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Baron S, Grinberg K, Sousa JP, Neves H, Harnett G, Bianchi M, Luiking ML, Nilsson S, Frazer K, Jack K, Scammell J, Warshawski S. Dimensions of clinical leadership among pre-registration nursing students: A cross-sectional study between two countries. Nurse Educ Pract 2024; 79:104092. [PMID: 39111019 DOI: 10.1016/j.nepr.2024.104092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 07/17/2024] [Accepted: 07/31/2024] [Indexed: 08/30/2024]
Abstract
AIMS To explore a) pre-registration students' self-perceptions of clinical leadership behaviours and b) differences in students' self-perceptions of leadership behaviours between two countries (UK and Israel). BACKGROUND Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students' perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years. DESIGN AND METHODS A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1 % (Israel) and 17.9 % (England). RESULTS Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05). CONCLUSIONS Differences in students' clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care.
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Affiliation(s)
- Sue Baron
- Department of Nursing Science, Faculty of Health and Social Science, Bournemouth University, UK.
| | - Keren Grinberg
- Department of Nursing Science, Faculty of Social and Community Sciences, Ruppin Academic Center, Israel.
| | - Joana Pereira Sousa
- School of Health Sciences, Polytechnic of Leiria; Center for Innovative Care and Health Technology-ciTechCare, Leiria, Portugal.
| | - Hugo Neves
- Health Sciences Research Unit: Nursing, Nursing School of Coimbra (ESEnfC), Coimbra 3000, Portugal.
| | - Gerardina Harnett
- Department of Nursing and Healthcare Sciences at the Munster Technological University, Ireland.
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Switzerland.
| | | | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Kate Frazer
- UCD School Nursing, Midwifery and Health Systems, Dublin 4, Ireland.
| | - Kirsten Jack
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK.
| | | | - Sigalit Warshawski
- Nursing Department, Steyer School of Health Professions, Faculty of Medical and Health Sciences, Tel-Aviv University, Israel.
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Sinclair S, Dhingra S, Bouchal SR, MacInnis C, Harris D, Roze des Ordons A, Pesut B. The initial validation of an Evidence-informed, competency-based, Applied Compassion Training (EnACT) program: a multimethod study. BMC MEDICAL EDUCATION 2024; 24:686. [PMID: 38907199 PMCID: PMC11193287 DOI: 10.1186/s12909-024-05663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Compassion is positively associated with improved patient outcomes, quality care ratings, and healthcare provider wellbeing. Supporting and cultivating healthcare providers' compassion through robust and meaningful educational initiatives has been impeded by a lack of conceptual clarity, inadequate content coverage across the domains of compassion, and the lack of validated evaluation tools. The EnACT program aims to address these gaps through an Evidence-informed, competency-based, Applied, Compassion Training program delivered to healthcare providers working in various clinical settings. In this study, we describe the development and initial validation of the program, which will inform and be further evaluated in a forthcoming Randomised Controlled feasibility Trial (RCfT). METHOD A multimethod design was used to explore learner needs, experiences, and outcomes associated with the program. Pre- and post-training surveys and qualitative interviews (1 month post training) were conducted among twenty-six healthcare provider learners working in acute care and hospice. Quantitative measures assessed professional fulfillment/burnout, self-confidence in providing compassion, learner satisfaction, and compassion competence. Qualitative interviews explored learners' experiences of the program, integration of learnings into their professional practice, and program recommendations. RESULTS Learners exhibited relatively high self-assessed compassion competence and professional fulfillment pre-training and low levels of burnout. Post-training, learners demonstrated high levels of compassion confidence and satisfaction with the training program. Despite high levels of reported compassion competence pre-training, a statistically significant increase in post-training compassion competence was noted. Thematic analysis identified five key themes associated with learners' overall experience of the training day and integration of the learnings and resources into their professional practice: (1) A beginner's mind: Learner baseline attitudes and assumptions about the necessity and feasibility of compassion training; (2) Learners' experiences of the training program; (3) Learner outcomes: integrating theory into practice; (4) Creating cultures of compassion; and (5) Learner feedback. CONCLUSION Findings suggest that the EnACT program is a feasible, rigorous, and effective training program for enhancing healthcare provider compassion. Its evidence-based, patient-informed, clinically relevant content; interactive in class exercises; learner toolkit; along with its contextualized approach aimed at improving the clinical culture learners practice holds promise for sustaining learnings and clinical impact over time-which will be further evaluated in a Randomized Controlled feasibility Trial (RCfT).
