Authors
- Dr. Hussein Omar (MSc, CCT & FRCPsych)
- Dr. Hana Al Geilani (MbchB UK & MrcPsych UK)
Compassion is the humane quality of understanding suffering in others and wanting to do something about it. It is an active emotion that demands a response, rather than simply an awareness of the plight of another. Empirically, it can be defined as a virtuous response that seeks to address the suffering of a person, through relational understanding and action.
Compassion-based care can be viewed as a practice that incorporates a dynamic, individualized and complex construct that stems from the innate virtues of a healthcare provider, and which can be further nurtured by experiential learning and reflective practices.
The provision of compassion involves a broad range of qualities, skills and behaviors which together focus on the alleviation of suffering. These include: showing warmth and understanding, providing personalized care, acting towards patients the way you would want them to act towards you, providing encouragement, communicating effectively, and acknowledging patients’ emotional issues.
Importantly, compassion requires health care professionals to engage suffering on both a personal and professional level, using interpersonal skills to care for patients, and intrapersonal skills to care for themselves as caregivers.
Recently, there has been an increase in research on the neurophysiological, psychological and social dimensions of compassion. However, the need for compassion within health care is not a new concept. It dates back to the first principle of the American Medical Association code of ethics which stated, “A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights”.
The benefits of compassion-based care are numerous and include: improved health care provider-patient relationships; higher patient satisfaction; reduced patient anxiety; higher pain tolerance; and improved stress response.
While the importance of compassion has been extolled in fields such as psychology, social work, and theology, it is now being recognized for its positive impact in healthcare. Compassion-based care is emerging as a competency that healthcare providers are expected to deliver. More recently, recommendations from the Francis Inquiry report advised that all health professionals be trained in compassion, that compassion be considered and evaluated as a core competency of healthcare providers, and that system-wide standards of compassionate care be adopted and implemented.
Arguably, there has not been a time in living memory where we are more in need of compassion-based care than now. The COVID-19 pandemic has negatively affected many people’s mental and physical health and created barriers for people who were already suffering from mental and/or physical illnesses.
A poll from July 2020 found that as a result of worry and stress over Coronavirus, many adults were reporting specific negative impacts on their mental health and wellbeing, such as difficulty sleeping (36%), reduced appetite (32%), increased alcohol consumption or substance use (12%), and worsening of chronic conditions (12%). As the pandemic wears on, public health measures expose many people to situations linked to poor mental health outcomes, such as isolation and job loss. Young adults have also experienced dire consequences such as closure of universities and loss of income.
A recent study revealed that the COVID-19 pandemic has had a significant psychological impact on frontliners and health care workers. When one is psychologically compromised, compassion towards others may be compromised too, just when the others (patients) need it most.
During these unprecedented times, we and our patients are experiencing isolation, fear, anxiety, low mood and many more uncertainties about the future. Providing compassion-based care can empower people to speak openly of their suffering and allow them to feel confident to ask for help, knowing that everything possible will be done to meet their needs.
Cultivating compassion training and intervention has been shown in numerous studies to improve health outcomes. There is therefore a compelling need to incorporate compassion-based training in clinical practice at all levels. That would make compassion a more valued and explicit part of clinical practice. Organizations must institutionalize compassion, so that it becomes self-sustaining.
Creating a compassionate workplace can have a positive impact on staff’s commitment to an organization and how they view their colleagues, alongside helping them to deal with the suffering and distress that they face in their job. Perceptions of one’s organization can be shaped by experiencing compassion first-hand, and from seeing others receive such treatment, thereby promoting staff resilience.
Future research should focus on developing a conceptual model for compassion-based care and identifying educational approaches to enhance compassionate interactions with patients.
The current times call for careful reflection and reinvestment in compassion as a crucial approach to provision of care. COVID-19 has shown us that there is no distinction between a healthy person and a healthy world; both are immensely strengthened by inculcating compassion at the heart of healthcare.