1
|
Avilés L, Castillo-Mansilla D, Wang Y, Smith P. Person-centred care and online pedagogy in nursing education: a discussion paper. Nurse Educ Pract 2024; 78:103998. [PMID: 38810351 DOI: 10.1016/j.nepr.2024.103998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
AIM To discuss person-centred care in nursing education and the role of online pedagogy to facilitate meaninful learning. BACKGROUND The core principles and values of person-centred care are at the centre of national and international healthcare education. Person-centred care recognises partnerships and relationships between nurses, healthcare practitioners and individual patients, carers and their families and part of the training of healthcare professionals. However, the literature on how person-centred care is taught to facilitate meaningful learning in nursing education particularly in the context of online pedagogy is limited. DESIGN A critical discussion paper. METHODS A critical discussion of person-centred care and online pedagogy that can facilitate teaching practices are presented, drawing on authors' positionality and case exemplars. RESULTS Teaching person-centred care using online pedagogy appears to have a promising impact on undergraduate and postgraduate nursing students' experiences. Engaging students in critical examination and reflection on the complexities of person-centred care in practice creates meaningful experiential learning for both students and educators. CONCLUSION Evidence suggests that the use of online pedagogy is a beneficial and effective way to incorporate the teaching of person-centred care into nursing education, yet more evidence is needed to evaluate its impact on nursing practice.
Collapse
Affiliation(s)
- Lissette Avilés
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom.
| | - Daniela Castillo-Mansilla
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom; Universidad de Chile, Facultad de Medicina, Av. Independencia 1027, Independencia, Santiago, Región Metropolitana 8380453, Chile
| | - Yin Wang
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom
| | - Pam Smith
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Doorway 6 Old Medical School, Teviot Place, Edinburgh EH8 9 AG, United Kingdom
| |
Collapse
|
2
|
Field-Richards SE, Aubeeluck A, Callaghan P, Keeley P, Redsell SA, Spiby H, Stacey G, Lymn JS. The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study. Int J Nurs Stud 2024; 153:104732. [PMID: 38493656 DOI: 10.1016/j.ijnurstu.2024.104732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/13/2024] [Accepted: 02/20/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Compassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing. OBJECTIVE To explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care. DESIGN Longitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework. SETTING(S) Three United Kingdom universities. PARTICIPANTS Pre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8. METHODS Work package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26. RESULTS Qualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification. CONCLUSIONS There is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education. REGISTRATION N/A. Tweetable abstract Insufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R.
Collapse
Affiliation(s)
| | - Aimee Aubeeluck
- School of Health Sciences, University of Nottingham, Nottingham, UK. https://twitter.com/aimee_aubeeluck
| | - Patrick Callaghan
- School of Applied Sciences, London South Bank University, London, UK. https://twitter.com/profmanpat
| | - Philip Keeley
- School of Nursing and Midwifery, Keele University, Keele, UK.
| | - Sarah Anne Redsell
- School of Health Sciences, University of Nottingham, Nottingham, UK. https://twitter.com/SarahRedsell
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, Nottingham, UK.
