A supportive environment that is conducive to learning was another factor that patients thought to be advantageous in compassion training [50]. This entailed not only being physically present with the patient and addressing their medical needs, but seeking to understand their unique needs (e.g. Tarberg AS, Kvangarsnes M, Hole T, Throns M, Madssen TS, Landstad BJ. Ironically, the majority of studies focused on HCPs perspectives on patient factors (personality, behaviours, communication issues, etc.) 3. The relationship between perceived organisational threat and compassion for others: implications for the NHS. Big Bend Hospice to open care unit at TMH with help of local credit union An imperative, and neglected, factor to cultivating and sustaining compassion in healthcare identified in this recent realist review, was the role of healthcare system and organizational leaders in creating the conditions, educational resources, and policies to ensure that compassion is not only embedded across the healthcare system, but is considered a shared responsibility, and not simply the onus of HCPs [54]. Each positive gesture further solidifies the commitment to providing patient-centered quality care aimed at improving patient outcomes. 2). Most include a cognitive element: understanding what is important to the other by exploring their perspective; a volitional element: choosing to act to try and alleviate the . (2018) generated a HCP model of compassion, in which HCPs defined compassion as a virtuous and intentional response to know a person, to discern their needs and ameliorate their suffering through relational understanding and action (p. 5) [45]. Fernando A, Rea C, Malpas P. Compassion from a palliative care perspective. Royal College of Nursing, 2018 Principles of Nursing Practice Over to you What matters most in end-of-life care: perceptions of seriously ill patients and their family members. For nurses in palliative care, action was evident in being proactive in planning the palliative pathway with the patients and families before the patient had reached their terminal phase [89]. As a library, NLM provides access to scientific literature. GUID:34E1500F-E371-4919-A7B6-D71CF6B86EEF, Ethics approval and consent to participate, Compassion, Healthcare, Patients, Healthcare providers, Scoping review, Intervention. Only primary and secondary studies using qualitative, quantitative, or mixed method designs were included. (2020) also conceptualized compassion in midwifery care through a model, highlighting its key components as being with me, relationship with me, and empowering me [109]. The majority of these studies presenting perspectives on compassion were qualitative in design (n=35), followed by mixed methods (n=5) and cross-sectional survey studies (n=5). For the narrative synthesis [66], any quantitative data were initially translated to qualitative descriptions. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2004. Gould et al. p. 2021. examples of compassion in care; examples of showing compassion in care; lord of the flies chapter 2 study questions answers; example of compassion in healthcare; everfi higher education answer key; prc.gov.ph exam results cpa; florida cdl test questions and answers; somebody answer the phone remix; psi exams locations; cfa level 3 exam date . This lack of patient perspectives was a key limitation identified in a previous scoping review by Sinclair et al. Burnout and compassion fatigue: chronic workplace stress and emotional 15 other terms for compassionate care - words and phrases with similar meaning. shows that participating in these types of self-exploration activities can improve a nurses resilience which is associated with increased hope and reduced stress. With increased resilience and reduced stress, nurses are ready to provide quality and compassionate patient care. A comparison of the perceptions of people in the United States and Ireland. Australia, Colombia, Cyprus, Czech Republic, Greece, Hungary, Isreal, Italy, Norway, Philippines, Poland, Spain, Turkey, UK, USA, Hospital palliative care unit; hospital and rural palliative care consult service; hospice; outpatient oncology palliative care, Rehabilitation Units (Spinal Injury and Brain Injury), Hospital and community based pediatric and adult palliative care settings, Experimental lab conditions in the medical context, Social care staff and students, members of the public (, Acute care: orthopaedic, surgery, cardiology and respiratory medicine, Internal, surgical, emergency, burn, CCU, and ICU, Hospital: Adult general wards (6 internal and 4 surgery), Patients with personal experience with nursing care (, Hospital palliative care unit and palliative care consult service, Patients (i.e. An empirically-based, clinically-relevant, patient orientated definition of compassion, that reflects the dynamic nature and multiple domains of the construct of interest is imperative to the fidelity and advancement of educational and clinical interventions designed to improve it. [. Additionally, nurses in hospital settings felt muted in their ability to provide compassion when their managers failed to support them in its delivery [74]. Compassionate care in nursing isnt a difficult thing to practice. (2017) conducted a quantitative (baseline and 4months post) intervention with clinicians (ward managers, healthcare assistants, staff nurses and charge nurses) and patients [97]. As such, the provision of compassion depended on the individual nurses own personal values balanced with their duty of care [90]. Dewar B, Mackay R. Appreciating and developing compassionate care in an acute hospital setting caring for older people. At level 1, a minimum threshold of 80% agreement (number of agreements/number of agreements + disagreements) [62, 63] was utilized to guide screening of the remaining titles and abstracts. While recent reviews have identified the current landscape of compassion training programs [53, 54], (i.e. Exploring Nurses' meaning and experiences of compassion: an international online survey involving 15 countries. Burridge L, Foster M. Compassion in rehabilitation nurses who provide direct patient care: principles to pragmatics. How Nurses Lead With Compassion Patients experiencing illness may be met with challenges ahead: tests. Available from. Overall, the CLECC program was favorable towards reducing negative staff-patient interactions and was anecdotally felt to offer potential benefit in reducing patients experiences of lack of emotional connection with the healthcare team [97]. As such, studies that focused on other related concepts such as compassion fatigue, compassion satisfaction, empathy, or intervention studies aimed at fostering self-compassion (i.e. While the recent development of a psychometrically rigorous and robust patient-reported compassion measure has partially addressed this issue, there is now a critical need to further address this theory-practice gap through the development of evidence-based educational training programs that equip practicing HCP with the attitudes, knowledge, skills, and behaviours that comprehensively traverse each of the domains of compassion. Ordons AL R d, MacIsaac L, Hui J, Everson J, Ellaway RH. Apart from the original scoping review [1] and a more recent review targeting compassion in the pediatric population [58], no other completed knowledge synthesis reviews were identified on this topic. Compassion training in healthcare: what are patients perspectives on training healthcare providers? It becomes mundane. Inclusion in an NLM database does not imply endorsement of, or agreement with, For example, using the Physician Compassion Questionnaire to rate clinicians on five dimensions of warm-cold; pleasant-unpleasant; compassionate-distant; sensitive-insensitive; and caring-uncaring [104], advanced cancer patients in a randomized clinical trial considered physicians who provided a more optimistic prognosis to be significantly more compassionate compared to physicians who delivered less optimistic prognostic information [104, 105]. Findings from Brennan et al. Dalvandi A, Vaisi-Raygani A, Nourozi K, Ebadi A, Rahgozar M. The importance and extent of providing compassionate nursing care from the viewpoint of patients hospitalized in educational hospitals in Kermanshah - Iran 2017. Tierney S, Seers K, Tutton E, Reeve J. Thus, for sake of clarity, this narrative synthesis consists of 50 studies. Therefore, in keeping with the iterative nature of scoping reviews [56, 57], the objective of this scoping review was to provide an update to our original review [1] to include contributions to the healthcare literature over the past 5 years. While one intervention studys primary aim was to evaluate the Creating Learning Environments for Compassionate Care (CLECC), an educational programme focused on developing managerial and team practices at a group level to enhance team capacity to provide compassionate care for patients (Table (Table4),4), researchers utilized the Jefferson Scale of Empathy (JSE) to obtain a nurse-reported measure of empathy at baseline and follow-up [97], rather than using a valid and reliable measure of compassionthe construct of interest. Keep in mind that this also goes for their families. While studies suggested that compassion could be cultivated [82, 88, 95] and broad educational approaches such as personal development practices were proposed [95], the intricacies of how and what would be required in a training program remained largely unexplored. These terms, however, did not show up consistently in the 44 included studies of the original review and as such, were not included into the refined updated search strategy. People want to feel heard. Twenty-seven studies reported participants perspectives on the nature of compassion, which included the conceptualization of compassion and/or its temporal aspects (Table (Table33). Skorpen Tarberg A, Landstad BJ, Hole T, Throns M, Kvangarsnes M. Nurses experiences of compassionate care in the palliative pathway. BMC Med Educ. 8600 Rockville Pike Mills J, Wand T, Fraser JA. No new themes or subthemes were identified from the updated search. These interventions studies traversed the themes of clinical and educational interventions (Table (Table33). Bleiker J, Knapp K, Morgan-Trimmer S, Hopkins S. What medical imaging professionals talk about when they talk about compassion. Emotional intelligence. 