151
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Handzo GF, Wintz SK. A New Paradigm for Testing Clinical Competence in Chaplaincy Certification. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2020; 74:53-60. [PMID: 32181709 DOI: 10.1177/1542305020904401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article describes the rationale, evolution, implementation, and evaluation of a process for testing clinical competence in health care chaplaincy certification. The process developed by the Spiritual Care Association uses Zoom technology, simulated patient actors, and evidence-based behaviors. Evaluation of the process by users has been very positive. The process seems to have acceptable validity, reliability, and usability and should be considered as an alternative to self-report clinical encounters as a test of clinical competence.
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Affiliation(s)
- George F Handzo
- Credentialing and Certification Spiritual Care Association New York, USA
| | - Susan K Wintz
- Professional and Community Education Spiritual Care Association New York, USA
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152
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Olausson K, Sharp L, Fransson P, Nyholm T, Zackrisson B, Östlund U. What matters to you? - Free-text comments in a questionnaire from patients undergoing radiotherapy. Tech Innov Patient Support Radiat Oncol 2020; 13:11-16. [PMID: 32128457 PMCID: PMC7042152 DOI: 10.1016/j.tipsro.2019.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/13/2019] [Accepted: 11/22/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment. METHODS The data consisted of free-text comments from one open-ended question: "Is there anything else you want us to know" and were analysed using qualitative content analysis. RESULTS Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The hand-written, free-text comments reflected the patients' experience of the RT process and were abstracted into the four major categories with sub-categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses' role and performance. The categories reflect the patients' experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients' daily lives. CONCLUSION The main conclusions from this study are that the involvement of patients in choosing daily appointment times, providing good information during the RT process to make the patients feel safe, experience and attitude of the staff and respect for the patient's autonomy are highly ranked values for patients. An implementation of person-centred care may help relieve many of these problems.
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Affiliation(s)
| | - Lena Sharp
- Karolinska Institute, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
- Regional Cancer Centre, Stockholm-Gotland, Sweden
| | - Per Fransson
- Umeå University, Department of Nursing, Umeå, Sweden
| | - Tufve Nyholm
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
| | | | - Ulrika Östlund
- Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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153
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Schuler MS, Horowitz JA. Nursing Students' Attitudes Toward and Empathy for Patients With Substance Use Disorder Following Mentorship. J Nurs Educ 2020; 59:149-153. [DOI: 10.3928/01484834-20200220-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 11/04/2019] [Indexed: 11/20/2022]
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154
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Sinclair S, Kondejewski J, Schulte F, Letourneau N, Kuhn S, Raffin-Bouchal S, Guilcher GMT, Strother D. Compassion in Pediatric Healthcare: A Scoping Review. J Pediatr Nurs 2020; 51:57-66. [PMID: 31901770 DOI: 10.1016/j.pedn.2019.12.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 12/30/2022]
Abstract
PROBLEM Compassion has been described as a central construct or essential feature of quality healthcare and is as important to patients' and families' overall healthcare experience as the health interventions and treatments they receive. However, there is little shared understanding of what constitutes compassion, how it is delivered within a pediatric setting, and pediatric patients' and families perspectives and preferences for receiving it. ELIGIBILITY CRITERIA Studies that (1) described the nature of the existing literature on compassion in pediatric healthcare; (2) summarized key concepts in the existing evidence base that pertain to compassion in pediatric healthcare; and 3) identified factors that are associated with compassion in pediatric healthcare were eligible for inclusion in this review. SAMPLE Twenty-nine papers were included in the review. RESULTS Findings revealed several factors are associated with compassion in pediatric healthcare, including continuity of care, communication, and coordination of care. Most notably, identified studies treated compassion in a subsidiary fashion, and this review revealed no studies that provided a patient-informed evidence-based definition of compassion in the pediatric healthcare setting. CONCLUSION Future research is required to generate a comprehensive and accurate understanding of the terms 'compassion' and 'compassionate care' when used in the context of pediatric healthcare. IMPLICATIONS This research will inform the therapeutic processes and ultimately enable the development of strategies to improve the delivery of compassionate healthcare to pediatric patients.
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, Canada; Compassion Research Lab, University of Calgary, Canada; Department of Oncology, Division of Palliative Medicine, Cumming School of Medicine, University of Calgary, Canada.
| | - Jane Kondejewski
- Faculty of Nursing, University of Calgary, Canada; Compassion Research Lab, University of Calgary, Canada
| | - Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Canada
| | - Nicole Letourneau
- Faculty of Nursing, University of Calgary, Canada; Departments of Psychiatry & Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | - Susan Kuhn
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada
| | | | - Gregory M T Guilcher
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Canada
| | - Douglas Strother
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Canada
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155
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Jang MS, Kim S. [Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study]. J Korean Acad Nurs 2020; 49:423-436. [PMID: 31477672 DOI: 10.4040/jkan.2019.49.4.423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/10/2019] [Accepted: 05/21/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. METHODS Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through in-depth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. RESULTS Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. CONCLUSION The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
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Affiliation(s)
| | - Sungjae Kim
- College of Nursing·The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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156
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Landers M, Hegarty J, Saab MM, Savage E, Cornally N, Drennan J, Bassett G, Lunn C, Coffey A. Nurses’ and midwives’ views of the “Leaders for Compassionate Care Program”: A qualitative analysis. Collegian 2020. [DOI: 10.1016/j.colegn.2019.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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157
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Moudatsou M, Stavropoulou A, Philalithis A, Koukouli S. The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel) 2020; 8:E26. [PMID: 32019104 PMCID: PMC7151200 DOI: 10.3390/healthcare8010026] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/23/2020] [Accepted: 01/25/2020] [Indexed: 12/17/2022] Open
Abstract
The current article is an integrative and analytical literature review on the concept and meaning of empathy in health and social care professionals. Empathy, i.e., the ability to understand the personal experience of the patient without bonding with them, constitutes an important communication skill for a health professional, one that includes three dimensions: the emotional, cognitive, and behavioral. It has been proven that health professionals with high levels of empathy operate more efficiently as to the fulfillment of their role in eliciting therapeutic change. The empathetic professional comprehends the needs of the health care users, as the latter feel safe to express the thoughts and problems that concern them. Although the importance of empathy is undeniable, a significantly high percentage of health professionals seem to find it difficult to adopt a model of empathetic communication in their everyday practice. Some of the factors that negatively influence the development of empathy are the high number of patients that professionals have to manage, the lack of adequate time, the focus on therapy within the existing academic culture, but also the lack of education in empathy. Developing empathetic skills should not only be the underlying objective in the teaching process of health and social care undergraduate students, but also the subject of the lifelong and continuous education of professionals.
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Affiliation(s)
- Maria Moudatsou
- Department of Social Work, Hellenic Mediterranean University, 71410 Heraklion, Greece;
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (Quality of Life Lab), Hellenic Mediterranean University, 71410 Heraklion, Greece;
- Centre of Mental Health, 71201 Heraklion, Greece
| | - Areti Stavropoulou
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (Quality of Life Lab), Hellenic Mediterranean University, 71410 Heraklion, Greece;
- Nursing Department, University of West Attica, 12243 Athens, Greece
| | - Anastas Philalithis
- Department of Social Medicine, Medical School, University of Crete, 70013 Heraklion, Greece;
| | - Sofia Koukouli
- Department of Social Work, Hellenic Mediterranean University, 71410 Heraklion, Greece;
- Laboratory of Interdisciplinary Approaches for the Enhancement of Quality of Life (Quality of Life Lab), Hellenic Mediterranean University, 71410 Heraklion, Greece;
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158
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Aghaei MH, Vanaki Z, Mohammadi E. Emotional Bond: The Nature of Relationship in Palliative Care for Cancer Patients. Indian J Palliat Care 2020; 26:86-94. [PMID: 32132791 PMCID: PMC7017707 DOI: 10.4103/ijpc.ijpc_181_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 11/02/2019] [Indexed: 01/04/2023] Open
Abstract
Aim Relationship between care providers and cancer patients is one of the main elements in providing healthcare to these patients. Understanding the characteristics and the nature of the relationship is a basis for further organization of palliative care and will enhance the performance of care providers. The purpose of this study was to investigate the nature of the relationship in palliative care for cancer patients. Methods In this qualitative study, 16 participants with rich experiences in the field of cancer patient's palliative care were selected by purposive sampling. A semi-structured face-to-face interview was conducted with each of the participants. After data collection, all interviews were transcribed and reviewed, and then primary codes, sub-categories, and categories were extracted. Results Data analysis emerged three categories; being alongside the patient, establishing and maintaining cordiality relationship, and mutual understanding with the patient. Moreover, an emotional bonding was the main theme that defined the nature of relationship between the care provider team and cancer patients in a palliative care approach. Conclusion Effective relationship based on emotional bonding is the foundation of palliative care in cancer patients. Considering the structures and palliative care settings in health systems, it is possible to provide training programs regarding the strategies related to establishing emotional bond for effective delivery of palliative care.