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, Canada.
- Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Compassion Research Lab, University of Calgary, Calgary, Canada.
| | - Swati Dhingra
- Faculty of Nursing, University of Calgary, Calgary, Canada
- Compassion Research Lab, University of Calgary, Calgary, Canada
| | | | - Cara MacInnis
- Compassion Research Lab, University of Calgary, Calgary, Canada
- Department of Psychology, Acadia University, Wolfville, Canada
| | - Daranne Harris
- Faculty of Nursing, University of Calgary, Calgary, Canada
- Compassion Research Lab, University of Calgary, Calgary, Canada
| | | | - Barbara Pesut
- School of Nursing, University of British Columbia, Kelowna, Canada
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Chatburn E, Marks E, Maddox L. Item development for a patient-reported measure of compassionate healthcare in action. Health Expect 2024; 27:e13953. [PMID: 39102708 PMCID: PMC10801284 DOI: 10.1111/hex.13953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Compassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient-reported measure, one that captures the observable actions of compassionate care delivery or 'compassionate healthcare in action' by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout. METHODS A multistage mixed-methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two-round modified online Delphi process. RESULTS Consensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development. CONCLUSIONS This item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process. PATIENT OR PUBLIC CONTRIBUTION This study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages.
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Affiliation(s)
- Eleanor Chatburn
- Psychology DepartmentUniversity of BathBathUK
- Present address:
DClinPsy, LecturerUniversity of East AngliaNorwichUK
| | | | - Lucy Maddox
- Psychology DepartmentUniversity of BathBathUK
- University of ExeterExeterUK
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Sinclair S, Harris D, Kondejewski J, Roze des Ordons AL, Jaggi P, Hack TF. Program Leaders' and Educators' Perspectives on the Factors Impacting the Implementation and Sustainment of Compassion Training Programs: A Qualitative Study. TEACHING AND LEARNING IN MEDICINE 2023; 35:21-36. [PMID: 35085055 DOI: 10.1080/10401334.2021.2017941] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/19/2021] [Indexed: 06/14/2023]
Abstract
PHENOMENON Training programs have been used to improve compassion in healthcare, but the factors necessary to make such programs successful and sustainable have not been identified. This thematic analysis aimed to bridge the gap between theory and practice by drawing on the experiences of international leaders and educators of compassion training programs to develop a clear understanding of what is relevant and effective and how compassion training is implemented and sustained. APPROACH International leaders and educators of compassion training programs (N = 15) were identified through convenience sampling based on academic and gray literature searches. Semi-structured face-to-face interviews with these participants were conducted between June 2020 and November 2020 in order to identify facilitators, barriers, and environmental conditions influencing the implementation and maintenance of compassion training programs. The interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. FINDINGS Six categories affecting the operationalization of compassion training programs were identified 1) origins, foundational principles and purpose, 2) curricular content, 3) methods of teaching and learning, 4) trainer qualities, 5) challenges and facilitators, and 6) evaluation and impact. INSIGHTS Compassion training should be rooted in the construct of interest and incorporate patients' needs and their experience of compassion, with patient-reported compassion scores integrated before and after training. Compassion training should be delivered by highly qualified educators who have an understanding of the challenges associated with integrating compassion into clinical practice, a dedicated contemplative practice, and a compassionate presence in the classroom. Prior to implementing compassion training, leadership support should be secured to create an ethos of compassion throughout the organization.
