Abstract
BackgroundRecent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare.MethodsSearches of eight electronic databases and the grey literature were conducted to identify empirical studies published over the last 25 years. Eligible studies explored perceptions or interventions of compassionate care in clinical populations, healthcare professionals, and healthcare students. Following the title and abstract review, two reviewers independently screened full-texts articles, and extracted study data. A narrative approach to synthesizing and mapping the literature was used.Results and discussionOf 36,637 records, 648 studies were retrieved and 44 studies were included in the review. Less than one third of studies included patients. Six themes emerged from studies that explored perceptions of compassionate care: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Intervention studies included two compassionate care trials with patients and eight educational programs that aimed to improve compassionate care in clinicians and students.ConclusionsThis review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research. A deeper understanding of the key behaviors and attitudes that lead to improved patient-reported outcomes through compassionate care is necessary.
Highlights
Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice
Compassionate care seems intuitive, and the vast majority of clinicians are dedicated to imbuing their practice with compassion, incidents of substandard care—such as those described in the Francis Report [5]—have generated concern internationally about the state of compassion in health systems
Most studies originated in the United States (n = 21) or the United Kingdom (n = 15), and were published between 2010 and 2014 (n = 32)
Summary
Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care seems intuitive, and the vast majority of clinicians are dedicated to imbuing their practice with compassion, incidents of substandard care—such as those described in the Francis Report [5]—have generated concern internationally about the state of compassion in health systems. This troubling trend prompted the Institute of Medicine [16] to issue a report on improving medical education by enhancing the behavioral and social science curricula in medical school. In studies on the key components of quality care, clinicians consistently ranked technical skills higher than intrinsic qualities, which is opposite to responses from patients and families [3, 9, 25, 26]
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