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Affiliation(s)
- Mir Hossein Aghaei
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zohreh Vanaki
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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159
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McNally PJ, Charlton R, Ratnapalan M, Dambha-Miller H. Empathy, transference and compassion. J R Soc Med 2020; 112:420-423. [PMID: 31609173 DOI: 10.1177/0141076819875112] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Rodger Charlton
- Undergraduate Primary Care Education, University of Leicester, Leicester LE1 7RH, UK
| | - Mohana Ratnapalan
- Primary Care and Population Sciences, University of Southampton, Southampton SO16 5ST, UK
| | - Hajira Dambha-Miller
- Primary Care and Population Sciences, University of Southampton, Southampton SO16 5ST, UK.,Oxford Empathy Programme, University of Oxford, Oxford OX2 6GG, UK
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160
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Lee SJ, Park MS, Choi YR, Chang SO. Concept Development of Identification of Discomfort for Nursing Home Patients With Advanced Dementia. Int J Nurs Knowl 2020; 32:274-285. [PMID: 31957245 DOI: 10.1111/2047-3095.12277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/31/2019] [Accepted: 01/09/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study is to clarify the concept of discomfort identification by concept development in the nursing home. METHODS The Schwartz-Barcott and Kim's hybrid model was used. FINDINGS The identification of discomfort can be explained as an interactive and confirmative process of sympathetically responding to patients with dementia's problem behavior expressions that communicate unmet needs. CONCLUSIONS The identification of discomfort has the potential to improve the detection of multidimensional discomfort related to nursing diagnosis as a holistic and patient-centered approach. IMPLICATION FOR NURSING PRACTICE The findings could help nursing home nurses have a better understanding of identification of discomfort and can improve nurses and interdisciplinary caregivers' knowledge for developing appropriate comfort caring activities.
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Affiliation(s)
- Su Jung Lee
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Min Sun Park
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Young-Rim Choi
- Korea University College of Nursing, Seoul, Republic of Korea
| | - Sung Ok Chang
- Korea University College of Nursing, Seoul, Republic of Korea
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161
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162
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Lamiani G, Dordoni P, Vegni E, Barajon I. Caring for Critically Ill Patients: Clinicians' Empathy Promotes Job Satisfaction and Does Not Predict Moral Distress. Front Psychol 2020; 10:2902. [PMID: 31969851 PMCID: PMC6960200 DOI: 10.3389/fpsyg.2019.02902] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 12/06/2019] [Indexed: 12/30/2022] Open
Abstract
Background Several studies have highlighted the benefits of empathy in healthcare settings. A correlation between clinicians' empathy and patients' adherence and satisfaction, as well as the ability for the clinician to accurately assess family members' needs, has been found. However, empathy is often seen by clinicians as a risk factor for their wellbeing. This study aims to assess whether the level of empathy of clinicians working in critical care settings may expose them to moral distress, poor job satisfaction, and intention to quit their job. Methods Italian clinicians who attended the 2016 "Smart Meeting Anesthesia Resuscitation in Intensive Care" completed the Empathy Quotient questionnaire, the Moral Distress Scale-Revised, and two questions assessing job satisfaction and intention to quit the job. Multiple linear and logistic regressions were performed to determine if clinicians' empathy influences moral distress, job satisfaction, and intention to quit. Age, gender, and profession were used as control variables. Results Out of 927 questionnaires distributed, 216 were returned (23% response rate) and 210 were used in the analyses. Respondents were 56% physicians, 24% nurses, and 20% residents. Over half of the clinicians (58%) were female. Empathy resulted the only significant predictor of job satisfaction (β = 0.193; p < 0.05). None of the variables included in the model predicted moral distress. Conclusion Empathy determined neither moral distress nor intention to quit. Findings suggest that empathy is not a risk factor for critical care clinicians in developing moral distress and the intention to quit their job. On the contrary, empathy was found to enhance clinicians' job satisfaction.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Paola Dordoni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Isabella Barajon
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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163
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Dignity: The Cornerstone of Nursing Care Among Hospitalized Mothers of Infants in Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2020; 34:E44-E50. [PMID: 33079813 DOI: 10.1097/jpn.0000000000000522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
: One of the most important areas of nursing care delivery is "dignity." Because of the increase in hospitalized infants in neonatal intensive care units in recent years, this has led to an increased focus on "family care and maternal dignity." Given the importance of understanding the phenomenon of maternal dignity in order to improve cooperation in the care of their infants and promote family-centered care, this study aims to describe the lived experience of hospitalized mothers of infants within the context of dignity. This is a descriptive phenomenological qualitative research study. Twenty mothers were invited to participate in this study using purposeful sampling. The data were generated through individual, semistructured interviews and field notes were developed during the interviews. Data were analyzed using the Colaizzi method.Findings of the study were presented in 3 themes: "privacy," "respecting individual identity," and "authority," and 7 additional subthemes. Mothers in this study needed to take care of their infants in an environment where their personal privacy is preserved, their individual identity is respected, and they have sufficient authority in obtaining medical decisions. It is essential that healthcare teams and policy makers of health organizations provide an appropriate supportive environment in terms of promoting mothers' dignity in different dimensions and subsequently improving family-centered care.
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164
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Compassionate and Clinical Behavior of Residents in a Simulated Informed Consent Encounter. Anesthesiology 2020; 132:159-169. [DOI: 10.1097/aln.0000000000002999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Background
Compassionate behavior in clinicians is described as seeking to understand patients’ psychosocial, physical and medical needs, timely attending to these needs, and involving patients as they desire. The goal of our study was to evaluate compassionate behavior in patient interactions, pain management, and the informed consent process of anesthesia residents in a simulated preoperative evaluation of a patient in pain scheduled for urgent surgery.
Methods
Forty-nine Clinical Anesthesia residents in year 1 and 16 Clinical Anesthesia residents in year 3 from three residency programs individually obtained informed consent for anesthesia for an urgent laparotomy from a standardized patient complaining of pain. Encounters were assessed for ordering pain medication, for patient-resident interactions by using the Empathic Communication Coding System to code responses to pain and nausea cues, and for the content of the informed consent discussion.
Results
Of the 65 residents, 56 (86%) ordered pain medication, at an average of 4.2 min (95% CI, 3.2 to 5.1) into the encounter; 9 (14%) did not order pain medication. Resident responses to the cues averaged between perfunctory recognition and implicit recognition (mean, 1.7 [95% CI, 1.6 to 1.9]) in the 0 (less empathic) to 6 (more empathic) system. Responses were lower for residents who did not order pain medication (mean, 1.2 [95% CI, 0.8 to 1.6]) and similar for those who ordered medication before informed consent signing (mean, 1.9 [95% CI, 1.6 to 2.1]) and after signing (mean, 1.9 [95% CI, 1.6 to 2.0]; F (2, 62) = 4.21; P = 0.019; partial η2 = 0.120). There were significant differences between residents who ordered pain medication before informed consent and those who did not order pain medication and between residents who ordered pain medication after informed consent signing and those who did not.
Conclusions
In a simulated preoperative evaluation, anesthesia residents have variable and, at times, flawed recognition of patient cues, responsiveness to patient cues, pain management, and patient interactions.