| | - Gemma Stacey
- Florence Nightingale Foundation, London, UK. https://twitter.com/GemmaStacey10
| | - Joanne S Lymn
- School of Health Sciences, University of Nottingham, Nottingham, UK. https://twitter.com/JoanneLymn
| |
Collapse
|
3
|
Pryjmachuk S, Kirk S, Fraser C, Evans N, Lane R, Neill L, Camacho E, Bower P, Bee P, McDougall T. Service design for children and young people with common mental health problems: literature review, service mapping and collective case study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-181. [PMID: 38767587 DOI: 10.3310/dkrt6293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Background The mental health of children/young people is a growing concern internationally. Numerous reports and reviews have consistently described United Kingdom children's mental health services as fragmented, variable, inaccessible and lacking an evidence base. Little is known about the effectiveness of, and implementation complexities associated with, service models for children/young people experiencing 'common' mental health problems like anxiety, depression, attention deficit hyperactivity disorder and self-harm. Aim To develop a model for high-quality service design for children/young people experiencing common mental health problems by identifying available services, barriers and enablers to access, and the effectiveness, cost effectiveness and acceptability of such services. Design Evidence syntheses with primary research, using a sequential, mixed-methods design. Inter-related scoping and integrative reviews were conducted alongside a map of relevant services across England and Wales, followed by a collective case study of English and Welsh services. Setting Global (systematic reviews); England and Wales (service map; case study). Data sources Literature reviews: relevant bibliographic databases and grey literature. Service map: online survey and offline desk research. Case study: 108 participants (41 children/young people, 26 parents, 41 staff) across nine case study sites. Methods A single literature search informed both reviews. The service map was obtained from an online survey and internet searches. Case study sites were sampled from the service map; because of coronavirus disease 2019, case study data were collected remotely. 'Young co-researchers' assisted with case study data collection. The integrative review and case study data were synthesised using the 'weaving' approach of 'integration through narrative'. Results A service model typology was derived from the scoping review. The integrative review found effectiveness evidence for collaborative care, outreach approaches, brief intervention services and the 'availability, responsiveness and continuity' framework. There was cost-effectiveness evidence only for collaborative care. No service model appeared to be more acceptable than others. The service map identified 154 English and Welsh services. Three themes emerged from the case study data: 'pathways to support'; 'service engagement'; and 'learning and understanding'. The integrative review and case study data were synthesised into a coproduced model of high-quality service provision for children/young people experiencing common mental health problems. Limitations Defining 'service model' was a challenge. Some service initiatives were too new to have filtered through into the literature or service map. Coronavirus disease 2019 brought about a surge in remote/digital services which were under-represented in the literature. A dearth of relevant studies meant few cost-effectiveness conclusions could be drawn. Conclusions There was no strong evidence to suggest any existing service model was better than another. Instead, we developed a coproduced, evidence-based model that incorporates the fundamental components necessary for high-quality children's mental health services and which has utility for policy, practice and research. Future work Future work should focus on: the potential of our model to assist in designing, delivering and auditing children's mental health services; reasons for non-engagement in services; the cost effectiveness of different approaches in children's mental health; the advantages/disadvantages of digital/remote platforms in delivering services; understanding how and what the statutory sector might learn from the non-statutory sector regarding choice, personalisation and flexibility. Study registration This study is registered as PROSPERO CRD42018106219. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/09/08) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 13. See the NIHR Funding and Awards website for further award information.
Collapse
Affiliation(s)
- Steven Pryjmachuk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Susan Kirk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Claire Fraser
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Nicola Evans
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | - Rhiannon Lane
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | | | - Elizabeth Camacho
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Peter Bower
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Penny Bee
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Tim McDougall
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| |
Collapse
|
4
|
Pryjmachuk S, Kirk S, Fraser C, Evans N, Lane R, Crooks J, McGowan R, Naughton G, Neill L, Camacho E, Bower P, Bee P, McDougall T. A collaboratively produced model of service design for children and young people with common mental health problems. BMC Health Serv Res 2024; 24:133. [PMID: 38268003 PMCID: PMC10809440 DOI: 10.1186/s12913-024-10562-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Little is known about the effectiveness of, and implementation complexities associated with, service delivery models for children and young people (CYP) experiencing 'common' mental health problems such as anxiety, depression, behavioural difficulties and self-harm. This paper outlines how a model for high-quality service design for this population group was developed by identifying available services, their effectiveness, cost-effectiveness and acceptability, and the barriers and enablers to access. METHODS Sequential, mixed-methods design, combining evidence syntheses (scoping and integrative reviews of the international literature) with primary research (a collective case study in England and Wales). Data from these two elements were collaboratively synthesised in a subsequent model-building phase. RESULTS The scoping review yielded a service model typology. The integrative review found effectiveness evidence only for four models: collaborative care (the only service model to also have cost-effectiveness evidence), outreach approaches, brief intervention services and an organisational framework called 'Availability, Responsiveness and Continuity'. No service model seemed more acceptable than others. Three case study themes were identified: pathways to support; service engagement; and learning and understanding. The model-building phase identified rapid access, learning self-care skills, individualised support, clear information, compassionate and competent staff and aftercare planning as core characteristics of high-quality services. These characteristics were underpinned by four organisational qualities: values that respect confidentiality; engagement and involvement; collaborative relationships; and a learning culture. CONCLUSIONS A consistent organisational evidence-base for service design and delivery in CYP's mental health spanning many years appears to have had little impact on service provision in England and Wales. Rather than impose - often inflexible and untested - specific local or national models or frameworks, those commissioning, designing and delivering mental health services for CYP should (re)focus on already known, fundamental components necessary for high-quality services. These fundamental components have been integrated into a collaboratively produced general model of service design for CYP with common mental health problems. While this general model is primarily focused on British service provision, it is broad enough to have utility for international audiences.
