Healthcare providers' perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study

Singh, Pavneet, Raffin-Bouchal, Shelley, McClement, Susan, Hack, Tom, Stajduhar, Kelli, Hagen, Neil A, Sinnarajah, Aynharan, Chochinov, Harvey Max and Sinclair, Shane (2018) Healthcare providers' perspectives on perceived barriers and facilitators of compassion: Results from a grounded theory study. Journal of Clinical Nursing . ISSN 0962-1067

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Compassion is considered a component of quality healthcare that healthcare providers (HCPs) are increasingly expected to provide. While there have been some studies exploring facets of HCPs' perspectives on the barriers and facilitators to providing compassion, a comprehensive understanding based on direct reports from HCPs is lacking. The aim of this study was to explore HCP perspectives and experiences of perceived barriers and facilitators of compassion. This study used Straussian grounded theory to examine HCP perspectives. Semi-structured focus groups with frontline HCPs and individual interviews with peer-nominated exemplary compassionate care providers were audio-recorded, professionally transcribed, and analyzed. Fifty-seven participants were recruited from 3 healthcare settings within both rural and urban settings in Alberta, Canada, using convenience, snowball, and theoretical sampling. Qualitative analysis of the data generated two categories and associated themes and sub-themes delineating perceived barriers and facilitators to compassion. The first category, challenges to compassion, reflects participants' discomfort associating the notion of barriers to compassion, and contained several themes participants conceptualized as challenges: personal challenges, relational challenges, systemic challenges, and maladaptive responses. The second category, facilitators of compassion, included the themes of: personal facilitators, relational facilitators, systemic facilitators, and adaptive responses of intentional action. Although participants described certain factors such as system and time constraints along with interaction styles of patients and families that can challenge HCP compassion, these challenges were not considered insurmountable. While acknowledging these as challenges, participants identified HCPs themselves, including their responses towards the identified challenges of compassion, as significant factors in this process -a novel finding from this study. This study provides insight into HCPs' perspectives on the notion of barriers and facilitators in the provision of compassion. This article is protected by copyright. All rights reserved. [Abstract copyright: This article is protected by copyright. All rights reserved.]

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