Compassionate care: The most efficient tool you're not using.

Healthcare systems face a growing challenge: as technology advances, patients increasingly feel like data points in systems that prioritise efficiency over empathy. This paper addresses the global healthcare crisis of disconnection, arguing that fundamental change requires putting human experience at the centre through Caring Science principles in nursing. COVID-19 clearly revealed this disconnect. While showcasing scientific advances, it exposed gaps in compassionate care and fair access globally. Nurses struggled to maintain human connection while dealing with resource shortages and isolation protocols, proving that advanced medical treatments alone cannot address the physical, emotional, spiritual, and social factors that influence health. This work draws on peer-reviewed studies, contemporary research, and theories of human caring to demonstrate the global responsibility and urgent need for integrating caring practices into healthcare systems. Collectively, this evidence underscores both the necessity of intervention and the effectiveness of Caring Science as a strategy for transforming organisational practices while highlighting a pressing truth: healthcare systems worldwide must move beyond efficiency alone and intentionally weave caring practices into their structures. This analysis examines Caring Science through three key areas: Relational, Organisational, and Global. Using Watson's Theory of Human Caring and current research, the paper shows how caring relationships can improve through thoughtful use of innovation. Recent healthcare improvements demonstrate promising results when technology integration enhances both nurse empowerment and patient outcomes within frameworks that prioritise human connection. Future directions position Caring Science as a mature, evidence-informed framework for addressing healthcare's complex challenges. The paper calls for 'sacred activism'-a commitment to protecting caring's essential dimensions while embracing beneficial innovation, positioning nursing to lead healthcare transformation through both the art and science of nursing that honours human dignity.

This narrative review explores five essential nursing specialties: addiction nursing, disaster nursing, critical care nursing, rehabilitation nursing, and geriatric nursing, within the context of increasingly complex healthcare environments. Addiction nursing is highlighted as a frontline discipline addressing the multifaceted causes and occupational risks of substance use disorders, affecting both patients and healthcare professionals. Disaster nursing emphasizes the importance of preparedness and structural resilience in response to global emergencies, calling for interprofessional collaboration and systemic reform. Critical care nursing is examined through the lens of moral sensitivity and occupational stress, reflecting the ethical demands and psychological toll faced by nurses in high-stakes settings. Rehabilitation nursing underscores the need for specialized training and adaptive, evidence-based educational models to support diverse patient recovery trajectories. Geriatric nursing responds to global demographic shifts and healthcare workforce shortages by advocating for the elimination of ageist attitudes and the promotion of dignified, compassionate elder care. Across all five domains, the review identifies common challenges, including ethical concerns, competency gaps, and workforce strain, which require targeted interventions through policy development, educational reform, and institutional support. The findings call for an integrative and human-centered approach to nursing practice that prioritizes emotional resilience, professional values, and the safeguarding of human dignity. Strengthening these specialties is critical not only to improving patient outcomes but also to supporting the sustainability and well-being of the nursing workforce in demanding care settings.

Mast Cell Activation Syndrome and Mimickers.

Functional neurological disorder (FND) is a common condition, associated with high disability and healthcare costs, and poor treatment access. This qualitative study aimed to explore participants' experiences of being diagnosed with functional neurological disorder (FND), accessing treatment, and navigating life after diagnosis. Participants were drawn from a randomised feasibility study of eye movement desensitisation and reprocessing therapy for people with FND (MODIFI, Trial Registration: NCT05455450 (www.clinicaltrials.gov)). Reflexive thematic analysis was used to analyse the data from eighteen semi-structured interviews with participants diagnosed with FND. Six main themes were identified: (1) the process of seeking a diagnosis and initial relief from the physical struggles, (2) receiving a diagnosis of FND, (3) treatment for FND, (4) the burden of FND in day-to-day life, (5) the need to assert agency and return to normal, and (6) hopes for the future. The findings emphasize the need for personalised and compassionate care for individuals suffering from FND, underpinned by increased service provision within the healthcare system.

