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Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Care | Research article

Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers

Authors: Lorraine Smith-MacDonald, Lorraine Venturato, Paulette Hunter, Sharon Kaasalainen, Tamara Sussman, Lynn McCleary, Genevieve Thompson, Abigail Wickson-Griffiths, Shane Sinclair

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Introduction

This paper details a subset of the findings from a participatory action research project exploring a palliative intervention in long-term care sites across Canada. The findings presented in this paper relate to understanding compassion within the context of a palliative approach to long-term care.

Methods

Findings presented are drawn from qualitative interviews and focus groups with residents, family members, healthcare providers, and managers from 4 long-term care sites across 4 provinces in Canada. In total, there were 117 individuals (20 residents, 16 family members, 72 healthcare providers, and 9 managers) who participated in one of 19 focus groups. Data was analyzed by multiple members of the research team in accordance with thematic analysis. Individual concepts were organized into themes across the different focus groups and the results were used to build a conceptual understanding of compassion within Long Term Care .

Findings

Two themes, each comprised of 5 sub-themes, emerged from the data. The first theme 'Conceptualizing Compassion in Long-Term Care generated a multidimensional understanding of compassion that was congruent with previous theoretical models. 'Organizational Compassion: resources and staffing', the second major theme, focused on the operationalization of compassion within the practice setting and organizational culture. Organizational Compassion subthemes focused on how compassion could support staff to enact care for the residents, the families, one another, and at times, recognizing their pain and supporting it through grief and mourning.

