The colours and contours of compassion: A systematic review of the perspectives of compassion among ethnically diverse patients and healthcare providers

Experience of compassionate care in mental health and community-based services for children and young people: facilitators of, and barriers to compassionate care- a systematic review

Compassion and compassionate care for children and young people (CYP) encompass a variety of emotions, including sympathy, empathy, and sadness for their suffering, alongside actions intended to alleviate their distress. While compassion is a well-recognised concept in health and social care, literature has identified various barriers and facilitators that affect the delivery of compassionate care. These include compassion fatigue, time limitations, organisational and clinical culture, insufficient resources or support, technological advancements, and burdensome administrative tasks. Despite being viewed as essential in health care, the concept of compassionate care remains poorly defined and expressed, particularly in the context of mental health services for CYP. This review explored the perspectives of CYPs, their parents, and staff regarding the compassionate care provided in community services. Additionally, it aimed to identify factors that facilitate or obstruct compassionate care for CYPs in both mental health and community settings services. From June to August 2024, a search was carried out for peer-reviewed articles and grey literature, with additional searches conducted in October 2024. The initial search produced 7,461 articles, with 23 selected for this review. A thematic synthesis organised the studies based on the main themes identified: 'Compassionate care is all about humanity' and 'the complex interplay of facilitators and barriers to compassionate care'. The identified articles highlighted the increasing need for compassionate care in community-based services for CYP, along with the range of facilitators and barriers to providing this care. Lastly, we propose an alternative definition of compassionate care tailored to these services.

The Mediating Role of Compassion in the Relationship Between Nurses' Ethnocultural Empathy and Cultural Sensitivity: Structural Equation Model Analysis

INTRODUCTION

Nurses must possess the capacity for compassionate care and exhibit empathy to promote culturally competent care. This research investigated the mediating role of compassion in the relationship between ethnocultural empathy and intercultural sensitivity among nurses.

METHOD

The study was conducted at a hospital that provides health care services to refugees. In total, 125 nurses were recruited through the simple random sampling technique. Data were collected using a personal form and three scales. Statistical analysis was performed using SPSS23 and AMOS24.

RESULTS

Nurses' cultural sensitivity positively influenced their compassion competence and ethnocultural empathy. Compassion competence did not function as a full mediator in the relationship between intercultural sensitivity and ethnocultural empathy.

DISCUSSION

This study revealed that exposure to different cultures contributed to compassion competence, ethnocultural empathy, and cultural sensitivity skills in nurses. Cultural competence is a critical component of nursing care; therefore, it should be developed through curriculum revisions and a sensitive and supportive discussion of experiences.

Kindness: Poor cousin or equal kin to Compassion and Empathy in the Healthcare Literature? A Scoping Review

OBJECTIVE

This scoping review seeks to understand how kindness, compassion and empathy are defined and conceptualised within existing healthcare services literature.

INTRODUCTION

Little consensus exists on how healthcare literature defines and conceptualises kindness. Kindness is often conflated with the terms compassion and empathy, which both have more prominence in the literature. However, evidence would suggest that all three terms are indeed different. To advance kindness as a key tenet of quality improvement and human experience outcomes in healthcare, a consensual definition must be established in the evidence base.

METHODS

We reviewed published research identified using search queries across five databases and one search engine. Studies were included in this review if the definition, measurement and/or conceptualisation of kindness, empathy and/or compassion were stated objectives of the work and the research was directly relevant to healthcare settings.

RESULTS

1348 results were screened, and with additional snowballing of some articles for relevant references, 107 progressed to full-text screening. Forty-two articles were subsequently included in this scoping review. By synthesising this evidence, we establish key commonalities and differences for kindness, compassion and empathy. We present a model for understanding how empathy, compassion and kindness can be viewed on a stimulus-response-action continuum. We also explore the definitional challenges expressed by many authors who call for these terms to be treated as separate concepts.

CONCLUSIONS

This review evidence demonstrates that kindness, compassion and empathy have clear themes that stand them apart, and they occupy different places on the stimulus-response-action continuum. Importantly, kindness deserves its own place in literature as a primary concept, not as a second tier to compassion or empathy. By comparing each term, these positions are now highlighted. They can help us to more articulately define, conceptualise and value kindness, compassion and empathy for their unique contributions to the humanity of healthcare.

