term paper in spanish

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Spanish translation of 'term paper'

Examples of 'term paper' in a sentence term paper

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3 Translation results for paper in Spanish

Example sentences of paper noun

• • We'll need pens, glue, and some paper .
• • Be sure to print the letter on good paper .
• • He scribbled the number on a scrap of paper .
• • a crumpled piece of paper
• • The border guards asked to see my papers .
• • They published a landmark paper in 1995.
• • The teacher was busy grading papers .
• • She did well on her history paper .

Synonyms of paper noun

Synonyms of paper verb, paper adjective, example sentences of paper adjective.

• • Their accounts showed lots of paper profits, but they went bankrupt anyway.
• • there's a paper boycott of that company's products that nobody seems to be honoring

Related phrases for paper

• carbon paper - papel carbón
• litmus paper - papel de tornasol
• toilet paper - papel higiénico
• tracing paper - papel de calcar
• scrap paper - papel borrador
• put pen to paper - (figurado) escribir
• paper tiger - (figurado) tigre de papel
• paper clip - clip, sujetapapeles
• slip of paper - papelito

Reverse translation for paper

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"term paper" in Spanish

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Home » Term Paper – Format, Examples and Writing Guide

Term Paper – Format, Examples and Writing Guide

Table of Contents

Definition:

Term paper is a type of academic writing assignment that is typically assigned to students at the end of a semester or term. It is usually a research-based paper that is meant to demonstrate the student’s understanding of a particular topic, as well as their ability to analyze and synthesize information from various sources.

Term papers are usually longer than other types of academic writing assignments and can range anywhere from 5 to 20 pages or more, depending on the level of study and the specific requirements of the assignment. They often require extensive research and the use of a variety of sources, including books, articles, and other academic publications.

Term Paper Format

The format of a term paper may vary depending on the specific requirements of your professor or institution. However, a typical term paper usually consists of the following sections:

• Title page: This should include the title of your paper, your name, the course name and number, your instructor’s name, and the date.
• Abstract : This is a brief summary of your paper, usually no more than 250 words. It should provide an overview of your topic, the research question or hypothesis, your methodology, and your main findings or conclusions.
• Introduction : This section should introduce your topic and provide background information on the subject. You should also state your research question or hypothesis and explain the importance of your research.
• Literature review : This section should review the existing literature on your topic. You should summarize the key findings and arguments made by other scholars and identify any gaps in the literature that your research aims to address.
• Methodology: This section should describe the methods you used to collect and analyze your data. You should explain your research design, sampling strategy, data collection methods, and data analysis techniques.
• Results : This section should present your findings. You can use tables, graphs, and charts to illustrate your data.
• Discussion : This section should interpret your findings and explain what they mean in relation to your research question or hypothesis. You should also discuss any limitations of your study and suggest areas for future research.
• Conclusion : This section should summarize your main findings and conclusions. You should also restate the importance of your research and its implications for the field.
• References : This section should list all the sources you cited in your paper using a specific citation style (e.g., APA, MLA, Chicago).
• Appendices : This section should include any additional materials that are relevant to your study but not essential to your main argument (e.g., survey questions, interview transcripts).

Structure of Term Paper

Here’s an example structure for a term paper:

I. Introduction

A. Background information on the topic

B. Thesis statement

II. Literature Review

A. Overview of current literature on the topic

B. Discussion of key themes and findings from literature

C. Identification of gaps in current literature

III. Methodology

A. Description of research design

B. Discussion of data collection methods

C. Explanation of data analysis techniques

IV. Results

A. Presentation of findings

B. Analysis and interpretation of results

C. Comparison of results with previous studies

V. Discussion

A. Summary of key findings

B. Explanation of how results address the research questions

C. Implications of results for the field

VI. Conclusion

A. Recap of key points

B. Significance of findings

C. Future directions for research

VII. References

A. List of sources cited in the paper

How to Write Term Paper

Here are some steps to help you write a term paper:

• Choose a topic: Choose a topic that interests you and is relevant to your course. If your professor has assigned a topic, make sure you understand it and clarify any doubts before you start.
• Research : Conduct research on your topic by gathering information from various sources such as books, academic journals, and online resources. Take notes and organize your information systematically.
• Create an outline : Create an outline of your term paper by arranging your ideas and information in a logical sequence. Your outline should include an introduction, body paragraphs, and a conclusion.
• Write a thesis statement: Write a clear and concise thesis statement that states the main idea of your paper. Your thesis statement should be included in your introduction.
• Write the introduction: The introduction should grab the reader’s attention, provide background information on your topic, and introduce your thesis statement.
• Write the body : The body of your paper should provide supporting evidence for your thesis statement. Use your research to provide details and examples to support your argument. Make sure to organize your ideas logically and use transition words to connect paragraphs.
• Write the conclusion : The conclusion should summarize your main points and restate your thesis statement. Avoid introducing new information in the conclusion.
• Edit and proofread: Edit and proofread your term paper carefully to ensure that it is free of errors and flows smoothly. Check for grammar, spelling, and punctuation errors.
• Format and cite your sources: Follow the formatting guidelines provided by your professor and cite your sources properly using the appropriate citation style.
• Submit your paper : Submit your paper on time and according to the instructions provided by your professor.

Term Paper Example

Here’s an example of a term paper:

Title : The Role of Artificial Intelligence in Cybersecurity

As the world becomes more digitally interconnected, cybersecurity threats are increasing in frequency and sophistication. Traditional security measures are no longer enough to protect against these threats. This paper explores the role of artificial intelligence (AI) in cybersecurity, including how AI can be used to detect and respond to threats in real-time, the challenges of implementing AI in cybersecurity, and the potential ethical implications of AI-powered security systems. The paper concludes with recommendations for organizations looking to integrate AI into their cybersecurity strategies.

