Compassionate Health Care Research Articles

Recovery needs and psychosocial rehabilitation trajectory of stroke survivors (PReTS): A qualitative systematic review of systematic reviews

Objective Stroke has a major impact on a person's life. While much research exists on stroke prevention and treatment, explorations into psychosocial recovery needs are lacking. This review critically consolidates the challenges and needs of stroke survivors and develops a trajectory that encapsulates their journey from illness to recovery. Data sources Six major databases were searched, including Academic Search Premier, CINAHL, Global Health, Medline, PsycArticles, and PsycINFO. Methods This review adhered to the PRISMA guidelines and employed the PICo (population, phenomena of interest, context) framework to screen for relevant qualitative reviews published between 1 January 2010 and 31 August 2023. Following full-text screening and the assessment of methodological quality using a modified version of the Assessment of Multiple Systematic Reviews scale, a total of 17 reviews were included for thematic synthesis. Results Included reviews referenced 400 qualitative primary studies involving more than 5623 stroke survivors. Data synthesis revealed 18 themes that were further organized into six conceptual categories: (1) The unfamiliar body, (2) compassionate healthcare system, (3) holistic rehabilitation, (4) intrapersonal strength, (5) interpersonal relations, and (6) thriving forward to form the psychosocial rehabilitation trajectory of stroke survivor (PReTS) model. The model recognizes the losses that can occur after a stroke and emphasizes the essentiality of addressing psycho-socio-emotional and spiritual needs alongside physical impairments. Conclusion The PReTS model is the first to highlight stroke survivors’ losses, recovery journeys, and psychosocial needs. The conceptualization serves to inform and advance stroke rehabilitation practices with holistic and wellness recovery research.

Embedding spirituality and compassion into clinical education: A pilot study of Spotlight sessions in Advanced Clinical Practice

ABSTRACT The need for spiritually sensitive and compassionate health care is recognised by health-regulatory bodies, yet, they are often not taught in health professional education. Guidelines identify expected competencies, but the best teaching techniques to develop these competencies, are unknown. Spotlights are a novel teaching method designed to integrate compassion and spirituality into existing academic curricula. Spotlights entail a moment in taught sessions, where the clinical knowledge that is being delivered, is used to scaffold discussions surrounding compassion and spirituality. A pilot project explored Spotlight’s ability to integrate compassion and spirituality into health professional education. Trainee Advanced Clinical Practitioners received between 23 and 46 Spotlights over an academic year. The effectiveness was assessed by an anonymous survey pre- and post-intervention. Mean post-intervention scores were largely unchanged from corresponding pre-intervention scores. High levels of compassion and positive perceptions of spirituality were found before the intervention. The study was not powered to assess efficacy and significance testing was not conducted. Surprising outcomes saw students autonomously incorporating Spotlights into their work and increased discussions surrounding spirituality. Thus suggesting these concepts were becoming embedded into the culture of the trainees. Spotlights were an implementable method, well received by students and educators alike. Highlights Compassionate and spiritually sensitive care is expected of health professionals. Teaching methods to develop these competencies are being explored. Spotlights are a novel teaching method to integrate compassion and spirituality into clinical education.

Harmony in Healthcare: The Symbiosis of Empathy and Equanimity

Empathy, defined as the ability to understand and share the feelings of others, plays a pivotal role in patient-centered care, enhancing communication, patient satisfaction, and treatment adherence. Equanimity, characterized by mental and emotional stability, complements empathy by providing healthcare professionals with the resilience and composure necessary for consistently delivering empathetic care. Together, these qualities form the bedrock of compassionate and effective healthcare, influencing patient outcomes and the well-being of healthcare providers. This review article explores the symbiotic relationship between empathy and equanimity in the context of the medical field. The article discusses the individual contributions of empathy and equanimity in the medical field, highlighting their interconnected roles in fostering a healthcare system that is not only medically proficient but also deeply human and empathetic.