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165
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Molala W, Downing C. Experiences of newly qualified critical care nurses caring for post-cardiothoracic surgery paediatric patients in a private hospital in gauteng. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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166
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Shorey S, Ng ED, Haugan G, Law E. The parenting experiences and needs of Asian primary caregivers of children with autism: A meta-synthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:591-604. [DOI: 10.1177/1362361319886513] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Parents of children with autism are faced with higher risks of unemployment, divorce, and poorer mental health than parents of children with other disorders. Such parenting stress can be further exacerbated by cultural and environmental factors such as the more conservative and collectivistic Asian values. Therefore, this review identifies and synthesizes literature on the parenting experiences and needs of Asian primary caregivers of children with autism using a critical interpretive method. A qualitative meta-summary was conducted. Seven electronic databases (CINAHL, Embase, ProQuest, PsycINFO, PubMed, Scopus, and Web of Science) were searched from each database’s date of inception to November 2018. In total, 44 studies were included in this review. Thirteen studies examined Asian immigrant parents’ experiences, and 31 studies were done among Asia-based parents. Six domains were identified: “personal parenting journey”; “adaptation and coping strategies”; “family, community, and social support”; “experiences with healthcare, education, and social services”; “future hopes and recommendations”; and “unique experiences of immigrants.” The distinctive influence of religious beliefs, cultural values, and environmental factors on Asian parenting experiences were discussed, and recommendations were proposed to better meet the needs of parents with autistic children.
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Affiliation(s)
| | | | - Gørill Haugan
- Norwegian University of Science and Technology (NTNU), Norway
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167
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Robinson J, Moeke-Maxell T, Parr J, Slark J, Black S, Williams L, Gott M. Optimising compassionate nursing care at the end of life in hospital settings. J Clin Nurs 2019; 29:1788-1796. [PMID: 31495001 DOI: 10.1111/jocn.15050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/25/2019] [Accepted: 08/18/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND An urgent need to improve palliative care in hospital has been identified. Moreover, service users consistently report care delivered by nurses in hospital as lacking compassion. Compassion is a fundamental component of nursing care, and promoting compassionate care has been identified as a policy priority in many countries. To help address this within the hospital context, we recently completed research exploring bereaved family experiences of good end of life care in hospital. We found that family accounts of good care aligned with Nolan and Dewar's compassionate care framework and subsequently extended the framework to the bi-cultural context of Aotearoa, New Zealand. AIMS AND OBJECTIVES In this discussion paper, we explore synergies between our newly developed Kapakapa Manawa Framework: a bi-cultural approach to providing compassionate care at the end of life and the Fundamentals of Care. We argue that our framework can be used to support the implementation of the relational component of the Fundamentals of Care and the delivery of compassionate nursing practice in hospitals in Aotearoa, New Zealand. DESIGN Discussion paper. METHODS Review of relevant literature and construction of two vignettes describing good end of life care from the perspectives of bereaved family-one Māori and one non-Māori. The vignettes provide practical examples of how the values of the Kapakapa Manawa Framework can be enacted by nurses to provide compassionate care in alignment with the relationship component of the Fundamentals of Care. CONCLUSIONS Whilst the Kapakapa Manawa bi-cultural compassionate care framework has grown out of research conducted with people nearing the end of their lives, it has the potential to improve nursing care for all hospital inpatients. RELEVANCE TO CLINICAL PRACTICE Addressing the wider policy and health system factors detailed in the Fundamentals of Care will support its implementation in the clinical setting.
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Affiliation(s)
- Jackie Robinson
- School of Nursing, University of Auckland, Auckland, New Zealand.,Auckland District Health Board, Auckland, New Zealand
| | | | - Jenny Parr
- Counties Manukau District Health Board, Auckland, New Zealand
| | - Julia Slark
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Stella Black
- Auckland University of Technology, Auckland, New Zealand
| | - Lisa Williams
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, University of Auckland, Auckland, New Zealand
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168
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Howick J, Bizzari V, Dambha-Miller H. Therapeutic empathy: what it is and what it isn't. J R Soc Med 2019; 111:233-236. [PMID: 29978750 DOI: 10.1177/0141076818781403] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jeremy Howick
- 1 Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Infirmary Quarter, Oxford OX2 6GG, UK
| | - Valeria Bizzari
- 2 Klinik für Allgemeine Psychiatrie mit Poliklinik, Universität Heidelberg, Vosstrasse, 4 Heidelrberg, Heidelberg 69115, Germany
| | - Hajira Dambha-Miller
- 3 Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR, UK
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169
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Developing Health Policy That Drives Compassion in a Value-Driven Health Care System. Prof Case Manag 2019; 24:329-332. [PMID: 31580303 DOI: 10.1097/ncm.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodriguez AM, Lown BA. Measuring compassionate healthcare with the 12-item Schwartz Center Compassionate Care Scale. PLoS One 2019; 14:e0220911. [PMID: 31487300 PMCID: PMC6728044 DOI: 10.1371/journal.pone.0220911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/25/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement. OBJECTIVE To address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing. METHODS Non-hospitalized patients with multiple chronic conditions were sampled using an on-line platform. Classical test theory and Rasch measurement theory were used to evaluate psychometric properties of the scale. Structured questions elicited cognitive responses regarding clarity of each item. RESULTS Classical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability. Patients' ratings of compassionate behaviors using the Schwartz Center Compassionate Care Scale correlated significantly with a related instrument designed to measure empathy, demonstrating convergent validity. Rasch measurement theory showed that reducing the number of response options on 3 items in the scale would improve respondents' discrimination between responses on these items. Although person-item threshold distribution analysis showed that patients may wish to rate compassionate care at levels both higher and lower than the scale permits, items could be ordered on an interval scale from low to high levels of compassionate care. CONCLUSIONS The current 12-item Schwartz Center Compassionate Care Scale demonstrates excellent psychometric properties by Classical Test Theory and Rasch measurement theory. The 12-item Schwartz Center Compassionate Care Scale adds questions related to understanding and discussing emotional, contextual issues and the needs of the patient and family. Easily completed on-line, it could be used for work-place based assessment and feedback to clinicians and performance or quality improvement.
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Affiliation(s)
- Ana Maria Rodriguez
- PatientsLikeMe, Boston, Massachusetts, United States of America
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Beth A. Lown
- The Schwartz Center for Compassionate Healthcare, Boston, Massachusetts, United States of America
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, United States of America
- * E-mail:
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Luna MJ, Ameli R, Sinaii N, Cheringal J, Panahi S, Berger A. Gender Differences in Psycho-Social-Spiritual Healing. J Womens Health (Larchmt) 2019; 28:1513-1521. [PMID: 31502927 PMCID: PMC6862956 DOI: 10.1089/jwh.2019.7837] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Many individuals exhibit significant distress in response to serious and/or life-limiting illness. However, there are others who make life-transforming changes, which involve healing experiences in the psychological, social, and spiritual domains of life regardless of illness outcome. The aim of the present study is to determine if there are any differences in psycho-social-spiritual healing between genders. Materials and Methods: The NIH Healing Experiences in All Life Stressors (NIH-HEALS), a 35-item measure of psycho-social-spiritual healing, is composed of three factors: Connection, Reflection & Introspection, and Trust & Acceptance. NIH-HEALS and a demographic questionnaire were administered to 193 patients with serious and/or life-limiting illness at the National Institutes of Health Clinical Center. Results: In response to NIH-HEALS, men and women significantly differed on the Reflection & Introspection factor. Women reported increased enjoyment of mind–body practices (p < 0.001), compassion (p = 0.005), gratitude (p = 0.014), and a desire to be more positive (p = 0.044) compared to men. Men rated their pain levels (p = 0.035) and severity of illness (p = 0.016) higher and their overall level of health (p = 0.010) poorer compared to women. Women's responses to items regarding compassion (rs = 0.37, p < 0.001) and gratitude (rs = 0.24, p = 0.015) correlated positively with better overall health ratings. Conclusion: Men and women show some differences in their self-reported psycho-social-spiritual healing, which may have implications when designing interventions aimed at promoting a healing experience in the context of serious and life-limiting illness.
