Embodying compassion: A systematic review of the views of nurses and patients

Abstract

Aims and objectives To provide a review of empirical research investigating how compassion is expressed by nurses and received by patients in hospital settings. Background Compassion is viewed as an important and fundamental part of a health professional practice. Universally, reports from both media and government agencies have addressed perceived deficits of compassion in healthcare with nurses accused of a lack of compassion. Research into compassion to date has largely focused on the problematic nature of compassion such as burnout, fatigue and other negative personal and work‐related outcomes. Design A systematic literature review of empirical research guided by a meta‐ethnographic approach supported the systematic comparison and translation of the included studies. Six online databases were searched from January 2006–December 2016. Methods This review was carried out according to the PRISMA‐P reporting guidelines. How compassion in healthcare was defined was extracted alongside findings on how compassion was expressed by nurses and received by patients. Synthesis of the research was completed resulting in new interpretations. Results Eleven papers met the inclusion criteria and were included in the review. Multiple differing definitions of compassion in healthcare were applied. Nurses embody and enact compassion through behaviours such as spending time with patients and communicating effectively with patients. Patients experience compassion through a sense of togetherness with nurses. Conclusion Existing research demonstrated dissonance between the expression of compassion by nurses and how compassion is experienced by patients. The themes identified in this review should be considered by health professionals providing patient care. Relevance to clinical practice Health providers should acknowledge and account for the time that nurses need with patients to demonstrate compassion in practice. Nursing education relating to the expression of compassion should articulate both the subjectivity and ambiguity of the term and examine the relationship between compassion and suffering.

Optimising compassionate nursing care at the end of life in hospital settings

“…This aligns with current understandings of compassion where recognition of the suffering of another, identification with the suffering itself, and how the person is being affected has to occur for the observer to feel compassion towards the person suffering. This then motivates the observer to act (Durkin, Usher, & Jackson, ).…”

“…The Kapakapa Manawa Framework differs from other accounts of how compassion should be integrated into nursing practice (Goodrich, ), by referring explicitly to compassion as a verb. The action taken is critical to the concept of compassion, as the observer is a participant in the suffering and is motivated to alleviate it (von Dietze & Orb, ; Durkin et al, ; Kanov et al, ).…”

“…This process typically unfolds over multiple care encounters, often over a relatively short period of time, particularly in a busy hospital setting (Wiechula et al, ). It is the way in which these interactions occur which are essential to achieving the sense of care and compassion that patients and families value (Durkin et al, ).…”

“…Although, there is ambiguity in regard to how compassion is described in nursing, a recent systematic review found that compassionate care requires a ‘connection’ to be made between the nurse and patient (Durkin et al, ). Establishing interpersonal connections between patients and nurses are considered to be core nursing skills (Fry et al, ).…”

“…In a busy clinical environment, being consistently present to this extent may be challenging. However, nurses understanding the impact of a busy workplace on their ability to interact positively with patients will provide them with opportunities to consciously integrate the behaviours and actions of compassionate care into practice (Durkin et al, ; Hunsaker et al, ; Papadopoulos et al, ).…”