Humanistic Behavior Skills and Emotional Labor Behaviors in Patient Care of Intensive Care Nurses

Öz

Purpose: This study investigated the relationship between humanistic behavior skills and emotional labor behaviors in patient care of intensive care nurses. Material and Methods: A descriptive cross-sectional and exploratory study. 232 intensive care nurses were included in the study. Data were collected using a Personal Information Form, the Humanistic Practice Ability of Nursing Scale (HPANS), and the Emotional Labor Scale for Nurses (ELS). This study adhered to the STROBE checklist for reporting. Results: The average age of intensive care nurses was 30.27±4.52, and 54.3% were female. The mean total score on the ELS was found to be 3.93±0.54. The mean scores for the superficial behavior, deep behavior, and sincere behavior sub-dimensions of this scale were found to be 3.92±0.63, 3.90±0.59, and 4.02±0.63, respectively. The mean score for the HPANS was determined to be 120.42±15.40. The mean scores for the sub-dimensions of this scale nursing communication skills, psychological adjustment skills, skills in applying ethical and legal issues, aesthetic nursing skills, and practical care skills were found to be 28.78±4.13, 16.04±2.69, 29.68±4.20, 11.92±1.96, and 33.98±4.68, respectively. A strong positive and statistically significant correlation (r=0.643; p=0.001) was found between the ELS and the HPANS. Conclusions: Intensive care nurses were found to have high emotional labor and humanistic behavior skills in nursing practice. Nurses were observed to exhibit the highest level of sincere behavior in patient care. It was determined that as the emotional labor behaviors of intensive care nurses increased, their humanistic behavior skills also increased. Care strategies that take into account emotional labor and humanistic behaviors should be developed to maximize individualized care practices in nurses.

Anahtar Kelimeler

• care
• emotional labor
• humanistic care
• intensive care nurse

Etik Beyan

For this research, the necessary institutional permissions were obtained from the Sivas Cumhuriyet University Health Sciences Research Ethics Committee (Karar No: 2025-04/15 Tarih: 24.04.2025) and from the hospitals where the research was conducted (E-93596471-010.0.-577130 ve E-76728045-511.06.01.01-280080557). Nurses were informed about the research. Written and verbal consent was obtained from the nurses who agreed to participate in the research. The research was conducted in accordance with the principles of the Helsinki Declaration.

Teşekkür

I would like to thank the intensive care nurses who participated in the study.

Yoğun Bakım Hemşirelerinin Hasta Bakımında Hümanist Davranma Becerisi ile Duygusal Emek Davranışları

Öz

Amaç: Bu çalışma, yoğun bakım hemşirelerinin hasta bakımında insancıl davranış becerileri ile duygusal emek davranışları arasındaki ilişkiyi araştırmıştır. Materyal ve Yöntemler: Tanımlayıcı kesitsel ve keşifsel bir çalışma. Çalışmaya 232 yoğun bakım hemşiresi dahil edilmiştir. Veriler, Kişisel Bilgi Formu, Hemşirelik Uygulamalarında Hümanist Davranma Becerisi Ölçeği (HDBÖ) ve Hemşireler için Duygusal Emek Ölçeği (DEÖ) kullanılarak toplanmıştır. Bu çalışma, raporlama için STROBE kontrol listesine uymuştur. Sonuçlar: Yoğun bakım hemşirelerinin ortalama yaşı 30,27±4,52 olup, %54,3'ü kadındır. DEÖ ortalama toplam puan 3,93±0,54 olarak bulunmuştur. Bu ölçeğin yüzeysel davranış, derin davranış ve samimi davranış alt boyutlarının ortalama puanları sırasıyla 3,92±0,63, 3,90±0,59 ve 4,02±0,63 olarak bulunmuştur. HDBÖ ortalama puanı 120,42±15,40 olarak belirlenmiştir. Bu ölçeğin alt boyutları olan hemşirelik iletişim becerileri, psikolojik uyum becerileri, etik ve yasal konuları uygulama becerileri, estetik hemşirelik becerileri ve pratik bakım becerileri için ortalama puanlar sırasıyla 28,78±4,13, 16,04±2,69, 29,68±4,20, 11,92±1,96 ve 33,98±4,68 olarak bulunmuştur. DEÖ ile HDBÖ arasında güçlü, pozitif ve istatistiksel olarak anlamlı bir korelasyon (r=0,643; p=0,001) bulunmuştur. Sonuçlar: Yoğun bakım hemşirelerinin hemşirelik uygulamalarında yüksek duygusal emek ve insancıl davranış becerilerine sahip oldukları bulunmuştur. Hemşirelerin hasta bakımında en yüksek düzeyde samimi davranış sergiledikleri gözlemlenmiştir. Yoğun bakım hemşirelerinin duygusal emek davranışları arttıkça, insancıl davranış becerilerinin de arttığı belirlenmiştir. Hemşirelerde bireyselleştirilmiş bakım uygulamalarını en üst düzeye çıkarmak için duygusal emeği ve insancıl davranışları dikkate alan bakım stratejileri geliştirilmelidir.

