Compassionate Care Research Articles

Perceived compassionate care and preoperative anxiety in hospitalized patients.

Quality nursing care and ethical responses to patient pain and suffering are very important in the preoperative period. However, few studies have addressed these variables. This study aimed to examine the relationship between compassionate care and preoperative anxiety from the perspective of hospitalized patients. The current study was a cross-sectional descriptive one. The participants were selected using convenience sampling. The data were collected using a demographic questionnaire, Burnell Compassionate Care Tool, and Amsterdam Preoperative Anxiety and Information Scale (APAIS). The collected data were analyzed with SPSS software (version 22) through descriptive and inferential statistics at a significance level of 0.05 (p < .05). This study was conducted on 704 candidates for surgery in the internal and surgical wards of a large teaching hospital located in the south of Iran from December 2022 to March 2023. The protocol for this study was reviewed and approved by the University Ethics Committee. The patients' average age was 36.61 ± 13.07. The average preoperative anxiety and need for information scores were 13.80 ± 2.66 and 7.44 ± 1.47, respectively. The average score of importance was 3.03 ± 0.19, and the average score of the extent of compassionate care provision was 1.22 ± 0.15. There was a significant relationship between preoperative anxiety with importance and the extent of compassionate care provision (r = 0.68, p < .001), r = -0.72, p < .001, respectively). A comparison of the demographic characteristics, need for information, importance, and provision of compassionate care showed that the extent of compassionate care provision had the greatest contribution in explaining preoperative anxiety (β = 0.50; p < .001). Even though patients' preoperative anxiety was high and providing compassionate care in the preoperative period had a great role in relieving their anxiety, many participants appear to have received little compassionate care. To this end, nursing managers should pay attention to the quality of compassionate care in the preoperative stage. Besides, healthcare staff should receive the necessary training in compassionate nursing care.

Healthcare professionals and students’ knowledge on termination of pregnancy: A systematic review

Abstract Background Providing safe termination of pregnancy (TOP) according to each country’s legalisation is an important public health matter internationally. Healthcare professionals (HCPs) and healthcare students have key roles and need to be aware of legislation and clinical practice guidelines on TOP in their country to facilitate safe and effective care. The main aim of this systematic review was to investigate the level of knowledge on TOP legislation among HCPs and healthcare students. The second objective was to assess the knowledge of TOP methods, procedures and/or potential associated complications. Methods This is a systematic review of qualitative and quantitative peer-reviewed studies published in English or Portuguese until July 2020. Databases included in the search were EBSCO, PubMed, Embase and Scopus. The quality appraisal was done using the CASP Critical Appraisal tools. Results A total of 31 studies were included, published between 2002 and 2020 and from several regions around the globe. No studies were carried out in Europe or the United Kingdom. A total of 22 studies included healthcare professionals and nine studies included students. Overall, all the studies showed poor knowledge of TOP legislation and TOP methods, procedures and complications. Knowledge of special circumstances established in the law where TOP might be legal was also very limited. In studies focussing on medical (MA) and surgical (SA) TOP, knowledge of MA was lower than of SA. Studies reported that practitioners and students have limited training in TOP. Overall, education/training and experience with TOP seem to be the main factors associated with increased levels of knowledge. Similar results were found for student’s knowledge. Conclusions This study highlighted the importance of involving and promoting the participation of HCPs and students in the provision of TOP services. A clear need and desire for staff education and training on TOP was shown. Key messages • TOP training is limited and broadly excluded from medical and healthcare education globally. Students and staff have recognised this issue and the critical impact it has on TOP care provided. • Adequate knowledge and training in TOP ensures service sustainability and preparation of current and future healthcare practitioners to provide high-quality, respectful and compassionate care.