Collapse
Affiliation(s)
- Steven Pryjmachuk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
- Manchester Mental Health NHS Foundation Trust, Manchester, UK.
| | - Susan Kirk
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Claire Fraser
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Nicola Evans
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | - Rhiannon Lane
- School of Healthcare Studies, Cardiff University, Cardiff, UK
| | | | | | | | | | | | - Peter Bower
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Penny Bee
- School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Tim McDougall
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| |
Collapse
|
5
|
Zhang J, Zou J, Wang X, Luo Y, Zhang J, Xiong Z, Zhang J. Clinical nurses' compassion fatigue psychological experience process: a constructivist grounded theory study. BMC Nurs 2023; 22:487. [PMID: 38114975 PMCID: PMC10729325 DOI: 10.1186/s12912-023-01665-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Clinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses. METHODS Charmaz's Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes. RESULTS The data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period. CONCLUSION Clinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses' compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.
Collapse
Affiliation(s)
- Jie Zhang
- Hunan University of Chinese Medicine, Changsha, China
| | - Jie Zou
- Hepatobiliary Pancreatic Cancer Center, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiao Wang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yaoyue Luo
- Hunan University of Chinese Medicine, Changsha, China
| | - Jin Zhang
- Hepatobiliary Pancreatic Cancer Center, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Zhiyao Xiong
- General Ward of Musculoskeletal & Burn & Pain Rehabilitation Department, Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Jingping Zhang
- Nursing Psychology Research Center of XiangYa School of Nursing, Central South University, 172 Tongzi Po Road, Changsha, Hunan, 410013, China.
| |
Collapse
|
6
|
Arman M. Empathy, sympathy, and altruism-An evident triad based on compassion. A theoretical model for caring. Scand J Caring Sci 2023; 37:862-871. [PMID: 36942653 DOI: 10.1111/scs.13163] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Based on existing confusion and a suggested contradiction regarding empathy and compassion in relation to caring science as well as in clinical health care. AIM The aim of the study was to find a knowledge base for the development of clinical caring science for, empathy, sympathy altruism, and compassion and their mutual relationship. DESIGN A theoretical paper. RESULTS The text discusses the different concepts separately, considering their history, research, obstacles, and bias and then brings them together in a concept model. The conclusion shows that empathy, sympathy, and altruism have no contradictions. Instead, they together form an evident triad based on compassion. Compassion is a prerequisite and a basis for the others to work. In clinical application, empathy is metaphorically a quality coming from the head, sympathy from the heart and altruism from the hand, merged in an attitude of compassion as a motif to care. The paper also reflects on the possibilities to increase and develop a compassionate mood and capacity by education and training.