Anahtar Kelimeler

• bakım
• duygusal emek
• hümanist bakım
• yoğun bakım hemşiresi

Etik Beyan

Araştırma için Sivas Cumhuriyet Üniversitesi Sağlık Bilimleri Araştırmalar Etik Kurulu’ndan (Karar No: 2025-04/15 Tarih: 24.04.2025), araştırmanın yürütüldüğü hastanelerden gerekli kurum izinleri (E-93596471-010.0.-577130 ve E-76728045-511.06.01.01-280080557) alınmıştır. Hemşirelere araştırma konusunda bilgi verilmiştir. Araştırmaya katılmayı kabul eden hemşirelerin yazılı ve sözlü onamları alınmıştır. Helsinki Deklerasyonu prensiplerine uygun hareket edilmiştir.

Teşekkür

Çalışmaya katılan yoğun bakım hemşirelerine teşekkür ederim.

Kaynakça

1. Altuntas, S., & Sahin Altun, O. (2015). The relationship between emotional labor behaviors and burnout levels of nurses. Journal of Health and Nursing Management, 1(2), 37-43. https://doi.org/10.5222/SHYD.2015.037
2. Back, C., Hyun, D., & Chang, S. (2017). Association between emotional labor, emotional dissonance, burnout and turnover intention in clinical nurses: A multiple-group path analysis across job satisfaction. J. Korean Acad. Nurs, 47, 770–780. https://doi.org/10.4040/jkan.2017.47.6.770
3. Baksi, A., & Durmaz Edeer, A. (2020). Investigation of the relationship between emotional labor and general health status of intensive care nurses. Hacettepe University Faculty of Nursing Journal, 7(2), 130-137. https://doi.org/10.31125/hunhemsire.763157
4. Busch, I.M., Moretti, F., Travaini, G., et al. (2019). Rimondini MHumanization of care: key elements identified by patients, caregivers, and healthcare providersA systematic review. Patient, 12(5), 461–74. https://doi.org/10.1007/s40271-019-00370-1
5. Degirmenci Oz, S., & Baykal, U. (2017). Emotional labor behavior of nurses. Journal of Health and Nursing Management, 4(3), 143-147. https://doi.org/10.5222/SHYD.2017.143
6. Degirmenci Oz, S. & Baykal, U. (2018). Development of the Emotional Labor Behavior Scale for Nurses. International Refereed Journal of Nursing Research, 12, 119-139. https://doi.org/10.17371/UHD.2018.1.3
7. Demir, Y., Oruc, P., Basturk, Y.A., & Ozpınar, S. (2021). Emotional labor behavior and affecting factors in nurses: a case of public hospitals. Samsun Journal of Health Sciences, 6(1), 76-84. https://doi.org/10.47115/jshs.790178
8. Dogan, A. & Unsal Sigrib, A. (2017). Emotional labor: a study on nurses. Journal of Work and Human, 4(2), 113-126. https://doi.org/10.18394/iid.342620

