Intensivists’ perceptions of what is missing in their compassionate care during interactions in the intensive care unit

Abstract

Background We proposed that the behaviors that demonstrate compassionate care in the intensive care unit (ICU) can be self-assessed and improved among ICU clinicians. Literature showing views of intensivists about their own compassionate care attitudes is missing. Methods This was an observational, prospective, cross-sectional study. We surveyed clinicians who are members of professional societies of intensive care using the modified Schwartz Center Compassionate Care Scale® (SCCCS) about their self-reported compassionate care. A modified SCCCS instrument was disseminated via an email sent to the members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine between March and June 2021. Results Three hundred twenty-three clinicians completed the survey from a cohort of 1000 members who responded (32.3% response rate). The majority (54%) of respondents were male physicians of 49 (+ − 10 SD) years of age and 19 (12 + − SD) years in practice. The mean SCCCS was 88.5 (out of 100) with an average score of 8 for each question (out of 10), showing a high self-assessed physician rating of their compassionate care in the ICU. There was a positive association with age and years in practice with a higher score, especially for women ages 30–50 years (P = 0.03). Years in practice was also independently associated with greater compassion scores (p < 0.001). Lower scores were given to behaviors that reflect understanding perspectives of families and patients and showing caring and sensitivity. In contrast, the top scores were given to behaviors that included conducting family discussions and showing respect. Conclusion Physicians in the ICU self-score high in compassionate care, especially if they are more experienced, female, and older. Self-identified areas that need improvement are the humanistic qualities requiring sensitivity, such as cognitive empathy, which involves perspective-taking, reflective listening, asking open-ended questions, and understanding the patient’s context and worldview. These can be addressed in further clinical and ICU quality improvement initiatives.

Translating theory into clinical practice: a qualitative study of clinician perspectives implementing whole person care

“…9 Interestingly, physicians' self-assessment of providing compassionate care identified listening and empathy as areas needing improvement. 10 Insights from research on empathy, self-awareness and mindfulness have helped to address some of these challenges. A narrative review of 20 articles on the role of mindfulness and compassion in physician-patient communication concluded that mindfulness fosters the development of self-awareness and empathy, and therefore enhances PCC.…”

“…Similarly, listening and paying attention were by far the most frequently cited physician behaviours that patients experienced as compassionate 9. Interestingly, physicians’ self-assessment of providing compassionate care identified listening and empathy as areas needing improvement 10…”

“… 9 Interestingly, physicians’ self-assessment of providing compassionate care identified listening and empathy as areas needing improvement. 10 …”