Exploring Empathy Dynamics in Virtual Patient Training

Abstract Background This study investigates the manifestation of empathy among nursing students and teachers during virtual patient training with VR glasses at the Medical Simulation Training Centre of Medical University - Plovdiv. The pilot training, conducted from March 22 to April 12, 2024, was part of the Erasmus+ project ‘Caring violent child safely in child psychiatric and residential units (Safe4Child) 2021-1-FI01-KA220-HED-000032106.’ Participants were divided into two focus groups: third-year nursing students and lecturers teaching specialized academic disciplines in nursing. Results A total of 34 participants partook in the study, comprising 16 instructors with basic nursing education and 16 third-year nursing students. Students exhibited considerable empathy towards the virtual child patient, expressing an inclination to provide assistance, acknowledging the necessity for personalized care, and displaying a curiosity about the patient’s experiences. They conveyed sentiments such as ‘I felt the need to help the child/patient’, ‘the child needs individual work with a nurse’ and ‘I want to understand the child’s experiences.’ In contrast, instructors demonstrated more reserved emotional responses, characterized by professionalism and a focus on offering comfort. They expressed, ‘Normal feelings...but you want to hug the child and comfort him.’ Conclusions The study unveiled a marked difference in empathy expression between students and instructors, with students displaying stronger emotional reactions. These findings underscore the need to recognize and address individual variances in empathy expression within nursing education. Tailored strategies should be devised to bolster empathy development in both students and instructors during virtual patient training. Further investigation is warranted to explore effective methodologies for optimizing empathy development and fostering compassionate patient care in nursing education. Key messages • A Comparative Analysis of Nursing Students and Instructors Using VR Glasses. • Erasmus+ project (Safe4Child) 2021-1-FI01-KA220-HED-000032106.

Transforming leaders to transform hospitals. Cultivating ethical leadership for compassionate healthcare

The importance of compassionate care has been widely acknowledged in the literature as a crucial component for enhancing patient care, improving clinical outcomes, and reducing burnout, compassion fatigue, malpractice, and healthcare costs (Watts et al., 2023). However, many healthcare systems continue to struggle with effectively implementing and sustaining compassionate care practices due to the burden of administration, limitations in resources, and a focus on efficiency and profitability. The purpose of this paper is to advocate for the necessity of (re) “humanizing” the healthcare environment, which is urgently needed today to counteract the trend of eroding the value or essence of care practices by refocusing on the patient and their family. Specifically, this paper will argue that to reverse this trend, it is crucial to transform the education of healthcare facility leaders and managers at all levels. It is vital to provide them with guidelines and training that is not only technical but also ethical, with a focus on character education. This approach would enable them to recognize the right values and effectively address complex situations from a moral perspective. Providing leaders with the opportunity to flourish through dedicated programs can positively transform our hospitals and healthcare facilities. Such programs are essential for creating a balanced healthcare environment where efficiency and compassionate care coexist, leading to improved care outcomes, reduced costs, and enhanced well-being for professionals.

The compassionate care framework plus quality control group improves the quality of postoperative nursing management for patients in anorectal surgery: An observational study.

This study aimed to investigate the effectiveness of the joint application of the compassionate care framework (CCF) and a quality control (QC) team in improving the quality of postoperative nursing management for patients in anorectal surgery. Patients who underwent anorectal surgery at the China-Japan Friendship Hospital between May 2022 and December 2022 were selected by convenience sampling. A digital random generator was used for random grouping. The odd numbers entered the control group (n = 53) and the even numbers entered the study group (n = 53). The control group received postoperative traditional nursing, and the study group received postoperative nursing and QC team management. A questionnaire survey was used to analyse patients' satisfaction with nursing. The two groups were compared for nursing quality scores, patient satisfaction with nursing care and incidence of complications. After management, compared with the control group, the study group scored significantly higher for the nursing process, environmental management, emergency response and safety protection (p < 0.05 for all). The study group also exhibited higher satisfaction scores with the nursing process, nurse-patient relationship and service attitude compared with the control group (p < 0.05 for all). The complication incidence rate in the study group was significantly lower than in the control group (p < 0.05). The combined use of the CCF and a QC team can effectively improve the quality of postoperative nursing management for patients in anorectal surgery, reduce the incidence of complications and enhance patient satisfaction with nursing care, thus holding significant potential for wider application.

Cross-national Psychometric Evaluation of the Jefferson Scale of Empathy-Medical Student Version.