The Validation of the Sinclair Compassion Questionnaire (SCQ) and SCQ Short Form in an English-Speaking U.S. Population: A Patient-Reported Measure of Compassion in Healthcare

Background: Compassion is recognized as a key component of high-quality healthcare. The literature shows that compassion is essential to improving patient-reported outcomes and fostering health care professionals' (HCPs) response and resilience to burnout. However, compassion is inherently difficult to define, and a validated tool to reliably quantify and measure patients' experience of compassion in healthcare settings did not exist until recently. The Sinclair Compassion Questionnaire (SCQ) was compared to six similar tools in 2022 and emerged as the most reliable tool to assess compassion. The purpose of our study was to validate the SCQ in an English-speaking U.S. population. Methods: A total of 272 patients completed our survey, which included the SCQ and 17 demographic-related questions. A confirmatory factor analysis (CFA) was conducted to establish the construct validity of the SCQ and also the five-item version, the SCQ Short Form (SCQ-SF). Results: The CFA confirmed a good model fit, with factor loadings ranging from 0.81 to 0.93. Further analysis showed strong reliability, ranging from 0.866 to 0.957, and with an overall Cronbach's alpha = 0.96. Conclusions: This study validates the SCQ and SCQ-SF in an English-speaking U.S. population and provides researchers and HCPs with a reliable psychometric tool to measure compassion across healthcare settings.

The "Doing" of Compassionate Care in the Context of Childbirth from a Women's Perspective

Women who are giving birth need to be met with compassion and understanding from healthcare professionals. However, there are growing concerns about the perceived lack of compassion in the delivery of healthcare services in general and maternity care in particular. We conducted 15 qualitative interviews with women who had given birth in Norway within the previous year, asking them to describe their experiences of compassionate care. We aimed to explore what healthcare professionals "do" that is experienced as compassionate. The analysis was informed by Paul Gilbert's theory of compassion and a concept analysis of compassionate midwifery undertaken by Ménage and colleagues. The compassionate caring actions of healthcare professionals that were identified in the women's narratives generated five themes: attuning actions, validating actions, contextualizing actions, empowering actions, and small acts of kindness. The findings build on the prior theoretical concepts used for the study and provide a nuanced account of how women perceive compassionate care from healthcare professionals. They could contribute to understanding more of the meaning and nature of compassionate care during childbirth. The analysis indicates the importance of ensuring that compassionate care is at the very core of maternity care services.

Conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities: a scoping review

Introduction

To examine the scope of existing literature on the conceptualization, use, and outcomes associated with compassion in the care of youth with childhood-onset disabilities.

Methods

A protocol was developed based on the Joanna Briggs Institute (JBI) scoping review method. MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, and EBSCOhost CINAHL, were searched.

Results

Eight studies were selected for inclusion; four used quantitative methodology, and four used qualitative methods. Compassion was not defined a priori or a posteriori in any of the included studies. The concept of self-compassion was explicitly defined only for parents of youth with childhood-onset disabilities in three studies a priori. The most reported outcome measure was self-compassion in parents of youth with childhood-onset disabilities. Self-compassion among parents was associated with greater quality of life and resiliency and lower stress, depression, shame and guilt.

Discussion

There is limited evidence on the conceptualization, use, and outcomes associated with compassion among youth with childhood-onset disabilities. Self-compassion may be an effective internal coping process among parents of youth with childhood-onset disabilities. Further research is required to understand the meaning of compassion to youth with childhood-onset disabilities, their parents and caregivers.

Systematic review registration

https://doi.org/10.17605/OSF.IO/2GRB4.

Adaptation and validation of a patient-reported compassion measure in the Spanish population: The Spanish version of the Sinclair Compassion Questionnaire (SCQesp)

International practice guidelines and policies recognize compassion as a fundamental dimension of quality care. A key element in enhancing compassion in healthcare settings is having reliable patient-reported experience measures. In the Spanish context, there is a need for a valid Spanish patient-reported compassion measure for use in both research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) represents the gold standard for patient-reported compassion measures in English-speaking settings. The primary aim of this study is to culturally adapt and validate the SCQ in a Spanish population. A Spanish version of the SCQ (SCQesp) was used to collect data from 303 Spanish patients (in two contexts: hospitalized and medical visit). Confirmatory factor analysis confirmed a one-factor solution in the 15-item (SCQesp) and five-item (SCQesp-SF) short form version. The SCQesp showed excellent values of reliability: Cronbach's α = 0.98; composite variance = 0.98 (0.905-0.854); and stratified variance = 0.78. The SCQesp-SF showed similar values of reliability. The SCQesp has excellent psychometric properties, making it a valid and reliable measure for assessing compassion in healthcare research and clinical care. This scientifically rigorous and psychometrically robust compassion measure in Spanish could allow healthcare providers, researchers, and leaders to routinely assess compassion.

