The Language of Compassion in Acute Mental Health Care

Crawford, Paul; Gilbert, Paul; Gilbert, Jeffrey M.; Gale, Corinne; Harvey, Kevin

doi:10.1177/1049732313482190

Cited by 66 publications

(72 citation statements)

References 16 publications

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“…The policies themselves provide limited definition and explanation of compassion and its meaning, leading some to consider whether the complex construct of compassion is fully understood [16,17] and, if not, can it therefore be successfully promoted in practice [18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Compassion in healthcare: a concept analysis

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Compassion in healthcare: a concept analysis

et al. 2017

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“…Factors implicated as barriers to empathy include stress, time pressure and anxiety 25–30. Such factors may also interfere with physician compassion as may aspects of the patient, clinical context and work environment 31 32. In addition, medical training itself has been posited as a barrier to empathy because empathy is occasionally seen as a threat to accurate diagnosis and objective management 33…”

Section: Introductionmentioning

confidence: 99%

Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire

Fernando

Consedine

2014

Postgraduate Medical Journal

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Objective Physicians are expected to be compassionate. However, most compassion research focuses on compassion fatigue-an outcome variablerather than examining the specific factors that may interfere with compassion in a physician's practice. This report describes the development and early psychometric data for a self-report questionnaire assessing barriers to compassion among physicians. Methods In 2011, a pilot sample of 75 physicians helped to generate an initial list of barriers to compassion. A final 34 item Barriers to Physician Compassion (BPC) questionnaire was administered to 372 convenience-sampled physicians together with measures of demographics, practice-related variables, stress, locus of control and trait compassion. Results The barriers to physician compassion were not one-dimensional. Principal component analysis revealed the presence of four distinct, face-valid and discriminable factors-physician burnout/overload, external distractions, difficult patient/family and complex clinical situation. All barrier components had adequate internal reliabilities (>0.70) and meaningful patterns of convergent and divergent validity. Conclusions Remaining compassionate in medical practice is difficult. With the newly developed BPC questionnaire, specific barriers to compassion can be assessed. These barriers illuminate potential targets for future self-and practice management, interventions and compassion training among physicians.

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“…It has been noted that if a sense of peril or risk predominates, with a focus on outputs and targets, a "production-line mentality" may ensue, impeding people's psychological capacity for compassion [13]. Hence, although CC is said to call for an understanding of why someone may not follow medical advice and being able to imagine what a patient is going through [14], HCPs may lack the time to appreciate a person's unique situation and what diabetes means to him/her; consequently, they may appraise non-adherence as a significant threat to their professional proficiency and ability to help.…”

Section: Discussionmentioning

confidence: 99%

Appraising the situation: a framework for understanding compassionate care

Tierney

Seers

Reeve

et al. 2017

J of Compassionate Health Care

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Background: Compassion in healthcare represents an ideal way of interacting with patients. It entails an active response to suffering, distress or discomfort that can be associated with people seeking health related support or treatment. However, reports from within healthcare highlight that compassionate care (CC) is not always achieved. It may be especially problematic when trying to work with a patient who seems unwilling or unable to engage with advice provided by a healthcare professional (HCP). Methods: We conducted a grounded theory study to understand the meaning of CC for HCPs working with patients with type 2 diabetes. Data were collected between May-October 2015 using focus groups and individual interviews; 36 HCPs took part in total. For the current paper, we used constant comparison to analyse data from transcripts where participants talked about working with a 'non-adherent' patient. Results: Analysis highlighted how appraisal of their encounter with a non-adherent patient could affect whether CC was seen as possible by participants. Therefore, we used a transactional model of emotions as a framework for understanding HCPs' narratives. This involved a consideration of their primary appraisal of such encounters, which participants said often resulted in a sense of threat, failure and rejection. Their secondary appraisals, which centred on coping resources, included problem-focused approaches (e.g. supporting the patient to plan how to move forwards in managing their health) and emotion-focused approaches (e.g. recognising change was hard, appreciating it may not be the right time for the patient to change). These appraisals could be modified by: a) gaining experience as a HCP; b) altering what was seen as professional success; c) their connection with the patient; d) how much autonomy they had in their job. Conclusions: Our findings provide new insights and emphasise that CC in response to non-adherent patients is not determined solely by a HCP's innate nature, but can be affected by an individual's appraisal of this interaction and the resources he/she has available to cope. This has implications for the environment within which staff work.

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The Language of Compassion in Acute Mental Health Care

Cited by 66 publications

References 16 publications

Compassion in healthcare: a concept analysis

Compassion in healthcare: a concept analysis

Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire

Appraising the situation: a framework for understanding compassionate care

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