Introduction :

The increasing number of cybersecurity threats in recent years has led to a growing interest in the potential of artificial intelligence (AI) to improve cybersecurity. AI has the ability to analyze vast amounts of data and identify patterns and anomalies that may indicate a security breach. Additionally, AI can automate responses to threats, allowing for faster and more effective mitigation of security incidents. However, there are also challenges associated with implementing AI in cybersecurity, such as the need for large amounts of high-quality data, the potential for AI systems to make mistakes, and the ethical considerations surrounding the use of AI in security.

Literature Review:

This section of the paper reviews existing research on the use of AI in cybersecurity. It begins by discussing the types of AI techniques used in cybersecurity, including machine learning, natural language processing, and neural networks. The literature review then explores the advantages of using AI in cybersecurity, such as its ability to detect previously unknown threats and its potential to reduce the workload of security analysts. However, the review also highlights some of the challenges associated with implementing AI in cybersecurity, such as the need for high-quality training data and the potential for AI systems to be fooled by sophisticated attacks.

Methodology :

To better understand the challenges and opportunities associated with using AI in cybersecurity, this paper conducted a survey of cybersecurity professionals working in a variety of industries. The survey included questions about the types of AI techniques used in their organizations, the challenges they faced when implementing AI in cybersecurity, and their perceptions of the ethical implications of using AI in security.

The results of the survey showed that while many organizations are interested in using AI in cybersecurity, they face several challenges when implementing these systems. These challenges include the need for high-quality training data, the potential for AI systems to be fooled by sophisticated attacks, and the difficulty of integrating AI with existing security systems. Additionally, many respondents expressed concerns about the ethical implications of using AI in security, such as the potential for AI to be biased or to make decisions that are harmful to individuals or society as a whole.

Discussion :

Based on the results of the survey and the existing literature, this paper discusses the potential benefits and risks of using AI in cybersecurity. It also provides recommendations for organizations looking to integrate AI into their security strategies, such as the need to prioritize data quality and to ensure that AI systems are transparent and accountable.

Conclusion :

While there are challenges associated with implementing AI in cybersecurity, the potential benefits of using these systems are significant. AI can help organizations detect and respond to threats more quickly and effectively, reducing the risk of security breaches. However, it is important for organizations to be aware of the potential ethical implications of using AI in security and to take steps to ensure that these systems are transparent and accountable.

References:

• Alkhaldi, S., Al-Daraiseh, A., & Lutfiyya, H. (2019). A Survey on Artificial Intelligence Techniques in Cyber Security. Journal of Information Security, 10(03), 191-207.
• Gartner. (2019). Gartner Top 10 Strategic Technology Trends for 2020. Retrieved from https://www.gartner.com/smarterwithgartner/gartner-top-10-strategic-technology-trends-for-2020/
• Kshetri, N. (2018). Blockchain’s roles in meeting key supply chain management objectives. International Journal of Information Management, 39, 80-89.
• Lipton, Z. C. (2018). The mythos of model interpretability. arXiv preprint arXiv:1606.03490.
• Schneier, B. (2019). Click Here to Kill Everybody: Security and Survival in a Hyper-Connected World. WW Norton & Company.
• Wahab, M. A., Rahman, M. S., & Islam, M. R. (2020). A Survey on AI Techniques in Cybersecurity. International Journal of Scientific & Engineering Research, 11(2), 22-27.

When to Write Term Paper

A term paper is usually a lengthy research paper that is assigned to students at the end of a term or semester. There are several situations when writing a term paper may be required, including:

• As a course requirement: In most cases, a term paper is required as part of the coursework for a particular course. It may be assigned by the instructor as a way of assessing the student’s understanding of the course material.
• To explore a specific topic : A term paper can be an excellent opportunity for students to explore a specific topic of interest in-depth. It allows them to conduct extensive research on the topic and develop their understanding of it.
• To develop critical thinking skills : Writing a term paper requires students to engage in critical thinking and analysis. It helps them to develop their ability to evaluate and interpret information, as well as to present their ideas in a clear and coherent manner.
• To prepare for future academic or professional pursuits: Writing a term paper can be an excellent way for students to prepare for future academic or professional pursuits. It can help them to develop the research and writing skills necessary for success in higher education or in a professional career.

Purpose of Term Paper

The main purposes of a term paper are:

• Demonstrate mastery of a subject: A term paper provides an opportunity for students to showcase their knowledge and understanding of a particular subject. It requires students to research and analyze the topic, and then present their findings in a clear and organized manner.
• Develop critical thinking skills: Writing a term paper requires students to think critically about their subject matter, analyzing various sources and viewpoints, and evaluating evidence to support their arguments.
• Improve writing skills : Writing a term paper helps students improve their writing skills, including organization, clarity, and coherence. It also requires them to follow specific formatting and citation guidelines, which can be valuable skills for future academic and professional endeavors.
• Contribute to academic discourse : A well-written term paper can contribute to academic discourse by presenting new insights, ideas, and arguments that add to the existing body of knowledge on a particular topic.
• Prepare for future research : Writing a term paper can help prepare students for future research, by teaching them how to conduct a literature review, evaluate sources, and formulate research questions and hypotheses. It can also help them develop research skills that they can apply in future academic or professional endeavors.