Compassionomics: The Science and Practice of Caring

PurposeTo summarize the scientific evidence that compassion can measurably improve patient outcomes, healthcare quality and safety, and the well-being of healthcare providers, and to consider specific strategies for cultivating compassion and better communicating it to patients. DesignPerspective MethodsWe selectively review the literature on compassion in health care, including obstacles to its expression and the demonstrated effects of provider compassion on patient outcomes, healthcare quality and cost, and provider well-being. We also review evidence regarding the trainability of compassion, discuss proven methods for cultivating individual compassion, and recommend strategies for incorporating it into routine medical practice. ResultsCompassion is the emotional response to another's pain or suffering, accompanied by a desire to alleviate it. Review of the literature shows that compassionate health care measurably improves physical and psychological patient outcomes, increases patient adherence, improves healthcare quality and safety, increases financial margins, and prevents physician burnout. Psychophysiological research demonstrates that empathy and compassion can be actively cultivated through intentional practice. Validated models of compassion-based interactions can facilitate the consistent expression of compassion in daily medical practice. ConclusionsGiven its many proven benefits to patients, healthcare organizations, and providers, compassion should be cultivated by healthcare providers and systems, and considered an essential component of optimal medical care.

The Healing Healthcare Initiative: Guiding leaders to heal a traumatized workforce.

The COVID-19 pandemic amplified burnout and moral distress among healthcare professionals and accentuated the systemic gaps and limitations of current approaches to workforce well-being. The Schwartz Center for Compassionate Healthcare launched the Healing Healthcare Initiative (HHI) in response to these compounded challenges. Aligned with national recommendations, the HHI framework comprises six key principles and eight implementation domains that foster compassionate and trauma-informed organizational cultures. C-suite level executive teams from six diverse healthcare organizations were selected to participate in the year-long pilot. Organizational and executive team surveys identified siloed well-being efforts and gaps in knowledge and awareness that undermine meaningful progress. The HHI pilot offers executive teams a space for reflection and open conversations, fostering trust within the team, and reinforcing the commitment to employee well-being. The program supports leadership teams in creating a strategy to implement the HHI framework that engages frontline workers in co-designing organizational solutions for a thriving workforce.

Stakeholder perspectives on the preferred service ecosystem for senior citizens living at home: a qualitative interview study

BackgroundMost senior citizens want to live independently at home as long as possible. The World Health Organization recommends an age-friendly community approach by transforming the service ecosystem for senior citizens and basing it on the question “What matters to you?”. However, there is limited research-based knowledge to determine the characteristics of the preferred service ecosystem from the perspectives of multiple stakeholders. Therefore, the aim of the study was to gain a deeper understanding of multiple stakeholder perspectives on the preferred service ecosystem for senior citizens living at home.MethodsFour stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study in 2019 and 2020: senior citizens, carers, healthcare professionals, and managers. Data were analysed according to qualitative content analysis.ResultsOverall, there was considerable correspondence between the four stakeholder groups’ perspectives on the preferred service ecosystem for senior citizens. Six themes were developed: (1) “self-reliance – living independently at home as long as possible”; (2) “remaining active and social within the community”; (3) “support for living at home as long as possible”; (4) “accessible information and services”; (5) “continuity of services”; and (6) “compassionate and competent healthcare professionals”.ConclusionsIn order to adapt and meet changing needs, the preferred service ecosystem should support senior citizens’ autonomy through interpersonal relationships and involvement. Healthcare managers and decision makers should consider a broader range of practical and social support services. Municipalities should plan for and develop age-friendly infrastructures, while healthcare professionals should rely on their compassion and competence to meet senior citizens’ needs.

HIV viral load suppression among people with mental disorders at two urban HIV clinics in Uganda: a parallel convergent mixed methods study using the social ecological model

