Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences

Abstract

Background:Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients’ perspectives of sympathy, empathy, and compassion are largely absent.Aim:The aim of this study was to investigate advanced cancer patients’ understandings, experiences, and preferences of “sympathy,” “empathy,” and “compassion” in order to develop conceptual clarity for future research and to inform clinical practice.Design:Data were collected via semi-structured interviews and then independently analyzed by the research team using the three stages and principles of Straussian grounded theory.Setting/participants:Data were collected from 53 advanced cancer inpatients in a large urban hospital.Results:Constructs of sympathy, empathy, and compassion contain distinct themes and sub-themes. Sympathy was described as an unwanted, pity-based response to a distressing situation, characterized by a lack of understanding and self-preservation of the observer. Empathy was experienced as an affective response that acknowledges and attempts to understand individual’s suffering through emotional resonance. Compassion enhanced the key facets of empathy while adding distinct features of being motivated by love, the altruistic role of the responder, action, and small, supererogatory acts of kindness. Patients reported that unlike sympathy, empathy and compassion were beneficial, with compassion being the most preferred and impactful.Conclusion:Although sympathy, empathy, and compassion are used interchangeably and frequently conflated in healthcare literature, patients distinguish and experience them uniquely. Understanding patients’ perspectives is important and can guide practice, policy reform, and future research.

Embodying compassion: A systematic review of the views of nurses and patients

“…The patient is aware of and is engaged by the virtues of the nurses caring for them specifically beneficence, love and kindness (Kret, ; Sinclair et al, ; Sinclair, McClement, et al, ). Motivation for the expression of compassion stemmed from a desire to act when a patient was observed to be suffering (Perry, ), to take care of the patient because they were in need (van der Cingel, ) and by the nurse doing the best they can to care (Horsburgh & Ross, ).…”

Coping strategies used by the elderly regarding aging and death: an integrative review

“…The connection between the health professional and the patient is an essential element of the quality of care provided 8 . For this reason, it is important to understand each person on an individual basis, considering how they experience losses and the coping strategies they use when faced with numerous adverse situations.…”

Measuring Compassion in Healthcare: A Comprehensive and Critical Review

“…Based on patient accounts, this study generated the following evidence-based definition of compassion: a virtuous response that seeks to address the suffering and needs of a person through relational understanding and action. The same research team discovered that patients were able to distinguish between and prefer compassion in comparison to related concepts of sympathy and empathy [30]. As the nature of compassion in clinical care becomes more evident, it is to be expected that the construct of compassion will be further delineated and become easier to measure.…”

“…In fact, the items in most instruments address empathy, with only the Compassion Competence Scale [34] including an item that directly measures the desire to help alleviate suffering, which is a key element that delineates compassion from the related construct of empathy [30]. A further limitation was that three studies included 'compassion' as a term in one of the items in their scale instead of providing an adjective describing a variable that facilitates assessment of compassion as a construct [35,36,38].…”