'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals.

AIMS AND OBJECTIVES: To explore the meaning ascribed to the concept of compassion by healthcare professionals. BACKGROUND: Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear. DESIGN: A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines. METHOD: Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed. FINDINGS: Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action. CONCLUSIONS: Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice. RELEVANCE TO CLINICAL PRACTICE: To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice. NO PATIENT OR PUBLIC CONTRIBUTION: This systematic review had no patient or public contribution.

Compassion fatigue in mental health nurses: A systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice that may result in negative outcomes for mental healthcare consumers. Compassion fatigue has clear emotional and physical costs and significant impacts on staff recruitment and retention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the first to evaluate the quantitative literature on compassion fatigue in mental health nurses. Research on compassion fatigue in mental health nurses does not accurately account for the unique care relationship between nurse and consumer. Competency-based education, strong mental health nurse leadership, positive organizational cultures, clinical supervision and reflection alongside individual self-care strategies may mitigate compassion fatigue. WHAT ARE THE IMPLICATIONS FOR FUTURE PRACTICE?: Resources are urgently needed for education and workforce development that addresses compassion fatigue in mental health nurses. Interventions addressing the physical, cognitive and emotional demands of care work are needed to ensure mental health nurses have the capability to provide sustainable compassionate care to consumers. ABSTRACT: Introduction Although compassionate care is an essential component of mental health nursing, understandings of the impact of compassion fatigue is poorly understood. Aims/Questions To examine and synthesize available data on the prevalence of compassion fatigue within mental health nurses and consider what variables impact compassion fatigue. Method A search of MEDLINE, EMBASE, PsychINFO, Emcare, Web of Science, Scopus, CINAHL and grey literature for articles published between 1992 and February 2021 was conducted. Data were extracted from articles meeting inclusion criteria and integrated using narrative synthesis. Results Twelve articles were included. Prevalence of compassion fatigue ranged from low to high. Variables were identified that may mitigate the risk of compassion fatigue. Strong leadership and positive workplace cultures, clinical supervision, reflection, self-care and personal well-being may protect mental health nurses against compassion fatigue. Discussion Future research is needed on mental health nurses lived experience of compassion fatigue and their understandings of compassion. Implications for Practice Interventions should focus on increasing awareness of compassion fatigue and building individual and organizational resilience. Both organizations and individuals should be aware of the role they play in maintaining the capacity and capability for mental health nurses to provide sustainable and compassionate mental healthcare.