The Art and Science of Compassionate Care: A Practical Guide

Description:

This book provides a practical guide on the art and science of compassionate care in an era of healthcare crisis due to the COVID-19 pandemic that is inflicting long-lasting financial and psychosocial trauma on an unprecedented scale. A new approach to compassionate care is presented based on the overarching concepts of empathy, person and family centeredness, therapeutic relationship, kindness, gratitude, spirituality, communication skills, shared decision making, positive psychology, adversity-activated development, self-care, compassion fatigue, spirituality which are more than ever critical in successfully managing the pandemic adversity in front of us.

This book draws on clinical experience, educational activities and evidence-based knowledge from academic physicians (primary, secondary and tertiary care), nurses, psychologists, health economists, healthcare managers, health policymakers, medical professionals students and patients. It provides skills and knowledge that can be implemented in daily clinical practice based on all levels of healthcare on a whole-person approach. An array of clinical cases, patient journeys, published evidence and practical experience is combined to deliver in a practical way unique guidance and advice. The target audience is all healthcare professionals, health policymakers, healthcare managers and patient associations. This approach of Compassionate Care is of great importance and can save lives and money in these unprecedented times of global healthcare care system challenges.

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Preface

There is no dispute that the current human society is in front of multiple crises. A prophetic document issued by WHO and United Nations Children’s Funds (UNICEF) underlined that “Unless we act immediately, we will continue to lose lives prematurely because of wars, violence, epidemics, natural disasters, the health impacts of climate change and extreme weather events and other environmental factors. We must not lose opportunities to halt disease outbreaks and global health threats such as antimicrobial resistance that spread beyond countries’ boundaries” [1]. Today, human society meets multiple crises that create a challenging environment fostering more resilient and sustainable healthcare systems.

The COVID-19 pandemic has dramatically affected our lives and imposed huge health and economic implications worldwide, as Cappelen et al. noted in their paper [2]. Based on this paper, “this crisis implied unprecedented medical, economic, and societal challenges leading to an enhancement of the unemployment rate and of the existing health inequalities”. Climate change and its subsequent natural disasters are another big health threat facing humanity and healthcare professionals worldwide [3]. War, including the last war in Ukraine, security crisis, and violence have contributed to the enhancement of health inequalities and poverty with an impact on premature death, poor quality of life and prolonged financial crisis. Finally, the burnout epidemic and ways to be resilient in the healthcare environment should be a priority.

An antidote and significant tool to successfully manage the aforementioned challenges whilst improving healthcare quality is the introduction of evidence-based compassionate care [4]. Unfortunately, ample evidence is showing a lack of compassionate care and most importantly decreasing compassion in our society in general [5, 6]. Almost half of Americans reported that the US healthcare system and healthcare providers are not compassionate [7].

The key word in a book that addresses compassion and compassionate care is that of suffering. Suffering is present in all unprecedented human crises mentioned above. As Dempsey noted “There are pain, fear, death, exhaustion, loss and uncertainty about the future” [8]. This uncertainty is translated into depression and anxiety, reducing people’s capacity in living independently and enjoying their lives. It advises for resilient healthcare services with a well-trained and coordinated workforce, a healthcare system that invests in caring based on positive relationships and the best interactions and practices to offer new directions in a changing world.

Caring is a key word that is reflected throughout this book. Caring could be translated into compassion, and Paul Gilbert supports this evolving process that requires three cognitive competencies to give rise to different insights and wisdoms, namely: knowing awareness, empathetic awareness, and knowing intentionally [9].

To what extent do these multiple crises have an impact on the moral attitudes of human beings? Cappelen et al. examined how a reminder of the COVID-19 pandemic causally affects people’s views on solidarity and fairness [2]. In a recent Opinion, the EC Expert Panel (EXPH, 2021) on effective ways of investing in health explored the concept of solidarity from both theoretical and implementation perspectives with a focus on health emergencies and how the principle of solidarity is enshrined in European Union (EU) law (2021). It summarised a set of recommendations, including the following: “The EU could invest more in strengthening integrated people-centred primary care including availability of interdisciplinary work, information and communication capacity and technology, prevention, health promotion and management of chronic care and vulnerability and as well as health care of socially isolated groups” [10]. This represents another indication of the need to focus on communication and compassionate care skills.

However, how much can we learn from this crisis? To what extent could this current painful experience lead the current world to construct a more compassionate society with a healthcare workforce capable and resilient to compassion fatigue? Paul Gilbert writes that if we are to create a more compassionate world, it depends on how we formulate, contextualise, and think about two issues:
1) Be much more engaged with the suffering in the world and how to address it, and as part of this,
2) Address the challenge of ‘resource caring and sharing’ versus ‘competitive controlling and holding’ [9].