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
- Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Compassion Research Lab, University of Calgary, Calgary, Alberta, Canada
| | - Daranne Harris
- Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
- Compassion Research Lab, University of Calgary, Calgary, Alberta, Canada
| | - Jane Kondejewski
- Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
- Compassion Research Lab, University of Calgary, Calgary, Alberta, Canada
| | - Amanda L Roze des Ordons
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Kelowna, British Columbia, Canada
- Divisions of Critical Care Medicine and Palliative Care, Department of Medicine, University of British Columbia, Kelowna, British Columbia, Canada
| | - Priya Jaggi
- Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
- Compassion Research Lab, University of Calgary, Calgary, Alberta, Canada
| | - Thomas F Hack
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada
- Psychosocial Oncology & Cancer Nursing Research, St. Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada
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Chen W, Modanloo S, Graham ID, Hu J, Lewis KB, Gifford W. A mixed-methods systematic review of interventions to improve leadership competencies of managers supervising nurses. J Nurs Manag 2022; 30:4156-4211. [PMID: 36194186 DOI: 10.1111/jonm.13828] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 01/04/2023]
Abstract
AIM This study aimed to synthesize evidence on interventions to improve leadership competencies of managers supervising nurses. BACKGROUND In recent years, numerous interventions have been developed to improve the leadership competencies of managers supervising nurses. However, researchers and nursing leaders are unclear about what aspects of interventions are effective for developing which competencies. METHODS We conducted a mixed-methods systematic review following the Joanna Briggs Institute (JBI) approach for evidence synthesis. The Medline (Ovid), CINAHL, Embase, Scopus, Nursing and Allied Health Database were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 69 studies (35 quantitative, 22 mixed methods, 12 qualitative) evaluating 68 interventions were included. Studies showed that interventions used modal activities such as lectures, group work and mentoring that generally had positive effects on improving leadership competencies such as supporting, developing and recognizing nurses. Opportunities to interact with peers increased managers' engagement in the interventions; however, many barriers existed for managers to use the competencies in practice including understaffing, insufficient time and lack of support from supervisors and staff. CONCLUSIONS Leadership interventions were shown to have beneficial effects on developing different competencies. Managers predominately felt positive about participating in leadership interventions; however, they expressed many difficulties applying what they learned in practice. IMPLICATIONS FOR NURSING MANAGEMENT Leadership interventions should include multimodal activities that give managers opportunities for interaction. When considering interventions for developing the leadership of managers, it is imperative to consider the practice environments for managers to be successful in applying the competencies they learned in practice.
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Affiliation(s)
- Wenjun Chen
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Shokoufeh Modanloo
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Ian D Graham
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epodemiology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jiale Hu
- Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Kouta C, Apostolara P, Rousou E, Maria M, Papadopoulos I. Nursing and Midwifery Managers’ Views on Compassion in Daily Practice: A Survey in Greece and Cyprus. JOURNAL OF HEALTH MANAGEMENT 2022. [DOI: 10.1177/09720634221128087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Compassionate care is a key component in nursing and midwifery quality care. It leads to positive patient outcomes, greater patient satisfaction, higher level of compliance, lower costs and reduction of nurse’s burnout. The aim of this article is to describe how nurses’ and midwives’ managers understand and practice compassion in Cyprus and Greece. This is a cross-sectional, descriptive, exploratory online survey using close and open-ended questions. Descriptive statistics and thematic analysis were applied. This is part of a larger study participating 17 countries. This article discusses Cyprus (Greek-Cypriots n = 47) and Greece data (n = 58). The sample included nurses and/or midwives in management positions, nurse educators/managers in the hospital, community or in educational setting. Participants in this study reported the necessity to be a compassionate manager. Some stated that nurses and midwives do not receive compassion from their managers. Thematic areas revealed include: (a) Defining compassion, (b) Giving/receiving compassion, (c) Manager as advocate (d) Importance of cultural characteristics (e) Advantages/barriers of compassion. Managing and leading staff with compassion have a positive effect in the quality, effectiveness and efficiency in daily practice. It enhances work satisfaction. Nurses’ and midwives’ managers in Cyprus and Greece highlight the importance of reinforcing themselves in providing compassionate care and supporting their staff.
