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AbstractCompassion and compassionate care are identified as essential elements in nursing. They enhance quality care, wellbeing, and the overall quality of patients’ lives. However, incidents of substandard care have highlighted inherent tensions between competing professional and organisational demands in a rapidly changing workplace. This research investigated nurses’ views of the promoters and inhibitors of provision and maintenance of compassionate care. Participants were third year student nurses and qualified nurses in a large inner-city Trust hospital. An integrative literature review revealed three overarching themes that impact on nurses’ ability to provide and maintain compassionate care. Sumner’s (2008a) Moral Construct of Caring in Nursing as Communicative Action Theory (MCCNCAT) was applied as the theoretical framework. Q methodology supported the investigation of subjectivity within an interpretive design. 54 statements were developed from the literature review and focus group participation, representing the breadth of debate on compassion and compassionate care. Participants (n=30) rank-ordered these statements onto a quasi-normal distribution grid (the Q sort). They provided post Q sort data via Report Sheets and semi-structured interviews; thematic analysis was used to explore interview data. Completed Q sorts were analysed using correlation and by-person factor analysis, resulting in two distinct factors. Some participants shared commonalities across factors and did not contribute to the construction of the factor estimates. Remaining participants (n=18) included student nurses (n=10) and qualified nurses (n=8). Compassionate care was found to be complex, interconnected, and multifaceted. There was consensus from student nurses and qualified nurses in the three overarching themes: • Personal/relational – Improved patient outcomes impact positively on patients and motivate nurses to provide compassionate care. Satisfaction gained from providing compassionate care creates a virtuous circle, enhancing wellbeing, personal motivation, professional commitment, and job performance. It supports collegial relationships and positive patient outcomes. • Organisational – Organisations must promote compassionate care, supporting nurses and providing necessary resources. Managers, leaders, mentors, and colleagues should demonstrate compassion towards patients and staff. Developing and supporting a culture of compassion can counter factors that inhibit compassionate care. Nurses should be encouraged to develop self-compassion, which promotes their own wellbeing. • Educational – Nurses’ clinical experiences should be connected to teaching and learning. This means replacing inappropriate didactic, classroom-based education with approaches that are experiential and creative, using strengthened links with practice, so that learning is relevant to the reality of clinical practice. These findings were incorporated in an explanatory diagram, underpinned by MCCNCAT (Sumner 2008a) which makes visible the dynamics involved and strategies that build and sustain compassionate care.
PublisherUniversity of Wolverhampton
TypeThesis or dissertation
DescriptionA thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the Professional Doctorate in Health and Wellbeing.
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