Chen, Shu-Yueh, Hsing-Chi Chang, & Hsiang-Chu Pai (2018, March). Caring behaviours directly and indirectly affect nursing students’ critical thinking. Scandinavian Journal of Caring Sciences, 32(1), 197-203. (doi: 10.1111/scs.12447) (Link:

Abstract: Objectives. The purpose of this study was to determine the effect of caring behaviours on critical thinking and to examine whether self-reflection mediates the effect of caring on critical thinking. We also tested whether caring behaviours moderated the relationship between self-reflection and critical thinking. Methods. For this descriptive, correlational, cross-sectional study, we recruited 293 fifth-year nursing students from a junior college in southern Taiwan. Data were collected in 2014 on critical thinking, caring behaviours and self-reflection with insight using the Taiwan Critical Thinking Disposition Inventory, a Chinese version of the Caring Assessment Report Evaluation Q-sort, and a Chinese version of the Self-Reflection and Insight Scale, respectively. Relationships among variables were analysed by structural equation modelling, with the partial least squares method and Sobel test. Results. The results showed that caring behaviours significantly positively affected critical thinking (β = 0.56, t = 12.37, p < 0.001) and self-reflection with insight (β = 0.54, t = 11.99, p < 0.001). Self-reflection and insight significantly positively affected critical thinking (β = 0.34, t = 6.48, p < 0.001). Further, self-reflection and insight mediated the relationship between caring behaviours and critical thinking. Caring behaviours did not, however, moderate the relationship between self-reflection (β = 0.001, t = 0.021, p > 0.05) and critical thinking. Conclusion. Caring behaviours directly affect self-reflection with insight and critical thinking. In addition, caring behaviours also indirectly affect critical thinking through self-reflection and insight.

Hsiang-Chu Pai <> is in the Department of Nursing, Chung-Shan Medical University, Taichung City, Taiwan.

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