Advantages of Term Paper

There are several advantages of writing a term paper, including:

• In-depth exploration: Writing a term paper allows you to delve deeper into a specific topic, allowing you to gain a more comprehensive understanding of the subject matter.
• Improved writing skills: Writing a term paper involves extensive research, critical thinking, and the organization of ideas into a cohesive written document. As a result, writing a term paper can improve your writing skills significantly.
• Demonstration of knowledge: A well-written term paper demonstrates your knowledge and understanding of the subject matter, which can be beneficial for academic or professional purposes.
• Development of research skills : Writing a term paper requires conducting thorough research, analyzing data, and synthesizing information from various sources. This process can help you develop essential research skills that can be applied in many other areas.
• Enhancement of critical thinking : Writing a term paper encourages you to think critically, evaluate information, and develop well-supported arguments. These skills can be useful in many areas of life, including personal and professional decision-making.
• Preparation for further academic work : Writing a term paper is excellent preparation for more extensive academic projects, such as a thesis or dissertation.

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‘Papel’ in Spanish Means More Than Paper

Word often refers to roles

Valerie Hinojosa  / Creative Commons.

• History & Culture
• Pronunciation
• Writing Skills
• B.A., Seattle Pacific University

The Spanish word papel is a cognate of the English word " paper " and often has the same meaning.

Papel also has an important and frequently used meaning not associated with the English word, that of a role, such as in a play or job .

Papel With Meanings Related to Paper

When referring to paper, papel can refer to paper in general or to a single sheet or piece, although hoja de papel can also refer to a sheet:

• Una bola de papel puede ser un buen juguete para tu gato. (A wad of paper can be a good toy for your cat.)
• Las dimensiones de un papel A4 son 297 mm x 210 mm. (The dimensions of an A4 sheet of paper are 297 millimeters by 210 millimeters.)
• Aunque de inicio no lo creas, una hoja de papel simple puede soportar un peso significativo. (Although at first you may not believe it, a single sheet of paper can support a significant weight.)
• El papel de arroz se usa en la cocina asiática. (Rice paper is used in Asian cooking.)
• El papel se ha convertido en uno de los productos embleméticos de nuestra cultura. (Paper has become one of the products characteristic of our culture.)
• Ayer yo necesitaba un papel para anotar algo. (Yesterday I needed a sheet of paper in order to write something down.)

Papel in singular or plural can refer to documents of various kinds:

• No necesito un papel para confirmar que estamos juntos. (I don't need a document to prove that we're together.)
• Me dijeron que necesito firmar algún papel de préstamo. (They told me I need to sign some loan document.)
• Si no tiene papeles de estadía legal y es arrestado, tiene derecho a guardar silencio y pedir un abogado. (If you don't have residence documents and are arrested, you have the right to remain silent and ask for a lawyer.)

Papel Referring to Roles

Papel frequently refers to an acting role:

• La modelo venezolana es conocida por su papel de Rosita. (The Venezuelan model is known for her role as Rosita.)
• Hollywood sólo tiene un papel para los actores árabes. (Hollywood has only one role for Arab actors.)
• Alejandro tenía un papel pequeño en una escena en la película. (Alejandro had a small role in one scene in the film.)

More broadly, papel can refer to almost any kind of role, for both people and things:

• La universidad tiene un papel importante porque forma valores. (The university has an important role because it forms values.)
• La iglesia tuvo un papel crucial en la Europa medieval. The church had a crucial role in medieval Europe.
• Los científicos desempeñarían un papel central en este proceso de reforma ambiental. Scientists played a central role in this process of environmental reform.
• La Cámara siempre entendió que el presidente tiene un rol importante en estos asuntos. (The House always understood that the president has an important role in these matters.)

Papel in Phrases

Among the phrases and idioms that use the word papel are these:

• asumir el papel — to assume the role
• hacer el papel, interpretar el papel — to play the role
• papel blanco, papel en blanco — blank sheet (can be used figuratively)
• papel cuché — glossy paper
• papel de aluminio, papel de estaño, papel de plata — aluminum foil (the latter two literally refer to tin and silver foil but are nevertheless sometimes used to refer to aluminum foil)
• papel de embalar — wrapping paper (such as for a gift)
• papel higiénico — toilet paper, bath tissue
• papel moneda — paper money
• papel periódico — newsprint
• papel picado  — a type of decorative perforated paper popular in Mexico as a decoration
• papel pintado — wallpaper
• perder los papeles — to lose self-control
• sobre el papel — in theory, on paper
• tomar un papel — to take a role
• trozo de papel — piece of paper

Etymology of Papel

Like the English word "paper," papel comes from the Latin papyrus , which came from the Greek papyros , referring to a plant from which paper was once made.

The meaning of papel as a role comes from the roll of paper that actors' roles once were written on. (Despite the different spelling, the English "role" also comes from that usage.) The Spanish rol is often used synonymously for that meaning.

Key Takeaways

• Papel is often synonymous with the English "paper" and can be used for different kinds of paper and documents.
• Papel also can refer to various kinds roles played by people or objects.
• Using 'Seguro' in Spanish
• Halloween Words
• Speaking of Work in Spanish
• Expressions with 'Hacer'
• Fickle or Partially Friends Abound in Spanish and English
• How To Use the Spanish Preposition ‘Para’
• Using the Spanish Verb ‘Levantar’
• Using the Spanish Verb ‘Ser’
• ‘Ojo’ Phrases and Idioms in Spanish
• Spanish Words From Greek Ending in '-ma' Often Masculine
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• When Spanish Words Become Our Own
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• Using the Spanish Word Tamaño

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Spanish to Go

Paper in Spanish

1. Paper in Spanish is “papel”. 2. To pronounce it correctly, say “pah-pehl” with emphasis on the second syllable. 3. Remember to roll your ‘r’ sound to achieve the authentic Spanish accent. 4. Use the word “papel” in a sentence by saying, “¿Me puedes pasar el papel?” to ask for a piece of paper.

