use of digital tablets eases the way to compassionate care during the COVID-19 pandemic

Objective: A patient communication program was implemented as a response to hospitals visiting restrictive policies during the COVID-19 pandemic. The aim of the program was to facilitate communication between patients and families, mainly through the use of digital tablets; thus program performance was evaluated by selecting the number of calls performed, the average call time, and the percentage of patients that used the program more than once. Methods: A communication service for hospitalized patients who did not have access to a personal electronic device or were unable to use their electronic device was launched at different MUHC hospitals. A dedicated team of re-deployed employees was available to help patients connect with their loved ones using a hospital tablet or telephone. Results: A total of 806 calls were performed between April and November 2020. Eighty one percent of the calls were performed during the non-visitors policy implementation, being video calls preferred over phone calls. The average call time was 15 min, 34% of the patients had a video call with their loved one more than once and 40% of the calls were performed in the intensive care unit. Conclusion: The patient communication program can be described as a new delivery model of compassionate care. It was effective, helped reduce patients’ isolation and met the needs of family members and caregivers during the hospital non-visitors policy directed by the Ministère de la Santé et des Services Sociaux de Québec during the Covid-19 pandemic.

Compassion: the legacy of the pandemic in rural schools and communities

Purpose The purpose of this paper is to demonstrate how rural schools and communities responded to the COVID-19 pandemic through compassionate care. Design/methodology/approach This paper provides “compassion narratives” (Frost et al., 2006, p. 851) from five educators (i.e. the authors) working and/or living in rural communities. Each narrative describes how compassion was witnessed and experienced from various professional positions (which include classroom teacher; building-level leader; district-level leader; special services director and school psychologist; and assistant professor of educational leadership). Findings The compassion narratives described in this paper demonstrate how various organizations and communities responded to COVID-19 through compassionate care. They also provide a lens for considering how rural schools and communities might sustain compassion in a post-pandemic world. Originality/value This paper extends disciplinary knowledge by considering the healing, transformative power of compassion within rural schools and communities – not just in response to COVID-19 but in response to all future adversities.

Enacting Woundedness and Compassionate Care for Recurrent Metastatic Breast Cancer

This analysis integrates Arthur Frank’s timeless revelations about woundedness within the communication context of an oncology interview. A Patient whose life is threatened by recurrent metastatic breast cancer claims personal knowledge and visibly demonstrates impacts from illness experiences. Conversation Analysis (CA) was conducted on a video recorded and transcribed case study involving a Patient, her husband, and co-present oncologists. By focusing on narratives as talk-in-interaction, grounded exemplars are provided of primary interactional achievements: How woundedness gets displayed and responded to with empathy and compassionate witnessing; Patient’s flooding out with emotion and potential embarrassment; attempting to regain control and resume talking about her condition; and the serial organization of crying and laughter when managing noticeably delicate moments. In this interview, woundedness is not discounted or dismissed but recognized as legitimate suffering meriting shared commiseration. Understanding how to enact humane and communicatively competent skills during emotionally uncertain moments can enhance medical education.

Protocol for a Pilot Study of Schwartz Rounds in an Australian Setting: A Team and System Level Wellness Intervention (Preprint)

BACKGROUND Schwartz Rounds are a unique, organisation-wide interdisciplinary intervention aimed at enhancing staff wellbeing, compassionate care, teamwork, and organisational culture in healthcare settings. They provide a safe space wherein both clinical and non-clinical health staff can connect and share their experiences about the social and emotional aspects of health care. OBJECTIVE Although Schwartz Rounds have been assessed and widely implemented in the United States and United Kingdom, they are yet to be formally evaluated Australian healthcare settings. The purpose of this study is to evaluate the feasibility and impact of Schwartz Rounds on staff wellbeing, compassionate care and organisational culture, in a tertiary metropolitan hospital in Brisbane, Australia. METHODS This mixed methods repeated measures pilot study will recruit 24 participants in two groups from two departments, the Intensive Care Unit (ICU) and the gastroenterology department. Participants from each group will take part in three unit-based Schwartz Rounds. Primary outcomes will include the study and intervention feasibility measures while secondary outcomes will include Maslach Burnout inventory, the Schwartz Centre Compassionate Care Scale, and Culture of Care Barometer. Primary and secondary outcomes will be collected at baseline, post-round, and three-month follow-up. Two focus-groups will be held approximately two months after completion of the Schwartz Rounds. Descriptive statistics, t-tests, chi-square tests, and analysis of variance (ANOVA) will be used to compare quantitative data across time points and groups. Qualitative data from focus groups and free-text survey questions will be analysed using an inductive thematic analysis approach. RESULTS The study was approved by the Mater Hospital Human Research Ethics Committee (reference number: HREC/MML/71868) and recruitment commenced in July 2021; study completion is anticipated by May 2022. CONCLUSIONS The study will contribute to the assessment of feasibility and preliminary efficacy of the Schwartz Rounds in a tertiary Australian hospital, during the COVID-19 pandemic. CLINICALTRIAL Australian New Zealand Clinical Trials Registry Id is ACTRN12621001473853.