Collapse
Affiliation(s)
- Maria Arman
- Department of Neurobiology Care Science and Society, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
7
|
Bangham J. Making the 'genetic counsellor' in the UK, 1980-1995. MEDICAL HUMANITIES 2023; 49:248-259. [PMID: 37068944 PMCID: PMC10359581 DOI: 10.1136/medhum-2022-012472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 06/19/2023]
Abstract
The professional identity of the 'genetic counsellor' first took shape in the UK in the early 1990s, when the University of Manchester established the country's first masters-level training course. Postwar, genetic counselling had been carried out by (male) clinical geneticists, who, alongside their research, clinical and field-building activities, met patients and families to discuss inherited conditions and risk estimates, and who sometimes advised parents whether to attempt or continue pregnancies. By contrast, the new cohort of students in Manchester in the 1990s were not medically trained, were mostly women, and were schooled in the psychological and social consequences of genetic testing and diagnosis, as well as methods for the care, support and emotional management of patients and families. This was a significant change both in the practices of 'genetic counselling' and who was expected to practise it. Focusing on a small section of this history, between 1980 and 1995, this paper describes some of the historical threads that contributed to this change. It charts the early work of genetic nurses and social workers, who in the 1980s carved out distinctive roles within National Health Service genetics centres. It describes the separate, specialist provision developed by sickle cell and thalassaemia counsellors, who developed new approaches in dialogue with racialised and underserved patient communities. It examines growing interest in the late 1980s and early 1990s in the tacit social and cultural conditions of genetic counselling encounters, and how this cohered with attention from disability scholars, psychologists and social scientists. By describing these historical contributions, this paper explores how the intersecting gendered, racialised and disciplinary politics of clinical genetics shaped the new professional role of the 'genetic counsellor'.
Collapse
Affiliation(s)
- Jenny Bangham
- School of History, Queen Mary University of London, London, UK
| |
Collapse
|
8
|
Sowden E, Robinson D, Lovell K, Bee P, Fulwood A, Lidbetter N, Wilson Z, Brown A, Pedley R. Understanding the support needs of parents of children with obsessive-compulsive disorder: a qualitative descriptive study in the UK. BMC Psychiatry 2023; 23:309. [PMID: 37138253 PMCID: PMC10155140 DOI: 10.1186/s12888-023-04637-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/27/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Caring for a child with obsessive-compulsive disorder (OCD) can be extremely difficult, yet evidence-based support strategies for parents/carers are limited. A detailed understanding of parent support needs is an important first step in intervention development and qualitative research with this focus is currently lacking. In this study, the viewpoints of parents and professionals were used to understand support needs and preferences when caring for a child with OCD. This qualitative descriptive study formed part of a wider UK-based project aimed at developing better support for parents of children with OCD. METHOD Individual semi-structured interviews (and an optional one-week journal) with a purposive sample of parents of children and young people (CYP) with OCD, aged 8-18, and focus groups (or individual interviews where preferred) with a purposive sample of professionals supporting CYP with OCD. Data comprised transcripts of audio-recorded interviews and focus groups, and text from journals. Analysis was informed by the Framework approach involving inductive and deductive coding, supported by NVivo 12.0 software. Co-production methods were adopted throughout the research process, including the involvement of a parent co-researcher and charity collaborators. RESULTS Interviews were undertaken with 20 parents, of which 16 completed a journal. Twenty-five professionals took part in a focus group or interview. Five key themes relating to parent support challenges and support needs/preferences were identified (1) Coping with the impact of OCD; (2) Getting help for my child; (3) Understanding parents' role; (4) Making sense of OCD; (5) Joined-up care. CONCLUSION Parents caring for children with OCD have clear caregiver support needs which are currently not being met. Through triangulation of parent and professional accounts, this study has identified parent support challenges (e.g., emotional impact of OCD, visibility of caring role, misunderstanding about OCD) and support needs/ preferences (e.g., headspace/respite, compassion/sensitivity, guidance on accommodation) to lay the vital foundations for the development of effective parent support interventions. There is now an urgent need to develop and test an intervention to support parents in their caregiving role, with the aim of preventing and/or reducing their levels of burden and distress and ultimately, improving their quality of life.
Collapse
Affiliation(s)
- Emma Sowden
- Department of Primary Care and Mental Health, University of Liverpool, 1st Floor Block B Waterhouse Building, Brownlow Street, L69 3GL, Liverpool, UK.