This study aimed to examine the factorial structure of the Jefferson Scale of Empathy-Medical student version (JSE-S) and assess items' discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages. JSE-S datasets were retrieved from previous studies of 4113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient's Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while when the JSE-S increased, the standard error also increased. There was no consistent support across countries for the JSE-S three-factorial structure. Items provided redundant information and discriminatory power decreased when aiming to differentiate students at high empathy levels. A JSE-S revision to improve cross-cultural comparability, results' generalizability and validity should focus on suppressing or reformulating items that cannot differentiate medical students' empathy.

Evaluating a peer-support mind-body medicine intervention for healthcare leaders.

Mind-body medicine (MBM) is an evidence-based intervention associated with trauma and stressful events. The MBM intervention alleviates symptoms of work-related stress and builds resilience by utilizing self-care techniques facilitated in small group settings. Healthcare leaders who experienced traumatic stress through the COVID-19 pandemic may benefit from interventions aimed at their needs. We evaluated the effects of a peer support MBM intervention on perceived stress, resilience, well-being, and empathy for nurse leaders and compassionate care leaders. A pre-post intervention was conducted via 7 virtual and 2 on-site groups, recruiting from a large multihospital health system in the United States. Participants engaged in an 8-week program facilitated by a certified faculty group leader from The Center for Mind-Body Medicine and engaged in resilience skills building activities along with facilitated sharing. Validated instruments were used to measure outcomes at pre, post, 1 month, and 6 month follow-up intervals. Surveys included open-ended questions for qualitative feedback related to facilitators, barriers, and group experiences. Seventy-three leaders completed the MBM program, and 22 completed the four research surveys; all qualitative responses were included for feedback. Perceived stress decreased after the intervention (p < .008) and was maintained for 6 months post intervention (p < .005). Resilience increased after the intervention (p < .034) and for 1 month (p < .049) but decreased after 6 months. Qualitative responses showed that time and workload factors were the most significant barrier to participation, while the benefits included protected time with peers, learning well-being skills, and having a safe place to process emotions. Healthcare leaders face unique challenges, including workplace trauma and crises. Interventions that support their stress response, resilience, and overall well-being should take into consideration the nature of their work, the balance of time demands, and the need for peer support to overcome barriers to sustainable interventions.

Adding Life to Years: Comprehensive end-of-life care for all

This study builds upon our 2019 End-of-Life Care (EoLC) research, focusing on enhancing the quality and accessibility of EoLC in Hong Kong. With the introduction of the Advance Decision on Life-sustaining Treatment Bill, we identified the need for a more comprehensive approach to address the full spectrum of care needs beyond medical decisions. Our methodology leveraged insights from diverse stakeholders across various sectors and disciplines. The study revealed critical gaps in the system, service provision, and education related to EoLC. We propose six key recommendations: (1) develop a territory-wide standardised advance care planning (ACP) framework, (2) formulate an EoLC service strategy, (3) establish clear communication pathways to connect EoLC services, (4) promote public life and death education, (5) equip community professionals with ACP training, and (6) enhance university curriculum and on-the-job training in health and social care. These recommendations aim to create a cohesive EoLC ecosystem that respects individual preferences, optimises resource allocation, and addresses the challenges of an aging population. By implementing changes at system, service, and education levels, we envision EoLC in Hong Kong to be delivered in a person-centred, dignified, and coordinated manner, ensuring compassionate care at the final stage of life.