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Affiliation(s)
- Christiana Kouta
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Paraskevi Apostolara
- Department of Nursing, University of West Attica, Egaleo Park Campus, Athens, Greece
- Department of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Elena Rousou
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | | | - Irena Papadopoulos
- Research Centre for Transcultural Studies in Health, School of Health and Education, Middlesex University, London, United Kingdom
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Li T, Jiang T, Shi G, Song C, Shi T. Correlation between self-awareness, communication ability and caring ability of undergraduate nursing students/A cross-sectional study. NURSE EDUCATION TODAY 2022; 116:105450. [PMID: 35797836 DOI: 10.1016/j.nedt.2022.105450] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Caring ability is the core ability of nursing. Here we explored the factors affecting the caring ability of undergraduate nursing students. Self-awareness and communication ability are potential variables to improve caring ability. OBJECTIVE To explore the relationship between self-awareness, communication ability and caring ability of domestic undergraduate nursing students and to explore whether communication ability has an intermediary effect between self-awareness and caring ability. DESIGN A descriptive cross-sectional study using an online questionnaire. SETTING AND PARTICIPANTS Undergraduate nursing students (n = 1411) who attended Dalian Medical University, Liaoning, China. Participants were recruited through convenience and snowball sampling methods using online platforms. METHODS The questionnaire used the Self-Consciousness Scale, Clinical Communication Competence Evaluation Scale and Caring Ability Inventory. The data were processed and analyzed by SPSS 24.0 and Amos 23.0. Descriptive statistics, Pearson correlation analysis and structural equation modeling were performed for data analysis. RESULTS There was a significant positive correlation between undergraduate nursing students' caring ability and their self-awareness and communication ability (p < 0.001). Communication ability played a partial mediating role between self-awareness and caring ability (p < 0.001), and the mediating effect was 34.2 %. CONCLUSIONS The self-awareness of undergraduate nursing students directly affects their caring ability and can also indirectly affect their caring ability through their communication ability. Educators can guide and cultivate student self-awareness and communication ability and promote self-regulation, so as to improve students' caring ability and improve clinical development.
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Affiliation(s)
- Tingting Li
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tongtong Jiang
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Genya Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chunli Song
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tieying Shi
- Department of Nursing, The First Affiliated Hospital of Dalian Medical University, Dalian, China.
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Adolfo CS, Almazan JU, Cruz JP, Albougami ASB, Roque MY, Montayre J. Saudi Arabian nurses' workaholic tendencies and their predictive role in professional quality of life. Perspect Psychiatr Care 2022; 58:1144-1152. [PMID: 34254308 DOI: 10.1111/ppc.12913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 05/18/2021] [Accepted: 06/05/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine whether nurses' workaholic tendencies and demographic variables predict their professional quality of life. DESIGN A cross-sectional design was utilized among 427 Saudi nurses which conveniently selected in four tertiary public hospitals in Saudi Arabia. FINDINGS Nurses' have higher workaholic tendencies level and moderate professional quality of life levels. Working more than 40 h per week correlates with one's risk of workaholism. Certain professional quality of life subscales is associated with gender, marital status, hospital experience, and work addiction tendencies. PRACTICE IMPLICATIONS The present study contributes to the development of new clinical practices by enlightening readers of the implications of workaholism for nurses' professional quality of life, so that this can be addressed and managed properly.