The increasing prevalence of HIV in the United highlights the need for a well-trained workforce capable of providing compassionate and equitable care. This study aimed to assess attitudes toward people living with HIV/AIDS, willingness to provide care, and associated factors among students in the health professions at a public university in the Mountain West Region of the United States. A cross-sectional design was used, and the study included undergraduate and graduate students in health sciences and allied disciplines. Data was collected using validated tools from September 1 to September 30, 2023. All students in the relevant departments were invited to participate. Out of 177 students who responded, 175 completed at least the section of the questionnaire on sociodemographic information. The mean age of respondents was 23.5 years (SD 6.25 years), with the majority being female (84.0%) and under 35 years of age (93.0%). The prevalence of stigmatizing attitudes was 60%, and 68% of participants showed a high willingness to provide care. Participants over 35 years of age were less likely to have stigmatizing attitudes compared to those 35 years or younger (AOR = 0.13, p-value 0.014). Students in higher undergraduate years were less likely to have stigmatizing attitudes compared to first year students (OR = 0.32, p-value 0.024). Students with an urban upbringing were less likely to have stigmatizing attitudes compared to those from rural areas (AOR = 0.25, p-value 0.012). Graduate students were less likely to have a high willingness to provide care compared to first year undergraduate students (AOR = 0.21, p-value 0.01). This study identified gaps in the attitudes and willingness of health sciences students to care for people with HIV/AIDS and provides evidence to inform curricular reforms. The online version contains supplementary material available at 10.1186/s12982-026-01923-0.

Crisis Resolution and Home Treatment Teams are an important part of modern mental health services; however many regions across the UK continue to operate generic crisis teams across all age groups. Older adult mental health often comes with complexities and co-morbidities; specialist knowledge in this age group is beneficial for effective support. The Crisis Intervention Team for Older People (CITOP) operates as a community-based service across Hull and the East Riding of Yorkshire, using a psychosocial model to support older adults in crisis. This service evaluation examined whether the functional pathway within CITOP was associated with reduced inpatient admissions, improvements in psychological wellbeing, and delivering compassionate patient care. A naturalistic observational design was used, using routinely collected clinical data. Aims were reviewed using discharge destination data, Recovering Quality of Life Questionnaire-10 (ReQol-10) scores at the point of referral and discharge, and patient responses to the Friends and Family Test (FFT). Of the 78 functional referrals included, 88.5% were discharged to CMHTs or primary care, and 11.5% were admitted to an inpatient unit. Paired ReQol-10 data were available for 21 service users, showing a median increase from 12 at referral to 20 at discharge. This difference was statistically significant (Wilcoxon signed-rank test), Z=−3.72, p<.05, with a large effect size (r=.81). Responses on the FFT implied that CITOP was respectful of patient-centred values, provided positive emotional support, and a good level of information and education. Taken together, these findings suggest that CITOP provides an essential specialist crisis service for older adults with potential benefits in reducing admissions, improving psychological wellbeing, and delivering compassionate and person-centred care. While this is a preliminary evaluation, limited by a small sample size and incomplete outcome data, it offers a foundation for future, larger-scale studies.

Balancing residents' autonomy with patient safety is a delicate and ongoing challenge in clinical education. Too little supervision risks patient harm, while too much supervision stifles growth, confidence, and motivation. The solution lies in graded responsibility-entrusting residents with autonomy in a structured manner, supported by thoughtful supervision, timely feedback, and mentorship. A supportive learning environment that permits small, recoverable failures, models professionalism, and nurtures reflection can shape residents into competent, empathetic, and accountable physicians. Ultimately, this balance safeguards today's patients while preparing tomorrow's doctors to deliver safe and compassionate care.

Background: Emergency obstetric situations require rapid clinical decision-making, technical competence, and emotional preparedness to ensure safe and compassionate care for both mother and newborn. However, nursing students often have limited opportunities to experience such high-risk, low-frequency events during clinical placements. Simulation-based education has emerged as an effective strategy to prepare future nurses for caring in emergency contexts, allowing them to develop both technical and non-technical skills in a safe learning environment. This study aimed to evaluate the effects of a high-fidelity obstetric emergency simulation program on nursing students' knowledge, perceived safety, and learning experience. Methods: A mixed-methods design was employed, combining a quasi-experimental pretest-posttest assessment without a control group and qualitative analysis of open-ended reflections. Eighty-two third-year nursing students participated in two simulation sessions addressing obstetric emergencies such as breech birth, shoulder dystocia, out-of-hospital delivery, eclampsia, postpartum hemorrhage, and maternal cardiac arrest. Data were collected using validated instruments measuring knowledge, perceived safety, and satisfaction and self-confidence in learning, and were analyzed using Wilcoxon signed-rank tests and thematic analysis. Results: Significant improvements were observed in specific knowledge areas related to complex obstetric maneuvers and in their perceived safety when managing emergency situations (p < 0.001, r > 0.40). Participants reported high levels of satisfaction and confidence in learning. Qualitative findings highlighted increased emotional preparedness, improved clinical reasoning, and recognition of the importance of teamwork and reflective debriefing in emergency care contexts. Conclusions: High-fidelity simulation appears to be an effective educational strategy for preparing nursing students to provide safe and confident care in obstetric emergencies. Integrating simulation into nursing curricula can strengthen both technical competence and the emotional readiness required for caring in urgent and high-pressure clinical situations.

