Compassion in care is not routinely measured, hindering positive outcomes for patients
Calgary, Alberta – Health care has become part of daily conversation over the last year. But when measuring the quality of health care, empirical data doesn’t currently tell the whole story. A team at University of Calgary discovered that several research studies, formal health inquiries and survey data from patients in the health-care system show compassion is lacking from patients’ experience.
“Compassion was identified as a significant contributor, and often the main culprit for low patient satisfaction, increased patient complaints, low quality care ratings and increased adverse health events,” says University of Calgary’s researcher and professor Dr. Shane Sinclair (PhD).
As a result, Dr. Sinclair and his team, including co-Principal investigator Dr. Thomas Hack from the University of Manitoba, developed a scientific measure to assess, monitor and improve compassion in health-care research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) (www.compassionmeasure.com) is based on data gathered from more than 600 patients in acute care, long-term care and hospice settings in a study funded by the Canadian Institutes of Health Research (CIHR).
“There are other tools that attempt to measure compassion, but there was nothing out there that was developed from the perspective of patients directly that measured compassion in a sufficiently rigorous and comprehensive manner. Current tools have significant limitations, including but not limited to, self-reporting bias, and they often use poorly developed definitions and empirical models of compassion.”
Dr. Sinclair, associate professor, Faculty of Nursing and director of the Compassion Research Lab
Sinclair’s SCQ is a valid and reliable patient-reported compassion measure to allow researchers, health-care providers, system leaders and governments to assess, monitor and improve patients’ experience of compassion. Sinclair and his team began systematically planning for the development of the measure in 2013. At its foundation is a patient-derived model and definition of compassion which informed the entire study: “A virtuous response that seeks to address the suffering and needs of a person through relational understanding and action.”
Sinclair and his team developed the 15-question SCQ to be administered to patients on a routine basis to measure their ongoing experience of compassion from their health care providers in real time. The results from all questions are added up and averaged to provide health-care providers with a comprehensive, patient-reported compassion score.
A “side-scale” was also developed, to measure the importance of specific aspects of compassion to each individual patient. “These questions let us personalize the delivery of compassion to each individual patient. Not everyone perceives compassion in the same way—for some people compassion is optimally felt through attending to their physical needs in a proactive manner and for others it involves being treated as a person and not just a patient. So it’s important to tailor compassionate care to each individual, which the SCQ-I allows us to do,” says Sinclair.
Sinclair says he hopes compassion will be routinely measured on an ongoing basis with other health outcomes. Translating the measure into practical use, eventually the SCQ could be embedded in patient medical records that could be aggregated to produce institutional compassion scores, allowing health care teams to improve compassion and patients and families to determine things such as which long-term care home to place their loved ones in, based on the compassion scores of those facilities.
“Compassion has always been an important detail when caring for and treating those at end-of-life. I am overjoyed to know that compassion-based research is being prioritized within health care, as it carries potential to change the future of hospice palliative care in Canada,” states Laurel Gillespie, CEO of Canadian Hospice Palliative Care Association.
Sinclair says the CIHR funding is a sign that the government and health-care systems are taking compassion more seriously. The study has also been published in the British Medical Journal Open.
Accreditation Canada/Health Standards Organization, the body responsible for health-care accreditation, is considering forming a working group to explore compassion becoming a component of health-care institution accreditation.
“My desire is to get this embedded in health care so that it can have an impact at the bedside,” says Sinclair.
Shane Sinclair, PhD, is an associate professor and cancer care research professor with the Faculty of Nursing. He is also the director of the Compassion Research Lab and a member of the Alberta Children’s Hospital Research Institute and Arnie Charbonneau Cancer Institute at the Cumming School of Medicine.
Thomas Hack, PhD, CAHS, is a Professor in the College of Nursing in the Rady Faculty of Health Sciences at the University of Manitoba. He is also the Director of Psychosocial Oncology and Cancer Nursing Research at St. Boniface Research Centre.
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