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Affiliation(s)
- María José Luna
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rezvan Ameli
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ninet Sinaii
- Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Julia Cheringal
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Samin Panahi
- Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Ann Berger
- Clinical Center, National Institutes of Health, Bethesda, Maryland
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Abstract
PURPOSE OF REVIEW Compassion has been recognized as a key aspect of high-quality healthcare, particularly in palliative care. This article provides a general review of the current understanding of compassion in palliative care and summarizes emergent compassionate initiatives in palliative care at three interdependent levels: compassion for patients, compassion in healthcare professionals, and compassionate communities at the end of life. RECENT FINDINGS Compassion is a constructive response to suffering that enhances treatment outcomes, fosters the dignity of the recipient, and provides self-care for the giver. Patients and healthcare professionals value compassion and perceive a general lack of compassion in healthcare systems. Compassion for patients and for professionals' self-care can be trained and implemented top-down (institutional policies) and bottom-up (compassion training). 'Compassionate communities' is an important emerging movement that complements regular healthcare and social services with a community-level approach to offer compassionate care for people at the end of life. SUMMARY Compassion can be enhanced through diverse methodologies at the organizational, professional, and community levels. This enhancement of compassion has the potential to improve quality of palliative care treatments, enhance healthcare providers' satisfaction, and reduce healthcare costs.
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173
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Worley J. Effective Strategies for Working With Patients With Substance Use Disorders. J Psychosoc Nurs Ment Health Serv 2019; 57:11-15. [PMID: 31461514 DOI: 10.3928/02793695-20190815-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Substance use is at epidemic proportions in the United States. Substance use disorders (SUDs) are difficult to treat and considered to be chronic with a high mortality rate. Nurses are in a prime position to help patients with SUDs in a variety of settings, but they often lack knowledge about the disorder and the skills to provide effective care. The identification and treatment of co-occurring disorders, such as trauma, are important when providing care for patients with SUDs. Empathy and perspective taking were once thought to be helpful when working with patients, but evolving thought is that compassion is more effective as it involves feeling for, and not with, patients and includes taking action to help another. Harm reduction strategies, such as accepting people where they are, as well as the use of motivational interviewing strategies are also effective when working with patients with SUDs. Involving patients with SUDs in their treatment plans through shared decision making is also effective in building a therapeutic relationship and improves outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 57(9), 11-15.].
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174
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Compassion and Vigilance. INTERNATIONAL JOURNAL OF CHILDBIRTH 2019. [DOI: 10.1891/2156-5287.9.1.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Background: Compassion has long been advocated as a fundamental element in nursing practice and education. However, defining and translating compassion into caring practice by nursing students who are new to the clinical practice environment as part of their educational journey remain unclear. Objectives: The aim of this study was to explore how Chinese baccalaureate nursing students define and characterize compassionate care as they participate in their clinical practice. Methods: A descriptive qualitative study design was used involving a semi-structured in-depth interview method and qualitative content analysis. Twenty senior year baccalaureate nursing students were interviewed during their clinical practicum experience at four teaching hospitals. Ethical considerations: Permission to conduct the study was received from the Institutional Review Boards and the participating hospitals. Results: Baccalaureate nursing students defined and characterized compassionate care as a union of “empathy” related to a nurse’s desire to “alleviate patients’ suffering,” “address individualized care needs,” “use therapeutic communication,” and “promote mutual benefits with patients.” Students recognized that the “practice environment” was characterized by nurse leaders’ interpersonal relations, role modeling by nurses and workloads which influenced the practice of compassionate care by nursing personnel. Conclusion: Compassionate care is crucial for patients, nurses, and students in their professional development as well as the development of the nursing profession. In order to provide compassionate care, a positive practice environment promoted by hospital administrators is needed. This also includes having an adequate workforce of nurses who can role model compassionate care to students in their preceptor role while meeting the needs of their patients.
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Affiliation(s)
- Jing Jing Su
- The Chinese University of Hong Kong, Hong Kong; Sun Yat-sen University Nanfang College, China
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Gott M, Robinson J, Moeke-Maxwell T, Black S, Williams L, Wharemate R, Wiles J. 'It was peaceful, it was beautiful': A qualitative study of family understandings of good end-of-life care in hospital for people dying in advanced age. Palliat Med 2019; 33:793-801. [PMID: 31027476 DOI: 10.1177/0269216319843026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Hospitals are important sites of end-of-life care, particularly for older people. A need has been identified to understand best practice in hospital end-of-life care from the service-user perspective. AIM The aim of this study was to identify examples of good care received in the hospital setting during the last 3 months of life for people dying in advanced age from the perspective of bereaved family members. DESIGN A social constructionist framework underpinned a qualitative research design. Data were analysed thematically drawing on an appreciative enquiry framework. SETTING/PARTICIPANTS Interviews were conducted with 58 bereaved family carers nominated by 52 people aged >80 years participating in a longitudinal study of ageing. Data were analysed for the 21 of 34 cases where family members were 'extremely' or 'very' satisfied with a public hospital admission their older relative experienced in their last 3 months of life. RESULTS Participants' accounts of good care aligned with Dewar and Nolan's relation-centred compassionate care model: (1) a relationship based on empathy; (2) effective interactions between patients/families and staff; (3) contextualised knowledge of the patient/family; and (4) patients/families being active participants in care. We extended the model to the bicultural context of Aotearoa, New Zealand. CONCLUSION We identify concrete actions that clinicians working in acute hospitals can integrate into their practice to deliver end-of-life care with which families are highly satisfied. Further research is required to support the implementation of the relation-centred compassionate care model within hospitals, with suitable adaptations for local context, and explore the subsequent impact on patients, families and staff.
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Affiliation(s)
- Merryn Gott
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Jackie Robinson
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand.,3 Auckland District Health Board, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Stella Black
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- 1 School of Nursing, University of Auckland, Auckland, New Zealand.,2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Rawiri Wharemate
- 2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand
| | - Janine Wiles
- 2 Te Ārai Palliative Care and End of Life Research Group, University of Auckland, Auckland, New Zealand.,4 School of Population Health, University of Auckland, Auckland, New Zealand
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Marsh P, Thompson S, Mond J. Living, loving, dying: Insights into rural compassion. Aust J Rural Health 2019; 27:328-335. [PMID: 31241231 DOI: 10.1111/ajr.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 05/08/2019] [Accepted: 05/15/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To improve understandings of the enablers and barriers to maintaining good quality of life for people dying, caring and grieving in rural areas. DESIGN AND SETTING In-depth interviews designed on participatory research principles were held with bereaved carers living in a small community in rural Tasmania. Participants had cared for someone until their death within the 3-year period prior. PARTICIPANTS Nineteen participants comprising 18 bereaved former carers and one person with a life-limiting illness, and all but four were over retirement age. STUDY AIM To explore experiences of end-of-life care in a rural community. RESULTS Participants discussed the challenges they experienced during end-of-life caring, including transport into the city for treatment, and access to basic and specialised services. However, they also reported positive aspects of formal and informal palliative care, and described experiences of personable, expert, flexible and innovative caregiving. CONCLUSIONS The rural location enabled personalised and innovative expressions of care. This research adds new insight into rural end-of-life palliation, as a complex intersection of supererogation, innovation and place-driven care.
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Affiliation(s)
- Pauline Marsh
- Centre for Rural Health, UTas, Hobart, Tasmania, Australia
| | | | - Jonathan Mond
- Centre for Rural Health, UTas, Hobart, Tasmania, Australia
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179
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Norouzadeh R, Anoosheh M, Ahmadi F. Contingency Help: The Main Strategy of Iranian Nurses in Dealing With the Family of the End-of-Life Patients. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:426-445. [PMID: 31188718 DOI: 10.1177/0030222819854909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Families are struggling with many challenges in the final stages of patient life. It is important to understand what actions nurses do for the family of the end-of-life (EOL) patients. This study aimed to explain the main strategy of nurses' dealing with the family of the EOL patients. Data were analyzed using conventional content analysis. Semistructured interviews were conducted on 32 nurses from hospitals in Tehran. Nurses used six measures of explaining the bitter reality, effective communication, management of violence, referral, consolation, and reinforcement. "Contingency help" was conceptualized as the main strategy. Nurses through "contingency help" were involved in solving the emotional, physical, financial, and spiritual needs of the family. Nurses will be able to apply the results of this study to the development of care policies for the family of the EOL patients.
