The original review included studies published up to December 31, 2014. As indicated by patient-reported evaluations of emotional care using the Patient Evaluationof Emotional Care during Hospitalisation (PEECH) tool, higher scores post-intervention indicated better patient-reported experiences. Code of Medical Ethics: Principle 1. Patience is a VirtueIts easy to get frustrated when juggling patients or having a chaotic workday. Royal College of Nursing, 2018 Principles of Nursing Practice Over to you It provides patients with emotional support and the confidence they need to fight disease, prepare for recovery, or enter into a serious medical procedure. The LCCP also influenced ways of working and specific practice development techniques particularly, staff receiving regular feedback from patients on how their delivery of compassion influenced their communication with their patients [70]. Confidence in caring: a framework for best practice. In fact, many nurses do it subconsciously already. Heyland DK, Dodek P, Rocker G, Groll D, Gafni A, Pichora D, et al. Department of Health and Social Care (UK). 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. Leo Buscaglia observed, Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around. From sharing real-life anecdotes with patients to respecting patients choices, there are a multitude of ways to be sensitive to patient needs and show compassion. In another study, patient participants felt that compassion was demonstrated through HCPs ability to demonstrate intuition, provide evidence-based care, and be proficient in managing time in their clinical practice [99]. Future studies on the topic of compassion need to investigate and honour these differences, whether in the form of validating existing definitions, measures, and interventions of compassion within various cultures, genders, or individuals who experience systemic inequities in care and in society more broadly. 2The Chinese University of Hong Kong, Hong Kong; University of Dodoma, Tanzania. Cochrane: Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). holding a patients hand, giving a back rub, placing a hand on the patient, healing touch, or human touch) to be paramount to relieving ones suffering and offering a sense of healing and comfort [87, 88]. For example, HCPs in critical and palliative care settings perceived technology as distracting them from attending to their patients emotional needs, requiring them instead to focus more on physical aspects of care [72]. With respect to the literature on challenges and enablers of compassion within practice settings, time constraints, workloads, and staff shortages, remained a prevalent issue in this updated review, as was the case in our original review [7274, 77, 79, 81, 84, 92, 94, 95, 100, 101, 106, 112]. Uncharted territory: measuring costs of diagnostic errors outside the medical record. In addition to an overview of how the field of compassion in healthcare has evolved, readers of this review will gain evidence-based knowledge in four specific areas: 1) the nature of compassion and how it is conceptualized in the healthcare literature; 2) the feasibility and reputed impact of clinical and educational compassion interventions; 3) challenges and enablers to integrating compassion in contemporary healthcare; and 4) whether compassion can be meaningfully and rigorously measured. Since the original scoping review on compassion in healthcare, while a greater number of studies incorporated patient perspectives, clinical or educational interventions appeared to be limited. emotional) and appreciate the patient as a person [6, 44, 45, 73, 79, 89, 99, 101, 110, 111]. In one study, HCP participants felt that a personal interest in compassion must be vested in, dismissing the notion of any external motivations or conditions compelling one to being compassionate (i.e. Two studies collected data from 15 different countries (Table (Table2),2), with two other secondary studies utilizing this larger dataset to report exclusively on the results from Greece and Cyprus, and the USA exclusively. Bethesda, MD 20894, Web Policies A lack of compassion has been associated to increased patient/family complaints, healthcare costs, and adverse medical events [19, 24, 2936]. Compassion was also perceived as requiring HCPs to slow down [83, 89], particularly in the palliative care context where creating a space for dying was characterized by slowness [89]. Skorpen Tarberg A, Landstad BJ, Hole T, Throns M, Kvangarsnes M. Nurses experiences of compassionate care in the palliative pathway. Wear D, Zarconi J. Any new potential categories, themes, and/or subthemes that emerged were documented and discussed through a consensus process (SM, PJ, SS). How does one provide compassionate care while maintaining their own well-being? Fourth, while the evidence that self-compassion improves compassion is lacking [115], in excluding intervention studies that focused on improving self-compassion as a means to create more compassionate HCPs, there is a remote possibility that pertinent results were missed. Key Learning Themes Compassion arises from: Awareness of human suffering. and transmitted securely. Our search strategy resulted in a total of 14,166 records identified from the eight databases (Fig. 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. Stanford Health Care seeks to heal humanity through science and compassion, one patient at a time, through its commitment to care, educate and discover. Brennan H, Westbrook J, Parry S. An understanding, a way of life: an exploration of learning disability professionals experiences of compassion. How Nurses Lead With Compassion Patients experiencing illness may be met with challenges ahead: tests. Henshall LE, Alexander T, Molyneux P, Gardiner E, McLellan A. It was also stated in one study that through relational communication, actively listening, involved listening to the subtext of what is not said (i.e., being attuned to the non-verbal cues, using silence, and paying attention to tone of voice), can help uncover patients concealed suffering [45]. Taylor A, Hodgson D. The Behavioural display of compassion in radiation therapy: purpose, meaning and interpretation. 