Towards an understanding of compassion from an Islamic perspective

'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals

AIMS AND OBJECTIVES

To explore the meaning ascribed to the concept of compassion by healthcare professionals.

BACKGROUND

Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear.

DESIGN

A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines.

METHOD

Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed.

FINDINGS

Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action.

CONCLUSIONS

Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice.

RELEVANCE TO CLINICAL PRACTICE

To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice.

NO PATIENT OR PUBLIC CONTRIBUTION

This systematic review had no patient or public contribution.

Effects of Religious Versus Non-religious Self-compassion Interventions on Anxiety and Quality of Life of Iranian Infertile Women: A Randomized Controlled Trial

Anxiety is one of the common psychological problems among infertile women, which affects their quality of life. The purpose of this study was to compare the effects of self-compassion intervention based on a religious and non-religious perspective regarding the anxiety and quality of life of infertile women. A randomized clinical trial design with experimental and control groups was used. A total of 78 infertile women who lived in Yazd province, Iran, were referred to Yazd reproductive sciences institute, were selected by available sampling and randomly assigned to two experimental and one control groups. The participants of the first experimental group received eight sessions of self-compassion-focused intervention based on religious instructions. The second experimental group received eight sessions of non-religious self-compassion intervention, while the control group was put on the waiting list. Data were collected using Quality of Life in Infertile Couples Questionnaire (QOLICQ) and Beck anxiety inventory (BDI) in the pretest, posttest and 2-month follow-up phases and then analyzed using repeated measures as well as one-way analysis of variance. The results showed as compared to control group at the posttest and follow-up phases, the quality of life (p < 0.001) and anxiety (p < 0.001) of infertile women increased and decreased, respectively, across both experimental groups. Comparison of experimental groups showed that although the difference between the two groups in the subscales of social relationships and sexual satisfaction was not significant, the gain scores of quality of life and anxiety were significantly greater in the first experimental group. These findings indicate that given the religious background of infertile women, religious self-compassion intervention can be relatively more effective in improving the quality of life and anxiety of infertile women than non-religious intervention.

Moderating Role of Self-Compassion in the Relationships Between the Three Forms of Perfectionism with Anger, Aggression, and Hostility

The prevalence of aggression in adolescents is on the rise, and it could be a serious public health concern. Studies have found positive relationships between perfectionism with anger, aggression, and hostility. However, the moderating role of self-compassion in the links between perfectionism with anger, aggression, and hostility has not been studied. To better understand the relationships between the three forms of perfectionism with anger, aggression, and hostility, this study aimed to explore the moderating role of self-compassion. Participants were 380 undergraduates selected using a multi-stage cluster sampling technique from three universities in Iran. Participants completed the Self-Compassion Scale, the Multidimensional Perfectionism Scale, and the Aggression Questionnaire Scale. The results from structural equation modelling analysis showed that other-oriented perfectionism and socially prescribed perfectionism positively predicted anger, aggression, and hostility. The results showed that self-oriented perfectionism significantly and positively predicted anger and hostility; but there were no observed statistically significant relationships of self-oriented perfectionism with verbal aggression and physical aggression. The findings showed that self-compassion played a moderating role in the relationships between other-oriented perfectionism and socially prescribed perfectionism with anger, aggression, and hostility; however, it did not play a moderating effect on self-oriented perfectionism with anger, aggression, and hostility. The findings provide a deeper understanding of the moderating role of self-compassion in the links between other-oriented perfectionism and socially prescribed perfectionism with anger, aggression, and hostility among undergraduates. The findings of this study could be applicable for psychologists and counselors who deal with aggressive behavior, anger, and hostility in undergraduate students to assess the three forms of perfectionism and self-compassion.

Nursing Care Experiences With Syrian Refugees in Southern Turkey: A Metaphor Analysis

BACKGROUND

Healthcare professionals' "cultural prejudices" toward individuals' cultural beliefs, attitudes, and perceptions affect the care they provide. Their awareness of their bias is closely associated with the quality of healthcare provided.

PURPOSE

This study was designed to assess nurses' perceptions regarding providing care to Syrian refugee patients using metaphors and to evaluate their views based on these metaphors.

METHODS

The participants in this qualitative study consisted of 80 nurses who worked in Level 1 and Level 2 health institutions. Data were collected using an interview form prepared by the researchers. The form included descriptive characteristics of the nurses and two expressions used to determine the nurses' opinions on providing care for Syrian refugee patients. The nurses were given an incomplete sentence, which was "Providing care for a Syrian refugee patient…because…," and were asked to complete the blanks. The data were analyzed using the content analysis method.