Culturally sensitive neonatal palliative care: a critical review

Although there are known disparities in neonatal and perinatal deaths across cultural groups, less is known about how cultural diversity impacts neonatal palliative care. This article critically reviews available literature and sets out key questions that need to be addressed to enhance neonatal palliative care provision for culturally diverse families. We begin by critically reviewing the challenges to recording, categorizing and understanding data which need to be addressed to enable a true reflection of the health disparities in neonatal mortality. We then consider whose voices frame the current neonatal palliative care agenda, and, importantly, whose perspectives are missing; what this means in terms of limiting current understanding and how the inclusion of diverse perspectives can potentially help address current inequities in service provision. Utilizing these insights, we make recommendations towards setting a research agenda, including key areas for future enquiry and methodological and practice-based considerations.

Health-care leaders' and professionals' experiences and perceptions of compassionate leadership: A mixed-methods systematic review

PURPOSE

The purpose of this study is to identify and synthesise the best evidence on health-care leaders' and professionals' experiences and perceptions of compassionate leadership.

DESIGN/METHODOLOGY/APPROACH

A mixed-methods systematic review was conducted in accordance with the Joanna Briggs Institute methodology for mixed-methods systematic reviews using a convergent integrated approach. A systematic search was done in January 2023 in PubMed, CINAHL, Scopus, Medic and MedNar databases. The results were reported based on Preferred Reporting Items for Systematic Reviews and Meta-analyses. The data was analysed using thematic analysis.

FINDINGS

Ten studies were included in the review (five qualitative and five quantitative). The thematic analysis identified seven analytical themes as follows: treating professionals as individuals with an empathetic and understanding approach; building a culture for open and safe communication; being there for professionals; giving all-encompassing support; showing the way as a leader and as a strong professional; building circumstances for efficient work and better well-being; and growing into a compassionate leader.

PRACTICAL IMPLICATIONS

Compassionate leadership can possibly address human resource-related challenges, such as health-care professionals' burnout, turnover and the lack of patient safety. It should be taken into consideration by health-care leaders, their education and health-care organisations when developing their effectiveness.

ORIGINALITY/VALUE

This review synthesised the knowledge of compassionate leadership in health care and its benefits by providing seven core elements of health-care leaders' and professionals' experiences and perceptions of compassionate leadership.

The Language of Compassion: Hospital Chaplains' Compassion Capacity Reduces Patient Depression via Other-Oriented, Inclusive Language

Objectives

Although hospital chaplains play a critical role in delivering emotional and spiritual care to a broad range of both religious and non-religious patients, there is remarkably little research on the best practices or "active ingredients" of chaplain spiritual consults. Here, we examined how chaplains' compassion capacity was associated with their linguistic behavior with hospitalized inpatients, and how their language in turn related to patient outcomes.

Methods

Hospital chaplains (n = 16) completed self-report measures that together were operationalized as self-reported "compassion capacity." Next, chaplains conducted consultations with inpatients (n = 101) in five hospitals. Consultations were audio-recorded, transcribed, and analyzed using Linguistic Inquiry Word Count (LIWC). We used exploratory structural equation modeling to identify associations between chaplain-reported compassion capacity, chaplain linguistic behavior, and patient depression after the consultation.

Results

We found that compassion capacity was significantly associated with chaplains' LIWC clout scores, a variable that reflects a confident leadership, inclusive, and other-oriented linguistic style. Clout scores, in turn, were negatively associated with patient depression levels controlling for pre-consult distress, indicating that patients seen by chaplains displaying high levels of clout had lower levels of depression after the consultation. Compassion capacity exerted a statistically significant indirect effect on patient depression via increased clout language.

Conclusions

These findings inform our understanding of the linguistic patterns underlying compassionate and effective chaplain-patient consultations and contribute to a deeper understanding of the skillful means by which compassion may be manifest to reduce suffering and enhance well-being in individuals at their most vulnerable.