Compassionate Reasoning

This book presents the case for Compassionate Reasoning as a moral and psychosocial skill for the positive transformation of individuals and societies. It has been developed from a reservoir of moral philosophical, cultural, and religious wisdom traditions over the centuries, combined with compassion neuroscience, contemporary approaches to conflict resolution, public health methodologies, and positive psychological approaches to social change. There is an urgent need for human civilization to invest in the broad-based cultivation of compassionate thoughts, feelings, and especially habits. This skill is then combined with moral reasoning to move the self and others toward less anger and fear, more joy and care in the pursuit of reasonable policies that build peaceful families, communities, and societies. There are many people who work for the sake of others, and tend to be kinder, more reasonable, more self-controlled, and more goal-oriented to peace. They are united by a set of moral values and the emotional skills to put those values into practice. The aim of this book is to articulate the best combination of those values and skills that lead to personal and communal sustainability, not burnout and self-destruction. The book pivots on the observable difference in the mind—and proven in neuroscience imaging experiments—between destructive empathic distress on the one hand, and on the other, joyful, constructive, compassionate care. Facing existential threats to life on the planet, humans can and must make such skills universally sustainable and ingrained.

Accessing unproven interventions in the COVID-19 pandemic: discussion on the ethics of ‘compassionate therapies’ in times of catastrophic pandemics

Since the onset of the SARS-CoV-2 pandemic, an array of off-label interventions has been used to treat patients, either provided as compassionate care or tested in clinical trials. There is a challenge in determining the justification for conducting randomised controlled trials over providing compassionate use in an emergency setting. A rapid and more accurate evaluation tool is needed to assess the effect of these treatments. Given the similarity to the Ebola Virus Disease (EVD) pandemic in Africa in 2014, we suggest using a tool designed by the WHO committee in the aftermath of the EVD pandemic: Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI). Considering the uncertainty around SARS-CoV-2, we propose using an improved MEURI including the Plan–Do–Study–Act tool. This combined tool may facilitate dynamic monitoring, analysing, re-evaluating and re-authorising emergency use of unproven treatments and repeat it in cycles. It will enable adjustment and application of outcomes to clinical practice according to changing circumstances and increase the production of valuable data to promote the best standard of care and high-quality research—even during a pandemic.

Development and assessment of the psychometric properties of a compassionate care questionnaire for nurses

Background Compassionate care is emphasized within professional ethics codes for nursing and is a key indicator of care quality. The purpose of the present study is to develop and assess the psychometric properties of a compassionate care instrument for nurses. Methods This methodological study was carried out in two phases -qualitative and quantitative-from February 2016 to October 2018. In the qualitative stage of the study, a content analysis approach was used to establish the concept of compassionate care through interviews with nurses, patients, and family caregivers. The initial draft of the questionnaire was developed based on the qualitative findings and a subsequent review of the literature. In the second phase, the psychometric properties of the questionnaire were assessed for validity and reliability. Data analysis was performed using descriptive and inferential statistics in SPSS v.16. Results From the results of the qualitative phase and review of literature, 80 items were extracted. In the quantitative phase, after evaluation of the face and content validity, 40 items were kept. After measurement of the construct validity, 28 items whose factor loading was above 0.4 were retained. Measurement of convergent validity showed a moderate correlation between the questionnaire and the nurses’ caring behaviors scale (r = 0.67, P = 0.01). The reliability of the 28-item questionnaire was tested by measuring its Cronbach’s alpha coefficient and intra-class correlation coefficient which were found to be 0.91 and 0.94 for the whole questionnaire, respectively. Conclusion The questionnaire has enough validity and reliability to be used for measuring the nurses’ compassionate care. Therefore, the instrument can be used to measure and record the quality of nursing care.