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. What are healthcare providers' understandings and experiences of The notion of whether one can be trained to become compassionate remains the topic of ongoing debate within the literature, although this debate has dissipated since the previous review. Lloyd M, Carson A. Program Leaders' and Educators' Perspectives on the Factors Impacting the Implementation and Sustainment of Compassion Training Programs: A Qualitative Study. HCP participants in multiple studies were clear that compassion was other-orientated, was predicated in suffering, and required action aimed at alleviating it [6, 82, 87]. Relationships between physician practice style, patient satisfaction, and attributes of primary care. (2019) [101]. Awareness and mastery of your emotions and others emotions will help you provide compassionate care. 15 other terms for compassionate care - words and phrases with similar meaning. Lastly, while assessing the transferability of recently developed valid and reliable patient compassion measures is needed, the existence and further development of valid and reliable research tools offers the ability to begin to meaningfully assess these differences, and provides the means to assess and deliver personalized compassion. answering to patients indifferently, ambivalence, and disregard) were equally transferrable to HCP colleagues [100]. However, a study by Singh et al. Inclusion in an NLM database does not imply endorsement of, or agreement with, Zamanzadeh V, Valizadeh L, Rahmani A, van der Cingel M, Ghafourifard M. Factors facilitating nurses to deliver compassionate care: a qualitative study. (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]. Studies within this current review have extended what previously was a largely dichotomous (nature vs. nurture) approach to this issue to a more intersectional understanding, comprised of various factors [80, 94]. In contrast to the original review, a larger number of studies sampled solely patients (n=12), and the remainder focused on clinicians (n=27) or a mix of clinicians and other (e.g. As a library, NLM provides access to scientific literature. Planning and implementing palliative care services: a guide for programme managers. Patients and clinicians also perceived compassion to be motivated by their own personal experiences of suffering, having had to provide care to ill family members, or to be developed through family upbringing, role modelling, self-reflection and life experiences [6, 76, 80, 110]. Given the large influx and the disparate nature of the topic within the healthcare literature over the past 5years, the objective of this study was to provide an update to our original scoping review to provide a current and comprehensive map of the literature to guide future research and to identify gaps and limitations that remain unaddressed. 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. In contrast, clinicians in a study conducted by Roze des Ordons et al. What are healthcare providers understanding and experiences of compassion: the healthcare compassion model. Even a simple offer to hear them out or talk things through goes a long way in expressing empathy and improving their mental state. Given the large influx and the disparate nature of the topic within the healthcare literature over the past 5 years, the objective of this study was to provide an update to our original scoping review to provide a current and comprehensive map of the literature to . HCPs and/or patients along with students, family caregivers or even the public) (Table (Table3).3). A few studies noted some subtle differences in the expressed relational needs of females versus males, which may impact compassion. Exploring compassion from the perspective of health care professionals working in palliative care. Inside the workplace, supportive inter- and intra-disciplinary relationships helped to enhance the unity of the care team and thus aid in the development of more concise care plans which led to more consistency in patient care [76, 102]. While one study aimed to investigate the impact of common humanity scenarios on cultivating compassion [75], results from this study were largely predicated on the relational features of compassion and failed to include its action component [75]. Sinclair et al. (2020) further differentiate that indicative communication is different from traditional communication, such that body language must be accompanied with tone of voice to demonstrate a compassionate intent [98]. Its easy to get frustrated when juggling patients or having a chaotic workday. 1. A nurse with the ability to communicate any instances of abatement in quality of patient care is critical to fostering the culture of the caring environment within the healthcare organization. Maintain cultural awareness as it relates to patient-centered care. Pavlova A, Wang CXY, Boggiss AL, O'Callaghan A, Consedine NS. Study 1. Defining compassion in the digital health age: protocol for a scoping (2019) reported that patients perceived compassion to be associated with a capable HCP [107]. While communicating relevant information in a timely manner was seen as paramount to providing compassion for patients undergoing withdrawal of life-sustaining treatment [86], it was also found that HCPs display of emotion could help further humanize the interaction with patients, as long as it was exhibited in ways that were not too burdensome to the patients family [86]. This initial analysis determined that two concepts were constant across the 44 studies: compassion and HCPs, becoming the focus of the refined search for the current review. Compassionate Care in Healthcare Systems: A Systematic Review Arksey H, Malley O, L. Scoping studies: towards a methodological framework. This updated review also revealed that HCP and patient perspectives on compassion and compassionate behaviours traversed the themes and subthemes that were previously identified (Table (Table1),1), including but not limited to temporal aspects of compassion (i.e. Introduction. Empathy and compassion. Of the 14,166 number of records identified, 5263 remained after removal of duplicates, and 50 articles were included in the final review. Furthermore, since cultural and gender differences pertaining to how compassion is both expressed and experienced were alluded to within the studies reviewed herein, these individuals and differences must evolve from the realm of platitudes and good intentions to the realm of research priorities and action. 