Patient-centered lean healthcare management from a humanistic perspective

BackgroundHealthcare organizations are under pressure to improve services because of an aging population and increasing healthcare demands. Lean healthcare management focuses on improving service quality and efficiency under the condition of limited resources, but it may overlook patients’ emotional needs and experiences, especially in developing countries. This study advocates integrating medical humanities with lean healthcare to develop a patient-centered service model.MethodsThe study employs literature review to discuss the critical role of medical humanities in lean healthcare frameworks, both theoretical and practical. Additionally, it conducts a qualitative study through semi-structured interviews to explore strategies for developing a humanistic lean healthcare model. The study conducts semi - structured interviews with eight management staff members and doctors in a tertiary hospital in China that actively adopts this approach.ResultsEight managers and doctors (five female and three male) were interviewed between January and March 2024 at their chosen locations. Firstly, the study identifies key benefits of integrating medical humanities into lean healthcare, which are as follows: (1) Enhancing the personalization and comprehensiveness of services. (2) Building trust in doctor-patient relationships. (3) Boosting the satisfaction of healthcare teams. Secondly, it highlights strategies for a humanistic approach, namely: (1) Conducting comprehensive patient assessments and providing personalized treatments. (2) Enhancing doctor - patient communication for emotional resonance. (3) Optimizing the medical environment for humanized services. (4) Developing humanistic qualities among healthcare professionals. (5) Using information technology effectively. Additionally, the study also addresses potential issues regarding lean healthcare’s focus on profitability and proposes preventive measures: (1) Implementing a scientific evaluation and incentive mechanism. (2) Enhancing transparency and oversight in healthcare. (3) Cultivating a patient - centric medical culture.ConclusionsThis research proposes a patient-centered lean healthcare model integrating medical humanities, providing a novel framework for improving service quality and efficiency while ensuring compassionate care. This management framework can support the reform of public hospitals in China and also serve as a reference for other countries.

Understanding what it is like to experience pain as you grow up: a poetic meta-ethnography.

A recent Lancet Commission raised concerns about the management of child and adolescent pain. We aimed to undertake a comprehensive review of qualitative research to understand children and adolescent pain experiences across contexts. We used the 7 stages of meta-ethnography to synthesise findings. We combined the strengths of arts-based methods, translating themes into poems in a range of languages. We screened 7471 titles, 464 abstracts, and 302 full texts, including 189 reports (177 unique samples) incorporating 5875 young people. Age range across studies was 2 to 38 years, with 93% including those between the age of 11 and 20 years old. Studies spanned 30 years (1993-2023) with 121 (64%) published in the last 10 years. Almost all (93%) were set-in high-income countries. We report 6 themes focusing on transition to adulthood: (1) I want to stay within the safety of home; (2) don't exclude me from my own care; (3) it might hurt but it's for my own good; (4) I rely on others but I want some independence; (5) I am no longer a child but I am not an adult yet; and (6) I wasn't prepared for the transfer to adult health care. Our findings focus on the complex transition into adulthood and the importance of creating a genuine healthcare partnership with young people by acknowledging their perspectives, creating a safe and supportive environment, and preparing them for the transition to adult pain care. Arts-based methods have the potential to make findings from qualitative evidence syntheses accessible and impactful for compassionate health care.

Measuring compassion in end-of-life cancer patients: The Italian validation of the Sinclair Compassion Questionnaire (SCQit).

Compassion is acknowledged as a key component of high-quality palliative care, producing positive outcomes for both patients and healthcare providers. The development of the Sinclair Compassion Questionnaire (SCQ) fulfilled the need for a valid and reliable tool to measure patients' experience of compassion. To validate the Italian version of the SCQ and to evaluate its psychometric properties in a sample of cancer patients with a life expectancy of less than 4 months. Cronbach's alpha estimates were computed to evaluate the internal reliability. Exploratory Factor Analysis, Confirmatory Factor Analysis, and Item Response Theory analyses were performed to assess the validity of the construct. Divergent validity was assessed using the Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction, the revised Edmonton Symptom Assessment Scale, and the Trust in Oncologist Scale-Short Form. Data were collected from 131 patients recruited in either a hospital or a hospice setting. The analyses confirmed the single factor structure of SCQit, with Confirmatory Factor Analysis factor loadings ranging between 0.81 and 0.92 and satisfactory internal reliability. Hospital setting and high diagnosis/prognosis awareness were associated with significantly lower SCQit scores, whereas practicing a religious faith was associated with greater experiences of compassion. The Italian version of the SCQ (SCit) is a valid and reliable measure of patient-reported compassion. The SCQit can be used in clinical practice and research to measure the compassion experiences of terminally ill cancer patients and to evaluate the effectiveness of training to promote compassionate care in healthcare professionals.

