The theoretical phase results
In this study, from various resources and databases, the definitions, dimensions, and characteristics of caring thinking, besides care thinking, and nursing are collected in the theoretical phase.
Caring Thinking
Cognitive and emotional thinking combination is caring thinking when it comes to important matters. Phrases such as "thinking with your heart" or thinking with your personal values are used in ordinary language. Caring thinking enables an individual to build a thorough value system forming comprehensive and sympathetic judgments. Caring thinking expressions are as many judgments as creative or critical thinking expressions. What allows an individual to select what he/she considers significant in a specific context is caring thinking (aesthetic, ethical, or scientific); it decides what a person concentrates on. The moral and aesthetic perceptions of people are determined by caring thinking in many ways. To think thoughtfully, indeed, means to think efficiently, ethically, normatively, appreciatively, and to actively take part in society with a concern for the common good (19). In a real sense, what people care about is visible in how they perform, take part, build, contribute, and relate to others. Thinking reveals people's ideals, besides what they think is valuable and what they will to fight and suffer for (20). The system and practice of behaviors are arranged by the caring thinking. Caring thinking is, thus, the action position of caring linked strictly to pragmatism. Hence, it may be stated that caring thinking is a kind of thinking that contributes to the right thinking (4).
Dimension of Caring Thinking
There are two ways to dimension caring thinking. Caring, as earlier mentioned, involves a subject and an object. The person is the subject, and the item focused on by caring is the object. As regards its subject, it includes several phases, like obeying the commands, self-awareness, own values, and ethical rules. It tends to itself, others, nature, and principles regarding its object (4, 20).
Caring Thinking Features
Caring roots in the human heart and values. In other terms, it arises from a person's internal behavior and thinking manner and is understood on the basis of the values. People care for what they admire more. Caring thinking offers a person a stronger value system. Enthusiasm and stimulations as emotional excitement, intensity, and profound sensitivity arise with caring thinking. Caring thinking has four characteristics of valuation, affective, active, and normative linked together.
Furthermore, Appreciative Thinking, Emphatic Thinking and Ethical Inquiry (Ethical Education & Virtue Education) are Thinking Forms Supporting Caring Thinking too.
Caring Thinking and Nursing
Caring thinking is a kind of formula that brings creative and critical thinking together. Among the formulas, this is a third form or a higher level. Feeling transformation into decision, choice, and judgment is caring. That is to say, it is the forms that turn feelings into decisions, choices, and judgments (4). Thinking is devoid of a values component without caring. Thinking is liable to approach its subject matters indifferently, apathetically, and uncaringly if it does not contain valuing or valuation; i.e., it could be diffident even about inquiry itself (20).
Indeed, Caring is the essence of nursing (21). Furthermore, enhancing nurses' ability to improve patient care outcomes is one of the needed goals for education in nursing. Learners need to transfer learned knowledge to actual practice to achieve this goal. Knowledge of thinking paradigms concerning specific subject content is needed to achieve efficient transfer (22), and Caring transformation into practice results in caring thinking (4). Thus, over caring thinking, behaviors can be made systematical; the most appropriate manner for this systematical behavior is pragmatism. Human is inclined to think in a way to get benefit from thinking. This is the reason why caring thinking is considered as a type for organizing people thinking practice (23).
Caring thinking is associated typically with the same taxonomy's efficient domain, although the critical and creative thinking tackles the Bloom Taxonomy's cognitive domain. Bloom considers emotional effects and affects in the evaluation and synthesis process but within cognitive processes (24).
The ethical inquiry role in the processes bears caring thinking's major features, like turning rules, values, and thoughts into action. Caring thinking direct association with virtue and ethics is shown by its convergence. Moral education, based on Burns and Rathbone (2010), includes two modules: virtue and caring theory education (25). Caring thinking was defined by Noddings (1988) as the moral requirement of ethical education, considering caring as the core of the educational approach and its drive. Accordingly, four fundamental activities were suggested by him as modeling, dialogue, practice, and confirmation (26).