Conclusions

Results suggest that compassion is an essential part of care and relationships within long-term care, though it is shaped by personal and professional relational aspects of care and bound by organizational and systemic issues. Findings suggest that compassion may be an under-recognised, but essential element in meeting the promise of person-centred care within long-term care environments.
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Literature
2.
go back to reference Ontario Long Term Care Association. This is Long-Term Care 2018. Ontario long term care association, Toronto; 2018. Ontario Long Term Care Association. This is Long-Term Care 2018. Ontario long term care association, Toronto; 2018.
3.
go back to reference Li J, Porock D. Resident outcomes of person-centered care in long-term care: a narrative review of interventional research. Int J Nurs Stud. 2014;51(10):1395–415.CrossRef Li J, Porock D. Resident outcomes of person-centered care in long-term care: a narrative review of interventional research. Int J Nurs Stud. 2014;51(10):1395–415.CrossRef
4.
go back to reference Simmons SF, Rahman AN. Next steps for achieving person-centered Care in Nursing Homes. J Am Med Dir Assoc. 2014;15(9):615–9.CrossRef Simmons SF, Rahman AN. Next steps for achieving person-centered Care in Nursing Homes. J Am Med Dir Assoc. 2014;15(9):615–9.CrossRef
5.
go back to reference Abbott KM, et al. Delivering person-centered care: important preferences for recipients of long-term services and supports. J Am Med Dir Assoc. 2018;19(2):169–73.CrossRef Abbott KM, et al. Delivering person-centered care: important preferences for recipients of long-term services and supports. J Am Med Dir Assoc. 2018;19(2):169–73.CrossRef
6.
go back to reference Steinberg KE. Person-centered care planning: preferences are a priority. J Am Med Dir Assoc. 2018;19(2):100–1.CrossRef Steinberg KE. Person-centered care planning: preferences are a priority. J Am Med Dir Assoc. 2018;19(2):100–1.CrossRef
7.
go back to reference Burack OR, et al. What matters Most to nursing home elders: quality of life in the nursing home. J Am Med Dir Assoc. 2012;13(1):48–53.CrossRef Burack OR, et al. What matters Most to nursing home elders: quality of life in the nursing home. J Am Med Dir Assoc. 2012;13(1):48–53.CrossRef
8.
go back to reference van der Steen JT, et al. White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliat Med. 2013;28(3):197–209.CrossRef van der Steen JT, et al. White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliat Med. 2013;28(3):197–209.CrossRef
9.
go back to reference Houttekier D, et al. Study of recent and future trends in place of death in Belgium using death certificate data: a shift from hospitals to care homes. BMC Public Health. 2011;11:228–38.CrossRef Houttekier D, et al. Study of recent and future trends in place of death in Belgium using death certificate data: a shift from hospitals to care homes. BMC Public Health. 2011;11:228–38.CrossRef
10.
go back to reference Sepúlveda C, et al. Palliative care: the World Health Organization's global perspective. J Pain Symptom Manag. 2002;24(2):91–6.CrossRef Sepúlveda C, et al. Palliative care: the World Health Organization's global perspective. J Pain Symptom Manag. 2002;24(2):91–6.CrossRef
12.
go back to reference Hanson LC, Henderson M. Care of the dying in long-term settings. Clin Geriatr Med. 2000;16(2):225–37.CrossRef Hanson LC, Henderson M. Care of the dying in long-term settings. Clin Geriatr Med. 2000;16(2):225–37.CrossRef
13.
go back to reference Beck I, Jakobsson U, Edberg A. Applying a palliative care approach in residential care: effects on nurse assistants’ experiences of care provision and caring climate. Scand J Caring Sci. 2014;28(4):830–41.CrossRef Beck I, Jakobsson U, Edberg A. Applying a palliative care approach in residential care: effects on nurse assistants’ experiences of care provision and caring climate. Scand J Caring Sci. 2014;28(4):830–41.CrossRef
14.
go back to reference Addicott R. Supporting care home residents at end of life. Int J Palliat Nurs. 2011;17(4):183–7.CrossRef Addicott R. Supporting care home residents at end of life. Int J Palliat Nurs. 2011;17(4):183–7.CrossRef
15.
go back to reference Sinclair S, et al. Compassion: a scoping review of the healthcare literature. BMC Palliative Care. 2016;15(1):6.CrossRef Sinclair S, et al. Compassion: a scoping review of the healthcare literature. BMC Palliative Care. 2016;15(1):6.CrossRef
18.
go back to reference Flocke SA, Miller WL, Crabtree BF. Relationships between physician practice style, patient satisfaction, and attributes of primary care. J Fam Pract. 2002;51(10):835–40.PubMed Flocke SA, Miller WL, Crabtree BF. Relationships between physician practice style, patient satisfaction, and attributes of primary care. J Fam Pract. 2002;51(10):835–40.PubMed
19.
go back to reference Paterson R. Can we mandate compassion? Hastings Cent Rep. 2011;41(2):20–3.CrossRef Paterson R. Can we mandate compassion? Hastings Cent Rep. 2011;41(2):20–3.CrossRef
