Other Titles
Hierarchical Modeling of Caring Science–Human Caring Culture, Magnet®-Aligned Nursing Behaviors, and Patient Experience [Title Slide]
Abstract
BACKGROUND: Empirical evidence is lacking to quantify whether Watson’s Human Caring Culture and Magnet aligned nurse behaviors influence patient-experience outcomes.1
PURPOSE: To evaluate whether Caring Culture,1 and nursing behaviors aligned with Magnet professional excellence,2-4 predicts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcomes, specifically: Hospital Rating and Likelihood to Recommend.5
METHODS: HCAHPS data (2021–2023) from a large academic hospital were analyzed. The dataset included five validated Caring Culture questions averaged as a composite measure. Magnet aligned nursing behaviors (communication, responsiveness, teamwork, and patient-centered care transition) were analyzed as predictors. Descriptive and univariate analyses were followed by three-block hierarchical multiple regression using Stata 19:
- Model 0—covariates (demographics and clinical factors);
- Model 1—Caring culture;
- Model 2—Magnet-aligned nursing behaviors.
RESULTS: The sample included 10,385 hospital rating responses (84% Top-Box 9–10; mean = 9.28 ± 1.43) and 10,406 Likelihood to Recommend responses (87% “Definitely yes”; mean = 3.83 ± 0.48).
- Model 0: Covariates explained limited variance in hospital rating (5%), and Likelihood to Recommend (2%).
- Model 1: Adding Caring Culture increased the explained variance to 43% and 34% respectively (R square change 0.38 and 0.31, p <.001).
- Model 2: Adding Magnet domains further increased explained variance to 50% and 39% respectively (R square change 0.07 and 0.05, p <.001).
Watson’s Human Caring Culture and all Magnet-aligned domains were positively associated with both outcomes (p <.001).
IMPLICATIONS: Integrating Caring Science and Magnet culture into nursing practice enhances healthcare culture and improves HCAHPS outcomes.
Notes
Presenter notes available in attached slide deck. To see the notes in Adobe Acrobat, go to Tools > Comment or look at your Layers Panel. If the notes were saved as comments or layers, you can toggle them visible.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Theory, Policy and Advocacy, Magnet Hospitals, Organizational Culture, Patient Attitudes, Patient Satisfaction
Recommended Citation
Yan, Alice; Hernandez, Grissel; Lough, Mary E.; Bradley, Kathleen; Munro, Cassendra; and Pines, Rachyl, "Hierarchical Models of Caring Culture, Magnet Culture, and Their Impact on Patient Experience" (2026). International Nursing Research Congress (INRC). 131.
https://www.sigmarepository.org/inrc/2026/presentations_2026/131
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-05
Hierarchical Models of Caring Culture, Magnet Culture, and Their Impact on Patient Experience
Toronto, Ontario, Canada
BACKGROUND: Empirical evidence is lacking to quantify whether Watson’s Human Caring Culture and Magnet aligned nurse behaviors influence patient-experience outcomes.1
PURPOSE: To evaluate whether Caring Culture,1 and nursing behaviors aligned with Magnet professional excellence,2-4 predicts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcomes, specifically: Hospital Rating and Likelihood to Recommend.5
METHODS: HCAHPS data (2021–2023) from a large academic hospital were analyzed. The dataset included five validated Caring Culture questions averaged as a composite measure. Magnet aligned nursing behaviors (communication, responsiveness, teamwork, and patient-centered care transition) were analyzed as predictors. Descriptive and univariate analyses were followed by three-block hierarchical multiple regression using Stata 19:
- Model 0—covariates (demographics and clinical factors);
- Model 1—Caring culture;
- Model 2—Magnet-aligned nursing behaviors.
RESULTS: The sample included 10,385 hospital rating responses (84% Top-Box 9–10; mean = 9.28 ± 1.43) and 10,406 Likelihood to Recommend responses (87% “Definitely yes”; mean = 3.83 ± 0.48).
- Model 0: Covariates explained limited variance in hospital rating (5%), and Likelihood to Recommend (2%).
- Model 1: Adding Caring Culture increased the explained variance to 43% and 34% respectively (R square change 0.38 and 0.31, p <.001).
- Model 2: Adding Magnet domains further increased explained variance to 50% and 39% respectively (R square change 0.07 and 0.05, p <.001).
Watson’s Human Caring Culture and all Magnet-aligned domains were positively associated with both outcomes (p <.001).
IMPLICATIONS: Integrating Caring Science and Magnet culture into nursing practice enhances healthcare culture and improves HCAHPS outcomes.
Description
References:
1. Sitzman, Kathleen, and Jean Watson. Caring Science, Mindful Practice, Second Edition: Implementing Watson's Human Caring Theory, Springer Publishing Company, 2018
2. Yu H, Brom H, Bauermeister JA, et al. How Organizational Inclusion Shapes Patient Satisfaction in Magnet Hospitals. Med Care. 2025;63(11):798-805. doi:10.1097/MLR.0000000000002201\
3. Pearson M. Transformational Leadership Principles and Tactics for the Nurse Executive to Shift Nursing Culture. JONA: The Journal of Nursing Administration. 2020; 50 (3): 142-151. doi: 10.1097/NNA.0000000000000858.
4. Rosenbaum KEF, Lasater KB, McHugh MD, Lake ET. Changes in Patient Care Experiences and the Nurse Work Environment: A Longitudinal Study of U.S. Hospitals. Med Care Res Rev. 2024;81(6):444-454. doi:10.1177/10775587241282403
5. Rodríguez-García M, Márquez-Hernández V, Belmonte-García T, Gutiérrez-Puertas L, Granados-Gámez G. Original Research: How Magnet Hospital Status Affects Nurses, Patients, and Organizations: A Systematic Review. AJN, American Journal of Nursing. 2020; 120 (7): 28-38. doi: 10.1097/01.NAJ.0000681648.48249.16.