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. Vivino BL, Thompson BJ, Hill CE, Ladany N. Compassion in psychotherapy: the perspective of therapists nominated as compassionate. Foreward YR, Shea S, Wynyard R, Lionis C, editors. What Is Compassion? - Verywell Mind Results of a systematic review. 2017;22(1-2, 112):127. Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? 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. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. An article published by the. Thirty studies explored the development of compassion, which included both its innate nature and external factors that could equip clinicians with the necessary skills to further enact compassion in their clinical care. In one study, there were reported improvements in participants perceived ability to show respect and empathy in their interactions with patients [69]. Sinclair S, Kondejewski J, Jaggi P, Dennett L, Roze des Ordons AL, Hack TF. J Res Nurs. 5 Examples of Great Health Care Management - Harvard Business Review This clinical model of compassion from BMC Medical Education illustrates the health care providers role in relation to patient care and compassion. antonyms. Data Availability Statement Go to: Abstract Background Compassionate and respectful care (CRC) is an essential element for health care providers (HCPs), which builds a positive environment and intimacy among health care professionals, patients, and families. More efficacious and evidence-based interventions or training programs tailored towards improving compassion for patients in healthcare is required. Compassionate and inclusive leadership | The King's Fund People want to feel heard. 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]. Henshall LE, Alexander T, Molyneux P, Gardiner E, McLellan A. Compassionate nursing care brings patients comfort when they are ill or suffering from distress. Nurses that are empathetic toward their patients have proven to decrease rates of depression and stress, in turn strengthening their will to live which can have major impacts on a patients recovery time and satisfaction. and mutual support to enhance team capacity to provide compassionate care. 15 Words and Phrases for Compassionate Care - Power Thesaurus But are you actually listening? 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. This suggests that in relation to compassion, barriers need to be reconceptualized as challengeschallenges that can be overcome. Silent voices: family caregivers narratives of involvement in palliative care. Compassionate Nurse Gets Patients the Right Care at the Right Time According to a systematic literature review in 2016 published by the National Center for Biotechnology, Compassion originates as an empathic response to suffering, as a rational process which pursues patients wellbeing, through specific, ethical actions directed at finding a solution to their suffering. mindfulness-based stress reduction or compassion-focused therapies) were excluded. government site. Compassion in practice: nursing, midwifery and care staffour vision and strategy. A total of 49 articles underwent data extraction and synthesis of results (Table2) (Fig. The development and validation of the Sinclair compassion questionnaire (SCQ). Patients and HCPs both recognized the intrinsic qualities or virtues of individual HCPs to be integral to providing compassion, some of which included virtues of love, kindness, genuineness, consideration, understanding, and wisdom [6, 44, 45, 50, 68, 73, 77, 79, 80, 82, 84, 85, 88, 90, 94, 95, 98, 101, 102, 106, 109112] (Table (Table3).3). While various participants in a study by Kneafsey et al. There are concrete examples as to what compassion looks like in practice. Here are a few things to consider about compassionate healthcare: Benefits of compassionate care When compassionate care is practiced, it can have many benefits. The study authors also reported that the program was felt to increase motivation and confidence in leading the delivery of compassionate care [69]. Overall, we found that the studies fell within two overarching categories: perspectives or behaviours of compassion, and compassion interventions (Table (Table1)1) [1]. Having even the slightest tone of sarcasm, irritation, or hostility in your voice when interacting with a patient will have noticeable effects on a patients trust in their caregivers. 4University of Nebraska, USA. A constructivist grounded theory study to explore compassion through the perceptions of individuals who have experienced nursing care. Only primary and secondary studies using qualitative, quantitative, or mixed method designs were included. In the acute care context, care was thought to be susceptible to fragmentation given the various division of HCP roles, multiple team members, shiftwork, and sequential transitions, all leading to varying intensity and duration of patient interactions [72]. Trzeciak S, Roberts BW, Mazzarelli AJ. Being able to more keenly perceive and manage emotions improves a nurse's ability to communicate more effectively in situations from day-to-day tasks to conflict resolution. Tracie Jolliff, Director of Inclusion at the NHS Leadership Academy, explains how inclusive leadership and cultures require personal dedication to change, as well as support and oversight at an organisational level. Dont Invalidate Their FeelingsNurses and healthcare workers see injury and illness all day, every day. Stakeholders: Charge nurses and nurse managers (n=14); Practitioners: Senior nurses within the LCC programme (n=7); Policy makers: Senior individuals in the NHS organization and higher education institution (n=5), Healthcare providers and managers (N=132), Medical imaging professional undergrad students (n=6), *P Perspectives, CI Compassion Interventions. Sinclair S, Jaggi P, Hack TF, McClement S, Raffin Bouchal S, Singh P. Assessing the credibility and transferability of the patient compassion model in non-cancer palliative populations. Eight electronic databases along with the grey literature were searched to identify empirical studies published between 2015 and 2020. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Since the publication of the original scoping review, studies presenting exclusively on patient conceptualizations of compassion have increased (nine studies in total compared to only two that were identified previously), addressing a previously identified limitationthe underrepresentation of the recipients of compassion patients themselves.