9. Dogan, N. & Tasci S. (2019). Emotional labor concept in nursing care. Turkiye Klinikleri J Nurs Sci, 11(4), 417- 426. https://doi.org/10.5336/nurses.2019-64790
10. Gao, M., Wang, Y., & Lei, Y. (2021). Applying the Carolina care model to improve nurses’ humanistic care abilities, American Journal of Translational Research, 13(4), 3591–3599
11. Ghanbari-Afra, L., Adib-Hajbaghery, M., & Dianati, M. (2022). Human Caring: A Concept Analysis. J Caring Sci, 11(4), 246-254. https://doi.org/10.34172/jcs.2022.21
12. Fang, L.W., Yueqi, W., Xiulan, Z., & Qu, L. (2021). Jieqiong, L Xiaomei. Effect evaluation of systematic tutorial training based on Watson’s caring theory on cultivating the humanistic care qualities of new nurses. Chinese Nursing Management, 21(1), 7.
13. Jia, W., Zhang, Z., Zhang, Q., Chen, X., Fang, J. & Cao, H. (2025). A cross section study on the relationship between nurse-reported missed care, emotional labour, and compassion fatigue in ıntensive care units. J Adv Nurs, 81: 5892-5902. https://doi.org/10.1111/jan.16725
14. Jin, R., Wang, Y., Shan, Y., & Li, J. (2025). The mediating effect of empathy in the relationship between humanistic practice competence and caring ability among newly employed nurses. International Journal of Africa Nursing SSciences, 232025), 100866 https://doi.org/10.1016/j.ijans.2025.100866
15. Kaplan, M., Kaplan, F., & Celik, H. (2025). The effect of humanistic behavior skills in nursing practice on caregiving competence. WORK: A Journal of Prevention, Assessment & Rehabilitation, 81(2), 2547- 2552. https://doi.org/10.1177/10519815241312603
16. Kilic S. (2012). Interpretation of correlation analysis results. Journal of Mood Disorders, 2(4), 191-193 Kuslu, S., Eminoglu, A., & Musluoglu, M. (2025). The effect of holistic and humanistic approach on professional pride in nursing care. Journal of Advanced Nursing, 82(4), 3037-3053. https://doi.org/10.1111/jan.70009
17. Li, Y., Luan, X., Liu, H., Li, X., & Chen, Y. (2020). Investigation on the status quo of humanistic care knowledge, attitude and practice among clinical nurses and analysis of influencing factors, Chinese Journal of Practical Nursing, 36, 1574–1581.
18. Lv, J., Su, Y., Tang, H., Jiang, X., & Chen, X. (2025). Humanistic nursing care management strategies: from formulation to implementation. Front. Public Health, 13, 1591077. https://doi.org/10.3389/fpubh.2025.1591077
19. Mahmoud, H.M.E., & Zakaria, M. (2021). The Relationship between emotional labor, workplace aggression and organizational role stress among nursing staff. Mansoura Nursing Journal (MNJ), 8, 91-107. https://doi.org/10.21608/mnj.2021.213165
20. Murat, M., Kose, S., & Kizilkaya Beji, N. (2024). Impact of nurse-patient interaction levels on nurses’ humanistic practice: A cross-sectional, descriptive and correlational study. Enfermería Clínica, 34(2024), 346- 356. https://doi.org/10.1016/j.enfcli.2024.03.003
21. Ozdemir, C., & Kaplan, A. (2024). Examining nurses' humanistic behaviour ability and empathy levels in clinical practice: A descriptive and exploratory study. J Clin Nurs, 33, 3115–3127. https://doi.org/10.1111/jocn.16992
22. Ren, Z., & Gai, H. (2023). Correlation between ICU nurses' humanistic care ability and compassion fatigue in class III grade a hospitals in Xi'an. Academic Journal of Medicine & Health Sciences, 4(12), 74-80. https://doi.org/10.25236/AJMHS.2023.041210