The “Art4ART” platform integrates Artificial Intelligence into oncology care by providing artistic stimuli to patients undergoing radiation therapy. This study preliminarily assesses the perceived ethical implications of the platform, examining healthcare professionals’ perceptions, by creating a 69-item questionnaire designed to evaluate the ethical principles of Beneficence, Non-Maleficence, Autonomy, Justice, and Explicability (in accordance with international guidelines). Thirty-four healthcare professionals working in an Italian research hospital (Dept. of Radiation Oncology) evaluated the Art4ART platform. Findings suggest the platform meets ethical standards by promoting wellbeing, supporting patient autonomy, and providing equitable access to care. Yet, certain areas, like data transparency and system monitoring, require further attention. Healthcare professionals also noted the need for enhanced training and clear communication on the system’s limitations and malfunction reporting. Overall, the platform’s focus on patient- centered care and the conveyance of positive values is well-received, underscoring the importance of ethical oversight in AI applications. This analysis highlights that the platform’s value lies not only in its technological features but also in fostering human-centered, compassionate care that respects oncology patient freedom and dignity within their therapeutic journey.

Palliative care is undergoing a significant transformation, driven by a global ageing population, a corresponding rise in chronic conditions and a growing need for integration across health and social care settings. Nurses are considered the primary providers of palliative care, supporting people with life-limiting illnesses in the home, hospital, care home and hospice environments. This article explores two domains that support a person-centred approach to palliative care: developing knowledge and skills; and leading and influencing care. The author identifies ways to develop and strengthen nurses' capabilities through education, reflection and mentorship, supported by leadership that advocates a person-centred approach, and organisational systems that enable compassionate care aligned with what matters to the individual. By identifying actionable initiatives across knowledge development and leadership, this article aims to prepare nurses for the challenges and opportunities of an evolving palliative care landscape.

Introduction: Sickle Cell Disease (SCD) remains a major health concern in Central India, particularly among tribal and underserved groups. Adolescents with SCD often experience a wide spectrum of physical, emotional, social, and academic challenges. Limited qualitative evidence captures adolescents lived narratives, which are essential for planning holistic interventions. Aim/Objective: To explore and describe the multifaceted lived experiences of adolescents (10-19 years) with SCD in central India. Methods: A descriptive phenomenological research design was utilized. Total eleven adolescents aged 10-19 years diagnosed with SCD were selected employing convenience sampling from a tertiary care hospital in Central India. In-depth semi-structured interviews were conducted ensuring privacy and confidentiality. Colaizzi's seven-step method was used for data analysis. Ethical approval and informed consent/assent were obtained prior to data collection. Results: Six major themes emerged including adolescents reported recurrent and unpredictable pain crisis leading to fatigue, reduced mobility, and frequent school absenteeism. These physical limitations disrupted daily functioning and restricted social participation. Emotionally, they experienced fear, frustration, and sadness, particularly during hospitalizations and academic loss, though many also expressed determination and hope for a better future. Social stigma, peer rejection, and concerns about future opportunities emerged as common struggles. However, strong familial support provided comfort. Health care experiences were mixed while participants valued compassionate care, they noted long waiting hours and limited adolescents-focused services. Medication routines and hospital visits were perceived as burdensome but necessary. Participants coped through rest, hydration, distraction, positive self-talk, and reliance on family and spiritual beliefs. Overall, adolescents demonstrated resilience despite interconnected physical, psychosocial, and healthcare challenges, emphasizing the need for age-appropriate psychosocial and educational support. Discussion/Conclusion: Adolescents with SCD endure substantial multidimensional burden that negatively affects their overall well-being and social identity. Findings highlight the need for adolescent-friendly pain management, mental health support, school-based awareness programs, and culturally tailored counseling interventions. Strengthening family support and community inclusiveness can improve resilience and quality of life in this underserved group.

