Introduction
Compassion appears to be a vital quality and feeling in the field of delivering medical services. However, there is no exact opinion in respect of its expression and even definition, and a great number of researchers present different points of view in this regard. For this reason, this paper is intended to analyze some articles on this topic and clarify this issue. All the works have to match the following criteria â the publication date ranging from 2018 to 2020 and being a comprehensive study of a particular issue. Therefore, the most relevant and profound explorations were gathered. The purpose of this paper is to present a literature review on compassion in the sphere of medicine and analyze all the items critically.
Defining Compassion in a Hospital Setting
The first article to be analyzed is Defining Compassion in a Hospital Setting: Consensus on the Characteristics that Comprise Compassion from Researchers in the Field written by Durkin, Jackson, and Usher. The aims are formulated in the following way: “to seek consensus on the key characteristics that comprise compassion in a health care setting from pre-defined experts currently researching in the field” (1, p. 146). Therefore, as for the type of the study, it is closer to a systematic review. The researchers stick to the method of the four-phase Delphi process, which consists of a literature review, an open-ended questionnaire, the analysis of the results and the connection to the literature, and two round Delphi approach.
The research reveals hardships in explaining the abstract term ‘compression’ in the context of delivering medical services. Therefore, it is difficult to evaluate the behavior of a professional, as the criteria are not elaborated. Nevertheless, a number of critical characteristics defining compassion in a hospital setting were identified. According to the authors, “compassion is expressed through meaningful action, helping behaviors, words, relational understanding, and interaction. The response to suffering is an empathetic one, not one of pity” (1, p. 155). In order to express this feeling, a health worker should achieve an emotional connection with a patient.
The results presented in the article may be considered relatively valid. The researchers have examined a huge variety of modern literature on this topic in order to present the most comprehensive picture. However, in order to achieve more clarity in this regard, some works of foreign scientists may be leveraged. Consequently, this theme may be continued, and the attitudes to compassion in the field of medicine in different countries may be compared. As for the articles in the English language, the research appears to be respectively profound and thorough. It also should be noted that the article contains a crucial insight, which is highly likely to be beneficial in case applied to practice. The authors state: “suffering from a patient is not necessary to express compassion” (1, p. 155). Such a conclusion may significantly relieve the stress of curing people and coping with their health problems, which is usual among health professionals.
Embodying Compassion
The same authors, namely Durkin, Usher, and Jackson, have presented another study, which is titled Embodying Compassion: A Systematic Review of the Views of Nurses and Patients. Both articles supplement each other and supply deep insight into the topic of compassion in the context of delivering medical services. While the aforementioned research focuses on the opinion of scientists in this field, this one concentrates on the views of nurses and patients. The purpose of Embodying Compassion regards the analysis of empirical research, revealing the way nurses usually express compassion and how it is perceived by the patients in hospital settings (2). The same as the study reviewed earlier, it implies a systematic literature review. It includes six online databases with a publishing filter from January 2006 to December 2016 (2). As for the methods, the review was conducted in accordance with the PRISMA-P reporting guidelines.
The results demonstrate that ambiguity in this issue exists, and it is difficult to explain how compassion is expressed by nurses and received by patients. The study highlights the connection between this feeling as a response to suffering. Durkin, Usher, and Jackson claim: “compassion occurs in partnership with the nurse as the observer of suffering and patient as the one who suffers” (2, p. 1390). As for the patient’s perception of this event, they mark the feeling of togetherness with the nurse, which contributes to achieving compassion.
However, this review cannot be considered reliable due to its considerable limitations. The body of evidence used in the article is relatively small. In addition, the same as the previously examined paper, it focuses only on research, which is published in English. Another aspect, which restricts the perspective of the research, is the fact that it covers only the hospital setting. Therefore, it can be significantly supplemented in case it is conducted within primary and secondary care. Moreover, communication with clients with impaired states of consciousness is not described too. This way, this topic should receive more attention in future explorations in order to provide a comprehensive view of the problem.
Despite being limited to some extent, the results of the study can be useful in practice. As has been mentioned above, they highlight the beneficial impact of the feeling of togetherness with a nurse on patients’ emotional state. It is helpful for keeping clients informed on their health conditions and receiving proper understanding. Consequently, health providers should pay attention to the correct atmosphere during the appointment and the time required to express compassion to each client.
Outcomes from a Compassion Training Intervention for Health Care Workers
Another perspective on this issue is supplied by Ling, Petrakis, and Olver in Outcomes from a Compassion Training Intervention for Health Care Workers. The researchers attempt to address the concerns of the health professional’s mental state and the amount of stress caused by interaction with clients. Therefore, the objectives imply an investigation of the effectiveness of compassion training in supporting nurses performing at the appropriate level and minimizing the overload by empathic distress (3). It should be highlighted that the study is based on the opinion that compassion and empathy are different events, and, unlike compassion, the latter is highly likely to lead to a poor mental state. Therefore, appropriate training could be resultative and prevent burnout among health workers.
