Aims and Objectives: To identify and synthesise empirical evidence on the perspectives of nurses regarding factors that enable and/or obstruct the delivery of compassionate care. Methodological Design and Justification: A scoping review was chosen for its capacity to perform a broad exploration of the available literature. Ethical Issues: This scoping review raises no ethical issues. Research Methods: This review includes studies that report enablers and barriers of compassionate care. Both qualitative and quantitative designs were included. The quality of each study was assessed using the Mixed Method Appraisal Tool (MMAT). A narrative synthesis was employed to summarise the results. Instruments: A search was conducted in the electronic databases of MEDLINE and CINAHL (1975–2021). Outcome Measures: Barriers and enablers to compassionate care from nurses' perspectives. Results: Fifteen empirical studies were included in this review. Four themes of enablers and barriers to compassionate care emerged: (1) personal characteristics, (2) professional characteristics, (3) patient-related factors, and (4) workplace-related factors. Main facilitators were a strong motivation to deliver compassionate care, the managements' support of compassion as a nursing value and operating in a healthy team culture. Main barriers were the absence of education and/or role models for compassionate care, heavy workloads, and the managements' prioritisation of task-centred care. Study Limitations: This study is limited by the inclusion of qualitative studies with small samples and the absence of data from Northern Europe and North America. Conclusions: The findings indicate that policymakers, healthcare leaders, and nursing management play an important role in nurses' ability to provide compassionate care. Through leadership that centralises compassion as a core nursing value, nurses receive greater support in prioritising compassion in patient care. This support is further enhanced by ensuring adequate staffing and manageable schedules, offering comprehensive training in compassionate care skills, and providing resources to support nurses' wellbeing. Trial Registration: PROSPERO: CRD42022324955 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324955.
DOCUMENT
To meet the care needs of the rapidly ageing patient populations, the cultivation of a compassionate patient-centred healthcare culture has become central in the value-based healthcare discourse. A participatory music practice, ‘Meaningful Music in Healthcare’ employs a person-centred approach to music-making in Dutch hospitals. A grounded theory analysis on ethnographically collected data suggests that music-making serves as a social change agent and cultural resource for catalysing compassionate contact between healthcare professionals and patients. Processes of experiential growth and shared values in music-making and healthcare help to enrich care relationships and allow the emotional dimension of nurses’ professional performance to be explored.
DOCUMENT
Objective: In the context of a programme to improve people-centered care, launched by the Tanzanian Ministry of Health, an international project (HEALCARe) was initiated to enhance the health literacy (HL) and respectful compassionate care (RCC) competencies of Bachelor’s nursing and midwifery students. Part of the project involved exploring the perceptions of different stakeholders regarding what facilitates these students’ competencies. This paper specifically reports the perceptions of faculty lecturers and clinical instructors. Methods: We conducted nine focus groups with lecturers and instructors from three Tanzanian universities and their teaching hospitals, with a total of 65 participants. Results: Through thematic analysis, seven themes were identified: ‘knowledge of HL,’ ‘knowledge of RCC,’ ‘modules with clear key components in the curriculum,’ ‘expert teaching in the faculty classroom,’ ‘priority of supervision in the clinical setting,’ ‘learning methods, materials and resources,’ and ‘evaluation tools and monitoring the transfer from theory to practice.’ Conclusions: The findings show that students need to be supported in transferring the theory taught in class to clinical practice in patient care. The curricula of all universities and corresponding hospitals should specifically address the training of HL and RCC competencies. This will facilitate the improvement of students’ competencies, contributing to better health outcomes in Tanzania.
DOCUMENT
1 Maternity services across Europe during the pandemic has undergone changes to limit virus transmission; however, many changes are not evidence-based. 2 Although these changes were introduced to keep women, babies and healthcare staff safe, the exclusion of companions and the separation of mothers and babies is particularly antithetical to a human rights-based approach to quality care. 3 A poll of COST Action 18211 network members showed that inconsistency in the application of restrictions was high, and there were significant deviations from the recommendations of authoritative bodies. 4 Concerns have emerged that restrictions in practice may have longer term negative impacts on mothers and their families and, in particular, may impact on the long-term health of babies. 5 When practice changes deviate from evidence-based frameworks that underpin quality care, they must be monitored, appraised and evaluated to minimise unintended iatrogenic effects.