The "Green Doctor" Initiative: Ethical Healthcare in the Age of Medical Commercialization

The "Green Doctor" initiative represents a groundbreaking shift in global healthcare systems, aiming to prioritize ethical, compassionate, and patient-centered care in an era of increasing commercialization. Proposed by Professor Reza Ghalamghash, the "Green Doctor" concept focuses on the moral obligations of healthcare professionals to provide care that transcends financial considerations and commercial pressures. This innovative model emphasizes the humanistic aspects of medicine, where physicians are encouraged to focus on patients' holistic well-being, mental and emotional health, and equitable access to care. In the face of rising healthcare costs, systemic inequities, and ethical dilemmas posed by profit-driven models, the "Green Doctor" approach is particularly timely. This article explores the philosophical foundation of the "Green Doctor" concept, its implications for healthcare systems around the globe, and its potential to drive meaningful change in public health policy and medical practices. Through a detailed exploration of real-world case studies, the article delves into how this model is being adopted in different healthcare settings, examining its efficacy in enhancing patient outcomes, promoting healthcare equity, and reshaping the relationship between doctors and their patients. Additionally, the article discusses the structural challenges faced by healthcare providers in implementing this approach, including financial constraints, regulatory hurdles, and the need for institutional support. It also highlights the role of technology in facilitating the "Green Doctor" model, particularly through the use of telemedicine, digital health platforms, and AI-driven diagnostics, which allow doctors to extend care to underserved populations while maintaining a patient-centered focus. Finally, the article assesses the future of the "Green Doctor" initiative in the context of evolving global healthcare challenges, offering insights into how it could serve as a sustainable model for ethical healthcare in the 21st century.

Phage-Based Therapy in Combination with Antibiotics: A Promising Alternative against Multidrug-Resistant Gram-Negative Pathogens.

The continued rise in antimicrobial resistance poses a serious threat to public health worldwide. The use of phages that can have bactericidal activity without disrupting the normal flora represents a promising alternative treatment method. This practice has been successfully applied for decades, mainly in Eastern Europe, and has recently been used as an emergency therapy for compassionate care in the United States. Here, we provide a comprehensive review of the pre-clinical and clinical applications of phage therapy concerning three major Gram-negative pathogens: Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The advantages and the challenges of expanding the usage of phages as an alternative or adjunctive treatment for antimicrobial-resistant bacterial infections are discussed. We emphasize the virologic complexities of using the highly adaptable phage populations as molecular tools, along with antibiotic chemical compounds, to effectively combat rapidly coevolving pathogenic bacteria in the host microenvironment. Pre-clinical studies, isolated clinical reports and a few randomized clinical trials have shown that bacteriophages can be effective in treating multidrug-resistant bacterial infections. The ability of some phages to revert the resistance against antibiotics, and possibly also against the human complement and other phages, appears to be a great advantage of phage therapy despite the inevitable emergence of phage-resistant strains. Bacteriophages (or specific phage-derived products) can enhance antimicrobial efficacy by reducing bacterial virulence via the alteration of basic bacterial structures, primarily of the cellular wall and membrane. Although several issues remain open regarding their effective clinical application, it appears that phage-based therapeutics in combination with antibiotics can provide an effective solution to the spread of antimicrobial resistance.

‘Where is the diversity in this facility?’ Experiences of emergency care among visible minority individuals in Kingston, Ontario

ABSTRACT Introduction Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities. Methods From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants’ interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group. Results Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities’ ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged. Conclusion Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable.

Development of the Compassionate Technology Scale for Professionals (CTS-P): value driven evaluation of digital mental health interventions

BackgroundCompassion is an essential and beneficial value in mental healthcare. However, how digital mental health interventions influence compassion in treatment has not been systematically investigated, due to the lack of appropriate measurement instruments. To address this gap, we developed the Compassionate Technology Scale for Professionals (CTS-P), aimed at mental health professionals.MethodsWe used Q-methodology, a method that combines quantitative and qualitative analysis to explore shared viewpoints on a particular topic, to select and refine items. Participants were 15 professionals from different areas of mental healthcare. In individual sessions, while thinking aloud, they sorted 35 statements on relevance for evaluating technology use on compassion. The statements were based on a scientific conceptualization of compassion with five elements. The sorting task was followed by a short interview to explore participants’ associations with compassion and technology.ResultsWith by-person factor analysis, we found three different viewpoints among participants, all with eigenvalues > 1 and with a total explained variance of 63.02%. We selected prioritized items of each viewpoint and for each theoretical element of compassion, resulting in a full scale (15 items) and a short scale (3 items). Based on qualitative input from participants, the scale was adapted to clarify its focus and the wording of items. While thinking aloud, participants shared benefits and critical notes regarding technology and compassion.DiscussionTogether with key stakeholders, we developed the CTS-P. Most participants prioritized the potential of technology to obtain more information and be closer to their client in facilitating compassion. The main critical note participants had was that technology is not necessary to support compassion at the therapist’s experiential level. This emphasizes the need to further explore how mental health professionals and technology can complement each other in a system of compassionate care. Future research should explore the factor structure, validity, and reliability of the scale through psychometric validation.ConclusionsThe CTS-P can make the extent to which technology for mental healthcare influences elements of compassion measurable and comparable. The scale can prove useful for prioritizing the value of compassion in both the development and use of digital mental health interventions.