Qualitative Investigation into the Perception towards Compassionate Parenting among Parents of Autistic Children: Cross-Cultural Comparison between the UK and The Netherlands

Parenting a child with autism spectrum disorder is believed to present challenges that lead to increased levels of stress, as well as a reduction in the quality of the relationship between parent and child. This study aims to investigate parental perceptions toward a compassionate parenting style of parenting to better understand how this style may influence relationships and quality of life in parents. Parents from the United Kingdom (six parents) and the Netherlands (five parents) were invited take part in semi-structured interviews, whereby the data collected were subsequently analysed using thematic analysis. Data from both British and Dutch groups were overall similar to each other. Four themes were identified from the aggregated data: (a) "Parents believe compassionate parenting is important" (parents believed that compassion is an essential element of their parenting style and improves situational outcomes); (b) "Compassionate parenting de-escalates stressful situations" (compassionate parenting reduces stress and improves the quality of life); (c) "High pressure situations as a threat to practice compassion" (challenges and limitations to compassionate parenting style); and (d) "Greater public and professional awareness of autistic behaviours" (the general public and professional services often lack awareness to recognise autistic behaviour traits). Results are consistent with research examining the perceptions of parents of neurotypical children, in that a more compassionate approach to parenting is valued, as it is believed to create a greater connection with the child. Our findings inform researchers and educators as to what parents of children with ASD find useful, important, and worthwhile. Future research needs to investigate how compassionate parenting impacts autistic children's quality of life.

The Impact of Work Environment on Nurses’ Compassion: A Multicenter Cross-Sectional Study

Introduction

Compassionate care is considered as the main part of the nurses’ identity and a core component of nursing care. One clinical environment where patients experience a lot of pain and nurses play a vital role in delivering care is the intensive care unit (ICU).

Objective

Considering the importance of compassionate care in intensive care units, this study aimed to assess the relationship between the work environment and nurses’ compassion in intensive care units.

Methods

In this cross-sectional survey, a total of 235 nurses were randomly selected from the intensive care units of four educational hospitals of Tabriz University of Medical Sciences from January to March 2021. Data were collected by demographic questionnaire, the Sussex-Oxford Compassion for Others Scale (SOCS-O) and the Practice Environment Scale of the Nursing Work Index (PES-NWI).

Results

The results showed that there was a significant and inverse relationship between the patient per nurse ratio and the mean score of nurses’ compassion (P < .05). Moreover, Pearson correlation coefficient showed that the mean total score of the nursing work index had a significant positive relationship with the mean score of the compassion for others (r = 0.16, P = .016).

Conclusion

Health care managers and leaders should pay more attention to the promotion of nurses’ working environments and they should remove the organizational barriers of compassionate care delivery.

Implementing compassion in pediatric healthcare: A qualitative study of Canadian patients', parents', and healthcare providers' perspectives

BACKGROUND

Compassion has received significant scholarly attention over the past decade. Research has been largely theoretical, with interventions focused on self-care practices of healthcare providers (HCPs), rather than implementation at a systems level. This study aimed to identify how compassion can be operationalized within pediatric healthcare.

DESIGN AND METHODS

Data was analyzed from a secondary dataset of a larger Straussian grounded theory study of perspectives and experiences of compassion in pediatric healthcare. Patients (n = 33); parents (n = 16); and HCPs (n = 17) were asked specifically how compassion could be implemented within the clinical culture and healthcare system.

RESULTS

66 participants generated an operational model of compassion indicating how compassion could be implemented across the organization and larger healthcare system. The data revealed four themes and associated subthemes: teach and train; recognize and reward; measure and report; and embed compassion across the healthcare system.

CONCLUSIONS

Improving compassion in pediatric healthcare needs to extend beyond the efforts of individual HCPs. Compassion is the responsibility of the entire healthcare system and needs to traverse the patient and family experience. In addition to embedding compassion in policy, procedures, practice, and education, compassion should be considered a performance indicator that is measured and reported.

PRACTICE IMPLICATIONS

This study provides a preliminary framework for organizational leaders to operationalize compassion across the services, structures, polices, procedures and practices of pediatric healthcare. This includes ongoing compassion training across the organization; assessing compassion, recognizing compassion as a performance indicator, and ensuring that the infrastructure and ancillary services of the organization reflect compassion.

Ethics Education: Using Storytelling to Teach Ethics to Novice Oncology Nurses

BACKGROUND

Oncology nurses face unique challenges in the care of patients from culturally diverse backgrounds. Culture, values, and preferences play important roles in patient decision-making regarding goals of care and treatment.