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Affiliation(s)
- Reza Norouzadeh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Monireh Anoosheh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
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Ellis EM, Barnato AE, Chapman GB, Dionne-Odom JN, Lerner JS, Peters E, Nelson WL, Padgett L, Suls J, Ferrer RA. Toward a Conceptual Model of Affective Predictions in Palliative Care. J Pain Symptom Manage 2019; 57:1151-1165. [PMID: 30794937 DOI: 10.1016/j.jpainsymman.2019.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/24/2019] [Accepted: 02/10/2019] [Indexed: 10/27/2022]
Abstract
CONTEXT Being diagnosed with cancer often forces patients and families to make difficult medical decisions. How patients think they and others will feel in the future, termed affective predictions, may influence these decisions. These affective predictions are often biased, which may contribute to suboptimal care outcomes by influencing decisions related to palliative care and advance care planning. OBJECTIVES This study aimed to translate perspectives from the decision sciences to inform future research about when and how affective predictions may influence decisions about palliative care and advance care planning. METHODS A systematic search of two databases to evaluate the extent to which affective predictions have been examined in the palliative care and advance care planning context yielded 35 relevant articles. Over half utilized qualitative methodologies (n = 21). Most studies were conducted in the U.S. (n = 12), Canada (n = 7), or European countries (n = 10). Study contexts included end of life (n = 10), early treatment decisions (n = 10), pain and symptom management (n = 7), and patient-provider communication (n = 6). The affective processes of patients (n = 20), caregivers (n = 16), and/or providers (n = 12) were examined. RESULTS Three features of the palliative care and advance care planning context may contribute to biased affective predictions: 1) early treatment decisions are made under heightened emotional states and with insufficient information; 2) palliative care decisions influence life domains beyond physical health; and 3) palliative care decisions involve multiple people. CONCLUSION Biases in affective predictions may serve as a barrier to optimal palliative care delivery. Predictions are complicated by intense emotions, inadequate prognostic information, involvement of many individuals, and cancer's effect on non-health life domains. Applying decision science frameworks may generate insights about affective predictions that can be harnessed to solve challenges associated with optimal delivery of palliative care.
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Affiliation(s)
- Erin M Ellis
- National Cancer Institute, Bethesda, Maryland, USA.
| | | | | | | | | | | | | | - Lynne Padgett
- Washington D.C. Veteran's Affairs Medical Center, Washington, District of Columbia, USA
| | - Jerry Suls
- National Cancer Institute, Bethesda, Maryland, USA
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Weingartner LA, Sawning S, Shaw MA, Klein JB. Compassion cultivation training promotes medical student wellness and enhanced clinical care. BMC MEDICAL EDUCATION 2019; 19:139. [PMID: 31077192 PMCID: PMC6511143 DOI: 10.1186/s12909-019-1546-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/03/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND Compassionate health care is associated with positive patient outcomes. Educational interventions for medical students that develop compassion may also increase wellness, decrease burnout, and improve provider-patient relationships. Research on compassion training in medical education is needed to determine how students learn and apply these skills. The authors evaluated an elective course for medical students modeled after the Compassion Cultivation Training course developed by the Stanford Center for Compassion and Altruism Research and Education. The elective goals were to strengthen student compassion, kindness, and wellness through compassion training and mindfulness meditation training modeled by a faculty instructor. The research objectives were to understand students' applications and perceptions of this training. METHODS Over three years, 45 students participated in the elective at the University of Louisville School of Medicine. The course administered a pre/post Kentucky Inventory of Mindfulness Skills that measured observing, describing, acting with awareness, and accepting without judgment. Qualitative analyses of self-reported experiences were used to assess students' perceptions of compassion training and their application of skills learned through the elective. RESULTS The mindfulness inventory showed significant improvements in observing (t = 3.62, p = 0.005) and accepting without judgment skills (t = 2.87, p = 0.017) for some elective cohorts. Qualitative data indicated that students across all cohorts found the elective rewarding, and they used mindfulness, meditation, and compassion skills broadly outside the course. Students described how the training helped them address major stressors associated with personal, academic, and clinical responsibilities. Students also reported that the skills strengthened interpersonal interactions, including with patients. CONCLUSIONS These outcomes illuminate students' attitudes toward compassion training and suggest that among receptive students, a brief, student-focused intervention can be enthusiastically received and positively influence students' compassion toward oneself and others. To underscore the importance of interpersonal and cognitive skills such as compassion and mindfulness, faculty should consider purposefully modeling these skills to students. Modeling compassion cultivation and mindfulness skills in the context of patient interactions may address student empathy erosion more directly than stress management training alone. This pilot study shows compassion training could be an attractive, efficient option to address burnout by simultaneously promoting student wellness and enhanced patient interactions.
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Affiliation(s)
- Laura A. Weingartner
- University of Louisville School of Medicine, Undergraduate Medical Education, 500 South Preston Street, Louisville, KY 40202 USA
| | - Susan Sawning
- University of Louisville School of Medicine, Undergraduate Medical Education, 500 South Preston Street, Louisville, KY 40202 USA
| | - M. Ann Shaw
- University of Louisville School of Medicine, Undergraduate Medical Education, 500 South Preston Street, Louisville, KY 40202 USA
- Department of Medicine, University of Louisville School of Medicine, 530 S Jackson Street, Louisville, KY 40202 USA
| | - Jon B. Klein
- Department of Medicine, University of Louisville School of Medicine, 530 S Jackson Street, Louisville, KY 40202 USA
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Tehranineshat B, Rakhshan M, Torabizadeh C, Fararouei M. Compassionate Care in Healthcare Systems: A Systematic Review. J Natl Med Assoc 2019; 111:546-554. [PMID: 31060872 DOI: 10.1016/j.jnma.2019.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 10/29/2018] [Accepted: 04/06/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND In spite of emphasis on patient-centered cares and promotion of their quality, shortcomings have been seen in health systems due to lack of compassion. PURPOSE The aim of the present study was to determine the definition, fields, facilitating and inhibiting factors of compassionate care in healthcare systems and the interventions designed to promote it. METHODS This study was conducted through narrative synthesis which is supposed to do systematic and synthesized review. Searching was done in English databases including Pub Med, CINAHL, Google Scholar, Web of Science, and Cochrane library, Ovid, Science Direct, WILEY by using keywords of Compassionate Care, Delivery of Health Care, Healthcare Systems, Compassion and Health Care Providers from 1987 to 2017. RESULTS Compassionate care has some dimensions including ethical, professional, effective communication, human, spiritual/religious and getting involve with patients. Facilitating and inhibiting factors consisted of the nurse's personal characteristics, patients' behavior and organizational factors included workload, role model, and value of compassionate care in healthcare systems. Educational interventions such as providing feedback and reorienting have been mostly used to improve the compassionate care. CONCLUSIONS Although compassionate care has been known as the main element of improving services quality in health care system, it has been studied restrictively from the viewpoints of the patients and all personnel in healthcare systems. The improvement of compassionate care through education cannot remove completely the gap between theory and practice, because it seems that clinical environment and organizational values of healthcare system are the largest facilitating and inhibiting factors for filling this gap. Therefore, it is necessary to take measures for promoting organizational culture.
