Components of Compassionate Care in Nurses Working in the Cardiac Wards: A Descriptive Qualitative Study

The mediating role of nurses' spiritual well-being between moral resilience and compassion fatigue: A multicenter structural equation model study

AIMS

To investigate the mediating role of spiritual well-being in the association between compassion fatigue and moral resilience among nurses.

BACKGROUND

Nurses are inevitably placed in situations of compassion fatigue. Their moral resilience and spiritual well-being may play a crucial role in mitigating the impacts of compassion fatigue. Nonetheless, spiritual well-being, which mediates the influence between compassion fatigue and moral resilience, remains scarce among nurses.

DESIGN

Cross-sectional and correlational design.

METHODS

Nurses (n = 465) from four government-owned tertiary hospitals in Saudi Arabia were recruited and completed three self-report scales from July to December 2023. Descriptive statistics (e.g., mean, standard deviation, frequency, and proportions) and inferential statistics (Spearman rho and structural equation modeling) were used for data analysis.

RESULTS

The emerging model afforded acceptable model fit parameters. Moral resilience had a negative effect on compassion fatigue (β = -0.05, p = 0.003) and a positive influence on spiritual well-being (β = 0.51, p = 0.003). Spiritual well-being negatively influenced compassion fatigue (β = -0.90, p = 0.003). Moral resilience had a moderate, negative, indirect effect on compassion fatigue through the mediation of spiritual well-being (β = -0.47, p = 0.002).

CONCLUSION

Our study offered a model that validated the mediating role of spiritual well-being in the association between moral resilience and compassion fatigue. Moral resilience directly and indirectly influences spiritual well-being and compassion fatigue, respectively.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Healthcare institutions that employ nurses must continually assess compassion fatigue levels and provide necessary interventions. Nurses, nurse managers, and healthcare institutions may leverage moral resilience to improve nurses' spiritual well-being while averting the negative effects of compassion fatigue. Healthcare institutions may incorporate spiritual care into their mainstream support interventions to enhance their compassion, reduce fatigue, and enhance their mental well-being.

Unveiling the impact: understanding long-term care workers' experiences and their perceptions of resident challenges amidst the COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises.

METHODS

A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts.

RESULTS

The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1) Tangling with Uncertainty, that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2) Finding Voice, that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3) Ripple Effects, of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4) Loss of Home, where workers perceived that protection of residents led to a loss of the residents' home environment, personal freedom, and autonomy.

CONCLUSIONS

The findings suggest that LTC workers' experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers' and residents' mental health benefits.

Nurses' perception of anticipated nursing care: A qualitative research

BACKGROUND

Anticipated nursing care is provided significantly earlier than expected by nurses, caregivers, and other healthcare staff for patients. This type of care is influenced by many factors and is followed by various positive and negative consequences. Accordingly, the present study sought to explore nurses' perceptions of anticipated nursing care.

METHODS

This qualitative study was conducted using content analysis on twelve nurses from different internal and surgical wards of Shahid Sadoughi Hospital, Yazd, Iran from November 2022 to September 2023The participants were selected using purposive sampling. The data were collected through semi-structured interviews with the nurses and analyzed using Graneheim and Lundman's qualitative content analysis method.

RESULTS

Data analysis revealed four main categories and eleven subcategories. The main categories included early and priority care with two subcategories, scope of anticipated care with four subcategories, predictors of anticipated care with three subcategories, and outcomes of anticipated care with two subcategories.

CONCLUSIONS

Based on the findings, it is suggested that nursing managers must focus on the antecedents of anticipated care and address strategies to improve the working conditions of nurses, changing routine procedures for providing care and the doctor-nurse interaction, developing and organizing training programs on clinical reasoning, decision-making and time management for nurses.

Psychiatric Wards Nurses' Experiences on Self-Compassion, Compassionate Care and Compassion Fatigue: A Qualitative Study

BACKGROUND

Compassion is an important component of providing quality nursing care, and the literature on compassionate care in psychiatric nursing is limited.

AIM

The aim of this qualitative descriptive study was to explore the experiences of psychiatric ward nurses regarding self-compassion, compassionate care and compassion fatigue.

METHODS

A qualitative descriptive study was conducted by thematic analysis with an inductive approach of semi-structured interviews with 16 psychiatric nurses across psychiatric ward in a state hospital, Kirkuk, Iraq, selected through purposeful sampling between 15 October and 15 November 2023.

RESULTS

The analysis of the data, two main themes emerged: 'freedom in difficulties' and 'togetherness of suffering'. These results indicate that psychiatric nurses need individual and organizational resources to provide compassionate care.

