Wang Y, Liu B, Pi Y, Hu L, Yuan Y, Luo J, Tao Y, Li P, Lu S, Song W. Risk factors for diabetic foot ulcers mortality and novel negative pressure combined with platelet-rich plasma therapy in the treatment of diabetic foot ulcers. Front Pharmacol. 2022;13:1051299. DOI: 10.3389/fphar.2022.1051299. PMID: 36588684; PMCID: PMC9800930.

Shemesh S, Sidon E, Heller S, Cohen N, Kosashvili Y, Dovrat R, Velkes S, Burg A. The quality of informed consent obtained for orthopedic surgeries-elective versus trauma: A prospective interview-based study. J Orthop Surg (Hong Kong). 2019;27(2):2309499019847021. DOI: 10.1177/2309499019847021. PMID: 31068118.

Gray M, Ratliff C, Mawyer R. A brief history of advanced practice nursing and its implications for WOC advanced nursing practice. J Wound Ostomy Continence Nurs. 2000;27(1):48-54. DOI: 10.1016/s1071-5754(00)90042-1. PMID: 10649144.

Amirmohseni L and Nasiri M. The Important Role of Specialist Nurse in the Improvement of Patients with Diabetic Foot Ulcer: Letter to the Editor. Jentashapir J Health Res. 2014;5(5): e23226. DOI: 10.5812/jjhr.23226

Okafor L, Chen AF. Patient satisfaction and total hip arthroplasty: a review. Arthroplasty 2019;1(1):6. DOI: 10.1186/s42836-019-0007-3

Revicki DA. Patient assessment of treatment satisfaction: methods and practical issues. Gut. 2004;53 Suppl 4(Suppl 4):iv40-4. DOI: 10.1136/gut.2003.034322. PMID: 15082613; PMCID: PMC1867784.

Graham B, Green A, James M, Katz J, Swiontkowski M. Measuring patient satisfaction in orthopaedic surgery. J Bone Joint Surg Am. 2015;97(1):80-4.

DOI: 10.2106/JBJS.N.00811