BackgroundUganda adopted and implemented the Universal Test and Treat (UTT) guidelines in 2017, which require HIV-infected persons to be initiated on antiretroviral therapy (ART) at any CD4 + cell count, and to be routinely monitored for viral load to assess response to ART. However, there is paucity of data on viral load suppression (VLS) among people living with HIV (PLHIV) with mental disorders. We conducted a parallel convergent mixed methods study to determine HIV VLS among people with a mental disorder and explored the socio-cultural determinants of VLS at Butabika hospital and Mulago (ISS) HIV Clinics in Uganda.MethodsWe conducted a retrospective medical records review; seven key informant interviews (KII) among purposively selected healthcare providers and 12 in-depth interviews (IDI) among clinically stable PLHIV with a mental disorder. Data was collected on demographics, mental disorder, ART, viral load status, social support, stigma, and disclosure of HIV status. Quantitative data was analysed using descriptive statistics and modified Poisson regression, while Inductive thematic analysis was used for the qualitative data.ResultsOf the 240 PLHIV with a mental disorder who were enrolled, 161 (67.1%) were female with mean age 38.9 (± 11.2) years. Overall, 88.8% (95% Cl: 84.0 – 92.2%) achieved VLS. Age (aPR = 1.00, 95%Cl = 1.00–1.00), male gender (aPR = 0.90, 95%Cl = 0.82–0.98), divorced (aPR = 0.88, 95%Cl = 0.82–0.94), widowed (aPR = 0.84, 95%Cl = 0.83–0.86), baseline CD4 count < 200 (aPR = 0.89, 95%Cl = 0.85–0.94), psychotic mental disorders (aPR = 1.11; 95%CI = 1.08–1.13) and fair (85–94%) ART adherence level (aPR = 0.69, 95%Cl = 0.55–0.87) and TDF/3TC/DTG (aPR = 0.92; 95%CI = 0.91–0.94) were associated with HIV VLS. Social support from family members, knowledge of impact of negative thoughts on VLS, fear of breaking up with partners and compassionate healthcare providers positively influenced VLS. Stigma and discrimination from the community, self-perceived stigma hindering social relations, socio-economic challenges and psychiatric drug stock-outs negatively affected VLS.Conclusion and recommendationsHIV VLS among PLHIV with mental disorders at institutions that provide integrated HIV and mental health care is still below the UNAIDS 95% target. Health promotion messaging focusing on benefits of VLS and countering stigma to create a safe environment; and active involvement of family members in care could improve HIV treatment outcomes for PLHIV with mental disorders.

Trauma Informed Educational Strategies and Recommendations for Post-Secondary Health Science Programs

While trauma-informed care is commonly discussed in the context of interactions between healthcare providers and patients, its significance also extends to educational environments. Within post-secondary institutions, a considerable number of students begin their academic journey carrying experiences of past traumas or encounter trauma during their training. This is particularly relevant for health science education, where the curriculum involves addressing sensitive topics within classroom, laboratory, and clinical settings. These learning situations can inadvertently expose students to the risk of reliving trauma or experiencing distressing emotional responses. Hence, educators need to be attuned to their students' traumatic backgrounds and incorporate evidence-based techniques that mitigate distress, to adequately prepare students for their clinical practice roles. The objective was to systematically identify trauma informed educational (TIE) strategies or recommendations that have been implemented in post-secondary health science programs. This scoping review was completed using the Joanna Briggs Institute (JBI) scoping review methodology. A search of academic literature was completed using the following databases: MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), Education Source Complete, and ERIC. Search results were screened by two reviewers for relevance and data extraction was completed using a customized tool. Results were synthesized and aggregated in JBI SUMARI. Findings from 42 studies with diverse methodological approaches identified seven elements characterizing trauma-informed strategies (awareness, prevention, preparation, exposure, coping skills, flexibility, and structure). These elements were observed across five distinct strata of educational settings: 1) institutional, 2) curriculum, 3) educator, 4) student, and 5) equity and diversity. Integrating TIE strategies into health science education is urgently needed to create safe learning environments, better equip educators, and empower students to navigate trauma-related content with confidence and sensitivity. As the healthcare landscape continues to evolve, a collective commitment to advancing trauma informed education will ultimately contribute to more resilient, informed, and compassionate healthcare professionals.