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Affiliation(s)
- Banafsheh Tehranineshat
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Community-based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Nemazee Sq., 7193613119, Shiraz, Iran.
| | - Camellia Torabizadeh
- Community-based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Nemazee Sq., 7193613119, Shiraz, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
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Meyers S, Rowell K, Wells M, Smith BC. Teacher Empathy: A Model of Empathy for Teaching for Student Success. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/87567555.2019.1579699] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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184
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Hall E, Hughes B, Handzo G. Time to follow the evidence – Spiritual care in health care. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.jemep.2019.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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185
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Younas A, Maddigan J. Proposing a policy framework for nursing education for fostering compassion in nursing students: A critical review. J Adv Nurs 2019; 75:1621-1636. [PMID: 30644122 DOI: 10.1111/jan.13946] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/31/2018] [Accepted: 11/13/2018] [Indexed: 12/30/2022]
Abstract
AIMS To propose a policy framework for nursing education to foster compassion in nursing students. DESIGN A critical review. DATA SOURCES Literature was searched in CINAHL, PubMed, Science Direct and Google Scholar and sources published from January 2008 - April 2018 were reviewed. REVIEW METHODS We screened abstracts and full-texts using specific inclusion criteria, developed summary tables for data extraction and synthesized data logically to develop the framework. RESULTS Twenty-nine sources were reviewed. Recognizing, accepting, and alleviating patients' suffering are direct indicators of compassionate care. Three policy directions were identified: ensure the nursing curriculum has an appropriate balance of teaching-learning strategies that target learning in the affective domain, directly promote the use of reflection and the development of reflective thinking in students as an approach to enhance excellence in clinical practice and integrate information and assess students' understanding and expression of compassion throughout the nursing curriculum. CONCLUSION Compassion is expressed when nurses authentically work to understand patients' suffering and become sensitive to their experiences. Future research should focus on developing strategies that align with the affective domain and use reflection to optimize nursing students' experiential learning. IMPACT Policies are needed for cultivating a compassionate care culture and for fostering students' compassion, but no guidelines exist for nursing institutions. Targeting the affective learning domain, facilitating reflection, and integrating compassionate care indicators in clinical learning experiences can be useful. Therefore, nursing institutions can use these findings to integrate and measure compassionate care in clinical and educational curricula to foster students' compassion.
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Affiliation(s)
- Ahtisham Younas
- School of Nursing, Memorial University of Newfoundland, St. John, NL, Canada
| | - Joy Maddigan
- School of Nursing, Memorial University of Newfoundland, St. John, NL, Canada
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186
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Hark LA, Madhava M, Radakrishnan A, Anderson-Quiñones C, Robinson D, Adeghate J, Silva S, Zhan T, Adepoju T, Dave Y, Fudemberg SJ. Impact of a Social Worker in a Glaucoma Eye Care Service: A Prospective Study. HEALTH & SOCIAL WORK 2019; 44:48-56. [PMID: 30561635 DOI: 10.1093/hsw/hly038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 10/17/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to evaluate the effects of a six-month social worker intervention for participants with a glaucoma-related diagnosis in an urban ophthalmic setting (N = 40). The social worker assessed common barriers to eye care, helping participants with transportation, access to low-vision resources, and supportive counseling. The Distress Thermometer, Patient Health Questionnaire-9, and a satisfaction survey were administered to determine the effect of the social worker intervention and participants' overall impressions of the social worker. The most common barrier to eye care was emotional distress (77.5 percent). There was a significant decrease in the number of participants with symptoms of major and moderate depression. Fourteen participants experienced a clinically relevant decrease in depression, 37 participants felt that the social worker's support addressed their issues, and 29 participants thought it helped them in managing their glaucoma. This study provides evidence that a social work intervention may improve care coordination and management of individuals afflicted with vision impairment due to glaucoma and other ocular diseases.
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Affiliation(s)
- Lisa A Hark
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Malika Madhava
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Anjithaa Radakrishnan
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Catherine Anderson-Quiñones
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Debra Robinson
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Jennifer Adeghate
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Stephen Silva
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Tingting Zhan
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Tomilade Adepoju
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Yatee Dave
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
| | - Scott J Fudemberg
- Lisa A. Hark, PhD, RD, is professor of ophthalmic sciences, administrative director of Jonas Children's Vision Care, and director of the Clinical Trials Unit, Irving Medical Center, Columbia University, 635 West 165th Street, Mailbox 10, New York, NY 10032; e-mail: . Malika Madhava, BS; Anjithaa Radakrishnan, BS, are medical students, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Catherine Anderson-Quiñones, BM, is study coordinator, Glaucoma Research Center, Wills Eye Hospital, Philadelphia. Debra Robinson, MSS, LSW, is a medical social worker, Generations Life Care, Chadds Ford, PA. Jennifer Adeghate, MD, is resident physician, Department of Ophthalmology, Weill Cornell Medical Center, New York. Stephen Silva, MD, is orthopedic resident (surgery), Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia. Tingting Zhan, PhD, is a biostatistician, Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia. Tomilade Adepoju, MD, is medical doctor and ophthalmology resident, Department of Ophthalmology, Nassau University Medical Center, East Meadow, NY. Yatee Dave, BA, is a medical student, Robert Wood Johnson Medical School, Rutgers University, Piscataway Township, NJ. Scott J. Fudemberg, MD, is ophthalmologist and glaucoma specialist, Glaucoma Research Center, Wills Eye Hospital, Philadelphia
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187
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Bickford B, Daley S, Sleater G, Hebditch M, Banerjee S. Understanding compassion for people with dementia in medical and nursing students. BMC MEDICAL EDUCATION 2019; 19:35. [PMID: 30683079 PMCID: PMC6347776 DOI: 10.1186/s12909-019-1460-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 01/09/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Compassion is an essential component of good quality care. Compassion towards people with dementia in health systems is often suboptimal, which can have negative impacts on clinical outcomes and patient experience. Attitudes are formed early in training and the literature on healthcare student compassion towards those with dementia is limited. This study aimed to understand how undergraduate medical and nursing students understand compassion towards people with dementia and factors influencing the delivery of compassionate care. METHODS Nine individual in-depth interviews and two focus groups were undertaken with 23 medical and nursing students. A topic guide was developed, and transcripts were analysed using thematic analysis. RESULTS The analysis identified three themes which students used to define compassion: (i) connection, (ii) care, and (iii) respect. Three factors were identified as being either facilitators or barriers to delivering compassionate care to people with dementia: (i) patient factors, (ii) student factors, and (iii) connection. Patient factors related to the presence of behaviours which might be challenging to manage. Student factors included student exposure to dementia, as well as student knowledge and skills. Connection focussed on whether there was an awareness and understanding of the person behind the diagnosis. CONCLUSION Undergraduate healthcare students are the future workforce for patients with dementia, and understanding how compassion develops within them is important. We found medical and nursing students had a broad understanding of compassion, and identified factors influence their compassion towards people with dementia. These novel data can be used to shape healthcare education programmes aimed at improving dementia care.
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Affiliation(s)
- Ben Bickford
- Centre for Dementia Studies, Brighton and Sussex Medical School, Trafford Centre, Univeristy of Sussex, Falmer, East Sussex BN1 9RY UK
| | - Stephanie Daley
- Centre for Dementia Studies, Brighton and Sussex Medical School, Trafford Centre, Univeristy of Sussex, Falmer, East Sussex BN1 9RY UK
| | - Gillian Sleater
- Centre for Dementia Studies, Brighton and Sussex Medical School, Trafford Centre, Univeristy of Sussex, Falmer, East Sussex BN1 9RY UK
| | - Molly Hebditch
- Centre for Dementia Studies, Brighton and Sussex Medical School, Trafford Centre, Univeristy of Sussex, Falmer, East Sussex BN1 9RY UK
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, Trafford Centre, Univeristy of Sussex, Falmer, East Sussex BN1 9RY UK
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188
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Durkin J, Usher K, Jackson D. Embodying compassion: A systematic review of the views of nurses and patients. J Clin Nurs 2019; 28:1380-1392. [DOI: 10.1111/jocn.14722] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/28/2018] [Accepted: 09/21/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Joanne Durkin
- School of Health University of New England Armidale New South Wales Australia
| | - Kim Usher
- School of Health University of New England Armidale New South Wales Australia
| | - Debra Jackson
- Oxford Institute of Nursing, Midwifery & Allied Health Research (OxINMAHR) Oxford Brookes University Oxford UK
- Faculty of Health University of Technology (UTS) Sydney New South Wales Australia
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189
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Zeighami Mohammadi S, Mohammadkhan Kermanshahi S, Vanaki Z. Pity: a qualitative study on Iranian women with breast cancer. Patient Prefer Adherence 2019; 13:21-28. [PMID: 30587941 PMCID: PMC6304825 DOI: 10.2147/ppa.s183712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Women with breast cancer (BC) are commonly confronted with others' pity. However, there is limited information about pity in Iranian women with BC. The aim of this study was to explore perceptions, reactions, coping strategies, and consequences of pity among Iranian women with BC. METHODS This qualitative study was carried out from March 2016 till October 2017. A purposive sample of 36 women with BC was selected with maximum variation from three health care centers in Alborz Province, Iran. Data were collected using semistructured interviews and analyzed using a conventional content-analysis approach. RESULTS Our findings indicated that Iranian women with BC experienced received pity and perceived unusual attention from others as due to certain reasons. Others' pity caused negative emotional reactions in them. They used self-protection strategies against others' pity. The consequences of self-protection against pity were normalizing the patient's flow of life and/or social isolation. CONCLUSION Pity is a serious psychosocial challenge in Iranian women with BC, with negative effects on quality of life. Therefore, pity should be considered in counseling and psychosocial screening of patients.