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| | - Debbie Robinson
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Karina Lovell
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, The University of Manchester, Manchester, UK
| | - Penny Bee
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, The University of Manchester, Manchester, UK
| | - Ashley Fulwood
- OCD UK, 8 Chapel Street, DE56 1AR, Belper, Derbyshire, UK
| | - Nicky Lidbetter
- Anxiety UK, Nunes House, 447 Chester Road, Old Trafford, M16 9HA, Manchester, UK
| | - Zoe Wilson
- OCD UK, 8 Chapel Street, DE56 1AR, Belper, Derbyshire, UK
| | - Abi Brown
- School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, The University of Manchester, Manchester, UK
| | - Rebecca Pedley
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
- School of Health Sciences, Faculty of Biology, Medicine and Health, National Institute for Health and Care Research Applied Research Collaboration Greater Manchester, The University of Manchester, Manchester, UK.
| |
Collapse
|
9
|
Esquivel Garzón N, Olivella M, Bastidas CV. Conectarnos con la compasión para preservar el cuidado humanizado. REVISTA LATINOAMERICANA DE BIOÉTICA 2022. [DOI: 10.18359/rlbi.5339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Este artículo revisa la compasión como requerimiento esencial para la atención humanizada, abordando elementos definitorios desde sus raíces filosóficas y su vínculo con la práctica de la enfermería. Objetivo: reflexionar sobre la compasión como un atributo inherente al cuidado humanizado, según lo reportado en la literatura. Materiales y métodos: artículo de reflexión, para el cual se realizó una búsqueda y la revisión de literatura en bases de datos científicas especializadas, con descriptores y operadores boleanos relacionados con el tema. Resultados: se presentan elementos conceptuales útiles para adoptar la compasión como un rasgo ético que se debe promover en la formación y el trabajo académico en las áreas de ciencias de la salud y, en especial, en enfermería.
Collapse
|
10
|
Pogue CA, Li P, Swiger P, Gillespie G, Ivankova N, Patrician PA. Associations among the nursing work environment, nurse-reported workplace bullying, and patient outcomes. Nurs Forum 2022; 57:1059-1068. [PMID: 35908259 PMCID: PMC9771862 DOI: 10.1111/nuf.12781] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/15/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bullying may undermine patient safety in healthcare organizations threatening quality improvement and patient outcomes. PURPOSE To explore the associations between the nursing work environment, nurse-reported workplace bullying, and patient outcomes. METHOD Cross-sectional analysis of nurse survey data (N = 943). The Practice Environment Scale of the nursing work index was used to measure the work environment, nurse-reported bullying was measured with the short negative acts questionnaire, and single items measured care quality and patient safety grade. Random effects logistic regressions were used to determine associations controlling for individual, employment, and organizational factors. FINDINGS Fourty percent of nurses reported experiencing bullying. A higher work environment composite score was significantly associated with a lower risk of bullying (OR = 0.16 [0.12, 0.22], p < .0001). Nurses experiencing bullying were less likely to report good/excellent quality of care (OR = 0.28 [0.18, 0.44], p < .0001) or a favorable patient safety grade (OR = 0.36 [0.25, 0.51], p < .0001). DISCUSSION The nursing work environment influences the presence of bullying, which can negatively impact patient outcomes. Improving nurse work environments is one mechanism to better address nurse bullying.
Collapse
Affiliation(s)
- Colleen A. Pogue
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Peng Li
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA
| | - Pauline Swiger
- Center for Nursing Science & Clinical Inquiry, Manson, Washington, USA
| | - Gordon Gillespie
- University of Cincinnati College of Nursing, Cincinnati, Ohio, USA
| | - Nataliya Ivankova
- University of Alabama at Birmingham School of Health Professions, Birmingham, Alabama, USA
| | | |
Collapse
|
11
|
Choe K, Kwon S, Kim S. How do ethically competent nurses behave in clinical nursing practice? A qualitative study. J Nurs Manag 2022; 30:4461-4471. [PMID: 36326092 DOI: 10.1111/jonm.13884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/30/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
AIM This study explored how ethically competent nurses behave in clinical nursing practice. BACKGROUND Nurses' ethical competency is crucial in nursing practice as it promotes patients' safety and quality of care. METHODS Using a purposive sampling technique, 20 clinical nurses in South Korea were interviewed via an online video platform. The data were analysed using a thematic analysis based on phenomenological approach. RESULTS The main theme found among the participating nurses' ethical competency was caring beyond egocentrism, with two subthemes: (1) patient-centred care based on compassion and (2) responsible behaviour based on nursing professionalism. Factors that enabled this included (1) reasonable work conditions, (2) interpersonal relationships, and (3) nurses' rich personal experiences. CONCLUSIONS Nurses' ethical competency depends on how far they can move away from their own egocentrism and act for their clients' benefit, wherein an appropriate workload and warm human relationships with one's colleagues are essential. Nurses should thus receive education on ethics and professionalism and participate in volunteer and leisure activities that cultivate their degree of empathy. IMPLICATION FOR NURSING MANAGEMENT Nursing leaders and managers should understand nurses' ethical competency and its enabling factors to devise effective strategies to promote it.