The research involves an experiment, during which 100 health care workers were delivered compassion training intervention. It consisted of “information defining compassion, research information from neuroscience demonstrating that compassion is a positive mind state and different from empathy, scenarios emphasizing common humanity” (3, p. 88). The participants were also offered some statements intended to hold a compassionate stance.
Before reviewing the outcomes of the study, attention should be paid to the approach used by the authors in order to define compassion. Unlike the researchers mentioned earlier, they do not reveal any difficulties in this respect. They give an explanation to this event by comparing it to pity, empathy, and sympathy, and define the differences between these terms. Ling, Petrakis, and Olver identify compassion as “feeling concerned in response to another’s suffering and wishing them to be free from that suffering” (3, p. 92). In addition, their approach includes the evaluation of this event as a positive mental state.
As for the results, the authors mark the effectiveness of the training as a preventative measure addressing the problem of empathic distress and burnout. Participants also highlighted the significance of supplying practical steps of releasing support for a patient, namely the slogans. However, the paper mentions considerable limitations, for instance, the long-term effect of such training was not reviewed, which is a crucial indicator of effectiveness. In addition, the survey was conducted via email, and the response rate was extremely low and comprised 22%. These aspects prevent an objective assessment of the results, and for this reason, this topic requires further exploration. Although the limitations of the research are strict, there are strong points, such as the proposal of a potentially beneficial solution to issues connected to the expression of compassion and an attempt to identify this term. Furthermore, insight into the difference between empathy and compassion may become a useful tool for minimizing the negative consequence of communication with patients. It is vital to distinguish them in order to prevent burnout.
Caring for Others without Losing Yourself
Neff, Knox, Long, and Gregory also attempt to regard the mental state of health care workers in their paper Caring for Others without Losing yourself: An adaptation of the Mindful SelfâCompassion Program for Healthcare Communities. However, the authors offer another perspective on this problem and concentrate on self-compassion. The aim of the article is to compare two studies on the “efficacy of the Self-Compassion for Healthcare Community program for enhancing well-being and reducing burnout among healthcare professionals” (4, p. 1). The first study had a quasi-experimental design, so its purpose was to contradict the waitlist of a control group and well-being outcomes for the Self-Compassion for Healthcare Community program (SCHC). The second one did not involve a control group and examined the impact of SCHC on burnout.
As for the results, study 1 revealed the increase of self-compassion under the influence of SCHC, which improved well-being, and the effect was maintained for three months. The second study demonstrated not only improvements in well-being but also the reduction of secondary traumatic stress and burnout (4). Neff, Knox, Long, and Gregory mark “changes in selfâcompassion explained gains in other outcomes, and initial levels of selfâcompassion moderated outcomes so that those initially low in selfâcompassion benefitted more” (4, p. 1). Therefore, it may be concluded that the SCHC program is highly likely to present a sufficient solution for self-compassion increase, well-being enhancement, and burnout reduction.
The evidence in the article may be considered valid and relevant, as all the circumstances of the studies were true-to-life. In addition, despite the fact that there are some limitations, they are not serious and may not dramatically warp the judgment. For instance, scientists pay attention to the aspect that all the participants were interested in learning emotional resilience, so the paper does not cover the indifferent ones (4). Moreover, the majority of the participants are female, namely 75% (4), though sex is not likely to change the results to a large extent. For this reason, it can be stated that the research appears to be comprehensive, and its conclusion may be applied to practice.
This way, the SCHC program may be an effective solution to the issues connected with self-compassion. Its beneficial impact cannot be underestimated, as it enhances the patient’s outcomes and improves the ability to confess the mistakes, which stimulates the desire to correct them. Consequently, the researchers advance a helpful practical step and a satisfactory solution, which is fruitful both for the health care worker and for the patient.
Psychological Perspective on Compassion in Modern Healthcare Settings
A psychological view on this issue is supplied by Rydon-Grange in Psychological Perspective on Compassion in Modern Healthcare Settings. The researcher highlights the fact that it is a common sight in modern hospitals that compassion is absent. She also criticizes the instructions to health care workers on showing more compassion, as they “neglect the complexity of this social emotion” (5, p. 729). Therefore, the objective of the paper is to apply “the psychological research on compassion to modern healthcare settings with the aim of creating a better understanding of the pathways leading to uncompassionate care” (5, p. 729). In order to review the results, it is essential to understand the author’s definition of compassion. Rydon-Grange refers to Goetz and his colleagues, who identify this event as the “feeling that arises in witnessing another’s suffering and that motivates a subsequent desire to help” (5, p. 730). Furthermore, the researcher claims that this compassion system of a person may be adaptive to the environment.