CONCLUSION

It is thought that developing programmes to improve the self-compassionate care of psychiatric nurses by institution managers and policy makers may be effective in reducing compassion fatigue and providing compassionate care. In the future research, how religion affects psychiatric nurses' ability to provide compassionate care and the role of belief in coping with compassion fatigue experienced by psychiatric nurses needs to be investigated.

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

INTRODUCTION

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

METHOD

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

RESULTS

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

DISCUSSION

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

Fostering Caring Attributes to Improve Patient Care in Nursing Through Small-Group Work: Perspectives of Students and Educators

Background: Nursing relies on the development of caring attributes to uphold exceptional standards of care. While small-group work is a common practice in nursing education, its pivotal role in nurturing these attributes often remains underexplored. Aim: This study explored how caring attributes emerge in small-group settings from the perspectives of nursing students and educators. Methods: This qualitative study conducted semi-structured group interviews separately for students and educators. Thirteen nursing students and ten educators at a professional educational institution were interviewed. Results: Through the interviews, four key sets of caring attributes nurtured through small-group work were identified: interpersonal communication with respect; compassion and empathy; competence and confidence; and accountability to commitment. These findings, based on the perspectives of students and educators, underscore the essential role of caring in nursing. They emphasize how collaborative group work can serve as a catalyst for the development of these vital attributes through meaningful interpersonal interactions. Notably, the cultivation of respectful communication skills among students emerged as pivotal for enriching interactions with healthcare professionals, patients, and families, ultimately enhancing the quality of care provided. By providing a platform for interactive learning and continual practice, small-group work facilitates the internalization of these caring attributes, nurturing nursing professionalism over the course of students' careers. Conclusions: This study offers invaluable insights into the profound impact of small-group work in fostering caring attributes and propelling advancements in nursing education and practice. By enhancing the development of these attributes, small-group work contributes to the delivery of compassionate and high-quality patient care.

Perceived compassionate care and preoperative anxiety in hospitalized patients

BACKGROUND

Quality nursing care and ethical responses to patient pain and suffering are very important in the preoperative period. However, few studies have addressed these variables.

OBJECTIVE

This study aimed to examine the relationship between compassionate care and preoperative anxiety from the perspective of hospitalized patients.

METHODS

The current study was a cross-sectional descriptive one. The participants were selected using convenience sampling. The data were collected using a demographic questionnaire, Burnell Compassionate Care Tool, and Amsterdam Preoperative Anxiety and Information Scale (APAIS). The collected data were analyzed with SPSS software (version 22) through descriptive and inferential statistics at a significance level of 0.05 (p < .05).

PARTICIPANTS AND SETTING

This study was conducted on 704 candidates for surgery in the internal and surgical wards of a large teaching hospital located in the south of Iran from December 2022 to March 2023.

ETHICAL CONSIDERATIONS

The protocol for this study was reviewed and approved by the University Ethics Committee.

FINDINGS

The patients' average age was 36.61 ± 13.07. The average preoperative anxiety and need for information scores were 13.80 ± 2.66 and 7.44 ± 1.47, respectively. The average score of importance was 3.03 ± 0.19, and the average score of the extent of compassionate care provision was 1.22 ± 0.15. There was a significant relationship between preoperative anxiety with importance and the extent of compassionate care provision (r = 0.68, p < .001), r = -0.72, p < .001, respectively). A comparison of the demographic characteristics, need for information, importance, and provision of compassionate care showed that the extent of compassionate care provision had the greatest contribution in explaining preoperative anxiety (β = 0.50; p < .001).

CONCLUSION

Even though patients' preoperative anxiety was high and providing compassionate care in the preoperative period had a great role in relieving their anxiety, many participants appear to have received little compassionate care. To this end, nursing managers should pay attention to the quality of compassionate care in the preoperative stage. Besides, healthcare staff should receive the necessary training in compassionate nursing care.

A Cross-Sectional Study of the Perception of Individualized Nursing Care Among Nurses in Acute Medical and Perioperative Settings

Background/Objectives: Individualized nursing care allows for systematic assessment and intervention; considers a patient's preferences, values, and context; and contributes to a positive care trajectory. However, its operationalization has proven to be challenging. This research aimed to evaluate nurses' perceptions of individualized care and analyze their relationship with sociodemographic variables. Methods: A cross-sectional study was conducted on 122 eligible and registered nurses at a Hospital Center, in the Ophthalmology (operating room and inpatient ward) service, the Cardiology service, the Internal Medicine service, and the Medical Emergency Unit, for adults/older adults in Portugal. The nursing version of the Individualized Care Scale (ICS-Nurse) was used for the assessment, including three sub-dimensions: clinical situation, personal life situation, and decisional control over care-related decisions. Cronbach's alpha and principal component analysis were used for the data analysis. The STROBE checklist was used to report this study. Results: No statistically significant differences were found based on the age, gender, level of education, or years of professional experience of the nurses within the sub-dimensions of individualization. The nurses overall had a good perception of the importance of individualized care (4.06 ± 0.46 ICS-A-NURSE) but faced difficulties in its implementation during the last shift they worked (3.97 ± 0.49 ICS-B-NURSE). Conclusions: The items considered to be of greatest importance were the response to the physical and emotional needs arising from illness and assistance in decision-making through educational instructions. Aspects related to the personal lives of patients, such as family inclusion in an individual's care plan, everyday habits, and previous experiences of hospitalization, received the lowest scores. Recognizing priority areas for improvement in the individualization of nursing care can contribute to developing training programs and policies that promote a holistic approach. Future studies should consider patient outcomes related to their needs for individualization.