Collapse
Affiliation(s)
- Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Soojin Kwon
- Department of Nursing, Ansan University, Ansan, Republic of Korea
| | - Sunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| |
Collapse
|
12
|
Oktay D, Ozturk C. Compassion fatigue in nurses and influencing factors. Perspect Psychiatr Care 2022; 58:1691-1700. [PMID: 34888873 DOI: 10.1111/ppc.12977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate compassion fatigue in nurses and the factors influencing the condition. DESIGN AND METHODS This descriptive, comparative, and cross-sectional study was conducted in state and university hospitals in the Turkish Republic of Northern Cyprus. A purposive sampling method was used. FINDINGS Almost all of the nurses have experienced low to moderate levels of compassion fatigue. Factors affecting the severity include age, years of seniority, service, marital status, children, and type of hospital. PRACTICE IMPLICATIONS Recommendations for reducing compassion fatigue are as follows: establishing clinical practice policies that reduce the development and possible consequences of compassion fatigue in addition to education and resilience training.
Collapse
Affiliation(s)
- Duygu Oktay
- Department of Pediatric Nursing, Faculty of Nursing, Near East University, Nicosia, Turkey
| | - Candan Ozturk
- Department of Pediatric Nursing, Faculty of Nursing, Near East University, Nicosia, Turkey
| |
Collapse
|
13
|
Bond C, Hui A, Timmons S, Charles A. Mental health nurses' constructions of compassion: A discourse analysis. Int J Ment Health Nurs 2022; 31:1186-1197. [PMID: 35607709 DOI: 10.1111/inm.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/30/2022]
Abstract
Compassion is an important element of contemporary nursing work. Compassion has been recognized as necessary for improving health outcomes. However, very little is known about how compassion is understood in the mental health practice setting. We conducted interviews with seven mental health nurses to explore their perspectives on compassion and views on compassion policy. Analysis of the data revealed that compassion was identified and discussed as Compassion as part of the person (and the profession); Compassion: Fundamental to the nursing role; Barriers to compassion; Perspectives on compassion policy. In addition, findings demonstrated ethical constraints on compassion in the mental health context, as well as the administrative burden on nurses more broadly, which was also a reported barrier to compassion. Mental health nurses identified compassion as fundamental to their clinical practice, yet compassion was impeded owing to practical and emotional constraints upon nurses. System-wide action must be taken to increase and support the mental health nursing workforce to strengthen the practice of compassion. This will be fundamental to improving health outcomes that are claimed to be enhanced by compassion. This study is reported according to the COREQ guidelines.
Collapse
Affiliation(s)
- Carmel Bond
- Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, University of Nottingham, Nottingham, UK
| | - Ada Hui
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Stephen Timmons
- Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, University of Nottingham, Nottingham, UK
| | - Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| |
Collapse
|
14
|
Boulton M, Garnett A, Webster F. A Foucauldian discourse analysis of media reporting on the nurse-as-hero during COVID-19. Nurs Inq 2021; 29:e12471. [PMID: 34729856 PMCID: PMC8646255 DOI: 10.1111/nin.12471] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 01/13/2023]
Abstract
This study uses a Foucauldian discourse analysis to explore media reporting on the role of nurses as being consistently positioned ‘heroes’ during COVID‐19. In so doing, it highlights multiple intersecting discourses at play, with the caring discourse acting as a central one in negatively impacting nurses' ability to advocate for safe working conditions during a public health emergency. Drawing on media reports during the outbreak of COVID‐19 in Ontario, Canada in the spring of 2020 and on historical information from SARS, this study seeks to establish caring as a discourse and examine if the caring discourse impedes nurses' ability to protect themselves from harm. The results of this analysis explicate how public media discourses that position nurses as caring, sacrificial and heroic may have impacted their ability to maintain their personal safety as a result of the expectations put upon the nursing profession.
