Compassion in palliative care: a review

Abstract

Purpose of review Compassion has been recognized as a key aspect of high-quality healthcare, particularly in palliative care. This article provides a general review of the current understanding of compassion in palliative care and summarizes emergent compassionate initiatives in palliative care at three interdependent levels: compassion for patients, compassion in healthcare professionals, and compassionate communities at the end of life. Recent findings Compassion is a constructive response to suffering that enhances treatment outcomes, fosters the dignity of the recipient, and provides self-care for the giver. Patients and healthcare professionals value compassion and perceive a general lack of compassion in healthcare systems. Compassion for patients and for professionals’ self-care can be trained and implemented top-down (institutional policies) and bottom-up (compassion training). ‘Compassionate communities’ is an important emerging movement that complements regular healthcare and social services with a community-level approach to offer compassionate care for people at the end of life. Summary Compassion can be enhanced through diverse methodologies at the organizational, professional, and community levels. This enhancement of compassion has the potential to improve quality of palliative care treatments, enhance healthcare providers’ satisfaction, and reduce healthcare costs.

Nurses’ experiences of compassionate care in the palliative pathway

“…Compassionate care was chosen as the theoretical framework (Blomberg et al, 2016; Brito‐Pons & Librada‐Flores, 2018; Crawford et al, 2014; Robinson et al, 2019). This framework had an impact on how the data were collected and interpreted.…”

“…Compassion is fundamental to palliative care and can create an environment of safety for patients and family caregivers. Compassionate care is built on trust and good relationships between the patient, the family and healthcare personnel (Brito‐Pons & Librada‐Flores, 2018; Larkin, 2016).…”

“…Six main elements of patient‐centred care are highlighted: (1) respect for patients’ values, preferences, and expressed needs; (2) coordination and integration of care; (3) information, communication, and education; (4) physical comfort‐relief of bothersome symptoms; (5) emotional support‐relief of fear and anxiety; and (6) involvement of family and friends (Kaasa et al, 2018). Nurses can play a key role in integrating palliative care and oncology by providing compassionate care (Brito‐Pons & Librada‐Flores, 2018).…”

Compassion in Clinical Care

“…A recent comprehensive review defined compassion in palliative care as a "a complex and multifacted response to suffering" involving, "sensitivity, recognition, understanding, emotional resonance, empathic concern, and distress tolerance for another's pain or suffering, coupled with a motivation, and relational action to ameiolorate it." [13] A grounded theory study of the perspectives of patients with advanced cancer regarding the differences between empathy, sympathy and compassion found that patients associated compassion with themes of being motivated by love; expressing an altruistic response; being action-oriented; and expressing a form of supererogatory kindness. Echoing the earlier commentary on the ambivalence of sympathy, patients considered it to be largely unhelpful, especially when compared to empathy and compassion which were viewed positively by patients, with most preferring compassion's orientation toward action-and virtue-based motivators.…”

Caring from the heart as belonging—The basis for mediating compassion

“…Compassion may be nursing's most vital and precious asset (Burnell, ; Cornwell, Donaldson, & Smith, ), but is poorly defined in current nursing literature (Adamson & Dewar, ; Dewar, Adamson, Smith, Surfleet, & King, ; Kenny, ; McCaffrey & McConnell, ). Still, compassion has recently emerged as a growing topic of interest in nursing literature (Bramley & Matiti, ; Brito‐Pons & Librada‐Flores, ; Department of Health & NHS Commissioning Board, ; McCaffrey & McConnell, ; Sinclair et al, ; Sinclair, McClement, et al, ; Sinclair, Norris, et al, ; Zamanzadeh, Valizadeh, Rahmani, Cingel, & Ghafourifard, ).…”