Insights into the relationship between professional values and caring behavior among nurses in neonatal intensive care units

OBJECTIVE

Professional values are crucial for delivering high-quality care in neonatal intensive care units while caring behavior impacts nurses' performance and well-being. The purpose of this study was to assess the relationship between professional values and caring behavior among nurses in neonatal intensive care units.

METHODS

A cross-sectional study involving 172 nurses was conducted using the Nursing Professional Value Scale and Caring Behaviors Assessment Tool. The study was carried out between 1 October and 5 December 2023.

RESULTS

Nurses demonstrated a moderate to high degree of professional commitment, with a mean professional value score of 91.1 ± 11.1. The mean score for caring behavior was 99.7 ± 12.4. The highest-rated domain was setting up a supporting, protective, and corrective environment, with a mean score of 22.8 ± 2.7. A low positive relationship was found between the supportive, protective, and corrective environment domain and nurses' professional value (r = 0.18, p = 0.017), as well as between overall caring behavior and nurses' professional value (r = 0.16, p = 0.038).

CONCLUSION

The results indicate a favorable relationship between professional values and caring behavior, especially in areas like establishing a supportive workplace. However, both professional value and caring behavior needs improvement in certain aspect. Enhancing these aspects could further strengthen their relationship, ultimately improving the quality of care provided to newborn patients and their families.

PRACTICE IMPLICATIONS

To cultivate a positive work environment and instill caring behaviors and professional values among NICU nurses, it is imperative to allocate sufficient time and resources. This investment is necessary for nurturing a culture of care, improving patient outcomes, and fostering a supportive environment for NICU nurses, newborn, and their families.

Exploring the impact of compassion and leadership on patient safety and quality in healthcare systems: a narrative review

BACKGROUND

Patient safety and healthcare quality are considered integral parts of the healthcare system that are driven by a dynamic combination of human and non-human factors. This review article provides an insight into the two major human factors that impact patient safety and quality including compassion and leadership. It also discusses how compassion is different from empathy and explores the impact of both compassion and leadership on patient safety and healthcare quality. In addition, this review also provides strategies for the improvement of patient safety and healthcare quality through compassion and effective leadership.

METHODS

This narrative review explores the existing literature on compassion and leadership and their combined impact on patient safety and healthcare quality. The literature for this purpose was gathered from published research articles, reports, recommendations and guidelines.

RESULTS

The findings from the literature suggest that both compassion and transformational leadership can create a positive culture where healthcare professionals (HCPs) prioritise patient safety and quality. Leaders who exhibit compassion are more likely to inspire their teams to deliver patient-centred care and focus on error prevention.

CONCLUSION

Compassion can become an antidote for the burnout of HCPs. Compassion is a behaviour that is not only inherited but can also be learnt. Both compassionate care and transformational leadership improve organisational culture, patient experience, patient engagement, outcomes and overall healthcare excellence. We propose that transformational leadership that reinforces compassion remarkably improves patient safety, patient engagement and quality.

Interventions for Compassion Fatigue in Healthcare Providers-A Systematic Review of Randomised Controlled Trials

BACKGROUND

Compassion fatigue is a significant issue considering its consequences including negative feelings, impaired cognition, and increased risk of long-term morbidities. We aimed to assess current evidence on the effects of interventions for compassion fatigue in healthcare providers (HCP).

METHODS

We used the Cochrane methodology for Systematic Reviews and Meta-Analyses (PRISMA) for conducting and reporting this review.

RESULTS

Fifteen RCTs (n = 1740) were included. The sample size of individual studies was small ranging from 23 to 605. There was significant heterogeneity in participant, intervention, control, and outcome characteristics. The tools for assessing intervention effects on compassion fatigue included ProQOL, compassion fatigue scale, and nurses compassion fatigue inventory. Thirteen out of the fifteen included RCTs had overall high risk of bias (ROB). Meta-analysis could not be performed given the significant heterogeneity.

CONCLUSIONS

Current evidence on interventions for reducing compassion fatigue in HCPs is inadequate. Given the benefits reported in some of the included studies, well-designed and adequately powered RCTs are urgently needed.