After reviewing psychological literature in this respect, Rydon-Grange highlights that the requirement to be more compassionate is ineffective and pays attention to mindfulness approaches. They are highly likely to prevent burnout among professionals in the field of medicine. This thesis may be considered rational, as they are supported by strong arguments from the field of psychology. Moreover, the study involves an empirical part, so this position is proved in practice. This way, the research is intended to provide a deep insight into human psychology and explain the influence of compassion. Therefore, the study may present an essential supplement to the articles reviewed above for achieving the best result.
However, in order to be applied to medical practice, the theory discussed in the article should be supported by further explorations. The work includes a comprehensive literature review and analysis presentation for deep comprehension of delivering uncompassionate care. That definitely contributes to elaborating some proposals on methods of supplying a client with compassion without burnout among health care professionals. Despite this beneficial aspect, the work does not contain any practical steps. Nevertheless, it should be noted that the research may become the base of efficient solutions in the future.
A Brief “Quiet Ego” Workplace Intervention
The final article in the review is A Brief “Quiet Ego” Workplace Intervention to Reduce Compassion Fatigue andImprove Health in Hospital Healthcare Workers, written by Wayment, Huffman, and Eiler. They are also determined to address the problem of impairment among nurses and other healthcare professionals. Consequently, the purpose of the work is to “offer a brief, 4- session workshop to teach healthcare providers an easy-to-learn self-management skill that could be implemented easily and effectively” (6, p. 81). The results of such a workshop depicted the effectiveness of such an approach. As the study takes into consideration the limitations of mindfulness, the advanced incentive may be considered one of the most perspective ones. The authors manage to combine the most beneficial measures presented above and propose a session of workshops intended to reduce the amount of stress among healthcare workers.
It should be noted that the authors advance an example of solutions applied to practice in the hospital setting. Consequently, the work involves a diverse set of skills, which are helpful in minimizing compassion fatigue and improving health state. The researchers propose a method of quiet ego intervention as a way of assisting employees with thinking, feeling, and acting in accordance with their values, which are based on compassion. However, their experiment was single-case, and in order to provide necessary improvements, it is vital to continue the study. Nevertheless, the researchers supply the most relevant and efficient solution in the long run.
Conclusion
Compassion in the field of delivering medical services is a vital quality, which appears to be too abstract to be defined precisely. This topic is profound, as it is essential to take into consideration the psychological aspects of workers and the interest of patients. Researchers approach the problem of stress among healthcare workers in different ways. Nevertheless, modern explorations contain a huge variety of ideas, which have the potential to present an acceptable solution.
References
Durkin J, Jackson D, Usher K. Defining compassion in a hospital setting: consensus on the characteristics that comprise compassion from researchers in the field. Contemporary Nurse. 2020. 56(2): 146-159.
Durkin J, Usher K, Jackson D. Embodying compassion: A systematic review of the views of nurses and patients. Journal of Clinical Nursing. 2018. 28: 1380â1392.
Ling D, Petrakis M, Olver JH. Outcomes from a compassion training intervention for health care workers. ERIS Journal. 2018. 4(18): 88-96.
Neff KD, Knox MC, Long P, Gregory K. Caring for others without losing yourself: An adaptation of the Mindful SelfâCompassion Program for Healthcare Communities. J Clin Psychol. 2020. 1â20.
Rydon-Grange M. Psychological perspective on compassion in modern healthcare settings. J Med Ethics. 2018. 44(11): 729-733.
Wayment HA, Huffman AH, Eiler, BA. A brief “quiet ego” workplace intervention to reduce compassion fatigue and improve health in hospital healthcare workers. Applied Nursing Research. 2019. 49: 80-85.
Footnotes
- Durkin J, Jackson D, Usher K. Defining compassion in a hospital setting: consensus on the characteristics that comprise compassion from researchers in the field. Contemporary Nurse. 2020. 56(2): 146-159. Web.
- Durkin J, Usher K, Jackson D. Embodying compassion: A systematic review of the views of nurses and patients. Journal of Clinical Nursing. 2018. 28: 1380â1392. Web.
- Ling D, Petrakis M, Olver JH. Outcomes from a compassion training intervention for health care workers. ERIS Journal. 2018. 4(18): 88-96. Web.
- Neff KD, Knox MC, Long P, Gregory K. Caring for others without losing yourself: An adaptation of the Mindful SelfâCompassion Program for Healthcare Communities. J Clin Psychol. 2020. 1â20. Web.
- Rydon-Grange M. Psychological perspective on compassion in modern healthcare settings. J Med Ethics. 2018. 44(11): 729-733. Web.
- Wayment HA, Huffman AH, Eiler, BA. A brief “quiet ego” workplace intervention to reduce compassion fatigue and improve health in hospital healthcare workers. Applied Nursing Research. 2019. 49: 80-85. Web.