Compassion: the missing link in quality of care

Abstract

This article discusses the impact of selected findings from a PhD-study that focuses on compassion as a guiding principle for contemporary nursing education and practice. The study, of which the literature review and empirical findings have already been published, looked at compassion as perceived within the relationship of nurses and older persons with a chronic disease. The patient group was chosen because daily life for them is characterized by long-term dependency on care. The literature review resulted in a theoretical framework of compassion that also explores other closely related concepts such as suffering and empathy. The empirical part of the study, in which 61 in-depth interviews and 6 group interviews with patients and nurses took place, showed that compassion is a mirroring process in response to grief. Compassion consists of seven dimensions such as attentiveness and presence, in which saliency, so as to anticipate patients' needs, is of major importance. Compassion is perceived by participants as an indispensable aspect of care, which helps to reveal relevant information in order to establish appropriate outcomes of care. This article focuses on the aspects of the PhD-study in which an analysis of compassion in the context of both modern as well as the history of nursing took place. Currently evidence based practice is regarded as the standard for good quality care. Nevertheless there is an on-going debate about what constitutes good quality care. Within this debate two opposing views are apparent. One view defines good care as care supported by the best scientific evidence. The other view states that good care takes place within the nurse-patient relationship in which the nurse performs professional care based on intuitive knowing. It is suggested that compassion is the (missing) link between these views.

Keywords: Chronic disease; Compassion; Evidence based practice; Nurse–patient relationship; Nursing theory; Older people; Professional behavior; Quality of care.