RESULTS

On the basis of "providing care for Syrian refugee patients," four categories of metaphors were determined: occupational awareness, health promotion, a difficult process/resistance, and providing service in vain. The participants generated 50 metaphors, with "humanity," "a baby/little child," and "a barrier" as the three most used metaphors, belonging to the "occupational awareness" and "a difficult process/resistance" categories, respectively.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The metaphors of nurses regarding giving care to Syrian refugee patients were mostly concentrated in the categories of "occupational awareness" and "a difficult process/resistance." Metaphors generated by the nurses offer a powerful research tool to reveal, understand, and explain nurses' personal perceptions and to develop and support nursing care accordingly. In addition, the subject of transcultural nursing should be discussed more extensively in nursing education programs. Understanding the social context of refugees is very important during the nursing care process.

The compassionate love for humanity scale (CLS-H-SF): psychometric properties of the Persian version

Compassionate love is beneficial in a variety of domains, including in education, health, and law, as well as in people’s personal lives. The topic of compassionate love has therefore attracted growing interest from researchers interested in its psychological and social dimensions. Given the importance of compassion to the education and health sectors, and the expansion of these sectors in Iran, this paper aims to provide Persian (Farsi) speaking practitioners and researchers with an effective instrument for measuring compassion. As such, the authors have translated the compassionate love for humanity scale-short form (CLS-H-SF) into the Persian language, and assessed the psychometric properties of this instrument among a sample of the Iranian population. A sample of 827 adults (49.9% women and 51.1% men) completed the Persian version of the CLS-H-SF through an online survey. Concurrent validity was assessed using the Persian versions of the positive and negative affect scale, self-esteem scale, and satisfaction with life scale. The CLS-H-SF positively correlated with positive affect, self-esteem and life satisfaction, and negatively correlated with negative affect. These findings indicate acceptable concurrent validity for the CLS-H-SF. Cronbach’s alpha for the scale was 0.88, indicating good internal consistency between items. A confirmatory factor analysis supported a one-factor model same as the English version of the CLS-H-SF. The findings of this study showed the Persian version of CLS-H-SF had acceptable validity and reliability in assessing compassionate love for humanity in Iranian adults.

Motivations and Experiences of Volunteering Medical Students in the COVID-19 Pandemic-Results of a Survey in Germany

Introduction: During the first lockdown of the COVID-19 pandemic, several medical students volunteered as assistants in hospitals, public health departments, and other healthcare services to support and substitute permanent staff. The underlying motivations to help are unclear. Therefore, we aimed to assess medical students' motivations and influencing variables such as perceived stress and burden, compassion, and indicators of spirituality. Materials and Methods: Cross-sectional survey (convenience sample) from May to June 2020, directly after the first lockdown, among medical students with standardized instruments. One of them is the 12-item Motivations to Help Scale (MtHS) which was designed to fit to the population of medical students. Results: Among the 731 completers, 52% were working as volunteers during the pandemic in different medical areas, most in hospitals and only a few in other areas (9% in public health departments, 6% in outpatient services), 37% would have liked to work but did not get an appropriate employment, and 21% did not intend to voluntarily support the hospital staff. Their mental burden during work was rather low, while they were somewhat affected by the personal fate of the patients. With respect to their motivations to volunteer as measured with the MtHS, Altruistic Intentions/Helping (Cronbach's alpha = 0.898) scored highest, followed by Practical Application/Learning (Cronbach's alpha = 0.808), while Role Testing/Recognition (Cronbach's alpha = 0.702) scored lowest. Those who volunteered had significantly higher scores for Altruistic Intentions/Helping and Practical Application/Learning, while the different phases of medical study (preclinical phase, clinical phase, and higher semester) had no influence on the extent of the students' motivation. The motivations to help were not at all or only marginally (inversely) related to indicators of stress and burden, while Altruistic Intentions/Helping was weakly related to affections by patients' fate. Conclusions: Medical students' intention to support healthcare professionals as supplementary assistants were both prosocial and proself motivated. With this opportunity to practically apply their current knowledge and to improve their skills and competences, volunteering students might be more motivated for their further studies and their future career as compassionate medical doctors.