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Affiliation(s)
| | | | - Zohreh Vanaki
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,
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190
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Almada AL, Casquinha P, Cotovio V, Santos MJHD, Caixeiro A. The Potential Role of Psychosocial Rehabilitation in Palliative Care. J R Coll Physicians Edinb 2018; 48:311-317. [DOI: 10.4997/jrcpe.2018.405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Palliative care is an approach to incurable and/or severe disease with limited prognosis, aiming to relieve the suffering and improve the quality of life of patients and their families. The existence of psychopathology is common in patients undergoing palliative care, and psychiatric comorbidities, such as depression and anxiety, are frequent and often underdiagnosed. This work constitutes a review of the literature and a reflection on the potential role of psychosocial rehabilitation in mental health in palliative care. Psychosocial rehabilitation may play a role in the mental health of patients undergoing palliative care, contributing to the minimisation of symptoms, support in daily life activities, the improvement of quality of life and the preparation for death.
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Affiliation(s)
- AL Almada
- Psychiatric resident (5th year), Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - P Casquinha
- Psychiatrist, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - V Cotovio
- Psychiatrist and Psychotherapist, Clinical Director of the Psychiatric Hospital, Casa de Saúde do Telhal, Sintra, Portugal
| | - MJ Heitor dos Santos
- Psychiatrist, Instituto de Medicina Preventiva e Saúde Pública, Universidade de Lisboa, Portugal
- Psychiatrist, Instituto de Saúde Ambiental Faculdade de Medicina, Universidade de Lisboa, Portugal
- Head of the Psychiatry and Mental Health Department of Hospital Beatriz Ângelo, Loures, Portugal
| | - A Caixeiro
- Psychiatrist, Head of the Rehabilitation Unit in Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
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191
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Kang JH, Go SI, Bruera E. Compassion is a key quality for palliative care teams. Cancer Med 2018; 7:5325-5326. [PMID: 30306724 PMCID: PMC6246948 DOI: 10.1002/cam4.1804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/31/2018] [Accepted: 09/09/2018] [Indexed: 11/22/2022] Open
Abstract
Multidisciplinary team members including doctors, nurses, and chaplains, and social workers involve palliative. Therefore, it is not easy to define palliative care in a word. We are convinced that compassion is at the core of palliative care.
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Affiliation(s)
- Jung Hun Kang
- School of Medicine, Gyeongsang National University, Jinju, Korea.,Department of Internal Medicine, Gyeongsang University Hospital, Jinju, Korea
| | - Se Il Go
- Department of Internal Medicine, Gyeongsang National University Hospital, Changwon, Korea
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas
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192
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Mohammadi F, Rakhshan M, Molazem Z, Zareh N, Gillespie M. Caregivers’ perception of dignity in teenagers with autism spectrum disorder. Nurs Ethics 2018; 26:2035-2046. [DOI: 10.1177/0969733018796679] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Maintaining dignity is one of patients is one of the main ethical responsibilities of caregivers. However, in many cases, the dignity of patients, especially autistic teenagers is not maintained. The extent to which dignity needs are met for this group within the Iranian care system is difficult to determine as dignity is an abstract concept, and there are few related research studies reported. Objectives: The objective of this study is to find out caregivers perspectives on dignity in teenagers with autistic spectrum disorder. Research design: This study uses a qualitative research design. The data were collected through individual, semi-structured interviews and field notes developed during the interviews. In order to analyze the data, qualitative conventional content analysis was used. Participants and research context: In all, 16 professional caregivers for autistic teenagers working in public hospitals were recruited based on a targeted sampling method to reach data saturation from February 2016 to July 2017. Findings: The findings of this study were presented in three main themes, “privacy,” “respecting individual identity,” and “comprehensive support,” and 11 categories. Ethical consideration: This study’s protocol was approved by the Research Ethics Committee of medical universities located in Southeast of Iran and the required ethical principles were followed throughout. Discussion and conclusion: Based on the findings of this study from the perspective of caregivers, autistic teenagers need to be cared for and educated in a respectful environment where their privacy is maintained, their individual identities are respected, and they receive comprehensive familial, social, and financial support. These conditions would maintain the dignity of such teenagers and would result in appropriate behavioral outcomes. Therefore, it is suggested that a cultural, professional and institutional background in which all components of the autistic teenager’s dignity are protected and emphasized be provided.
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193
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Facilitating affective elements in learning - In a palliative care context. Nurse Educ Pract 2018; 33:148-153. [PMID: 30296727 DOI: 10.1016/j.nepr.2018.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022]
Abstract
The aim of this study was to explore ways clinical supervisors facilitate the learning of the affective elements of professional competence in a clinical palliative care environment. The secondary aim was to advocate for and raise awareness of the importance of the affective domain in medical education. A clinical palliative care learning environment has been reported to be emotionally challenging. The affective and transformative learning processes taking place requires special support. However, little is known about how clinical supervisors facilitate this learning processes. A qualitative, explorative study was designed to capture supervisors' perceptions of their supervision using semi-structured interviews. Six experienced clinical supervisors working within a palliative care context were recruited using convenience sampling. Data were analyzed using inductive content analysis. The affective elements were viewed as essential for learning, clinical supervision, and professional competency. Supervisors use a variety of different ways of facilitation. Four main themes were identified; building a relationship, creating space for learning, creating a pedagogical environment, and Mirroring.
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194
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Palanica A, Thommandram A, Fossat Y. Eliciting clinical empathy via transmission of patient-specific symptoms of Parkinson’s disease. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1526459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Adam Palanica
- Labs Department, Klick Health, Klick Inc., Toronto, Ontario, Canada
| | | | - Yan Fossat
- Labs Department, Klick Health, Klick Inc., Toronto, Ontario, Canada
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195
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Abstract
Compassion has always been a vital component of healthcare anywhere in the world. With numerous definitions in a variety of contexts, it cannot simply be prescribed, measured or given in a bottle. When our patients are ill, great attention is paid to the verbal and non-verbal communication presented by a doctor and the manner in which they are delivered. However, with an ever-growing demand on the NHS workforce, numerous patient surveys across the UK have accused doctors for lacking compassion in their practice, amid the strains of their modern-day commitments. The concept of being caring to our patients is highlighted from the first walks of medical school or indeed any healthcare professional's training programme, meaning that patients will always be our prime audience for compassion. Yet, so often in medical training, it is emphasised how important it is to demonstrate a personal detachment between oneself and the patient and not to get too emotionally involved. So despite numerous challenges, how do we find the correct balance to optimise our day-to-day service and stay sensitive to the needs of our patients? This article reflects upon compassion from multiple perspectives in the NHS pertinent to doctors of all settings and experience levels, exploring the barriers, internal conflicts and facilitators of its delivery. We examine the objective evidence of measures that have been put in place to overcome these challenges and summarise key considerations to optimise the enablement of a workforce to deliver compassion at universally higher standards in future practice.
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Affiliation(s)
- Archik Das
- 1 Academic Foundation Year 2 Doctor, Warwick Medical School, Medical School Building, Coventry CV4 7AJ, UK
| | - Rodger Charlton
- 2 Professor of Undergraduate Primary Care Education, University of Leicester Medical School, Centre for Medicine, Lancaster Rd, Leicester LE1 7HA, UK
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Compassionate Care in Behavior Analytic Treatment: Can Outcomes be Enhanced by Attending to Relationships with Caregivers? Behav Anal Pract 2018; 12:654-666. [PMID: 31976276 DOI: 10.1007/s40617-018-00289-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The practice of behavior analysis has become a booming industry with growth to over 30,000 Board Certified Behavior Analysts (BCBAs) who primarily work with children with autism and their families. Most of these BCBAs are relatively novice and have likely been trained in graduate programs that focus primarily on conceptual and technical skills. Successfully working with families of children with autism, however, requires critical interpersonal skills, as well as technical skills. As practitioners strive to respond efficiently and compassionately to distressed families of children with autism, technical skills must be balanced with fluency in relationship-building skills that strengthen the commitment to treatment. The current article provides an outline of important therapeutic relationship skills that should inform the repertoire of any practicing behavior analyst, strategies to cultivate and enhance those skills, and discussion of the potential effects of relationship variables on treatment outcomes.