Introduction Compassion and empathy are foundational to quality healthcare, yet many existing measurement tools are Westerncentric and do not fully reflect Indian cultural nuances or health-system realities (1,2)). This study describes the development and validation of the Compassionate Score Card, a brief, context-sensitive scale designed to assess compassionate care among Indian healthcare professionals. Material:andMethods:Development followed a three-phase process. Phase 1 (item generation) integrated a review of international "gold standard" measures, such as the Sinclair Compassion Questionnaire, with hospital fieldwork involving semi-structured interviews and focus groups. This resulted in an item pool covering four domains: relational communication, sensitivity to patient context, professional behaviour, and active response to suffering. Phase 2 involved content and face validity testing with an expert panel (n=13) and cognitive interviews (n=20). Phase 3 consisted of psychometric testing with a larger sample, utilizing exploratory and confirmatory factor analysis, Cronbach’s alpha, and test-retest reliability (3,4) Results:The final CSC is a concise scale with high internal consistency and stable test-retest scores. Factor analysis supported a structure aligned with four domains: communication, sensitivity, insight, and action. The tool exhibited strong convergent and divergent validity through correlations with established compassion and person-centred care measures (5,6). Minimal floor and ceiling effects were observed, suggesting high sensitivity for evaluating training interventions. Conclusion:The CSC is a culturally grounded tool adapted to Indian clinical realities, including high patient loads and family-centred care. It offers a human-centred framework for assessing and strengthening compassionate practice. Future research should focus on cross-regional validation and examining links between CSC scores, patient safety, and staff well-being (7,8).

Hyperemesis gravidarum (HG) is a severe and potentially life-threatening form of nausea and vomiting in pregnancy, characterized by intractable vomiting, dehydration, electrolyte imbalance, nutritional deficiencies, and significant weight loss. Despite being a leading cause of early pregnancy hospitalization, its management remains inconsistent and often empirical. Emerging evidence suggests a paradigm shift in the understanding of HG pathophysiology, moving beyond traditional hormonal theories toward an integrated model involving genetic susceptibility and metabolic signaling pathways, particularly Growth Differentiation Factor 15 (GDF15) and RYR2-related mechanisms. This narrative review critically synthesizes current evidence regarding the evolving biological basis of HG and evaluates established and emerging therapeutic strategies. A multimodal, stepwise approach remains the cornerstone of management. First-line pharmacotherapy includes doxylamine-pyridoxine, followed by dopamine antagonists or 5-HT3 receptor antagonists such as metoclopramide and ondansetron, which demonstrate reassuring safety profiles in large cohort studies. Corticosteroids may be considered in refractory cases. Early correction of dehydration, electrolyte disturbances, and thiamine deficiency is essential to prevent complications such as Wernicke's encephalopathy. Nutritional support, preferably through enteral tube feeding rather than parenteral nutrition, should be prioritized when oral intake is inadequate. Integrating biological insights with standardized, compassionate, and multidisciplinary care may improve clinical outcomes and reduce the substantial physical and psychological burden associated with HG.

India's prison system has long been challenged for its administrative, rehabilitative, and structural issues. Therefore, it is crucial to understand the status of the prison system and identify the challenges in correctional reform. This study employed a narrative review and qualitative analysis of articles from the Scopus database published between 2020 and 2025. This study employed the TCCM framework to gain an in-depth understanding of scholarly articles in the field. A total of 18 articles were selected for the narrative review and further analysis. A major challenge has been identified: repressive institutional cultural practices that valued control and order over compassionate treatment and care are sustained by its colonial heritage. Moreover, the humanitarian understanding of progressive and inclusive reformation and social rehabilitation has been underdeveloped. The findings underscore the need to integrate prison health services with the public health system.

ABSTRACT This article explores how undergraduate curricula in medicine become dominated by specialist facts at the expense of general practice (family medicine). This ’generalist deficit’ arises largely from assessment focused upon diagnoses and a need for clinical certainty. The law of curriculum drift from generalism to specialism states that ‘effort expended upon improving the quality of assessment in medical education incrementally transforms learning from overarching generalist principles (“time as a tool”, incremental management, trial of treatment etc) to detailed specialist facts (diagnoses, tests and interventions)’. In their evaluation and expectations of curriculum content, students demand expansion of specialist factual teaching to help pass these assessments. Curriculum reform towards specialism is further driven by school performance in national assessments and by ‘metrics-based’ quality assurance of curricular content. Specialist content incrementally supplants important learning about the wide range of ‘normal’ presentations in healthy people, clinical restraint and compassionate patient-centred care. Alongside increasing financial cost, administrative workload and student stress, the processes above leave graduates unprepared for the real-world challenges of practising medicine and being a doctor. This reflective piece also considers wider factors like ’tariff’ funding, challenges in defining general practice and a failure to recognise that general practice is an ‘approach of practical problem-solving’. The author calls for assessment and teaching throughout undergraduate medical education to embrace clinical uncertainty. This is essential for preparing tomorrow’s doctors to work in the National Health Service in both primary and secondary care.