How to Say Paper in Spanish

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• Open access
• Published: 10 April 2024

Cultural adaptation and validation of the caring behaviors assessment tool into Spanish

• Juan M. Leyva-Moral 1 ,
• Carolina Watson 1 ,
• Nina Granel 1 ,
• Cecilia Raij-Johansen 1 &
• Ricardo A. Ayala 2 , 3  

BMC Nursing volume  23 , Article number:  240 ( 2024 ) Cite this article

Metrics details

The aim of the research was to translate, culturally adapt and validate the Caring Behaviors Assessment (CBA) tool in Spain, ensuring its appropriateness in the Spanish cultural context.

Three-phase cross-cultural adaptation and validation study. Phase 1 involved the transculturation process, which included translation of the CBA tool from English to Spanish, back-translation, and refinement of the translated tool based on pilot testing and linguistic and cultural adjustments. Phase 2 involved training research assistants to ensure standardized administration of the instrument. Phase 3 involved administering the transculturally-adapted tool to a non-probabilistic sample of 402 adults who had been hospitalized within the previous 6 months. Statistical analyses were conducted to assess the consistency of the item-scale, demographic differences, validity of the tool, and the importance of various caring behaviors within the Spanish cultural context. R statistical software version 4.3.3 and psych package version 2.4.1 were used for statistical analyses.

The overall internal consistency of the CBA tool was high, indicating its reliability for assessing caring behaviors. The subscales within the instrument also demonstrated high internal consistency. Descriptive analysis revealed that Spanish participants prioritized technical and cognitive aspects of care over emotional and existential dimensions.

Conclusions

The new version of the tool proved to be valid, reliable and culturally situated, which will facilitate the provision of objective and reliable data on patients beliefs about what is essential in terms of care behaviors in Spain.

• This paper provides a culturally translated, adapted, and validated version of the Caring Behaviors Assessment tool in the Spanish context, which can be used to obtain reliable and culturally adapted data on essential aspects of patient care.

• The findings of this study contribute to the wider global clinical community by demonstrating the importance of considering cultural factors when assessing and evaluating patient care from patients’ own perspective, and also emphasizes the need for culturally sensitive approaches in healthcare settings.

• This validated instrument facilitates the measurement of caring behaviors in the Spanish context, allowing for objective evaluation and improvement. Use of the Caring Behaviors Assessment tool could thus serve as a valuable resource for both future research and clinical practice.

Peer Review reports

Caring,  as a complex culturally derived phenomenon, encompasses recognition of individuals’ uniqueness and includes moral, emotional, and cognitive dimensions [ 1 ]. Within the field of nursing, the professional act of caring is defined as an interpersonal process characterized by nurses’ expertise, competencies, personal maturity, and interpersonal sensitivity. The ultimate aim is to meet patients’ bio-psycho-social needs, ensuring their protection, emotional support, and overall satisfaction [ 2 ]. Furthermore, caring has been understood as the pivotal element that patients expect and should encounter to feel satisfied with nursing services [ 3 ]. Therefore, the concept of caring is dynamic, requiring adaptation to diverse sociocultural contexts.

Drawing on humanistic, transformative, integrative, and complex ontological and epistemological perspectives, various nursing theories have been developed that focus on promoting human-centred care [ 4 , 5 ]. One such perspective is the theory of human-to-human relationships proposed by Travelbee [ 6 ], which emphasizes the unique and irreplaceable nature of anyone who has lived or will live in this world. In this perspective, therapeutic human relationships evolve through a series of interactive steps, including the emergence of identities and the development of empathy (and later sympathy) until finally establishing rapport with persons receiving care [ 7 ].

Similarly, Watson [ 8 , 9 ] has elaborated a care process consisting of the following ten steps (caritas process): 1) consciously practising kindness and honesty while providing care; 2) being authentically present in a facilitative manner; 3) cultivating spirituality by transcending the self; 4) developing and maintaining a relationship of trust; 5) supporting the expression of both positive and negative feelings; 6) using creativity to obtain information during the care process; 7) engaging in genuine teaching and learning that take a global view of phenomena, while considering the perspective of the other; 8) creating healing environments that enhance integrity, comfort, dignity, and peace; 9) consciously and intentionally assisting with basic needs while enhancing the mind, body, and spirit; 10) remaining open to the experience of life and death, including care of both the professional and the patient’s soul. In short, caring is the essence of nursing and is a fundamental element for establishing effective nurse-patient relationships and achieving high-quality health outcomes.

The quality of nursing care is directly related to patients’ general experience and satisfaction. Evidence shows that patient experience with nursing care is a crucial predictor of patient satisfaction [ 10 , 11 ]. Studies indicate that providing expert and integrated care contributes to patients’ sense of safety and feeling embraced [ 12 ]. Conversely, professional nursing practice based on the biomedical model has been associated with low patient satisfaction and limited professional fulfilment among nurses [ 13 ].

Nevertheless, measuring nursing care plays an essential role in assessing its effectiveness and quality. By measuring nursing care, healthcare organisations and policymakers can identify areas for improvement and make evidence-based decisions to enhance patient outcomes. While caring cannot be reduced to a mere collection of actions and behaviours, this step is crucial in systematising the components of care that impact patients’ experiences [ 14 ] and in determining the contribution of nursing to health systems [ 15 ]. Watson [ 9 ] argues that, without engaging in philosophical contradictions, the use of quantitative instruments to assess care is necessary to provide scientific evidence. Such evidence helps managers and researchers to evaluate the complex and unique role of nursing and its effects on health.

The presence of an adequate number of well-trained nurses is known to reduce the risk of patient mortality, with outcomes similar to those achieved by physicians [ 16 ]. Nevertheless, nursing care extends beyond numerical values and clinical outcomes. It is well-established that discrepancies exist between the perceptions of nurses and patients regarding what constitutes care, primarily due to the uniqueness of each individual; hence the application of individualized care is promoted and takes into account the sociocultural context [ 17 ]. Moreover, humanised care is associated with high levels of patient and family satisfaction in various contexts [ 18 ].