Reconciliation Pedagogy as Peacebuilding through Education in the Context of Cameroon

Purpose: The aim of the study was to examine Reconciliation Pedagogy as Peacebuilding through Education in the Context of Cameroon Methodology: Being a literature-based paper, there was introduction of the paper in which some concepts were defined, a review of relevant literature on Cameroonian scholarship about the ongoing crisis, review of global literature on reconciliation pedagogy, a description of the role of a Christian teacher as a reconciliation pedagogue, and a proposed reconciliation pedagogical framework from a Christian perspective. Findings: The Christian Teacher can positively provide good influence to help address the current Anglophone crisis in Cameroon through pedagogy for contextual reconciliation. This would be seen in actual ethical paradigms like forgiveness, compassionate care, honesty, love, justice and equity as Christian virtues of being and doing, which is a potential gap in teachers’ practice in a crisis situation. Hence, the paper seeks to provide a new paradigmatic shift in ethical discernment in teaching pupils/students who are the immediate beneficiaries of reconciliation pedagogy and the society at large. The focus is not on inculcating ideas but in shaping life through teaching and modeling of Christian virtues that would be constructive to the development of students and the society in general. This would be an integrative approach of historical, ethical, spiritual and practical principles and Christian thinking and doing. Unique Contribution to Theory, Practice and Policy: The paper suggests a contextual pedagogy for the Christian Teacher’s practice which is a form of summary of the roles they can play as reflective pedagogues. Hence, this paper sought to suggest reconciliation pedagogy from a Christian perspective for the Cameroonian context which is a characterized with human abuse and which both teachers and learners are victims. It is hoped that the suggested framework guides the Christian Teacher’s practice towards the reconstruction of the society as a step in the process of reconciliation in view of the current Anglophone crisis in Cameroon.

Urogynecologic Care for Women Who Are Incarcerated

In the United States, approximately 180,700 women are incarcerated across jails and prisons, comprising a demographic with an aging population and a higher growth rate compared to men. Despite this demographic trend, research into urogynecologic care for women who are incarcerated is notably lacking, with few studies addressing pelvic floor disorders such as incontinence, and even fewer focusing on access to treatment options like vaginal pessaries or surgical interventions. Women who are incarcerated may face unique challenges in obtaining urogynecologic care, including limited access to medical evaluations, invasive search procedures affecting intravaginal device use, and inadequate hygiene resources, all of which hinder effective management strategies. Barriers to nonsurgical treatments like pelvic floor physical therapy are exacerbated by transportation logistics, while access to surgical interventions is impeded by complex approval processes within correctional facilities. In addition, managing incontinence with limited access to hygiene products and bathroom facilities further compromises the health and dignity of incarcerated women. Urgent attention and advocacy are needed to address disparities in research and clinical care for incarcerated populations. As a first step, we urge clinicians to acquaint themselves with the correctional facilities in their areas and the current health care pathways for women incarcerated in these facilities. It is our collective responsibility to ensure equitable and compassionate care for this vulnerable population.

"I managed to stand on my own. I saved my baby's life.": qualitative analysis of birth experiences from women living with HIV in Cape Town, South Africa.