Patient heterogeneity shapes outpatient perceptions of healthcare service quality, yet this diversity is often underexamined. This research brief applies the SERVQUAL framework to assess expectation-perception gaps and patient satisfaction among 94 outpatients at a tertiary teaching hospital. Descriptive analysis showed tangibility as a relative strength, while reliability and empathy exhibited the largest observed gaps, indicating unmet expectations for dependable and compassionate care. Dichotomized satisfaction scores revealed highest satisfaction for tangibility (86%) and assurance (82%), with comparatively lower satisfaction for reliability and empathy (75%), aligning with observed service gaps. Variation in internal consistency across SERVQUAL dimensions further reflects variability in patient experiences rather than uniform service evaluation. Findings suggest that standardized service delivery alone may not ensure equitable satisfaction in high-volume outpatient settings. Targeted interventions, such as scheduling improvements, communication training, and patient-support roles, may enhance trust and perceived quality. Embedding patient experience metrics within quality dashboards is recommended to advance equitable outpatient care. Limitations include a modest sample size and descriptive design. Nonetheless, the study provides early, context-sensitive insights to inform patient-centered quality improvement in resource-constrained outpatient care.

Parricide is an exceptionally rare phenomenon, constituting approximately 2% to 3% of all homicides in the United States. Double parricide, involving multiple victims and/or offenders, is even less common. The most famous case of double parricide in recent history is that of the Menendez brothers, who were convicted of the 1989 murders of their parents. This narrative review examines the evolving societal, academic, and legal attitudes toward the Menendez brothers' case over 35 years. An examination was conducted of criminological studies, media analyses, legal records, and primary source materials such as letters and drawings from the Menendez case. Findings indicate a shift over 35 years from framing the brothers as deviant and greedy to understanding their actions as extreme responses to prolonged familial trauma. Media narratives, true crime portrayals, social media advocacy (through documentaries and platforms like TikTok), and evolving victimology and trauma theories have influenced public opinion and legal reconsideration. The application of machine learning and artificial intelligence (AI)-driven analysis through multiple professional lenses reveals patterns in pre-offense communications and artwork that may have been underappreciated in traditional forensic evaluation. Forensic nurses are essential in assessing trauma, documenting abuse, and contributing to interdisciplinary evaluations. Trauma-informed approaches enhance accurate risk assessment and ethical consideration of both survivors' and offenders' experiences in cases of extreme familial violence. The emerging integration of AI tools in forensic practice offers forensic nurses new capabilities for systematic case analysis, while maintaining the critical human expertise needed for clinical judgment and compassionate care. The Menendez case serves as a powerful reminder that our understanding of complex human behavior deepens over time, and that maintaining openness to new perspectives and methodologies is essential to providing ethical, evidence-based forensic care.

Limited research has explored women's experiences of engaging with specialist perinatal mental health services for trauma. Perinatal psychological trauma is common and impacts the woman, her baby and family. Engagement with services is a critical first step in receiving interventions that support recovery. This study aimed to explore women's experience of accessing specialist perinatal mental health services following a psychologically traumatic pregnancy or birth, and to identify strengths and areas for improvement in service delivery. This qualitative descriptive study employed in-depth interviews with a purposeful sample of nine women to explore their experiences. Two themes were developed: seeking perinatal trauma support and healing trauma through compassionate encounters. Women experienced a wide variety of traumatic events that affected their physical and mental wellbeing, relationships and subsequent pregnancy planning. They described overcoming initial reluctance to engage with the service due to fear of judgement and perceived stigma associated with perinatal mental health. The therapeutic relationship formed with a known healthcare professional was instrumental in helping women to address their trauma. Compassionate care from non-judgemental and consistent specialist perinatal mental health clinicians is central to sustained engagement with SPMHS and perinatal trauma recovery. Advocacy within the therapeutic relationship plays a pivotal role in helping women with trauma histories navigate the maternity healthcare system during current or subsequent pregnancies. These findings provide further evidence for the role of specialist perinatal mental health services in supporting women with perinatal psychological trauma and can inform future policy and service design.

Descriptive cross-sectional analysis of nursing diagnoses, interventions, and outcomes in neonatal intensive care based on Roy's and Swanson's models.