Caring Efficacy Scale (CES)

The Caring Efficacy Scale© (CES) was developed as a tool for conducting patient outcome and cost studies. The CES assesses how strongly one has developed a caring relationship with the client or patient. The implication of this survey instrument is that one has the ability, attitude and cognition needed to elicit a behavior in the direction of interest. The instrument was initially created based on Watson’s (1979, 1985, 1988, 1996) Theory of Transpersonal Caring, which emphasizes the unique combination of scientific knowledge and humanistic aspects of nursing; by facilitating the Theory of Transpersonal Caring, a nurse would establish an intimate, caring relationship with the client.

The Caring Efficacy Scale© was also developed based on Bandura’s (1977, 1986) concept of efficacy, as described in his social learning theory. This framework is based on a triadic reciprocality where 3 factors influence behavior: environmental factors, biological factors, and cognitive factors. Bandura claims that “Perceived self-efficacy refers to beliefs in one’s capabilities to organize and execute courses of action required to meet given situational demands.” Hurley (1990) describes self-efficacy as a sense of “I can do”. Both emphasize a sense of free-will.

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Caring Efficacy Scale

Validity and Reliability

Reliability was tested on a random sample of 47 new nurses – proving that there was strong reliability and validity. There were two tests (Form A and Form B) of reliability conducted on the long form of the caring efficacy scale – returning alpha values of .85 and .88.

The caring efficacy scale was also tested for content validity and was shown to have a high validity. This investigation was carried out by Coates (1997) where faculty members were asked to rate the 30 items in Form B based on Watson’s Theory.

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Statistics Solutions consists of a team of professional methodologists and statisticians that can assist the student or professional researcher in administering the survey instrument, collecting the data, conducting the analyses and explaining the results.

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Dissertations Using the Caring Efficacy Scale©

Below is a list of dissertations using the CES.  The full version of these dissertations can be found using ProQuest.

Amendolair, D. (2007). Caring behaviors and job satisfaction: A study of registered nurses in medical surgical units in north and south carolina acute care hospitals. Capella University).

Lawrence, M. D. (2002). An exploratory study of the relationship between burnout and caring efficacy in nurses working in an urban setting. The University of Manitoba (Canada)).


Coates, C. J. (1997). The caring efficacy scale: Nurses’ self-reports of caring in practice settings. Advanced Practice Nursing Quarterly, 3(1), 53-59.

Lorig, K., Stewart, A., Ritter, P., Gonzales, V., Laurent, D., & Lynch, L. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks, CA: Sage Publications. View

Watson, J. (1985). Nursing: Human science and human care. Norwalk, CT: Appleton-Century-Crofts. View

Watson, J.(1988). New dimensions of human caring theory. Nursing Science Quarterly, 1, 175-181.