Questions as to what extent we can use compassion as an antidote to suffering and how compassionate connected care can improve safety, quality, and experience, as Dempsey reports, guided the construction and content of this book [8].

The overall aim of this book is to provide a practical guide on how we can deliver care that makes a difference. Our aim is to bridge the gap between theory and clinical practice in compassionate care, the heart of caring.
The main objectives are to provide:
1. A new holistic framework for implementing Compassionate Care in clinical practice
2. Practical skills for healthcare professionals on how to better manage the burnout epidemic and ways to be resilient in the current healthcare environment
3. A compassionate care curriculum based on a well-rounded and multidisciplinary approach
4. Description of new models for spiritual compassionate care, patient-centred care, and self-care
5. The physiological, psychological, spiritual, and financial benefits of Compassionate Care
6. Role of compassionate care in primary, secondary, and tertiary care.

It is a unique patient-centred guide with specific cases and examples on a variety of important pillars of high-quality care that can be put into daily clinical practice making a difference.

Table of contents:

Preface
References
Contents
1: Compassionate Care and Evidence-Based Medicine
Introduction
A Definition of Compassion
A Brief History of Evidence-Based Medicine
Criticisms of Evidence-Based Medicine
Clinical Guidelines
Guidelines, Not Tramlines
Patient Autonomy and Shared Decision Making
Compassionate Care in the Future
References
2: Compassionate Self-Care for the Compassionate Healthcare Professional: Challenges and Interventions
Introduction
Case 1: Restrictive Emotionality
Case 2: “I Need to Need”
Case 3: Self-Doubt
Case 4: Emotional and Verbal Self-Oppression
Case 5: Injecting Life into Living
Case 6: A Preventable Death
Self-Care: Challenges
Self-Care: Interventions into Practice
Redefining Success
References
3: Compassionate Care in Crisis
Introduction
Crises
Pandemic Crises
Refugee Crises
Healthcare Crisis
Compassion Crises
Conclusion
References
4: Cultivating Compassion in the New Generation
Introduction
Why Is This Important for Students?
How Compassion Is Developed or Eroded
What to Teach and How to Teach It?
Cultivate, Check, Conserve
Prospective Medical Students
Medical Students
Junior Doctors
Senior Doctors
Conclusion
References
5: Compassionate Care Within the Primary Health Care Setting: Before and During a Public Health Crisis
Traditional General Practice and the Role of Compassion
Changes in Family Medicine Following COVID
Role of GPs in the Vaccination Roll-Out
Mental Health During COVID-19 and the Role of PHC
Loneliness and Isolation
Hard-to-Reach Populations/Rural Areas
Organisational Factors
Solidarity and the COVID-19 Pandemic
Concluding Remarks
References
6: Compassionate Critical Care: A “3C” Model
Introduction
ICU Environment
Concept of Compassionate Care and Difference with Empathy
Health Care Professionals Role in Providing Compassionate Care
Value and Goals of Compassionate Carer
Enhancing Communication Between HCP, Patients and Family
Maintaining CCC and Preventing Fatigue in ICU HCPs
References
7: Communicating Genuine Empathy for Compassionate Care: A Case for Identity Exploration, Congruence, and Inclusive Organisational Cultures
Introduction: The Expression of Genuine Empathy in Healthcare
Authenticity, Identity Development, and Congruence in the Communication of Genuine Empathy
Cultivating a Culture of Inclusion in Healthcare Organisations
Conclusion
References
8: Organising Compassionate Care with Compassionate Leadership
Introduction
The Need for Compassionate Leadership in Healthcare
What Is Compassionate Leadership?
Compassionate Leadership as a NEAR Process
Noticing
Empathising
Appraising
Responding
A Systems View of Compassionate Leadership
Three Lens for Viewing Compassionate Leadership
Power
Paradox
Conservation of Resources
Discussion
Conclusions
References
9: Compassionate Care and Health Economics
Introduction
The Status Quo: Measuring Outcomes in Economic Evaluations for Compassionate Care
Proposal for a Change: DCEs to Inform Health Economics for Compassionate Care
Case Study: Application of DCE to Value the Implementation of Compassionate SDM for Diabetes Care
Conclusion
References
10: Compassionate Spiritual Care
Introduction
Compassion and Spiritual Care: A Focus on Definitions
The Role of Spiritual Care Services in Clinical Practice
Skills and Attitudes for Effective Compassionate Spiritual Care
The Impact of Spiritual Care in Healthcare
Five Key Spiritual Virtues for Compassionate Healthcare Professionals and Spiritual Care Services Personnel
Gratitude
Forgiveness
Prayer
Altruistic Behavior
Conclusion
References
Conclusion: The Spirit of This Book
Useful Chapter Conclusions and Key Recommendations