25.
go back to reference 2016, S.e.a.V.N.F., 9780192830982.001.0001/acref-9780192830982-e-3125?rske, and y.iHDCC9&result.1. Last accessed: November 7. 2016, S.e.a.V.N.F., 9780192830982.001.0001/acref-9780192830982-e-3125?rske, and y.iHDCC9&result.1. Last accessed: November 7.
26.
go back to reference Nunberg G, Newman E, editors. The American heritage dictionary of the English language. New York: Houghton Mifflin; 2000. Nunberg G, Newman E, editors. The American heritage dictionary of the English language. New York: Houghton Mifflin; 2000.
27.
go back to reference Schulz R, et al. Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. Am J Geriatr Psychiatry. 2006;14(8):650–8.CrossRef Schulz R, et al. Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. Am J Geriatr Psychiatry. 2006;14(8):650–8.CrossRef
28.
go back to reference Soto-Rubio, A. and S. Sinclair, In Defense of Sympathy, in Consideration of Emapthy and in Praise of Compassion: A History of the Present. Journal of Pain Symptom Managment, 2018. In Press. Soto-Rubio, A. and S. Sinclair, In Defense of Sympathy, in Consideration of Emapthy and in Praise of Compassion: A History of the Present. Journal of Pain Symptom Managment, 2018. In Press.
29.
go back to reference Schantz ML. Compassion: a concept analysis. Nurs Forum. 2007;42(2):48–55.CrossRef Schantz ML. Compassion: a concept analysis. Nurs Forum. 2007;42(2):48–55.CrossRef
30.
go back to reference Crowther J, et al. Compassionin healthcare: lessons from a qualitative study of the end of life care of people with dementia. J R Soc Med. 2013;106(12):492–7.CrossRef Crowther J, et al. Compassionin healthcare: lessons from a qualitative study of the end of life care of people with dementia. J R Soc Med. 2013;106(12):492–7.CrossRef
31.
go back to reference Lown BA, Rosen J, Marttila J. An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Aff (Millwood). 2011;30:1772–8.CrossRef Lown BA, Rosen J, Marttila J. An agenda for improving compassionate care: a survey shows about half of patients say such care is missing. Health Aff (Millwood). 2011;30:1772–8.CrossRef
32.
go back to reference Easter DW, Beach W. Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Probl Surg. 2004;61(3):313–8.CrossRef Easter DW, Beach W. Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Probl Surg. 2004;61(3):313–8.CrossRef
33.
go back to reference Davison N, Williams K. Compassion in nursing. 2: factors that influence compassionate care in clinical practice. Nurs Times. 2009;105(37):18–9.PubMed Davison N, Williams K. Compassion in nursing. 2: factors that influence compassionate care in clinical practice. Nurs Times. 2009;105(37):18–9.PubMed
34.
go back to reference Hsu I, et al. Providing support to patients in emotional encounters: a new perspective on missed empathic opportunities. Patient Educ Couns. 2012;88(3):436–42.CrossRef Hsu I, et al. Providing support to patients in emotional encounters: a new perspective on missed empathic opportunities. Patient Educ Couns. 2012;88(3):436–42.CrossRef
35.
go back to reference Friele RD, Sluijs EM, Legemaate J. Complaints handling in hospitals: an empirical study of discrepancies between patients' expectations and their experiences. BMC Health Serv Res. 2008;8(1):199.CrossRef Friele RD, Sluijs EM, Legemaate J. Complaints handling in hospitals: an empirical study of discrepancies between patients' expectations and their experiences. BMC Health Serv Res. 2008;8(1):199.CrossRef
36.
go back to reference Van Der Cingel M. Compassion in care: a qualitative study of older people with a chronic disease and nurses. Nurs Ethics. 2011;18(5):672–85.CrossRef Van Der Cingel M. Compassion in care: a qualitative study of older people with a chronic disease and nurses. Nurs Ethics. 2011;18(5):672–85.CrossRef
37.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
38.
go back to reference Sinclair S, et al. Compassion in health care: an empirical model. Journal of Pain Symptom Management. 2016;51(2):193–203.CrossRef Sinclair S, et al. Compassion in health care: an empirical model. Journal of Pain Symptom Management. 2016;51(2):193–203.CrossRef
39.
go back to reference Koch T. Establishing rigour in qualitative research: the decision trail. J Adv Nurs. 2006;53(1):91–100.CrossRef Koch T. Establishing rigour in qualitative research: the decision trail. J Adv Nurs. 2006;53(1):91–100.CrossRef
41.
go back to reference Hunter PV, Hadjistavropoulos T, Kaasalainen S. A qualitative study of nursing assistants' awareness of person-centred approaches to dementia care. Ageing & Society. 2016;36(6):1211–37.CrossRef Hunter PV, Hadjistavropoulos T, Kaasalainen S. A qualitative study of nursing assistants' awareness of person-centred approaches to dementia care. Ageing & Society. 2016;36(6):1211–37.CrossRef
42.
go back to reference Papadopoulos I, et al. Exploring Nurses' meaning and experiences of compassion: an international online survey involving 15 countries. Journal of Transcultral Nursing. 2015;28(3).CrossRef Papadopoulos I, et al. Exploring Nurses' meaning and experiences of compassion: an international online survey involving 15 countries. Journal of Transcultral Nursing. 2015;28(3).CrossRef