5 Examples of Great Health Care Management - Harvard Business Review Background Compassion is considered a vital component of quality healthcare. Forty-six studies explored perspectives on the nature of compassion or compassionate behaviours, traversing six themes: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. The undercurrent of grief and loss Nurses and nursing staff treat everyone in their care with dignity and humanity - they understand their individual needs, show compassion and sensitivity, and provide care in a way that respects all people equally. Similarly, Dalvandi et al. While these recent studies addressed a conceptual gap identified in the original review, a growing theory-practice gap has emerged in its place over the last 5 years between researchers and HCPs knowledge of compassion and their ability to adequately assess it in research and address in clinical practice. Lets ask our students. International, online survey studies conducted with a total of 1323 nurses, nurse educators, and nurse managers representing 15 different countries (Table (Table3)3) used a pre-imposed dictionary definition of compassion a deep awareness of the suffering of others and a wish to alleviate it [77, 82, 87, 88]. Four studies focused on compassion interventions for HCPs (i.e. Defining compassionate nursing care - PubMed 2The Chinese University of Hong Kong, Hong Kong; University of Dodoma, Tanzania. In general, literature on clinical challenges and enablers from the patient perspective appeared to be lacking. effecting HCPs ability to provide compassion in clinical care, with little discussion of HCP factors (personality, behaviours, communication issues, etc.). In a few studies, HCP participants felt that compassion should be a prerequisite to pursuing a career in healthcare [79, 80, 84, 94]. For Better Video Meetings, Try Taking Turns - Stanford Health Care McAlister AM, Lee D, Ehlert K, Kajfez R, Faber CJ, Kennedy M. Qualitative coding: an approach to assess inter-rater reliability. The included studies from the original review (n=44) were first analyzed for keywords and subject headings by KAH. The importance of compassion and respectful care for the health But to the patient experiencing it, this could not be further from the truth. Studies were predominantly qualitative in nature, with some quantitative and mixed-methods study designs. We were interested in studies that had a primary aim to explore compassion towards others within the clinical setting or those that focused on interventions or educational programs aimed at improving compassion in clinical care. Accessed on December 16th, 2019 from. The heart of caring understanding compassionate care through storytelling. Studies that did include patients perspectives, identified language barriers as a significant challenge to experiencing compassion from their HCPs [72, 100, 102, 111], reportedly undermining HCPs motivation or aptitude for providing compassion in the process [100, 111]. 3 -6 Within this . Heyland DK, Cook DJ, Rocker GM, Dodek PM, Kutsogiannis DJ, et al. The role of professional education in developing compassionate practitioners: a mixed methods study exploring the perceptions of health professionals and pre-registration students. Understand that to them, their current situation is frightening and the future looks uncertain. A previous review on compassion in healthcare (1988-2014) identified several empirical studies and their limitations. All Info - H.R.4363 - 118th Congress (2023-2024): To address the health "Don't get weak in your compassion": bereaved next of kin's suggestions for improving end-of-life care in veterans affairs medical centers. Epstein RM, Franks P, Shields CG, et al. nursing students, residents, medical students, etc. With the emergence of empirical models and definitions of compassion [6, 45], and a valid and reliable patient-reported compassion measure for research and clinical use [15], studies have now shifted towards determining whether compassion can be trained or cultivated in practicing clinicians, while nurturing and sustaining the innate qualities related to compassion that these individuals already possess [8, 4649]. The other three intervention studies identified were educational interventions conducted in the UK, aimed towards HCPs, which analyzed the Leaders for Compassionate Care Program (LCCP) within the hospital settings, none of which included patient outcomes [6971]. Compassionate nursing care brings patients comfort when they are ill or suffering from distress. Simulation training for improving the quality of care for older people: an independent evaluation of an innovative programme for interprofessional education. Program Leaders' and Educators' Perspectives on the Factors Impacting the Implementation and Sustainment of Compassion Training Programs: A Qualitative Study. As an additional measure of rigour and quality assurance, the data extraction form was initially tested between the reviewers for 10 articles, with modification incorporated thereafter [65]. Two reviewers (SM and PJ) independently reviewed each study meeting the criteria for a full-text review to identify eligible studies for data extraction. Patients felt that compassion alleviated their suffering, enhanced overall well-being, and positively augmented the quality of care they received from their HCPs by allaying distress and enhancing their relationship with their HCPs [6, 44, 111]. Why and how is compassion necessary to provide good quality healthcare? Leaders for Compassionate Care Programme (LCCP): To empower leaders while supporting their teams in delivering high-quality and compassionate patient-centered care. Burnout and compassion fatigue: chronic workplace stress and emotional withdrawal. Relationships between physician practice style, patient satisfaction, and attributes of