Measuring Compassion in Healthcare: A Comprehensive and Critical Review
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.
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.
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.
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.
KeywordsHealthcare Provider Instructional Quality Compassionate Care Compassion Satisfaction Healthcare Student
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
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.
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