Experiences of participation in patient's with infective endocarditis: a qualitative study

Abstract Funding Acknowledgements Type of funding sources: None. Background Infective Endocarditis (IE) is a life-threatening disease with increasing incidence worldwide. An important aspect in a patient’s course of illness is having a close and understanding caregiver. Receiving support from a partner or spouse has been found to be associated with increased survival and lower recurrence of heart diseases. Likewise, the caregiver may be able to experience positive emotions and personal growth by being an important part of the patient’s course of illness. Previous studies have explored patients’ and caregivers’ experiences with participation during the patient’s course of illness. To our knowledge, these perspectives have not yet been studied in patients with IE and their caregivers. Purpose The purpose of this study was to explore and elucidate patients with IE and their caregivers’ experiences with each other’s participation during the patient’s course of illness including hospitalization and recovery at home. Methodology The design was a holistic single-case study, where patients with IE and their caregivers were the target of interest. The empirical data was collected using qualitative, semi-structured dyadic interviews where the participants were interviewed in pairs. Theory-driven and data-driven coding was used as the analytical tools in the analysis of the data. Results The empirical data suggest that social support plays a significant role in the participants’ lives and course of illness, in which emotional support, physiological and practical assistance, as well as attitude transmission accounted for the greatest sources of impact. Important factors to the psychological well-being of participants were spending time with family members and maintaining a positive outlook on life. In light of theories of coping in social psychology, some participants reported using emotion-focused coping, problem-focused coping and protective buffering coping, whilst others did not use these. The majority of the caregivers reported that the course of illness did not have an impact on their working life and social relations, while some stated that it had a negative impact on their work, finances, mental and physical energy and social relations. An additional insight was given as the participants shared their thoughts on a need for psychological counseling and their experiences with compassionate healthcare professionals. Conclusion: The study concludes that the participation of patients with IE and their caregivers in the course of illness played an important and positive role in their lives. As such, it could be advised that healthcare professionals should focus more on how patients and their caregivers cope both individually and together in the course of illness. Understanding their perspectives could have implications on how healthcare professionals plan health measures to improve outcomes for both the patient and the caregiver.

Pregnancy loss following miscarriage and termination of pregnancy for medical reasons during the COVID-19 pandemic: a thematic analysis of women’s experiences of healthcare on the island of Ireland

BackgroundLosing a baby during pregnancy can be a devastating experience for expectant parents. Many report dedicated, compassionate healthcare provision as a facilitator of positive mental health outcomes, however, healthcare services have been severely impacted during the COVID-19 pandemic.AimTo explore women’s experiences of healthcare service provision for miscarriage and termination of pregnancy for medical reasons (TFMR) on the island of Ireland during the COVID-19 pandemic.MethodsFindings combine data from elements of two separate studies. Study 1 used a mixed methods approach with women who experienced miscarriage and attended a hospital in Northern Ireland. Study 2 was qualitative and examined experiences of TFMR in Northern Ireland and Ireland. Data analysed for this paper includes open-ended responses from 145 women to one survey question from Study 1, and semi-structured interview data with 12 women from Study 2. Data were analysed separately using Thematic Analysis and combined for presentation in this paper.ResultsCombined analysis of results indicated three themes, (1) Lonely and anxiety-provoking experiences; (2) Waiting for inadequate healthcare; and (3) The comfort of compassionate healthcare professionals.ConclusionsWomen’s experiences of healthcare provision were negatively impacted by COVID-19, with the exclusion of their partner in hospital, and delayed services highlighted as particularly distressing. Limited in-person interactions with health professionals appeared to compound difficulties. The lived experience of service users will be helpful in developing policies, guidelines, and training that balance both the need to minimise the risk of infection spread, with the emotional, psychological, and physical needs and wishes of parents. Further research is needed to explore the long-term impact of pregnancy loss during a pandemic on both parents and health professionals delivering care.

Compassion, collaboration, and community: Strategies for staff well-being.

Compassion, collaboration, and community: Strategies for staff well-being.

Compassionate mental healthcare relies on a valued workforce

A healthy and valued workforce is vital for safe and compassionate mental healthcare. That was my take-home from the recent senior leadership symposium on advancing and sustaining the mental health nursing workforce.