primary care. The theme for this section focused on caring, compassion and competence in healthcare. Here are just a few examples of how to practice compassion in nursing: Think Before You SpeakBe present and mindful of what your patient is saying to you. The centrality and willingness to proactively address multifactorial suffering, is not only the central aim of palliative care [4042], but is a defining feature of a compassionate relationship in comparison to other forms of relationships, including empathetic and caring relationships [44]. http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://www.theberylinstitute.org/page/PXCONSUMERSTUDY, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/212450/Liverpool_Care_Pathway.pdf, https://policybase.cma.ca/en/viewer?file=%2fdocuments%2fPolicyPDF%2fPD19-03.pdf#phrase=false, https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/principles-of-medical-ethics.pdf, Perspectives on compassion and compassionate behaviour, Interpersonal factors associated with compassion in the clinical setting, Barriers and enablers to compassionate care, Randomized controlled trial (quantitative), Various (i.e. A systematic review of compassion training in health care. The effect of organizational and personal variables on the ability to practice compassionately. Consumer study on patient experience. 1 weather alerts 1 closings/delays Four studies identified educational challenges and barriers to providing compassion [50, 74, 83, 107]. Knowing the patient well enough to determine their cultural view can augment the nurse-patient relationship in a positive way. Nurses must be able to discuss issues and indicate a clear vision of how compassionate organizations should function with both peers and leaders. This space was commonly described by patients as extending beyond a clinical relationship to one in which HCPs would actively engage in the patients suffering through awareness and engaged caregiving [6, 44, 45, 73, 91, 101, 110, 111]. The absence of a comprehensive knowledge base and an ambiguous understanding of how compassion is conceptualized by patients and HCPs in various healthcare contexts, makes operationalizing and improving its delivery to patients an extremely daunting and challenging task. (2019) concur with this notion of the importance of HCPs fostering strong connections with their colleagues to enhance the delivery of compassion within their organizational settings [79]. 2013. For more information or additional questions, contact the Kirby Bates Associates team of experts today. Congruence in the calibration exercise of the 50 articles was 90%, after which one reviewer (SM) proceeded with screening the remaining titles and abstracts [64]. Furthermore, researchers agree that while compassion is vital across healthcare settings, it is a central goal and tenant of quality palliative care where multifactorial suffering is prevalent, requiring future research, including how it can be sustained in palliative care providers [3942]. clinicians and patients), operational definitions and cultivation techniques, while also affirming the interpersonal nature of compassion, its predication on action, and associated barriers and facilitators in both education and practice [1]. Studies were excluded if they sampled healthy non-clinical populations exclusively, as our focus was on clinicians or patientsindividuals within society who have had significant experiences of suffering. Saab MM, Drennan J, Cornally N, Landers M, Hegarty J, Savage E, et al. Curr Opin Support Palliat Care. Despite considerable advancement in the field of compassion in healthcare over the past 30years, including the identification of associated research gaps and recommendations to guide research [1], there has been a rapid influx of disparate studies over the past 5 years (Fig. answering to patients indifferently, ambivalence, and disregard) were equally transferrable to HCP colleagues [100]. Studies also failed to include patient-derived definitions of compassion, and studies that exclusively sampled patients and/or outcomes related to patients health and quality of life were also lacking [1]. Compassion in healthcare has continued to receive growing interest over the past decade [1] from researchers, educators, clinicians, policy makers, patients, and families alike, with patients strongly emphasizing its importance to their overall quality of care [25]. The role of compassion in maintaining quality essential health services Despite this lack of conceptual clarity, the attributes or skills comprising compassion were recognized across most of the studies, including the dynamic, responsive, and proactive nature of compassionate action, in comparison to a more static, reactionary, and passive nature of empathy, sympathy, and routine care [44, 50, 86, 92, 99, 107]. Research published by the U.S. National Institutes of Healths National Library of Medicine (NIH/NLM) states that, The delivery of high quality compassionate care is also a significant patient reported outcome, which positively affects a patients perception of care and quality of life, while mitigating against patient complaints and malpractice suits.. The previously identified categories, themes, and subthemes (Table1) [1] that emerged from the data in the original scoping review were utilized as a template, allowing us to map the current results onto these pre-existing categories, themes, and