23. Sebrant, L., & Jong, M. (2021). What's the meaning of the concept of caring.: A meta-synthesis? Scand J Caring Sci, 35, 353–365. https://doi.org/10.1111/scs.12850
24. Taghinezhad, F., Mohammadi, E., Khademi, M., & Kazemnejad, A. (2022). Humanistic care in nursing: Concept analysis using rodgers’ evolutionary approach. Iran J Nurs Midwifery Res, 27, 83-91. https://doi.org/10.4103/ijnmr.ijnmr_156_21
25. Teófilo, T.J.S., Gomes Viana, A.C., Oliveira J dos S., & Abreu, W.J.C.P de. (2026). Empathy in Jean Watson’s Theory of Human Caring: Philosophical Reflections on the Caritas® Processes and Mindfulness. Journal of Holistic Nursing. Online First. https://doi.org/10.1177/08980101261427830
26. Wang, Y., Han, T., Han, G., & Zheng Y. (2023). The relationship among nurse leaders’ humanistic care behavior, nurses’ professional identity, and psychological security. Am J Health Behav, 47(2), 321- 336. https://doi.org/10.5993/AJHB.47.2.12
27. Xu, Y-W, & Fan, L. (2023). Emotional labor and job satisfaction among nurses: The mediating effect of nurse–patient relationship. Front. Psychol, 14:1094358. https://doi.org/10.3389/fpsyg.2023.1094358
28. Yanmis, S., Bahcecioglu Turan, G., & Ozer, Z. (2022). Turkish validity and reliability study of humanistic practice ability of nursing scale. International Journal of Clinical Practice, 8435530. https://doi.org/10.1155/2022/8435530
29. Yasar, O., & Yildirim, D. (2024). Investigating the relationship between nurses’ humanistic practice abilities and caring behaviors: a correlational descriptive study. JAREN, 10(2), 95-101. https://doi.org/10.55646/jaren.2024.60590
30. Yildiz, A., & Dinc, L. (2023). Emotional labor among Turkish nurses: A cross‐sectional study. Nursing Inquiry, 30, e12544. https://doi.org/10.1111/nin.12544
31. Yilmaz, S., Hacihasanoglu Asilar, R., & Cicek, Z. (2006). Examination of the general mental state of nurses. Sted, 15(6): 92-97.
32. Yilmaz Kusakli, B., Cesur Ozmen, E., Civanoglu, S.P. (2021). Emotional labor and management of emotions in nursing. J Educ Res Nurs.18(2), 216-219.
33. Yilmaz Coskun, E., Ceylan, B., & Kocoglu-Tanyer, D. (2026). Humanistic behavior, empathic anger and professional commitment among nurses: A correlational study. Archives of Psychiatric Nursing, 61:152092. https://doi.org/10.1016/j.apnu.2026.152092
34. Yilmaz, B., Orak, O.S. (2020). Relationship between emotional labour behavior and psychological symptoms among nurses. Journal of Health and Nursing Management, 2(7), 187-201. https://doi.org/10.5222/SHYD.2020.35220
35. Zamaniniya, Z., Khademi, M., Toulabi, T., & Zarea, K. (2021). The out-comes of humanistic nursing for critical care nurses: A qualitative study. Nursing and Midwifery Studies, 10(2), 115 https://doi.org/10.4103/nms.nms_32_19
36. Zhang, J., Zhou, X., Wang, H., Luo, Y., & Li, W. (2021). Development and validation of the humanistic practice ability of nursing scale. AsianNursing Research, 15(2), 105–112. https://doi.org/10.1016/j.anr.2020.12.003
37. Zhang, Y., K. Fei, W. Tang, et al. 2026. “The mediating effect of professional benefits on nurse's work stressor and humanistic practice ability of ICU nurses.” Nursing Open, 13(6), e70449. https://doi.org/10.1002/nop2.70449
38. Zhou, L., Xiong, W., Hu, M., & Chang H. (2025). Emotional labor and its influencing factors of clinical nurses: a cross-sectional study based on latent profile analysis. Front. Public Health, 13, 1496648. https://doi.org/10.3389/fpubh.2025.1496648