A Student-Faculty Collaboration for Authentic Teaching of the Effects of Discrimination on Brain Health (P5-2.002)

<h3>Objective:</h3> We describe the co-creation, implementation, and evaluation of a learning session from a pre-clerkship neurology course about the effects of social discrimination on the body’s stress response and development of empathetic communication skills for providers. <h3>Background:</h3> To provide compassionate and high-value healthcare, providers and medical students must recognize physiological and clinical manifestations of stress in response to social discrimination and have the tools to communicate with their patients in a culturally responsive manner. However, many medical educators may feel unprepared to teach these topics to students. <h3>Design/Methods:</h3> Second-year medical student (M2) leaders from diverse backgrounds and faculty developed together an hour-long flipped classroom teaching session for M1 students addressing discrimination-related manifestations of stress. Before class, M1 students read academic texts and viewed lecture videos created by M2 students and faculty. M1 student groups created their own clinical case examples of patients experiencing stress related to racism, heterosexism, and ableism. During class, M1 students used these cases to facilitate group discussions on how providers can utilize screening tools and patient-physician dialogue frameworks. After the session, a debriefing period was offered to address lasting concerns, reflections and offer additional resources. <h3>Results:</h3> A post-session survey found that 87% of students agreed that the session increased their overall understanding of the role of discrimination in the development of stress-related illnesses. 100% of students agreed with the statement that the session dealt with sensitive issues in a culturally responsive manner. Qualitative student responses indicated that the participation of M2 students was highly valued, and that the session was perceived as authentic and delivered in a respectful manner. <h3>Conclusions:</h3> Co-curriculum design with faculty and diverse student leaders offers a unique opportunity to teach challenging DEI topics that require authenticity and respect. Tips &amp; tricks for creating a similar session at your institution will be provided. <b>Disclosure:</b> Ms. Chachere has nothing to disclose. Miss Taylor has nothing to disclose. Mrs. Mills has nothing to disclose. Miss Wilson has nothing to disclose. LeChauncy Woodard has nothing to disclose. Prof. Thesen has nothing to disclose.

Bringing Gender-Affirming Care to Primary Care: Use of a Multimodal Curriculum to Educate Nurse Practitioners and Nurse Practitioner Students.

An increasing number of individuals who identify as transgender and gender diverse require informed and compassionate health care, yet there is a dearth of research about which educational strategies are best used to provide nurses and nurse practitioners the foundation upon which to provide appropriate health care. This study evaluated a multimodal approach that included guided readings, a transgender patient panel, standardized patient simulation, and group discussion. The Sexual Orientation Counselor Competency Scale was administered pre- and postintervention. Results demonstrated increases in knowledge, skills, and attitudes among the 16 participants. A high level of satisfaction was expressed for the overall program, but especially for the patient panel and standardized patient encounter. Nurse educators are encouraged to include information about health care of the transgender patient into curricula.

The Rural and Underserved Service Track (TRUST): A novel, interprofessional, co-curricular program focusing on care for diverse, underserved populations

The Rural and Underserved Service Track (TRUST) is a two-year, co-curricular, interprofessional program composed of students from medicine, nursing, pharmacy, and social work. Students participate in eight learning retreats, where students, healthcare professionals, patients, and faculty discuss the care needs of underserved populations, as well as ten service-learning activities, where students lead and deliver healthcare related activities to an audience of underserved community members. Each learning retreat consists of the following components: pre-retreat assignment, introductory presentation, panel discussion, clinical skill, and case study. Service activities are all student-led and cover a variety of topics, from affording medications to working with patients who have intellectual and developmental disabilities. TRUST has seven objectives, with the overall goal of training students to have the skills necessary to work on interprofessional teams and provide compassionate healthcare to diverse, underserved patient populations.The purpose of this manuscript is to describe the ways in which students perceived TRUST's learning objectives and to assess how the learning objectives supported their future clinical practice. Assessments were collected from students at multiple points throughout the TRUST program, including post-retreat assessments. Four-hundred and seventy-eight quotes were retrospectively analyzed from students' post-retreat assessments and ascribed to components of the learning retreat and learning objectives. Quotes were most often attributed to the retreat as a whole (38.3%) and the panel discussions (25.5%). More than half of all student quotes (58.4%) were ascribed to TRUST learning objectives, with “ethics and cultural sensitivity” (26.5%), “interprofessional team” (22.5%), “current and emerging health issues” (19.0%), and “barriers to care” (17.1%) occurring the most frequently, suggesting that these areas are likely the most impactful for students and represent a surrogate for achievement of learning objectives. Although prospective data is needed, early findings suggest that this novel interprofessional program has had a positive impact on students, faculty, and the community.

Pathways, Contexts, and Voices of Shame and Compassion: A Grounded Theory of the Evolution of Perinatal Suicidality.

