Compassion: a scoping review of the healthcare literature

Abstract

BackgroundRecent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare.MethodsSearches of eight electronic databases and the grey literature were conducted to identify empirical studies published over the last 25 years. Eligible studies explored perceptions or interventions of compassionate care in clinical populations, healthcare professionals, and healthcare students. Following the title and abstract review, two reviewers independently screened full-texts articles, and extracted study data. A narrative approach to synthesizing and mapping the literature was used.Results and discussionOf 36,637 records, 648 studies were retrieved and 44 studies were included in the review. Less than one third of studies included patients. Six themes emerged from studies that explored perceptions of compassionate care: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Intervention studies included two compassionate care trials with patients and eight educational programs that aimed to improve compassionate care in clinicians and students.ConclusionsThis review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research. A deeper understanding of the key behaviors and attitudes that lead to improved patient-reported outcomes through compassionate care is necessary.

Measuring compassionate care: views of healthcare staff

“…Exploring compassion in healthcare is warranted because it is identified as a priority for patients and their relatives, important for recovery and contributing to satisfaction with services (Sinclair et al 2016). This study highlights the complexity of measuring compassionate care, and the potential consequences if it is carried out in a simplistic way.…”

“…Relationships between staff and patients, as well as staff with each other, are recognised as central to compassionate care (Sinclair et al 2016), but the environments in which treatments are provided might not allow for such a connection. Hence, structural factors, such as time and resources, might promote or impede the expression of compassionate care (Tierney et al 2016).…”

The enduring self: personhood, autonomy and compassion in the context of community-based dementia daycare centers

“…Although we know how to describe and talk about compassion, the empirical evidence is still in its infancy. The workplace culture of the day care center, the built environment within which the care is provided, has to be conducive to compassionate care and include the culture of person-centered care [58,59]. Here the role of managers and health policy reimbursement issues are of critical importance to maintain not only trained staff, but the appropriate ratio of staff/patient to provide services in a personcentered way.…”

What Moral Distress in Nursing History Could Suggest about the Future of Health Care

“…In so doing, I shared the concerns of educators cultivating the moral development of clinical professionals [4][5][6][7]. Nurses were professionally concerned about the role of emotions in providing compassionate care to patients [8][9][10][11]. And feminist moral theory was foregrounding emotional factors in ethical theories based on care, compassion, and empathy [12,13].…”