Abstract
Critical Review of the Literature: Do Compassion-Based Interventions (CBIs) for Healthcare Professionals Cultivate Compassion?: A Systematic ReviewPurpose: To investigate if Compassion-based Interventions (CBIs) actually cultivate compassion with working healthcare professionals (HCPs), and if these effects are sustained.
Method: Databases (MEDLINE, APA PsycINFO, Embase, and CENTRAL) and grey literature were searched. Additional articles were identified through contacting experts and hand-searching reference lists. Articles were eligible if one of the primary objectives of the intervention was to increase compassion or self compassion in working HCPs (in patient-facing roles) and if a measure of compassion or self-compassion was included. Quality assessment was conducted using the Mixed Methods Appraisal Tool. A narrative synthesis was conducted.
Results: Out of 10,092 retrieved studies, 84 full texts were assessed which yielded nine articles (reporting on ten studies) that met inclusion criteria. There was significant variation in the type, format, content, duration, and dosage of the interventions, with only one tested in a randomised controlled trial. Significant enhancements in self-rated self-compassion were reported with medium to large effect sizes but there was only limited support for the cultivation of compassion for others.
Conclusion: Given the considerable intervention heterogeneity, limited availability of controlled or randomised trials, lack of follow-up measures, and numerous quality issues it is not possible to make any conclusions about the effect of CBIs on cultivating compassion or self-compassion with HCPs. Further research using more rigorous trial designs is required that also incorporates more consistent measurement of key compassion constructs.
Service Improvement Project: Patient Experiences of the Implementation of an Enhanced Cognitive Behavioural Therapy (CBT-E) Treatment Model in an Adult Inpatient Eating Disorders Unit
Objective: An NHS tertiary adult eating disorder service wanted to understand the patient experience and understanding of the implementation of Enhanced Cognitive Behavioural Therapy (CBT-E) as a service-wide treatment model, with a view to informing its ongoing service developments.
Methods: Semi-structured interviews with six current inpatients (of which one was recently stepped down to community care) were analysed using the qualitative content analysis method.
Results: Five categories were identified: awareness of service changes, experiences of key processes in the inpatient pathway, awareness and understanding of the CBT E model, hopes and experiences of individual CBT-E, and other patient feedback.
Conclusions: The clinical implications of these results are discussed with recommendations offered to the service.
Main Research Project: Measuring What Matters: Developing a Patient Reported Experience Measure of Compassionate Care
Background: Compassionate care is viewed as a fundamental component of healthcare today, and yet many published studies in this expanding field lack sufficient patient involvement and focus on subjective experience rather than practical examples of compassionate care. This project aimed to develop a new patient reported experience measure (PREM) that captures the observable behaviours of compassionate care delivery by a healthcare professional working in any care setting. It aimed to involve people with lived experience of healthcare delivery, both patients and staff, at all stages of the project.
Methods: Items were derived inductively from thematic analysis of patient and clinician interviews about what compassionate care meant to them (n=8), with additional items derived deductively from a literature review of existing measures. A panel of patient, clinician, and researcher experts in compassionate care were recruited (round one n=33, round two n=29) who refined these items in a two-round modified online Delphi process.
Results: The item generation process produced an initial conceptual model of compassionate care comprising of seven domains and a list of 51 candidate items. After two rounds of ratings by experts, consensus was reached on 21 items in six domains: understanding, communication, attention, action, emotional sensitivity, and connection.
Conclusions: The Compassionate Care Measure is a new tool designed to systematically measure what compassionate care actually looks like to patients. It has a broad range of practical applications. Further research is planned to establish the psychometric properties of the new measure.
| Date of Award | 8 Aug 2021 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Elizabeth Marks (Supervisor), Lucy Maddox (Supervisor) & James Gregory (Supervisor) |
Keywords
- Clinical psychology
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