There is growing recognition of obstetric violence in health facilities across the globe. With nearly one in three pregnant women living with HIV in South Africa, it is important to consider the influence of HIV status on birth experiences, including potential experience of obstetric violence as defined by the Respectful Maternity Care Charter. This qualitative analysis aims to understand the factors that shape birth experiences of women living with HIV, including experiences at the nexus of HIV status and obstetric violence, and how women react to these factors. Data were collected in a Midwife Obstetric Unit in Gugulethu, Cape Town, South Africa, through 26 in-depth interviews with women living with HIV at 6-8weeks postpartum. Interviews included questions about labor and early motherhood, ART adherence, and social contexts. We combined template style thematic analysis and matrix analysis to refine themes and subthemes. Participants described a range of social and structural factors they felt influenced their birth experiences, including lack of resources and institutional policies. While some participants described positive interactions with healthcare providers, several described instances of obstetric violence, including being ignored and denied care. Nearly all participants, even those who described instances of obstetric violence, described themselves as strong and independent during their birth experiences. Participants reacted to birth experiences by shifting their family planning intentions, forming attitudes toward the health facility, and taking responsibility for their own and their babies' safety during birth. Narratives of negative birth experiences among some women living with HIV reveal a constellation of factors that produce obstetric violence, reflective of social hierarchies and networks of power relations. Participant accounts indicate the need for future research explicitly examining how structural vulnerability shapes birth experiences for women living with HIV in South Africa. These birth stories should also guide future intervention and advocacy work, sparking initiatives to advance compassionate maternity care across health facilities in South Africa, with relevance for other comparable settings.

Nurses’ perceptions of compassionate care in pediatric oncology: a qualitative interview study

BackgroundCompassion is a crucial aspect in the management of pediatric oncology patients as it has the potential to enhance nurse satisfaction levels, thereby further enhancing the quality and safety of the care they deliver. This study aimed to investigate nurses’ understanding and experience of compassionate care when working in pediatric oncology departments.MethodsThis research utilized a qualitative descriptive design. Content analysis was used to make sense of data collected via individual and semi-structured interviews conducted with nurses (n = 32) working in pediatric oncology departments.ResultsNurses’ understanding of compassionate care for children with cancer was organized into two categories: Humanistic compassionate care and compassionate end-of-life care. The humanistic compassionate care category comprised of three subcategories: (1) empathy, (2) altruism, and (3) respect for the cultural values and beliefs of the family. The compassionate end-of-life care category comprised of two subcategories: (1) facilitating parents’ presence at the child’s bedside and (2) creating suitable conditions for accepting the death of a child.ConclusionCompassionate care for children with cancer is marked by a strong emphasis on humanistic, cultural, and end-of-life considerations. Our findings further emphasize the paramount importance of taking families’ presence, wishes and beliefs into consideration within this context.

Perceived Impact of Healthcare Relationships and Interactions on Parental Experiences of Prenatal Diagnosis and Termination of Pregnancy for Foetal Anomaly on the Island of Ireland.

The aim of this study was to explore parents' experiences of their relationships and interactions with healthcare professionals (HCPs) during care related to prenatal diagnosis and termination of pregnancy for foetal anomaly (TOPFA). A qualitative approach was used. Participants included 33 parents (23 women and 10 men) from Northern Ireland (n = 11) and Ireland (n = 22) who had a TOPFA. Data collection methods included semi-structured interviews and written narrative accounts. Data were analysed using thematic analysis. Findings confirmed that TOPFA was a traumatic, life-altering experience for parents, impacting their health and well-being. The actions, behaviours and words of HCPs impacted how parents perceived and interpreted their healthcare experiences and their access to services and supports. In relation to this, five themes are presented: (1) the importance of compassionate and non-judgemental care, (2) the value of effective information and communication, (3) the desire for compassionate care for baby and facilitation of memory making, (4) the need for continuity of care and (5) parents' experiences of healthcare relationships during times of legislative change. This research reveals the important role HCPs play in helping parents cope with prenatal testing and TOPFA. Parents who had a positive relationship with an HCP, in which information was communicated effectively and compassionate and non-judgmental care was provided, felt more supported and more able to accept and adapt to their loss. An advisory group composed of parents who had experienced TOPFA and HCPs with experience in caring for such families were involved in the study from the outset, contributing to the design and development of data collection materials, interpretation of the findings and design of dissemination materials.