Educators can facilitate knowledge transfer by using caring thinking and developing instructional designs that incorporate subject content and cognitive processes associated with the subject content use. It is, however, difficult to develop such instructional designs (27). In this situation, nurses and clients can understand and experience the true concept of care, provide quality care and feel worthwhile.
Results of the fieldwork phase
Two hundred thirty primary codes, 18 subclasses, 10 classes, and 4 themes were gained in the phase of fieldwork (Table 2).
Table 2
|
Themes
|
Categories
|
Sub-categories
|
Correct thinking
|
Controlled thinking
|
Thoughtful thinking
|
Emotional thinking
|
Logic
|
Ethically thinking
|
Critic
|
Analysis
|
Responsibility
|
Self-concept
|
Real self
|
Powerment
|
Empathy
|
Kindness
|
Compassion
|
Sympathy
|
Respect
|
Affective thinking
|
Professional commitment
|
Conscience
|
Self-awareness
|
Competency
|
Professional identity
|
Assurance
|
Relationship
|
Ethically thinking
|
Virtue thinking
|
Do's and Don'ts
|
Believes
|
Good and bad
|
Privacy
|
Territory
|
Theme 1: Correct thinking
Theme 1 showed that most participants regarded caring thinking as correct thinking. This issue is so evident as regards nursing and nursing care. There is no error in nursing.
Here is an expression of a nurse in this regard: "Actually, caring thinking takes care of the flow of thought. For nurses to make timely decisions and measure all aspects of a client's conditions, it requires the aggregation of critical thinking, ethical thinking, creative thinking and affective thinking. Altogether they create caring thinking."
Theme 2: Ethically thinking
Documentation of the ethics and valuation in nursing care was focused on in the phase of the fieldwork. To care is to concentrate on what we esteem, to appreciate its worth, to value its value. An ethical inquiry role in the procedures bears the caring thinking's major features like turning rules, values, and thoughts into action.
An academic nurse in this regard stated:" Each of us has our own values and beliefs, and in the care we provide, these internal values, our laws and our thoughts are reflected in our behavior. When nurses respect the values of patients, it means to work ethically. Protecting the privacy of the patient by the nurse, respecting the patient's rights and their beliefs to provide necessary needs and nursing care is an example of ethical thinking that is a significant feature of caring thinking."
Theme 3: Responsibility
The responsibility of nurses was the problem that was mentioned frequently by the participants or attained by observational field notes. This theme revealed that responsibility is essential to be in action at any event possible if it is determined as the possible result's acceptance in advance.
One of the participants expressed it in this regard: "The responsible nurse, after providing care, evaluates the quality of care from the patient to assess the recovery and the impact of care. One of the patients has said that some are doing their job and they are going to follow their work, but there are some who, after completing their work, will come back to you and ask questions, to see if the problem has been resolved or not."
Theme 4: professional commitment
This theme indicated that participants emphasize that professional commitment is how people think about their profession and the motivation to work in that profession, and nurses who have a higher commitment are more accountable.
A nurse expressed: "A professional commitment means adherence to the goal of nursing (care). Care is the basis of our work. Therefore, we must know everything that makes us care and think correctly."
Results of Final analytical phase
The data found in the literature review in the theoretical phase were compared with the codes and classes gained from the phase of fieldwork in the final analytical phase; as a final point, the caring thinking concept's shared characteristics were recognized, and the concept was defined.
In the third phase of the concept analysis, with a combination of theoretical phase results and insights achieved in the fieldwork phase, the final definition of the concept was presented:" Caring Thinking is the side of giftedness that emerges from the person's heart, thinking with your heart and personal values. It enables people to build a sound value system to make comprehensive and compassionate judgments. Whilst emotional over excitability (or intensity) and deep sensitivity are at the center of Caring Thinking. Caring thinking, on the other side, is considered a type of thinking to organizes our thinking practice, contributing to correct thinking."