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Affiliation(s)
- Cris S Adolfo
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Joseph U Almazan
- Department of Medicine, Nazarbayev University School of Medicine, Kerey and Zhanibek Khans St 5/1, Nursultan, 010000, Kazakhstan
| | - Jonas P Cruz
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Al Dawadmi, Saudi Arabia
| | - Abdulrhman S B Albougami
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Mark Y Roque
- Department of Mother and Child, College of Nursing, Taibah University, Taibah, Saudi Arabia
| | - Jed Montayre
- Department of Nursing, School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
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Malenfant S, Jaggi P, Hayden KA, Sinclair S. Compassion in healthcare: an updated scoping review of the literature. Palliat Care 2022; 21:80. [PMID: 35585622 PMCID: PMC9116004 DOI: 10.1186/s12904-022-00942-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/05/2022] [Indexed: 11/28/2022] Open
Abstract
Background A previous review on compassion in healthcare (1988-2014) identified several empirical studies and their limitations. 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 guide future research and to identify gaps and limitations that remain unaddressed. Methods Eight electronic databases along with the grey literature were searched to identify empirical studies published between 2015 and 2020. Of focus were studies that aimed to explore compassion within the clinical setting, or interventions or educational programs for improving compassion, sampling clinicians and/or patient populations. Following title and abstract review, two reviewers independently screened full-text articles, and performed data extraction. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. Newly identified categories were discussed among the team until consensus was achieved. Results Of the 14,166 number of records identified, 5263 remained after removal of duplicates, and 50 articles were included in the final review. Studies were predominantly conducted in the UK and were qualitative in design. 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. patients and/or family members) (n = 11). 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. Four studies reported on the category of educational or clinical interventions, a notable decrease compared to the 10 studies identified in the original review. Conclusions 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. More efficacious and evidence-based interventions or training programs tailored towards improving compassion for patients in healthcare is required. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00942-3.
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Affiliation(s)
- Sydney Malenfant
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.,Section of Palliative Care, Department of Family Medicine, Alberta Health Services, Zone, Calgary, Canada
| | - Priya Jaggi
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Shane Sinclair
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada. .,Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada. .,Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
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10
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Wolbers I, Lalleman PCB, Schoonhoven L, Bleijenberg N. The Ambassador Project: Evaluating a Five-Year Nationwide Leadership Program to Bridge the gap Between Policy and District Nursing Practice. Policy Polit Nurs Pract 2021; 22:259-270. [PMID: 34693816 DOI: 10.1177/15271544211050917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
District nurses have a crucial position in healthcare provision and are expected to use leadership practices to ensure optimal quality patient care. To better equip them, a leadership program named the ambassador project was developed to support the development of a liaison role between policy and district nursing practice. This research aims to evaluate from different perspectives the impact of this nationwide, five-year leadership program for district nurses at the organizational, regional, and societal levels. A mixed-methods study was conducted using two focus groups based on peer-to-peer shadowing (n = 14), semistructured interviews (n = 13), and an online questionnaire (n = 45). The analysis shows that the impact of a nationwide leadership program for district nurses was perceived as predominantly positive, and nurses experienced an increase in courage, assertiveness, professional pride, and leadership skills. They obtained confidence in representing the group of district nurses at the organizational, regional, and societal levels when speaking with various key stakeholders from the healthcare system. They were able to bridge the gaps among daily practice, policymaking, and politics by using translations and shaping actions and information into terms suiting the needs of those involved.
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Affiliation(s)
- I Wolbers
- 8119University of Applied Sciences Utrecht, Utrecht, The Netherlands. Heidelberglaan 7, 3584 CS Utrecht, The Netherlands. + 31 618648355.
| | - P C B Lalleman
- Professor, 3170Fontys University of Applied Sciences, Eindhoven, The Netherlands. Rachelsmolen 1, 5612 MA Eindhoven, The Netherlands. + 31 610512726.
| | - L Schoonhoven
- Professor of Nursing Science, 168086Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
| | - N Bleijenberg
- Professor of Nursing Science, 168086Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
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Sinclair S, Kondejewski J, Jaggi P, Roze des Ordons AL, Kassam A, Hayden KA, Harris D, Hack TF. What works for whom in compassion training programs offered to practicing healthcare providers: a realist review. BMC MEDICAL EDUCATION 2021; 21:455. [PMID: 34454489 PMCID: PMC8403363 DOI: 10.1186/s12909-021-02863-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Patients and families want their healthcare to be delivered by healthcare providers that are both competent and compassionate. While compassion training has begun to emerge in healthcare education, there may be factors that facilitate or inhibit the uptake and implementation of training into practice. This review identified the attributes that explain the successes and/or failures of compassion training programs offered to practicing healthcare providers. METHODS Realist review methodology for knowledge synthesis was used to consider the contexts, mechanisms (resources and reasoning), and outcomes of compassion training for practicing healthcare providers to determine what works, for whom, and in what contexts. RESULTS Two thousand nine hundred ninety-one articles underwent title and abstract screening, 53 articles underwent full text review, and data that contributed to the development of a program theory were extracted from 45 articles. Contexts included the clinical setting, healthcare provider characteristics, current state of the healthcare system, and personal factors relevant to individual healthcare providers. Mechanisms included workplace-based programs and participatory interventions that impacted teaching, learning, and the healthcare organization. Contexts were associated with certain mechanisms to effect change in learners' attitudes, knowledge, skills and behaviors and the clinical process. CONCLUSIONS In conclusion this realist review determined that compassion training may engender compassionate healthcare practice if it becomes a key component of the infrastructure and vision of healthcare organizations, engages institutional participation, improves leadership at all levels, adopts a multimodal approach, and uses valid measures to assess outcomes.