subthemes. relational care and clinical communication), action, and practicality. Accessed on August 19, 2021 from, American Medical Association. While role models in the form of teachers or peers were seen as imperative for motivating physicians and nurses (especially newly graduated clinicians) to be compassionate [80, 94], it was also suggested that uncompassionate behaviours (i.e. Similar to the previous scoping review [1], perspectives on compassion were presented from either patients or HCPs, or a combination of participants (i.e. HCP and patient participants in other studies felt that the need for HCPs to juggle daily administrative or organizational requirements contributed to a myopic focus of care that centred on tasks or checking off ticky boxes rather than on providing high-quality, compassion [77, 109]. Over the past five years, the term "burnout" has become closely associated with the health care field. At the title and abstract screening (level 1), a calibration exercise of a random sample of articles (n=50) was conducted by two independent reviewers (SM and SS), to test the screening tool to ensure a standardized application of the selection criteria. Sinclair S, Torres M, Raffin-Bouchal S, Hack TF, McClement S, Hagen N, et al. Sinclair S, Kondejewski J, Jaggi P, Roze des Ordons AL, Kassam A, Hayden KA, et al. According to a systematic literature review in 2016 published by the, U.S. National Institutes of Healths National Library of Medicine (NIH/NLM), states that, The delivery of high quality compassionate care is also a significant patient reported outcome, which positively affects a patients perception of care and quality of life, while mitigating against patient complaints and malpractice suits., , There is extraordinary potential for blending the best of evidence-based medicine with real patient centeredness, performing medicine with patients rather than doing it to them, to the benefit of all., Showing compassion in healthcare can make a world of difference in someones day. Empathy, sympathy and compassion in healthcare: Is there a problem? Is One article [67] contained two separate eligible studies and has been reported herein as two separate studies [67, 68]. "Greg is a devoted advocate who keeps the patient at the center of our efforts," Kevin says. Before responding to their concerns, think to yourself if I were in this patients shoes, what information would I want to hear? Ironically, this care strategy was actually perceived by participants to be more of a barrier to providing compassion, as nurses were left to prioritize their documentation over direct patient care [96]. Enabling the flow of compassionate care: a grounded theory study. This article is based on reporting that features expert sources. care, Compassion satisfaction, Compassionate practice and compassionate caring. Lastly, a compassionate approach was perceived to help enable physicians to better cope with more challenging patient scenarios, such as those patients presenting with more psychosocial or emotional distress [94]. Empathy, sympathy and compassion also share elements with other forms of pro-social behaviour such as generosity, kindness and patient-centredness. (2017) contained two eligible studies and have been reported herein separately [67, 68], Summary of studies that explored either perspectives of compassion or compassion interventions in healthcare. It provides patients with emotional support and the confidence they need to fight disease, prepare for recovery, or enter into a serious medical procedure. 06.30.2023. Several features that patients recognized as signifying compassion included: kindness, authenticity, attentiveness, forming a relational connection, displaying presence and warmth, acceptance, understanding, listening, helping, communicating effectively, being involved, and being gentle and caring [6, 44, 98, 101103, 106, 107, 109112]. A recent systematic review of predictors of physician compassion revealed similar findings, namely that research on the barriers and facilitators to compassion in healthcare remains disproportionately practitioner-centric, requiring greater research on the both the patient perspective and the influence of broader organizational and system factors [61]. On the contrary, those patients who recoined healthcare interactions lacking in compassion reported negative outcomes such as frustration, being overwhelmed, and a lack of dignity and hope [6]. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. People tend to love talking about themselves, so if a patient is experiencing anxiety, divert the conversation to something that they personally care about; and show genuine interest in it. Key Learning Themes Compassion arises from: Awareness of human suffering. Being able to more keenly perceive and manage emotions improves a nurses ability to communicate more effectively in situations from day-to-day tasks to conflict resolution. Code of Medical Ethics: Principle 1. Several studies reported that compassion can be taught and that HCPs can be equipped with tangible knowledge and skills for improving compassion in their professional practice [50, 82, 88, 94, 95, 101, 106]. Similarly, nurses in one study felt that to be compassionate, there is a strong need for competency in relieving pain through both pharmacological and non-pharmacological means [87], including but not limited to, providing emotional comfort.