43.
go back to reference Van Der Cingel M. Compassion and professional care: exploring the domain. Nurs Philos. 2009;10(2):124–36.CrossRef Van Der Cingel M. Compassion and professional care: exploring the domain. Nurs Philos. 2009;10(2):124–36.CrossRef
44.
go back to reference Sinclair S, et al. Compassion fatigue: a meta-narrative review of the healthcare literature. Int J Nurs Stud. 2017;69:9–24.CrossRef Sinclair S, et al. Compassion fatigue: a meta-narrative review of the healthcare literature. Int J Nurs Stud. 2017;69:9–24.CrossRef
45.
go back to reference Jones J, et al. Delivering compassionate care in intensive care units: nurses' perceptions of enablers and barriers. J Adv Nurs. 2016;72(12):3137–46.CrossRef Jones J, et al. Delivering compassionate care in intensive care units: nurses' perceptions of enablers and barriers. J Adv Nurs. 2016;72(12):3137–46.CrossRef
46.
go back to reference Barron K, Sloan G, Deery R. Community mental health nurses' understanding of compassion: a naturalistic, interpretative approach. Journal of Psychiatry Mental Health Nursing. 2017;24(4):211–20.CrossRef Barron K, Sloan G, Deery R. Community mental health nurses' understanding of compassion: a naturalistic, interpretative approach. Journal of Psychiatry Mental Health Nursing. 2017;24(4):211–20.CrossRef
47.
go back to reference Dewar B, Nolan M. Caring about caring: developing a model to implement compassionate relationship centred care in an older people care setting. Int J Nurs Stud. 2013;50(9):1247–58.CrossRef Dewar B, Nolan M. Caring about caring: developing a model to implement compassionate relationship centred care in an older people care setting. Int J Nurs Stud. 2013;50(9):1247–58.CrossRef
48.
go back to reference Dewar B, Mackay R. Appreciating and developing compassionate care in an acute hospital setting caring for older people. Int J Older People Nursing. 2010;5(4):299–308.CrossRef Dewar B, Mackay R. Appreciating and developing compassionate care in an acute hospital setting caring for older people. Int J Older People Nursing. 2010;5(4):299–308.CrossRef
49.
go back to reference Horsburgh D, Ross J. Care and compassion: the experiences of newly qualified staff nurses. J Clin Nurs. 2013;22(7–8):1124–32.CrossRef Horsburgh D, Ross J. Care and compassion: the experiences of newly qualified staff nurses. J Clin Nurs. 2013;22(7–8):1124–32.CrossRef
50.
go back to reference Curtis K, Horton K, Smith P. Student nurse socialisation in compassionate practice: a grounded theory study. Nurse Educ Today. 2012;32(7):790–5.CrossRef Curtis K, Horton K, Smith P. Student nurse socialisation in compassionate practice: a grounded theory study. Nurse Educ Today. 2012;32(7):790–5.CrossRef
51.
go back to reference Singh P, et al. Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: results from a grounded theory study. J Clin Nurs. 2018. In Press. Singh P, et al. Healthcare providers’ perspectives on perceived barriers and facilitators of compassion: results from a grounded theory study. J Clin Nurs. 2018. In Press.
52.
go back to reference Tellis-Nayak V. A person-centered workplace: the Foundation for Person-Centered Caregiving in long-term care. J Am Med Dir Assoc. 2007;8(1):46–54.CrossRef Tellis-Nayak V. A person-centered workplace: the Foundation for Person-Centered Caregiving in long-term care. J Am Med Dir Assoc. 2007;8(1):46–54.CrossRef
53.
go back to reference Stajduhar KI, Martin W, Cairns M. What makes grief difficult? Perspectives from bereaved family caregivers and healthcare providers of advanced cancer patients. Palliative and Supportive Care. 2010;8(3):277–89.CrossRef Stajduhar KI, Martin W, Cairns M. What makes grief difficult? Perspectives from bereaved family caregivers and healthcare providers of advanced cancer patients. Palliative and Supportive Care. 2010;8(3):277–89.CrossRef
54.
go back to reference Kaasalainen S, et al. Nurses perceptions around providing palliative care for LTC residents with dementia. J Palliat Care. 2007;23(3):173–80.CrossRef Kaasalainen S, et al. Nurses perceptions around providing palliative care for LTC residents with dementia. J Palliat Care. 2007;23(3):173–80.CrossRef
55.
go back to reference Sinclair S. Impact of death and dying on the personal and professional lives of palliative care professionals. Can Med Assoc J. 2011;183(2):180–7.CrossRef Sinclair S. Impact of death and dying on the personal and professional lives of palliative care professionals. Can Med Assoc J. 2011;183(2):180–7.CrossRef
Metadata
Title
Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers
Authors
Lorraine Smith-MacDonald
Lorraine Venturato
Paulette Hunter
Sharon Kaasalainen
Tamara Sussman
Lynn McCleary
Genevieve Thompson
Abigail Wickson-Griffiths
Shane Sinclair
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1135-x

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