OBJECTIVES

This article describes the content and outcome of an educational seminar for nurse residents, which uses storytelling to highlight the relationship between dynamic cultural influences and ethical decision-making.

METHODS

A 75-minute didactic seminar using storytelling, role-playing, and simulation was incorporated into a nurse residency program. Stories illustrate the role of oncology nurses in protecting and advocating for vulnerable patients, respecting and accommodating cultural differences, and increasing self-awareness of personal values that may influence decisions. Tests were administered to participants before, immediately after, and three months after the seminar to measure changes in knowledge.

FINDINGS

Over one year, 107 novice oncology nurses, in five cohorts, attended the seminar. Results demonstrated an overall increase and sustainment of knowledge regarding ethical decision-making in nurse residents and illustrated the effectiveness of storytelling as a method to promote ethical decision-making among staff.

Compassionate practice in a hospital setting. Experiences of patients and health professionals: A narrative inquiry

AIM

To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting.

BACKGROUND

Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients.

DESIGN

Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ).

METHODS

Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework.

RESULTS

Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering.

CONCLUSION

Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting.

IMPACT

Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice.

Compassion and empathy in community social workers: A qualitative study in Spain

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term 'compassion' generates controversy among social workers, while the term 'empathy' seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers' experiences with empathy and compassion in the community setting. Between January and June 2019, nine in-depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress.

Spanish Medical Interpreters' Management of Challenges in End of Life Discussions

OBJECTIVE

Professional medical interpreters facilitate patient understanding of illness, prognosis, and treatment options. Facilitating end of life discussions can be challenging. Our objective was to better understand the challenges professional medical interpreters face and how they affect the accuracy of provider-patient communication during discussions of end of life.

METHODS

We conducted semi-structured interviews with professional Spanish medical interpreters. We asked about their experiences interpreting end of life discussions, including questions about values, professional and emotional challenges interpreting these conversations, and how those challenges might impact accuracy. We used a grounded theory, constant comparative method to analyze the data. Participants completed a short demographic questionnaire.

RESULTS

Seventeen Spanish language interpreters participated. Participants described intensive attention to communication accuracy during end of life discussions, even when discussions caused emotional or professional distress. Professional strains such as rapid discussion tempo contributed to unintentional alterations in discussion content. Perceived non-empathic behaviors of providers contributed to rare, intentional alterations in discussion flow and content.

CONCLUSION

We found that despite challenges, Spanish language interpreters focus intensively on accurate interpretation in discussions of end of life.

PRACTICE IMPLICATIONS

Provider training on how to best work with interpreters in these important conversations could support accurate and empathetic interpretation.

Understanding the concept of compassion from the perspectives of nurses

BACKGROUND

The high level of satisfaction of users of a health service is largely due to the fact that they receive excellent care from healthcare professionals. Compassionate care is an essential component of excellent care. But what do nurses understand compassion to be?

RESEARCH OBJECTIVES

To analyse the concept of compassion from the perspective of nurses in the Andalusian Public Health System, Spain.

RESEARCH DESIGN

This is a qualitative study following the grounded theory model. Four focus groups and 25 in-depth interviews were conducted.

PARTICIPANTS AND RESEARCH CONTEXT

A total of 68 nursing professionals working in the Andalusian Public Health System (Spain) participated. Theoretical sampling was used, with participants being recruited using the snowball technique.

ETHICAL CONSIDERATIONS

This research was approved by the Research Ethics Committee of the Centro-Almería Health District (CEICA 27/9/17).

FINDINGS

From the analysis of the data, four themes emerged that helped to understand the concept of compassion according to nurses: 'Negative perception of the term compassion', 'Compassion and empathy as synonyms', 'Beyond empathy', and 'Effects of having a compassionate attitude'.

DISCUSSION

Nurses perceive the concept of compassion differently to each other and even contradictorily. This concept is imbued with cultural elements, which adds confusion to understanding it, and is even perceived as something negative similar to pity.

CONCLUSION

Nurses confuse the concepts of empathy and compassion as if they were synonymous. Before considering training in compassion for healthcare professionals, it is essential to clarify the concept of compassion through educational interventions.

Pakistani nursing students' perspectives of compassion: A convergent mixed methods study

BACKGROUND

There has been increased research on the conceptualization of compassion in nursing. Nursing institutions expect educators to foster student compassion. However, limited research exists on students' perceptions of compassion in nursing.