Nurse’s Experiences in Implementing an Islamic Care Nursing Practice in Sharia-based Hospital Yogyakarta: A Phenomenological Study

BACKGROUND: Caring is the concept of a basic approach in nursing. It is an action that affects the level of satisfaction in hospitalized patients. Caring practice is very important for patient satisfaction. If it is in accordance with patient expectations, it will be considered as satisfying nursing services. However, in reality, there are still many nurses who have not shown caring practice toward patients and there may be some nurses who do not have time to listen to patients, provide comfort, or other caring actions. Nurses are considered to be noble professions as they are the people who take care and help the patients. The noble profession can be seen through the practice of the nurse such as caring actions which can improve patient satisfaction, especially Islamic caring, which is to include Islamic values in the hospital regardless of the patient’s status. AIM: This study aims to explore the experiences of nurses in implementing Islamic caring practices at the Islamic Hospital in Yogyakarta. METHODS: This study used a qualitative method with a phenomenological approach. The data collection conducted in this study was an in-depth interview method. The number of participants in this study was six nurses who worked at PKU Muhammadiyah Yogyakarta Hospital and Nur Hidayah Hospital, Yogyakarta. RESULTS: The results of this study showed four main themes regarding the experience of nurses in implementing Islamic caring practices at the Islamic Hospital in Yogyakarta. CONCLUSION: The four main themes are nurse’s spiritual experiences, sharia-based services, attitudes toward Islamic caring practices, and the support and the barrier in carrying out Islamic caring practices.

Understanding the concept of compassion from the perspectives of nurses

BACKGROUND

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

RESEARCH OBJECTIVES

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

RESEARCH DESIGN

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

PARTICIPANTS AND RESEARCH CONTEXT

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

ETHICAL CONSIDERATIONS

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

FINDINGS

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

DISCUSSION

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

CONCLUSION

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

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

BACKGROUND

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Relational inquiry approach for developing deeper awareness of patient suffering

To practice compassion, the recognition, understanding, and alleviation of patient suffering are of utmost importance. Nursing literature provides ample guidance about the nature and meaning and patients' views about compassion and physical and psychological suffering. However, missing is the discussion about how nurses can achieve a deeper awareness of patients' suffering to practice compassion. This paper aims to describe the relational inquiry nursing approach and illustrate how this approach can enable nurses to develop a deeper awareness of patient suffering. The relational inquiry approach encompasses two components: a relational consciousness and inquiry as a form of action. Relational consciousness requires the nurses to focus on the concrete situations and relationships as well as recognize the intrapersonal, interpersonal, and contextual factors affecting the situations. The interpersonal factors are among and between the individuals, intrapersonal factors are within the individuals, and contextual factors are the hidden factors influencing the individuals and situations. Inquiry as an action requires a critical analysis of the experiences of individuals, situational contexts, and knowledge to inform the nursing care modalities and actions. This approach encourages nurses to use the philosophies of hermeneutic phenomenology, critical theory, and pragmatism. The phenomenological worldview allows nurses to interpret their own and patients' experiences, the critical theory worldview allows nurses to examine the influence of social and cultural factors, and pragmatism allows nurses to question their prior knowledge and develop new knowledge in each situation. The relational inquiry approach allows nurses to develop a deeper understanding of patient suffering through building a therapeutic and trustworthy relationship, active listening, focusing on the details, and engaging in broad and situations specific inquiries to understand the patient narrative of suffering. Two case exemplars are shared to demonstrate how relational inquiry allowed nurses to move beyond recognizing physical suffering and understand patients' emotional and psychological suffering.

Exploring the lived experience of Jordanian male nurses: A phenomenological study

BACKGROUND

Human beings have an inbuilt desire to care and nurture others. In some professions such as nursing, women are perceived as privileged in relation to these traits, and women are in the majority in the nursing profession. The Gender theory suggests that men should adapt to feminine traits and nature in order to fit in the nursing profession. However, there is a paucity of literature in relation to Arab male nurses' experience in nursing.

PURPOSE

The purpose of this study was to explore the Jordanian male nurses' experiences of their career within their Arabic community.

METHODS

A hermeneutic phenomenological approach, underpinned by VanManen's perspective was used. Twenty-two Jordanian male nurses were approached from four hospitals in Jordan. Four focus groups comprising 5-6 interviewees in each were used. The focus groups were audio-recorded and transcribed verbatim. The data were analyzed using Van Manen's hermeneutic approach and themes extracted from the Arabic version were compared critically with the analysis of the English version to develop the meaning of the narratives.

DISCUSSION

Three major themes emerged from the data: (i) personal gains; (ii) masculinity; (iii) and cultural influences. Whilst male nurses recognized nursing is a female dominant profession, they viewed themselves as more independent in decision making and more productive than their female counterparts. Significantly, the participants described nursing as a means of fulfilling their spiritual needs and thus a personal gain. The interviewees linked their masculinity to resilience and endurance. Participants described that men in nursing face some social constraints within the Arab community.

CONCLUSION

The study findings partly supported the fact that nursing in Jordan is a predominantly female profession which lends support to the gender theory in which Jordanian male nurses experienced a social bias and disadvantages by Arabic culture stereotypes of a male nurse. Although nursing is still a feminine career, the findings of this study raise awareness that gender role stereotype might not hold a strong stance in relation to nursing and that could be attributed to elements such as economic and payment status.