Collapse
Affiliation(s)
- Maggie Boulton
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Anna Garnett
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Fiona Webster
- Arthur and Sonia Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| |
Collapse
|
15
|
Dickman NE. Radical responsibility beyond empathy: Interreligious resources against liberal distortions of nursing care. Nurs Philos 2021; 23:e12372. [PMID: 34580968 DOI: 10.1111/nup.12372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/11/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private individualism. Second, I turn to the Jewish philosophies of Martin Buber and Emmanuel Levinas, and their advocacy for a kind of responsibility that precedes the constitution of individuality as this can provide a resource for action and practice circumventing liberal influenced empathy. I note critical reservations about direct and practical application of Levinasian ethics in nursing care, and turn to engaged Buddhist philosophies of interdependence-such as in Thich Nhat Hanh and the Dalai Lama-as a corrective. Third, I conclude by indicating ways interreligious radical responsibility can reorient us toward housekeeping habits of character and away from exceptional crisis management, noting specific examples and actions in health care, nursing education and nursing scholarship.
Collapse
Affiliation(s)
- Nathan Eric Dickman
- Department of Humanities and Fine Arts, University of the Ozarks, Clarksville, Arkansas, USA
| |
Collapse
|
16
|
Pérez-García E, Ortega-Galán ÁM, Ibáñez-Masero O, Ramos-Pichardo JD, Fernández-Leyva A, Ruiz-Fernández MD. Qualitative study on the causes and consequences of compassion fatigue from the perspective of nurses. Int J Ment Health Nurs 2021; 30:469-478. [PMID: 33128301 DOI: 10.1111/inm.12807] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/26/2020] [Accepted: 10/05/2020] [Indexed: 01/18/2023]
Abstract
Compassion is one of the core elements of nursing care. Continued exposure to patient pain and suffering puts nurses at risk of developing compassion fatigue. The aim of this study was to understand the causes and consequences of compassion fatigue from the perspective of nurses. To this end, a qualitative design based on the hermeneutic phenomenology paradigm was used. Five focus group sessions were held with 43 nursing professionals. Two themes and six sub-themes emerged from the analysis of their discourses in relation to the impact of compassion fatigue on nurses. Based on the results obtained, the causes perceived as generating compassion fatigue are the lack of time and resources to provide comprehensive nursing care. The consequences identified were difficulties in carrying out their work, repercussions on family and private life, anxiety, stress, and, in some cases, the desire to quit the profession. This study concluded that healthcare organizations are key to fostering compassionate care and that cultivating compassion is necessary to prevent compassion fatigue.
Collapse
|
17
|
Coster S, Gould RL, Coulson M, Norman IJ. An online mindfulness intervention to enhance compassion in nursing practice: A feasibility and acceptability study with nursing students. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2020; 2:100004. [PMID: 38745902 PMCID: PMC11080300 DOI: 10.1016/j.ijnsa.2020.100004] [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: 02/17/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background Compassion is an important component of nursing care, but public enquiries into care failures have noted that it is not always evident. Mindfulness interventions have the potential to support compassion. However, the feasibility of delivering a mindfulness intervention at scale to nursing students has not been established. Objectives To develop and test the feasibility and acceptability of a tailored mindfulness based online intervention to foster compassion in nursing students within clinical practice. Design A randomised feasibility study with a waiting list control. Setting A UK nursing faculty within a large university. Participants Post-graduate, post-registration and pre-registration nursing students (N = 77). Methods An online five module mindfulness based intervention (Mindful Nursing Online) was developed and tailored to support compassion in clinical nursing. The feasibility study comprised 77 participants randomised in a 2:1 ratio into an immediate access group (intervention, n = 50) or a delayed access group (waiting list control, n = 27). Data on feasibility through completion, attrition and practice rates, were collected through follow-up questionnaires at post-intervention, and 14 and 20 weeks after baseline. Acceptability data was collected through semi-structured interviews with 12 participants. Results Non-completion rates were high with all five modules completed by only 28% (n = 14) of participants, and three modules completed by only 46% (n = 23). The most commonly cited reason for non-completion was lack of time. However, the interview data suggested those who completed the intervention were using mindfulness techniques in practice. They described feeling less stressed on the ward, having an increased focus on patients and a greater appreciation of the importance of self-care. Evaluative feedback therefore showed that the intervention was perceived to be effective at promoting mindfulness skills and was relevant to nursing work. Conclusion Minimising attrition and enhancing engagement with the intervention should be the key objectives of a future study. Feedback from participants who completed the intervention indicates that a brief mindfulness intervention delivered online may support the delivery of compassionate nursing care.