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
- Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
| | - Jane Kondejewski
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Priya Jaggi
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Amanda L Roze des Ordons
- Department of Critical Care Medicine and Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Aliya Kassam
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Office of Postgraduate Medical Education, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Daranne Harris
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
- Compassion Research Lab, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 99 Curry Place, Winnipeg, Manitoba, R3T 2M6, Canada
- Psychosocial Oncology & Cancer Nursing Research, St. Boniface Hospital Research Centre, Room CR3018, 369 Taché Ave, Winnipeg, Manitoba, R2H 2A6, Canada
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Sinclair S, Kondejewski J, Jaggi P, Dennett L, Roze des Ordons AL, Hack TF. What Is the State of Compassion Education? A Systematic Review of Compassion Training in Health Care. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1057-1070. [PMID: 33830949 PMCID: PMC8231671 DOI: 10.1097/acm.0000000000004114] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion education. METHOD The MEDLINE, Embase, CINAHL Plus with Full Text, Sociological Abstracts, Web of Science, ERIC, and Education Research Complete databases were searched from inception to March 2020 in this systematic review. Studies that evaluated a compassion education intervention for health care providers or those in training to enhance compassion toward patients and/or families were included. A narrative synthesis of the included studies was performed. The components of each intervention were mapped onto the domains of compassion described in the Patient Compassion Model. RESULTS One hundred eight peer-reviewed publications describing 103 interventions were included. Modalities ranged from establishing curricula and interventions in clinical settings to programs that used humanities-based reflective practices, clinical simulation, role modeling, and contemplative practices, with many education interventions adopting a multimodal approach. Most interventions mapped to the virtuous response domain of the Patient Compassion Model; very few mapped to the other domains of this model. CONCLUSIONS Most interventions were limited as they focused on a single domain of compassion; did not adequately define compassion; were assessed exclusively by self-report; were devoid of a comparator/control group; and did not evaluate retention, sustainability, and translation to clinical practice over time. The authors suggest that compassion education interventions be grounded in an empirically based definition of compassion; use a competency-based approach; employ multimodal teaching methods that address the requisite attitudes, skills, behaviors, and knowledge within the multiple domains of compassion; evaluate learning over time; and incorporate patient, preceptor, and peer evaluations.
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Affiliation(s)
- Shane Sinclair
- S. Sinclair is associate professor and director, Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Jane Kondejewski
- J. Kondejewski is research assistant, Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Priya Jaggi
- P. Jaggi is research coordinator, Compassion Research Lab, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Liz Dennett
- L. Dennett is librarian, Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Amanda L. Roze des Ordons
- A.L. Roze des Ordons is clinical associate professor, Department of Critical Care Medicine and Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Thomas F. Hack
- T.F. Hack is professor, College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, and director, Psychosocial Oncology & Cancer Nursing Research, St. Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada
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O'Toole J, Bamberry L, Montague A. Residential aged care leadership in Australia-Time for a compassionate approach: A qualitative analysis of key leader skills and attributes. J Nurs Manag 2021; 29:2018-2027. [PMID: 33838067 DOI: 10.1111/jonm.13335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 12/01/2022]
Abstract
AIMS To examine the perceptions of leadership by leaders within residential aged care and to identify the crucial requirements for successful leadership in this complex industry. BACKGROUND As an industry capitalizing on the concept of 'care', one of the critical attributes this research has found to be absent in many aged care leadership approaches is compassion. METHODS A qualitative methodology using thematic analysis was used to explore the construction of leadership attributes needed within residential aged care, as perceived by leaders in these organisations. RESULTS Senior staff in the aged care industry believe that compassion is both a key component and a gap in the skill set of aged care leadership and leaders. While most studies define good leadership and care in relation to clinical 'safety' and 'efficiency', this research demonstrates that compassionate caring is central to high-quality care in residential aged care. CONCLUSIONS The aged care industry needs to enhance and encourage compassionate leadership as a cornerstone of humane and dignified care. IMPLICATIONS FOR NURSING When developing theoretical explanations for the role of leadership in aged care, researchers should contemplate compassion as a key attribute required in residential aged care leaders. Education and training in this industry must incorporate the attributes associated with compassion, including emotional intelligence and person-centred leadership.