One of the oldest and most widely used tools for assessing nursing care is the Caring Behaviours Assessment (CBA) tool, developed by Cronin and Harrison [ 19 ]. The authors were concerned about the exclusion of patients’ perspective in care settings and sought to identify which behaviours communicated care and how their effectiveness could be evaluated. Consequently, they created and validated the CBA, which comprises 63 items, grouped into seven subscales based on Watson’s ten carative factors. The instrument has been translated and validated in several languages, including Chilean Spanish [ 15 ]. However, the Spanish spoken in Spain exhibits distinct differences to the Chilean variety in word usage, meaning and cultural nuances, influenced by other languages spoken in the country such as Catalan or Galician. Consequently, despite extensive debate in recent years, there are currently no reliable assessment instruments available in the Spanish context that adequately consider cultural nuances in patients’ experiences. Therefore, using the CBA in an apparently similar but different language variety could lead to misinterpretation [ 20 ].

The aim of this study is to report the process of cultural translation, adaptation, and validation of the CBA in Spain, which to the best of our knowledge is the only culturally grounded version available. This new version of the CBA will provide a reliable means to obtain objective, tangible, and culturally adapted data on patients’ perceptions of the elements they deem to be essential in their care.

Approval was obtained from the relevant Ethics Committee on 2020 ( ethics committee name, hidden for blinding purposes ). Then, a study organised in three phases was undertaken on 2021–2022. The phases were as follows: 1. Transculturation. 2. Training. 3. Administration.

A previous publication reported the process of creating a version of the CBA in Latin-American Spanish, namely in Chile. The authors of that publication suggested several steps for obtaining a transculturally adapted version, which we used here. These steps were as follows:

Translating the CBA from English to Spanish : one translation (draft 1) was done by a non-nursing translator, and another one (draft 2) by two bilingual nurses, who were familiar with Watson’s theory. The two drafts were then contrasted, leading to an agreed translation (draft 3).

Back-translation from Spanish into English : A bilingual nurse who was familiar with the subject but unfamiliar with the CBA, back-translated draft 3 into English (draft 4).

Refining the Spanish draft prior to the pilot test : the authors reworked a refined version (draft 5) by contrasting the back-translation with the original CBA in English.

Pilot-testing the translated version : Once satisfactorily refined, the translated version was tested with 36 volunteers. This step included interviewing them to identify their understanding of each item.

Linguistic and cultural adjustment: draft 5 was further adjusted by analyzing the volunteers’ responses and using three linguistic criteria: semantic disambiguation, morpho-syntax, and language. This step aimed to ensure one of the key traits of the CBA: plain language. As in the Latin-American version by Ayala and Calvo [ 15 ], conjugation was adjusted (i.e., use of the subjunctive tense instead of the present tense), so that the items reflected hypothetical situations. Otherwise, it would be all too easy for patients to misconstrue that they were being asked to assess the actual care provided by specific nursing staff. Equally, the order of the Likert-type scale was maintained from 1 to 5, left to right. Lastly, grammatical structures and words that sounded natural in spoken Spanish were double-checked with a linguistic consultant. This process led to the preliminary version of the CBA in Spanish.

A team of research assistants was trained in the application of the instrument to ensure a standardised administration process. The training included, for example, that informed consent had to be obtained from all participants before they were given a copy of the questionnaire, that the instructions had to be read aloud to the participants clearly and calmly, that the instrument had to be completed privately, and that the assistants had to remain nearby and attend to participants’ queries. This phase was crucial to minimize the risk of inducing an observer effect on responses.

We administered the transculturally-adapted version of the CBA to a non-probability sample ( N  = 402). To test its psychometric properties [ 21 ], the preliminary version was applied to a sample of adults (between 5 and 10 per item; with a mean age of 39.5 years [SD = 16.5]), who had been hospitalised within the previous 6 months (mean = 2.75 times). This phase aimed to assess the CBA with users of similar characteristics and under similar conditions to those of the final intended users: the CBA is specifically designed to be used in hospital settings.

The procedure yielded 402 observations, providing a significant amount of data for the analysis of item/scale and subscale/scale consistency, as well as the overall reliability of the CBA in measuring a single construct. Of the 402 observations, 120 were excluded from the analysis as they were from health practitioners. As a result, the final sample size was for the analysis was N  = 282.

Statistical analysis

Our objective was to analyse the single items and item‐scale consistency, as well as explain potential differences in perceptions based on demographic data. In addition to assessing the validity of the scale, we also aimed to determine the relevance of diverse caring behaviours within the particular cultural setting of the study. To achieve this, we used correlation analyses to examine the associations between caring behaviors and relevant cultural factors.

Analyses were performed by examining mean and SD (± 1SD) values per item to identify the highest‐ and the lowest‐ranking behaviours. In addition, a Kaiser–Meyer–Olkin (KMO) factor adequacy and Bartlett’s test for sphericity were used to know if our dataset could be factored. Afterwards, Exploratory Factor Analysis (EFA) was used to find common structure in data. The final number of factors was obtained using a parallel analysis. The factorial method employed was minimum residual with Varimax rotation.

Finally, Cronbach’s alpha as well as McDonald’s omega were used to estimate internal consistency and reliability respectively. All statistical analyses were performed using R statistical software (v4.3.3) [ 22 ] and the package psych (v2.4.1) [ 23 ].

As previously mentioned, 120 out of the 402 participants were health professionals. Our initial intention was to retain them in the sample, but their responses made the items markedly redundant, likely due to their familiarity with philosophies of care or a self-validating effect. Therefore, these participants were excluded from the sample. The paragraphs below report the results of the validation tests.