Collapse
Affiliation(s)
- Samantha Coster
- Research Fellow, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London
| | - Rebecca L. Gould
- Lecturer, Division of Psychiatry, Faculty of Brain Sciences, University College London, London
| | - Mark Coulson
- Associate Professor of Psychology, School of Psychology, Faculty of Social Sciences, University of East Anglia, London
| | - Ian James Norman
- Executive Dean, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London
| |
Collapse
|
18
|
Tengelin E, Dahlborg E, Berndtsson I, Bülow PH. From political correctness to reflexivity: A norm‐critical perspective on nursing education. Nurs Inq 2020; 27:e12344. [PMID: 32009272 DOI: 10.1111/nin.12344] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/08/2020] [Accepted: 01/16/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Ellinor Tengelin
- Department of Health Sciences University West Trollhättan Sweden
| | | | - Ina Berndtsson
- Department of Health Sciences University West Trollhättan Sweden
| | - Pia H. Bülow
- Department of Social Work School of Health and Welfare Jönköping University Jönköping Sweden
- Department of Social Work University of the Free State Bloemfontein South Africa
| |
Collapse
|
19
|
Parveen K, Hussain K, Afzal M, Gilani SA. Determining the association of high‐commitment human resource practices with nurses’ compassionate care behaviour: A cross‐sectional investigation. J Nurs Manag 2020; 28:120-129. [DOI: 10.1111/jonm.12904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 11/09/2019] [Accepted: 11/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Kousar Parveen
- Lahore School of Nursing The University of Lahore Lahore Pakistan
| | - Khalid Hussain
- Department of management sciences COMSATS University IslamabadSahiwal Campus Sahiwal Pakistan
| | - Muhammad Afzal
- Lahore School of Nursing The University of Lahore Lahore Pakistan
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences The University of Lahore Lahore Pakistan
| |
Collapse
|
20
|
Tierney S, Bivins R, Seers K. Compassion in nursing: Solution or stereotype? Nurs Inq 2018; 26:e12271. [PMID: 30548117 PMCID: PMC6492101 DOI: 10.1111/nin.12271] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/05/2018] [Accepted: 10/13/2018] [Indexed: 11/30/2022]
Abstract
Compassion in healthcare has received significant attention recently, on an international scale, with concern raised about its absence during clinical interactions. As a concept, compassionate care has been linked to nursing. We examined historical discourse on this topic, to understand and situate current debates on compassionate care as a hallmark of high-quality services. Documents we looked at illustrated how responsibility for delivering compassionate care cannot be consigned to individual nurses. Health professionals must have the right environmental circumstances to be able to provide and engage in compassionate interactions with patients and their relatives. Hence, although compassionate care has been presented as a straightforward solution when crisis faces health services, this discourse, especially in policy documents, has often failed to acknowledge the system-level issues associated with its provision. This has resulted in simplistic presentations of 'compassion' as inexpensive and the responsibility of individual nurses, a misleading proposal that risks devaluing the energy and resources required to deliver compassionate care. It also overlooks the need for organisations, not just individuals, to be charged with upholding its provision.
Collapse
Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Roberta Bivins
- Department of History, University of Warwick, Coventry, UK
| | - Kate Seers
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|