DOCUMENT
Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
DOCUMENT
At the beginning of the twenty first century obesity entered Dutch maternity care as a ‘new illness’ challenging maternity care professionals in providing optimal care for women with higher BMI’s. International research revealed that obese women had more perinatal problems than normal weight women. However, the effect of higher BMIs on perinatal outcomes had never been studied in women eligible for midwife-led primary care at the outset of their pregnancy. In the context of the Dutch maternity care system, it was not clear if obesity should be treated as a high-risk situation always requiring obstetrician-led care or as a condition that may lead to problems that could be detected in a timely manner in midwife-led care using the usual risk assessment tools. With the increased attention on obesity in maternity care there was also increased interest in GWG. Regarding GWG in the Netherlands, the effect of insufficient or excessive GWG on perinatal outcomes had never been studied and there were no validated guidelines for GWG. A midwife’s care for the individual woman in the context of the Dutch maternity care system - characterised by ‘midwife-led care if possible, obstetrician-led care if needed’ - is hampered by the lack of national multidisciplinary consensus regarding obesity and weight gain. Obesity has not yet been included in the OIL and local protocols contain varying recommendations. To enable sound clinical decisions and to offer optimal individual care for pregnant women in the Netherlands more insights in weight and weight gain in relation to perinatal outcomes are required. With this thesis the author intends to contribute to the body of knowledge on weight and weight gain to enhance optimal midwife-led primary care for the individual woman and to guide midwives’ clinical decision-making.
DOCUMENT
Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
DOCUMENT
Reading a novel about a dying person and the people attending the dying, one can not only reflect upon the moral involvement between the literary characters depicted, but also upon the way in which the reader takes the position of a “bystander” in this scene. In two novels, The Death of Ivan Ilyich by Tolstoy and The Big Ward by the Dutch author Jacoba van Velde, this moral involvement can be interpreted as a form of “compassion”. Martha Nussbaum’s concept of “compassionate imagination” offers a perspective on the way in which the reader can be involved in this literary depiction of the dying. However, the Aristotelian criteria that Nussbaum proposes for the rational judgement of compassion and her ambitions that literature can “raise society’s floor” by developing “compassionate imagination” in readers, are difficult to apply to these specific cases. In comparing both novels, it is exactly the differences between them – the historical context and social classes depicted - that bring to light a problematic presupposition in Nussbaum, namely the a-historical universality in the compassionate involvement. A re-interpretation of one of the Aristotelian criteria for compassion leaves room for a “compassionate imagination” not based on a rational judgement but on a sense of shared vulnerability that is precisely evoked by the literary depiction of the dying.
LINK
The ageing of people with intellectual disabilities, with associated morbidity like dementia, calls for new types of care. Person-centered methods may support care staff in providing this, an example being Dementia Care Mapping (DCM). DCM has been shown to be feasible in ID-care. We examined the experiences of ID-professionals in using DCM. We performed a mixed-methods study, using quantitative data from care staff (N = 136) and qualitative data (focus-groups, individual interviews) from care staff, group home managers and DCM-in-intellectual disabilities mappers (N = 53). ageing, dementia, Dementia Care Mapping, intellectual disability, mixed-methods, personcentred care
MULTIFILE
In most countries, maternal and newborn care is fragmented and focused on identification and treatment of pathology that affects only the minority of women and babies. Recently, a framework for quality maternal and newborn care was developed, which encourages a system-level shift to provide skilled care for all.This care includes preventive and supportive care that works to strengthen women’s capabilities and focuses on promotion of normal reproductive processes while ensuring access to emergency treatment when needed. Midwifery care is pivotal in this framework, which contains several elements that resonate with the main dimensions of primary care. Primary health care is the first level of contact with the health system where most of the population’s curative and preventive health needs can be fulfilled as close as possible to where people live and work. In this paper, we argue that midwifery as described in the framework requires the application of a primary care philosophy for all childbearing women and infants. Evaluation of the implementation of the framework should therefore include tools to monitor the performance of primary midwifery care.
MULTIFILE