There is an urgent need to generate deeper understandings of how suicidality manifests and evolves during pregnancy and the following year. Several perinatal studies have examined the incidence of suicidal thoughts and behaviours and associated social and obstetric risk factors; however, there is very limited research offering insights into women's experiences of suicidality at this time in their lives. This study aimed to generate a theory to explain how suicidality evolves in the perinatal period. A grounded theory design was used with data generated using anonymous online surveys (119 participants) and in-depth interviews (20 participants) with women who received pregnancy care in the past 5years in Australia. The developed theory holds shame as a core concept. Origins and contexts of shame reflect current epidemiological understandings of risk for perinatal suicide, including experiences of gender-based violence, adverse childhood experiences, and a history of mental health difficulties. When women feel that they are defective, are unworthy of love and belonging, and do not possess what it takes to be a good mother, they can conclude that their family is better off without them. Pathways beyond shame were facilitated by compassionate and rehumanising care from family, friends, and care providers. Findings demonstrate that perinatal suicidality is a complex multidimensional phenomenon, influenced by socio-cultural expectations of motherhood and interpersonal, systemic, and intergenerational experiences of trauma. Increasing the prominence of perinatal suicide prevention within health professional education and practice, and addressing systemic barriers to compassionate health care are critical first steps to addressing perinatal suicide.

Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

Understanding patient experience is associated with quality, safe, and effective healthcare. However, there is a scarcity of knowledge explaining how patients experience non-conveyance, a setting where individuals receive unscheduled ambulance service response and paramedic-led care that results in a decision to not attend a hospital emergency department (ED). This research project aimed to investigate patients’ experiences of non-conveyance within an Australian ambulance service setting. Constructivist Grounded Theory methods were used to generate and analyse data from in-depth, semi-structured interviews with 21 participants who received paramedic-led healthcare from an Australian ambulance service between August 2020 and October 2021 that resulted in non-conveyance. A substantive theory centred on ‘Restoring self-efficacy’ was generated. It comprises three categorical concepts and their interconnected relationships, explaining how patients experience non-conveyance. ‘Losing independence’ conceptualises how a precipitating event forces patients to realise their circumstantial vulnerabilities, motivating action to seek support that leads to ambulance service response. ‘Restoring self-confidence’ emerged as the core concept, central to overall experience and a key influence on patients navigating the non-conveyance decision. When patients perceive that they have received professionally thorough and compassionate healthcare from paramedics, they form a trusting partnership resulting in the interpretation that their circumstances do not require conveyance to ED. With this reconstructed perspective, patients demonstrate increased ability for ‘Self-management’, by continuing to cope with their circumstances on their own after the episode of care. This paper provides a theoretical model for understanding how patients experience non-conveyance. Experience is influenced by dynamic, complex factors associated with restoring self-efficacy in relation to managing a health topic of interest. Restoration of self-efficacy was influenced by the patients’ interpretation of their interactions with paramedics. Future research may consider investigating the impacts of applying this knowledge to paramedic education and practice, and to quality indicators surrounding non-conveyance situations.

Experience of living with multimorbidity and health workers perspectives on the organization of health services for people living with multiple chronic conditions in Bahir Dar, northwest Ethiopia: a qualitative study