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Affiliation(s)
- Jacqueline O'Toole
- Monash Business School, Monash University, Caulfield East, Vic., Australia
| | - Larissa Bamberry
- School of Management and Marketing, Charles Sturt University, Albury, NSW, Australia
| | - Alan Montague
- School of Management, RMIT University, Melbourne, Vic., Australia
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Cummings GG, Lee S, Tate K, Penconek T, Micaroni SPM, Paananen T, Chatterjee GE. The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership. Int J Nurs Stud 2020; 115:103842. [PMID: 33383271 DOI: 10.1016/j.ijnurstu.2020.103842] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Nursing leadership plays a vital role in shaping outcomes for healthcare organizations, personnel and patients. With much of the leadership workforce set to retire in the near future, identifying factors that positively contribute to the development of leadership in nurses is of utmost importance. OBJECTIVES To identify determining factors of nursing leadership, and the effectiveness of interventions to enhance leadership in nurses. DESIGN We conducted a systematic review, including a total of nine electronic databases. DATA SOURCES Databases included: Medline, Academic Search Premier, Embase, PsychInfo, Sociological Abstracts, ABI, CINAHL, ERIC, and Cochrane. REVIEW METHODS Studies were included if they quantitatively examined factors contributing to nursing leadership or educational interventions implemented with the intention of developing leadership practices in nurses. Two research team members independently reviewed each article to determine inclusion. All included studies underwent quality assessment, data extraction and content analysis. RESULTS 49,502 titles/abstracts were screened resulting in 100 included manuscripts reporting on 93 studies (n=44 correlational studies and n=49 intervention studies). One hundred and five factors examined in correlational studies were categorized into 5 groups experience and education, individuals' traits and characteristics, relationship with work, role in the practice setting, and organizational context. Correlational studies revealed mixed results with some studies finding positive correlations and other non-significant relationships with leadership. Participation in leadership interventions had a positive impact on the development of a variety of leadership styles in 44 of 49 intervention studies, with relational leadership styles being the most common target of interventions. CONCLUSIONS The findings of this review make it clear that targeted educational interventions are an effective method of leadership development in nurses. However, due to equivocal results reported in many included studies and heterogeneity of leadership measurement tools, few conclusions can be drawn regarding which specific nurse characteristics and organizational factors most effectively contribute to the development of nursing leadership. Contextual and confounding factors that may mediate the relationships between nursing characteristics, development of leadership and enhancement of leadership development programs also require further examination. Targeted development of nursing leadership will help ensure that nurses of the future are well equipped to tackle the challenges of a burdened health-care system.
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Affiliation(s)
- Greta G Cummings
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada.
| | - Sarah Lee
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Monash University, Level 1, 264 Ferntree Gully Rd, Notting Hill, VIC 3168, Australia
| | - Kaitlyn Tate
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Tatiana Penconek
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Simone P M Micaroni
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada; Technical High School of Campinas, State University of Campinas (UNICAMP), Barão Geraldo, Campinas - São Paulo 13083-970, Brazil
| | - Tanya Paananen
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Gargi E Chatterjee
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
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