explore perceptions of caring in the contemporary clinical environment among nurses of various backgrounds.

| Literature review In the Theory of Human Caring, Watson (2006, 2009) emphasizes that human caring is more than physical behaviors and performance; it involves a sense of devotion and commitment in taking care of patients’ physical needs, as well as their psychosocial and spiritual well-being. In the Theory of Transcultural Care, Leininger (2002) focuses on the cultural context of caring, and emphasizes that caring behaviors can vary transculturally, because human beings simply cannot separate themselves from their cultural and social backgrounds. The two theorists demonstrate differences in philosophical, cultural, and empirical concerns regarding the meaning of caring. Nevertheless, both theorists recognize the concept of caring as the core and fundamental element of nursing. For years, these caring theories have been widely used to inform and transform nursing practice (Courtney & Wolgamott, 2015; Watson, 2009). In addition to these classical theories of caring, the meaning of caring has also been investigated recently through comparisons between the experiences of patients and nurses, as it is crucial to understand what nurses actually do, rather than what they say Received: 25 October 2017 Revised: 12 June 2018 Accepted: 28 June 2018 DOI: 10.1111/nhs.12561 Nurs Health Sci. 2019;21:85–92. wileyonlinelibrary.com/journal/nhs © 2018 John Wiley & Sons Australia, Ltd 85 (Papastavrou, Efstathiou, & Charalambous, 2011; Zamanzadeh, Azimzadeh, Rahmani, & Valizadeh, 2010). These studies affirm that the value patients place on nurses’ caring acts, and caring is reflected in a holistic assessment of attitudes, knowledge, and actions. This holistic view of caring emphasizes the importance of respecting patients’ views and wishes so that the care nurses provide meets patients’ expectations and needs (Liu, Mok, & Wong, 2006; Zamanzadeh et al., 2010). Although nursing care is often linked with improved patient satisfaction and reduced health-care costs (Omari, AbuAlRub, & Ayasreh, 2013; Papastavrou, Andreous, Tsangari, & Merkouris, 2014), recent studies conducted in China, Europe, and the USA indicate that many nurses and patients are not satisfied with the quality of care provided by nurses (Aiken et al., 2012; You et al., 2013), and the public perception of nurses is that they are uncaring (Aiken et al., 2014). Some scholars tried to correlate the present uncaring attitudes of nurses with the current health-care context (Corbin, 2008; Maben, Cornwell, & Sweeney, 2009). Corbin (2008) argued that “caring is not a lost but an art at odds with many of the conditions under which nurses are working today” (p. 164). Currently, nurses often feel constrained by social, economic, cultural, and personal variables, such as staff shortages, the traditional task-orientated approach to nursing, and their limited skills and lack of education (Roch, Dubois, & Clarke, 2014; Sharma & Shrestha, 2015). Nurses are unable to uphold the core value they once pursued, and this results in high rates of job dissatisfaction and intention to leave (Aiken et al., 2014). Nursing care is defined as a context-specific interpersonal human act of kindness (Finfgeld-Connett, 2008a), and context might affect the caring relationship in either positive or negative ways. A substantial body of evidence indicates that the public perception of uncaring nurses might be due to the caring behaviors and attitudes of nurses not always aligning with patients’ expectations of a caring relationship. (Papastavrou et al., 2011; Wiechula et al., 2016). In today’s fast-paced technological, task-oriented health-care context (Watson, 2009), patients value technical care as much as compassionate nursing care (Papastavrou et al., 2011). Nurses might need to adjust their caring values, attitudes, and behaviors to meet patients’ expectations with respect to both of these aspects of care (Wiechula et al., 2016). In view of the ever-changing nature of the health-care context, the meaning of caring is continuously developing and can vary greatly with context (Leininger & McFarland, 2006). As a result, there is an inconsistency between the philosophy of caring and the actual experience of nurses and public complaint regarding the uncaring behaviors of nurses in clinical practice. It is important to understand the fundamental meanings of caring in the contemporary health-care setting, as caring actions are always situated in an embodied account of meaning (Glenberg, 1997). 1.2 |

Aim

The purpose of the present study was to explore perceptions of caring in the contemporary clinical environment among nurses of various backgrounds.