BackgroundMultimorbidity-the simultaneous occurrence of two or more chronic Non-Communicable Diseases) in an individual is increasing globally and challenging health systems. Although individuals living with multimorbidity face a range of adverse consequences and difficulty in getting optimal health care, the evidence base in understanding the burden and capacity of the health system in managing multimorbidity is sparse in low-and middle-income countries (LMICs). This study aimed at understanding the lived experiences of patients with multimorbidity and perspective of service providers on multimorbidity and its care provision, and perceived capacity of the health system for managing multimorbidity in Bahir Dar City, northwest Ethiopia.MethodsA facility-based phenomenological study design was conducted in three public and three private health facilities rendering chronic outpatient Non-Communicable Diseases (NCDs) care in Bahir Dar City, Ethiopia. Nineteen patient participants with two or more chronic NCDs and nine health care providers (six medical doctors and three nurses) were purposively selected and interviewed using semi-structured in-depth interview guides. Data were collected by trained researchers. Interviews were audio-recorded using digital recorders, stored and transferred to computers, transcribed verbatim by the data collectors, translated into English and then imported into NVivo V.12 software for data analysis. We employed a six-step inductive thematic framework analysis approach to construct meaning and interpret experiences and perceptions of individual patients and service providers. Codes were identified and categorized into sub-themes, organizing themes and main themes iteratively to identify similarities and differences across themes, and to interpret them accordingly.ResultsA total of 19 patient participants (5 Females) and nine health workers (2 females) responded to the interviews. Participants’ age ranged from 39 to 79 years for patients and 30 to 50 years for health professionals. About half (n = 9) of the participants had three or more chronic conditions.The key themes produced were feeling dependency, social rejection, psychological distress, poor medication adherence and poor quality of care.Living with multimorbidity poses a huge burden on the physical, psychological, social and sexual health of patients. In addition, patients with multimorbidity are facing financial hardship to access optimal multimorbidity care. On the other hand, the health system is not appropriately prepared to provide integrated, person-centered and coordinated care for people living with multiple chronic conditions.Conclusion and recommendationsLiving with multimorbidity poses huge impact on physical, psychological, social and sexual health of patients. Patients seeking multimorbidity care are facing challenges to access care attributable to either financial constraints or the lack of integrated, respectful and compassionate health care. It is recommended that the health system must understand and respond to the complex care needs of the patients with multimorbidity.

Understanding compassionate care from the patient perspective: Highlighting the experience of head and neck cancer care.

To address the knowledge gap in the practice of compassionate healthcare by elucidating patient perspectives on compassion, empathy, and sympathy. Semi-structured telephone interviews were conducted at two time points with patients undergoing head and neck cancer treatment. Questions explored participants' understanding of compassion, sympathy, and empathy, as they relate to each other and to healthcare. Interviewers manually recorded responses. Qualitative exploratory methods were used to analyze data; inductive line-by-line coding was conducted to develop primary codes. Themes emerged through categorization of codes. Ninety-five interviews conducted with 63 participants across two time points revealed four major themes - Compassion-vs-Empathy-vs-Sympathy, Coping Methods, Showing Care, and Nature of Interaction - encompassing seven categories, with a total of 24 codes. Codes were consistent across time points, except for two new codes, "positivity" and "personalized" emerging during follow-up interviews. Patient narrative from this study supported the concept that compassion is multidimensional and enabled several dimensions to be identified, highlighting the importance of patient perspectives in improving the provision of compassionate healthcare. Findings should be considered in future training and practice.

Feasibility and acceptability testing of CommSense: A novel communication technology to enhance health equity in clinician-patient interactions.

Quality patient-clinician communication is paramount to achieving safe and compassionate healthcare, but evaluating communication performance during real clinical encounters is challenging. Technology offers novel opportunities to provide clinicians with actionable feedback to enhance their communication skills. This pilot study evaluated the acceptability and feasibility of CommSense, a novel natural language processing (NLP) application designed to record and extract key metrics of communication performance and provide real-time feedback to clinicians. Metrics of communication performance were established from a review of the literature and technical feasibility verified. CommSense was deployed on a wearable (smartwatch), and participants were recruited from an academic medical center to test the technology. Participants completed a survey about their experience; results were exported to SPSS (v.28.0) for descriptive analysis. Forty (n = 40) healthcare participants (nursing students, medical students, nurses, and physicians) pilot tested CommSense. Over 90% of participants "strongly agreed" or "agreed" that CommSense could improve compassionate communication (n = 38, 95%) and help healthcare organizations deliver high-quality care (n = 39, 97.5%). Most participants (n = 37, 92.5%) "strongly agreed" or "agreed" they would be willing to use CommSense in the future; 100% (n = 40) "strongly agreed" or "agreed" they were interested in seeing information analyzed by CommSense about their communication performance. Metrics of most interest were medical jargon, interruptions, and speech dominance. Participants perceived significant benefits of CommSense to track and improve communication skills. Future work will deploy CommSense in the clinical setting with a more diverse group of participants, validate data fidelity, and explore optimal ways to share data analyzed by CommSense with end-users.