Scores by items

As per descriptive statistics, we calculated mean scores ± 1SD for each of the 63 items of the CBA. The five highest‐ranking and five lowest‐ranking behaviours are listed below (Tables  1 and 2 ). The means ranged from a maximum of [4.87] (± 0.44) for item 3 “Know what they’re doing” to a minimum of [2.88] (± 1.06) for item 25 “Visit me if I move to another hospital unit.”

Cronbach’s alpha and MacDonald’s omega scores by subscales

To calculate the mean ± 1SD per subscale, the items were grouped into their respective subscales. Table 3 shows the scores by subscales alongside their reliability coefficients (ω). As expected, the subscale “Existential/phenomenological/spiritual forces” was the lowest-ranking subscale (3.76 ± 0.34), while “Human needs assistance” was the highest-ranking subscale (4.49 ± 0.23). Nevertheless, both Cronbach’s alpha and McDonald’s omega were 0.8 or higher in all subscales. Importantly, Cronbach’s alpha for the overall scale was 0.96, indicating that the instrument shows a high internal consistency, while McDonald’s omega showed high reliability (0, 97).

Consideration of scale purification

After running the statistical tests, we were dissatisfied with some of the results and deliberated on the need for scale purification [ 24 ]. We found that the items correlating less highly with the overall scale, typically those carrying some existential meaning, were not automatically associated by the respondents with nursing care, and some even considered they were not pertinent to nurses’ work.

Additionally, numerous participants informed us that some items were confusing or sounded redundant. This result had already been detected during the linguistic phase of the study (phase 1), when participants often pointed out that some questions were being asked twice, although differently, which they found somewhat tiresome or repetitive (see Table  4 ).

The decision to perform scale purification for the sake of simplicity required some debate among the listed researchers, as our aim was to have a very high correlation in all of the items. Naturally, this is not the aim of validating an instrument per se. More problematic still were the items that had relatively lower correlations but were meaningful from a theoretical perspective [ 25 ].

We thus aimed to combine personal judgement and statistical criteria, as keeping those items could allow changes in perception to be assessed across time. Furthermore, when removing the items in question, the overall Cronbach’s alpha increased only minimally (from 0.960 to 0.963). Therefore, we decided to keep all 63 items, as in the original CBA [ 19 ], resulting in the validated version of the CBA questionnaire in Spanish. The final version and the item-by-item translation are provided in the Supplementary material .

Exploratory factor analysis

Interestingly, EFA showed that while subscales 1, 2 and 5 are conceptually linked (Humanism/Faith-hope/Sensitivity, Helping/trust, Supportive/protective/corrective environment), these were also strongly associated in the dataset. Similarly, subscales 4 and 6 (Teaching/learning, Human needs assistance) and 3 and 7 (Expression of positive/negative feelings, Existential/phenomenological/spiritual forces) formed somewhat 4 separate groupings on their own. This was also highlighted by the parallel analysis, which showed that 5 factors were found. The latter was reassuring in terms of how well structured the CBA tool is. Additionally, EFA enabled us to identify that the highest loadings (L, see Table  5 ) were item 17 “Really listen to me when I talk” (L = 0.71); item 36 “Ask me what I want to know about my health/illness” (L = 0.70); item 37 “Help me set realistic goals for my health” (L = 0.69); item 06 “Encourage me to believe in myself” (L = 0.69); item 07 “Point out positive things about me and my condition” (L = 0.67); and item 28 “Encourage me to talk about how I feel” (L = 0.67).

KMO and Bartlett’s sphericity test showed that our data set was able to be factorized. KMO overall was 0.93, while Bartlett’s sphericity test (X 2  = 11126.8, p  < 0.05) also suggested that our dataset could be used in EFA. This analysis was done using 5 factors, as shown by the parallel analysis. Table 5 shows the item loadings higher than 0.5 for each factor, while the results for the EFA are shown on Table  6 . The first 3 factors explain 30% of observed variability, while adding factors 4 and 5, completed the 45% of variability explanation (see Table  6 ).

The variability explained after the EFA clearly demonstrates how complex the observed variability becomes following the application of the CBA tool.

How respondents answered the open‐ended question

Some carefully selected examples of the participants’ responses are shown in Table  7 . Additionally, in Phase 1 participants seemed surprised by the items relating to existential/phenomenological/spiritual dimensions. The participants disagreed that these dimensions pertained to nursing care (i.e., “What have nurses become now? Psychologists?”).

Discussion of cultural adaptation and validity of the CBA

The steps taken to ensure accurate cultural adaptation of the Spanish version of the CBA were essential to creating a version tailored to Spanish users, considering the specific features of a region influenced by several languages. Cronbach’s alpha for overall reliability was high (0.96), and all its subscales were 0.8 or higher. The overall Chronbach’s alpha is reassuring as it mirrors that of the Chilean Spanish CBA validated by Ayala and Calvo in 2017 [ 15 ], although in our study there was more dispersion across the subscales. Equally, McDonald’s omega showed high reliability.

Research studies conducted in different regions have also validated CBA versions for patients in the USA [ 26 ], Saudi Arabia [ 27 ] and Jordan [ 28 ]. These studies consistently reported overall Cronbach’s alpha values above 0.8, adding cumulative evidence in support of the CBA as a valid instrument to measure nurses’ caring behaviours.

Moreover, a descriptive analysis was conducted to identify the caring behaviours receiving the highest and lowest ranking. As expected, some items showed weaker correlations with the overall scale, and some participants even considered them “irrelevant” or unrelated to nurses’ duties. When we compared our study to that performed by Ayala and Calvo [ 15 ] and the original by Cronin and Harrison [ 19 ], similarities were found in the results for most of the items. However, differences were found in the item “consider my spiritual needs”, which was rated lower by the Spanish sample. This discrepancy may be related to cultural and contextual factors influencing perceptions and expectations regarding caring behaviours.

