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Measuring Compassion in Healthcare: A Comprehensive and Critical Review

  • Shane Sinclair
  • Lara B. Russell
  • Thomas F. Hack
  • Jane Kondejewski
  • Richard Sawatzky
Systematic Review

Abstract

Background

There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings.

Methods

PubMed, MEDLINE, CINAHL and PsycINFO databases and grey literature were searched to identify studies that report information on instruments that measure compassion or compassionate care in clinicians, nurses, healthcare students and patients. Textual qualitative descriptions of included studies were prepared. Instruments were evaluated using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool.

Results

Nine studies containing information on the Compassion Competence Scale, a self-report instrument that measures compassion competence among Korean nurses; the Compassion Scale, the Compassionate Care Assessment Tool©, and the Schwartz Center Compassionate Care Scale™, patient-reported instruments that measure the importance of healthcare provider compassion; the Compassion Practices Scale, an instrument that measures organisational support for compassionate care; and instruments that measure compassion in educational institutions (instructional quality and a Geriatric Attitudes Scale), were included. Each instrument is associated with significant limitations. Most only measure certain aspects of compassion and lack evidence of adaptability to diverse practice settings. The EMPRO of self-report instruments revealed a lack of psychometric information on measurement reliability, validity, responsiveness and interpretability, respondent, administrative and scoring burden, and use in subpopulations.

Conclusion

The findings of this narrative synthesis identified an unmet need for a psychometrically validated instrument that comprehensively measures the construct of compassion in healthcare settings.

Keywords

Healthcare Provider Instructional Quality Compassionate Care Compassion Satisfaction Healthcare Student 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Author contributions

All authors were involved in the study design, overseeing the review process and contributed to the manuscript. In addition to these substantive contributions, SS conceived, designed, oversaw the review and was the primary author of the manuscript. JK and SS conducted the searches and selected eligible studies. LBR and RS conducted the comparative review of the measurement instruments using the EMPRO. TFH provided expert opinion on review content.

Compliance with Ethical Standards

Funding

The preparation of this review was supported by Dr. Sinclair’s Cancer Care Research Professorship from the Faculty of Nursing, University of Calgary. Dr. Hack is supported by a Research Chair in Psychosocial and Supportive Care Oncology from the Canadian Breast Cancer Foundation. Dr. Sawatzky is supported by a Canada Research Chair in Patient-Reported Outcomes.

Conflict of interest

Drs. Sinclair, Russell, Hack, Kondejewski and Sawatzky have no conflicts of interest pertaining to the conduct or results of this study.

Supplementary material

40271_2016_209_MOESM1_ESM.docx (13 kb)
Supplementary material 1 (DOCX 13 kb)

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Shane Sinclair
    • 1
  • Lara B. Russell
    • 2
    • 3
  • Thomas F. Hack
    • 4
    • 5
  • Jane Kondejewski
    • 1
  • Richard Sawatzky
    • 3
    • 6
  1. 1.Faculty of NursingUniversity of CalgaryCalgaryCanada
  2. 2.School of NursingUniversity of VictoriaVictoriaCanada
  3. 3.Centre for Health Evaluation and Outcome SciencesProvidence Health CareVancouverCanada
  4. 4.Manitoba Palliative Care Research UnitCancerCare ManitobaWinnipegCanada
  5. 5.Rady Faculty of Health Sciences, College of NursingUniversity of ManitobaWinnipegCanada
  6. 6.School of NursingTrinity Western UniversityLangleyCanada

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