PURPOSE

To develop a comprehensive understanding of students' perspectives of compassion and compassionate care.

METHODS

A convergent mixed methods design. A purposive sample of 117 students completed an exploratory questionnaire and 17 participated in interviews. Descriptive analysis was used for quantitative data, thematic analysis for qualitative data, and joint displays for mixed analysis.

RESULTS

In total, 83% of students described compassion as "understanding and sharing patients' suffering" and 88% indicated that compassionate care entails "consciously trying to understand patients, their needs, and their suffering". The qualitative themes were, meanings of compassion and compassionate care, ways of developing and fostering compassion, antecedents of compassion and compassionate care, and compassion in practice.

CONCLUSIONS

Nursing students realized the importance of compassion for patients and nurses and identified different acts of compassionate care. The students noted the compassionate care entails deliberately caring for the "whole person" and can be fostered through practice, observations, and reflection.

Obstacles to compassion-giving among nursing and midwifery managers: an international study

AIM

To explore nursing and midwifery managers' views regarding obstacles to compassion-giving across country cultures.

BACKGROUND

The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking.

METHODS

Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open-ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo.

RESULTS

Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related.

CONCLUSIONS

Obstacles to compassion-giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving.

South Asian patients' perceptions and experiences of compassion in healthcare

Background: South Asians are one of the fastest growing ethnic populations in Western countries. Accordingly, providing culturally sensitive healthcare to South Asians is becoming increasingly important. Compassion is a key component of quality healthcare and is central to bridging ethnic and cultural differences between patients and their healthcare providers (HCP).Objective: We aimed to identify and describe the perspectives, experiences, importance, and impact of compassion among South Asian patients.Methods: Straussian grounded theory was used to examine the perspectives of South Asians patients who had recent experience(s) with the Canadian healthcare system. A convenience sample of 19 South Asian participants underwent semi-structured audio-recorded interviews in either English, Hindi, or Punjabi. Transcribed interview data were analyzed using constant comparison.Results: Three categories were generated from the data: (1) South Asians' understandings of compassion, (2) HCPs' cultural sensitivity as an indicator of compassion, and (3) enhancing compassion: importance and patient recommendations for overcoming barriers to compassion. The first category included themes exploring South Asian patients' perspectives of compassion. The second category was divided into themes which examined how delivery and receipt of compassion can be influenced by ethnic and cultural differences between patients and HCPs. The third category consisted of themes highlighting participants' views on the importance of compassion, recommendations for overcoming language and cultural barriers to providing compassion, and the role of compassion in bridging language, culture and ethnic differences between patients and HCPs.Conclusion: Compassion was described as a universal concept that is interpreted through the cultural and ethnic background of the recipient and provider in the way it is perceived, enacted, and received. This information can aid HCP to modulate compassion to South Asian patients and may provide a foundation for future studies on compassion within other cultural groups.

Contraste de perspectivas y experiencias sobre compasión de enfermeras colombianas con 14 países

Se exploraron puntos de vista y experiencias sobre compasión en la práctica de enfermeras colombianas y contrasta con los otros 14 países participantes del estudio internacional online. El estudio transversal exploratorio con survey internacional online con 10 preguntas (abiertas y cerradas), contó con 1323 enfermeras, 103 fueron de Colombia. Datos cuantitativos colombianos fueron analizados en Excel y los cualitativos en el programa Nvivo con análisis temático y consenso entre investigadores. La muestra colombiana contó con 83,5% docentes y eligieron la definición de compasión como la “conciencia profunda de sufrimiento de los otros y el deseo de aliviar ese sufrimiento” (84,3%). Piensan que la compasión puede ser enseñada (64,1%) pero no es impartida (45,1%) y es influenciada por la experiencia personal (38,2%) y los valores culturales (37,3%).  Los relatos de Colombia revelan barreras sociopolíticos, organizacionales y educativos para la atención compasiva. Perciben compasión de sus pacientes (84,7%), escasa compasión entre colegas (14,3%) y casi nula compasión por parte de los gerentes (1%). Sin embargo, emerge la naturaleza consciente e intencional de la compasión y el esfuerzo de enfermería por desarrollarla en cinco componentes: particularizar, invertir tiempo, estar presente, ir más allá y la defensa/abogacia. Se hacen evidentes algunas variaciones culturales de la compasión y formas de promoverla en un ejercicio profesional cada vez más transcultural.