Emergence of a 5-dimensional factorial solution for the CBA scale in the Spanish context

Our study presents evidence for a 5-dimensional factorial solution for the CBA scale in the Spanish healthcare context. The convergence of findings suggests that the identified dimensions capture meaningful variance in the dataset and reflect underlying patterns of caring behaviors within the Spanish healthcare context.

Our findings suggest a strong theoretical coherence among certain dimensions within the CBA (Caring Behavior Assessment) scale, reflecting interconnected clusters of caring behaviors. For instance, subscales 1, 2, and 5 demonstrate conceptual linkage, forming a cohesive first dimension that encompasses ‘Humanism/Faith-hope/Sensitivity, Helping/Trust, and Supportive/Protective/Corrective Environment’. Specifically, our analysis reveals an expanded understanding within the first dimension, encompassing not only the initial three carative factors as in the original version but also incorporating two additional factors. These include the formation of a humanistic-altruistic system of values, the installation of faith-hope, the cultivation of sensitivity to oneself and others, the development of a helping-trust relationship, and the provision for a supportive, protective, and corrective environment. This expanded dimension highlights the interconnectedness of empathy, compassion, trust, and reliability within caregiving relationships, reinforcing the foundational principles outlined in Watson’s Theory of Transpersonal Care [ 8 ] and also supported by established theories of patient-centered care [ 29 ]. Additionally, this dimension highlights the importance of providing a supportive, protective, and corrective mental, physical, sociocultural, and spiritual environment, aligning closely with Watson’s emphasis on creating conducive environments for healing and growth. By recognizing this evolution in our analysis, we underscore the ongoing refinement and adaptation of theoretical frameworks to specific contexts better capture the complexities of caregiving dynamics and promote holistic patient care.

While subscales 1, 2, and 5 form a single cohesive dimension, subscales 3, 4, 6 and 7, form separate groupings, resulting in a total of five dimensions, each representing specific facets of caring behaviors. The second dimension, ‘Teaching/Learning’, focuses on the educational aspects of caregiving and skills training. This dimension aligns with the principles of transpersonal care, emphasizing the importance of nurturing the growth and development of both caregivers and recipients through shared learning experiences. The third dimension, ‘Human Needs Assistance,’ emphasizes the importance of fulfilling the fundamental needs of people receiving care, reflecting the humanistic approach to caregiving that prioritizes the preservation of dignity and autonomy. The subscale ‘Expression of Positive/Negative Feelings’ captures the acknowledgement and validation of the emotional experiences of patients receiving care, resonating with the empathetic and compassionate aspects of transpersonal care. Lastly, the dimension ‘Existential/Phenomenological/Spiritual Forces’ addresses the existential, phenomenological, and spiritual aspects of caregiving. This dimension emphasizes the interconnectedness of mind, body, and spirit, echoing the holistic perspective of transpersonal care, which acknowledges the spiritual essence and interconnectedness of all beings. This comprehensive framework illuminates the multifaceted nature of caregiving, addressing diverse aspects essential for holistic patient care and well-being.

Relevant findings and preferences of Spanish individuals

The highest-ranking items among the Spanish participants mainly related to technical and cognitive components, such as competence in clinical procedures and the handling of equipment. Conversely, the lowest-ranking behaviours related to emotional and existential dimensions, such as talking about life outside the hospital, understanding patients’ experiences, and considering spiritual needs. These results may indicate that, within the Spanish context, these components are perceived by patients as less important than technical competencies, thus highlighting their priorities in terms of their care, even though the respondents were not hospitalised. These results suggest that clinical skills and technical competencies play an important role in patients’ perceptions of the quality of nursing care in Spain [ 30 ]. This finding is supported by a prior study [ 31 ] comparing nursing practice in Spain with that in the UK.

The prioritization of technical competencies over emotional and existential dimensions in nursing care may be explained by people’s prioritizing. Individuals usually prioritize basic needs and gradually move to more complex ones after basic needs are met. The perception of care may follow a similar pattern. The primary focus may thus be on safety and meeting the standard of performance required to guarantee this basic need, with less emphasis on the overall experience of wellbeing and being looked after. This approach also tends to be used in healthcare delivery, where the main focus is usually placed on survival-related outcomes [ 32 ]. However, as healthcare evolves toward value-based and person-focused approaches, there is growing awareness of the need to expand services and prioritize broader aspects of care. Expectations may thus be informed by factors such as recovery and quality of life, and become aligned with patients’ priorities, expectations and desire for comprehensive care and enhanced overall quality of life. By understanding this dynamic, healthcare professionals can better navigate the complexities of patient expectations and ensure the delivery of care in accordance with diverse needs and preferences.

However, to ensure comprehensive nursing care aligned with the expectations of individuals in Spain, it is essential to have a deep understanding of their individual needs and priorities. Validation studies conducted for specific populations may shed light on the elements of healthcare that are highly valued and contribute to humanisation. For example, research focusing on transgender populations has shown that being asked about their preferred form of address is highly valued [ 33 ] but does not seem to be a priority for the general population in our setting. Similarly, individuals in end-of-life processes place great importance on the ability of nurses and clinicians to show compassion and empathise with their feelings, while these qualities were not prioritised in the participants in our sample [ 34 ]. Equally, women going through challenging experiences, such as miscarriage, stressed that a key element of the care they required was being helped to cope with the future and understand their feelings [ 35 ].

In a similar vein, another study focused on how the general population perceived the quality of nursing services. The findings of that study revealed that various dimensions of quality, such as psychological, physical, and communication components, were rated at a moderate level, suggesting that there was room for improvement in meeting patients’ expectations [ 36 ]. This finding emphasises the importance of tailoring nursing care to specific populations to address the complexity of individual preferences, and highlights the need to focus on the multidimensional aspects of care to enhance the overall quality of nursing activity.