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197
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Sinclair S, Jaggi P, Hack TF, McClement SE, Raffin-Bouchal S, Singh P. Assessing the credibility and transferability of the patient compassion model in non-cancer palliative populations. BMC Palliat Care 2018; 17:108. [PMID: 30213263 PMCID: PMC6137734 DOI: 10.1186/s12904-018-0358-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 08/21/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A lack of evidence and psychometrically sound measures of compassion necessitated the development of the first known, empirically derived, theoretical Patient Compassion Model (PCM) generated from qualitative interviews with advanced cancer inpatients. We aimed to assess the credibility and transferability of the PCM across diverse palliative populations and settings. METHODS Semi-structured, audio-recorded qualitative interviews were conducted with 20 patients with life-limiting diagnoses, recruited from 4 settings (acute care, homecare, residential care, and hospice). Participants were first asked to share their understandings and experiences of compassion. They were then presented with an overview of the PCM and asked to determine whether: 1) the model resonated with their understanding and experiences of compassion; 2) the model required any modification(s); 3) they had further insights on the model's domains and/or themes. Members of the research team analyzed the qualitative data using constant comparative analysis. RESULTS Both patients' personal perspectives of compassion prior to viewing the model and their specific feedback after being provided an overview of the model confirmed the credibility and transferability of the PCM. While new codes were incorporated into the original coding schema, no new domains or themes emerged from this study sample. These additional codes provided a more comprehensive understanding of the nuances within the domains and themes of the PCM that will aid in the generation of items for an ongoing study to develop a patient reported measure of compassion. CONCLUSIONS A diverse palliative patient population confirmed the credibility and transferability of the PCM within palliative care, extending the rigour and applicability of the PCM that was originally developed within an advanced cancer population. The views of a diverse palliative patient population on compassion helped to validate previous codes and supplement the existing coding schema, informing the development of a guiding framework for the generation of a patient-reported measure of compassion.
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Affiliation(s)
- Shane Sinclair
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
| | - Priya Jaggi
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.,Research Institute in Oncology, Hematology, Cancer Care, 4005E-675 McDermot, Winnipeg, MB, R3E 0V9, Canada.,Psychosocial Oncology and Cancer Nursing Research, St. Boniface Hospital Research Centre, Room CR3018, 369 Taché Avenue, Winnipeg, MB , R2H 2A6, Canada
| | - Susan E McClement
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada.,Research Institute in Oncology, Hematology, Cancer Care, 4005E-675 McDermot, Winnipeg, MB, R3E 0V9, Canada
| | - Shelley Raffin-Bouchal
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Pavneet Singh
- Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
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Singh P, Raffin-Bouchal S, McClement S, Hack TF, Stajduhar K, Hagen NA, Sinnarajah A, Chochinov HM, Sinclair S. Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study. J Clin Nurs 2018; 27:2083-2097. [DOI: 10.1111/jocn.14357] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Pavneet Singh
- Faculty of Nursing; University of Calgary; Calgary AB Canada
| | | | - Susan McClement
- Research Institute in Oncology Hematology; Cancer Care Manitoba; Winnipeg MB Canada
- College of Nursing; Rady Faculty of Health Sciences; University of Manitoba; Winnipeg MB Canada
| | - Thomas F Hack
- Research Institute in Oncology Hematology; Cancer Care Manitoba; Winnipeg MB Canada
- College of Nursing; Rady Faculty of Health Sciences; University of Manitoba; Winnipeg MB Canada
- Psychosocial Oncology and Cancer Nursing Research; St. Boniface Research Centre; Winnipeg; Manitoba Canada
| | - Kelli Stajduhar
- School of Nursing and Institute on Aging and Lifelong Health; University of Victoria; Victoria BC Canada
| | - Neil A Hagen
- Department of Oncology; Cumming School of Medicine; University of Calgary; Calgary AB Canada
- Departments of Clinical Neurosciences and Medicine; Cumming School of Medicine; University of Calgary; Calgary AB Canada
| | - Aynharan Sinnarajah
- Department of Oncology; Cumming School of Medicine; University of Calgary; Calgary AB Canada
- Palliative/End of Life Care, Calgary Zone; Alberta Health Services; Calgary AB Canada
| | - Harvey M Chochinov
- Research Institute in Oncology Hematology; Cancer Care Manitoba; Winnipeg MB Canada
- Department of Psychiatry; University of Manitoba; Winnipeg MB Canada
| | - Shane Sinclair
- Faculty of Nursing; University of Calgary; Calgary AB Canada
- Department of Oncology; Cumming School of Medicine; University of Calgary; Calgary AB Canada
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199
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Measuring Compassion in Healthcare: A Comprehensive and Critical Review. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 10:389-405. [PMID: 27866323 DOI: 10.1007/s40271-016-0209-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings. METHODS PubMed, MEDLINE, CINAHL and PsycINFO databases and grey literature were searched to identify studies that report information on instruments that measure compassion or compassionate care in clinicians, nurses, healthcare students and patients. Textual qualitative descriptions of included studies were prepared. Instruments were evaluated using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. RESULTS Nine studies containing information on the Compassion Competence Scale, a self-report instrument that measures compassion competence among Korean nurses; the Compassion Scale, the Compassionate Care Assessment Tool©, and the Schwartz Center Compassionate Care Scale™, patient-reported instruments that measure the importance of healthcare provider compassion; the Compassion Practices Scale, an instrument that measures organisational support for compassionate care; and instruments that measure compassion in educational institutions (instructional quality and a Geriatric Attitudes Scale), were included. Each instrument is associated with significant limitations. Most only measure certain aspects of compassion and lack evidence of adaptability to diverse practice settings. The EMPRO of self-report instruments revealed a lack of psychometric information on measurement reliability, validity, responsiveness and interpretability, respondent, administrative and scoring burden, and use in subpopulations. CONCLUSION The findings of this narrative synthesis identified an unmet need for a psychometrically validated instrument that comprehensively measures the construct of compassion in healthcare settings.
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Forbat L, François K, O'Callaghan L, Kulikowski J. Family Meetings in Inpatient Specialist Palliative Care: A Mechanism to Convey Empathy. J Pain Symptom Manage 2018; 55:1253-1259. [PMID: 29425882 DOI: 10.1016/j.jpainsymman.2018.01.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 12/30/2022]
Abstract
CONTEXT Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in inpatient settings. OBJECTIVES To examine whether relatives report more empathy after a family meeting in a specialist palliative care inpatient ward. METHODS Pre/post self-complete questionnaires measuring relational empathy and information needs were administered. Qualitative interviews were also conducted. Data were collected during nine months from one inpatient specialist palliative care unit. Participants from 52 family meetings completed pre/post questionnaires, and 13 relatives participated in an interview that was analyzed thematically. RESULTS Families reported more empathy from staff after a family meeting (Wilcoxon test: n = 47; P > 0.001; Z score -4.17). Some families with relatives who do not speak with each other reported that meeting facilitators were unable to manage the pre-existing dynamics. CONCLUSION Family meetings improve reported empathy. It would be beneficial to have more specific preparation and planning by the clinical team for meetings with people who have a history of familial conflict, and those where the staff's agenda is around discharge planning. Published guidelines could be adapted to better support staff to run meetings where there are complex family dynamics. Adoption of family meetings in outpatient settings has the potential to improve perceptions of empathy with a larger patient group.
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Affiliation(s)
- Liz Forbat
- Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia; School of Health Sciences, Australian Catholic University, Canberra, Australia.
| | - Karemah François
- Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia; School of Health Sciences, Australian Catholic University, Canberra, Australia
| | - Lynne O'Callaghan
- Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia
| | - Julie Kulikowski
- Calvary Centre for Palliative Care Research, Calvary Public Hospital, Canberra, Australia
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