An awareness of contemporary nursing training and the scope of nurses’ work in society could fruitfully contribute to shifting such expectations away from a focus on technical and knowledge-related issues. As stated by López-Verdugo et al. [ 37 ], society often relies on misinformation when referring to nursing work, which is also often based on widely disseminated myths and stereotypes. A stereotyped image of nursing work, and of nurses themselves, may well lie beneath the reaction of some of the Spanish participants in our study when asked about the importance of emotional and spiritual needs in nursing care. Participants may not always fully appreciate the importance of integrated care, just as contemporary nursing remains largely unknown in Spain [ 37 ]. Therefore, a change in perspective is needed to foster greater appreciation of the profession for more rewarding experiences during periods of health and illness, both for users and for healthcare providers.

Previous research has emphasised human care as a driving force in nursing practice, highlighting that quality care relies on a holistic view of care that extends beyond technical proficiency [ 38 ]. Several studies have underscored that human care, which encompasses emotional support, effective communication, and attention to patients’ psychosocial needs, is essential for promoting patient satisfaction and achieving favourable health care outcomes [ 39 ].

A drawback of the CBA is its relatively long length, leading to a risk of tiring respondents. This limitation has been acknowledged in previous literature [ 15 ]. In addition, during the cultural adaptation phase of the present study, participants reported that some items were somewhat repetitive. To address this concern, future research could focus on validating abbreviated versions of this and other instruments. This approach would allow more streamlined integration of theoretical perspectives into routine assessments in clinical practice. Similarly, exploring the perspectives of specific population groups could provide a more nuanced understanding of their unique expectations regarding healthcare.

As patient-centered care gains recognition as a fundamental aspect of quality healthcare, understanding and measuring caring behaviors become necessary for healthcare organizations and professionals, highlighting the importance of tools like the CBA scale.

The interplay between theory and practice has gained prominence in nursing care over the past two decades. This dynamic encompasses various dimensions, ranging from abstract concepts like human sensitivity and emotional engagement to more tangible factors such as clinical skills. In this context, the use of tools to assess and translate nursing care into workable data have gained importance in healthcare policy and management. Indeed, such objective data can be useful for decision-makers in higher-level management, as nurses’ work is key to user satisfaction and the transformation of the biomedical paradigm in health care. Adapting and validating instruments can thus contribute to these processes.

Similarly, implementing ‘tooling up’ strategies can be a useful way of rendering nurses’ often invisible work visible, which, in the process, could incentivise a humane approach, which is perceived to have been lost in the evolutionary loop of healthcare in the industrialised world.

To support this endeavour, this article provides a validated version of the CBA for users in Spain. This version remains true to the original CBA but incorporates certain modifications into the Spanish version for respondents’ ease of use. Through a process of translation, cultural adaptation and statistical analysis, this new version has been demonstrated be a valid and culturally-appropriate instrument, which provides reliable, objective, comparable and culturally-sensitive data on patients’ perceptions of the most essential elements of care during hospitalization.

All authors declare that they have no conflicts of interest. The individuals who participated in this study were research participants and were not involved in the design, conduct, or preparation of the manuscript.

Relevance for clinical practice

The study addressed the problem of the lack of a culturally translated, adapted and culturally validated version of the Caring Behaviors Assessment (CBA) tool in the Spanish context. This was a significant issue as it hindered the collection of objective and culturally sensitive data on essential aspects of care.

The research will have an impact on several groups. First, it will benefit healthcare professionals and providers, policymakers and managers by providing them with a reliable instrument to evaluate and improve patient care. This instrument could enhance their understanding of patient needs and preferences, enabling them to identify areas for improvement and promote person-centered care.

Second, the research could directly benefit the Spanish-speaking population. Through the CBA tool, individuals will be able to ask for care that aligns more closely with their personal values and preferences, thus promoting a shift towards person-centered care.

Availability of data and materials

The datasets used and/or analyzsed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Caring Behaviors Assessment

Exploratory Factor Analysis

Standard Deviation

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Acknowledgements

We would like to express our gratitude to all the participants who took part in the study. We also wish to thank Dr Pedro Hervé (U. Magallanes, Chile) for providing statistical support. Lastly, we would like to thank Dr Sherill N. Cronin (Bellarmine University, USA) for giving us permission to use and translate the CBA tool into Spanish.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Juan M. Leyva-Moral, Carolina Watson, Nina Granel & Cecilia Raij-Johansen

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Contributions

JM.LM. and RA.A. made substantial contributions to the conception and design of the project. including the development of survey instruments and strategic planning for project dissemination. C.W. and N.G. played a key role in data acquisition, overseeing survey implementation and managing outreach efforts. JM.LM. and RA.A analyzed and interpreted data. C.W., C.RJ., and N.G. were involved in drafting and revising the manuscript. JM.LM and RA.A critically reviewed it for significant intellectual content. All authors read and approved the final manuscript.

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Correspondence to Carolina Watson .

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All ethical principles of biomedical research advocated in the Declaration of Helsinki were respected. This study has been reviewed and approved by the UAB Research Ethics Committee in accordance with ethical standards and guidelines. Approval reference number: (approval reference number CEEAH 5194). Participants were provided with a thorough explanation of the study procedures before accessing the questionnaire, ensuring their voluntary participation, with a commitment to maintaining the anonymity of the collected data. Informed consent was obtained from each participant before the completion of the questionnaires.

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Leyva-Moral, J.M., Watson, C., Granel, N. et al. Cultural adaptation and validation of the caring behaviors assessment tool into Spanish. BMC Nurs 23 , 240 (2024). https://doi.org/10.1186/s12912-024-01892-2

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DOI : https://doi.org/10.1186/s12912-024-01892-2

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