Barriers to Medical Compassion as a Function of Experience and Specialization: Psychiatry, Pediatrics, Internal Medicine, Surgery, and General Practice
Journal of Pain and Symptom ManagementPublished 5 January 2017Open access
Antonio Fernando, Nathan S. Consedine
Citations48
SJR quartileQ1
SJR score1.21
SNIP1.42
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion.
Abstract
Documenting and investigating barriers to compassion in different speciality groups have the potential to broaden current foci beyond the physician and inform interventions aimed at enhancing medical compassion. In addition, certain aspects of the training or practice of psychiatry that enhance compassion may mitigate barriers to compassion in other specialities.
Keywords
MedicineHealth Professions
Psychological BulletinCompassion: An evolutionary analysis and empirical review.
2,179 Citations2010Jennifer L. Goetz, Dacher Keltner +1 more
This empirical review reveals compassion to have distinct appraisal processes attuned to undeserved suffering; distinct signaling behavior related to caregiving patterns of touch, posture, and vocalization; and a phenomenological experience and physiological response that orients the individual to social approach.
Annals of Internal MedicineBurnout and Self-Reported Patient Care in an Internal Medicine Residency Program
2,163 Citations2002Tait D. Shanafelt, Katharine A. Bradley +2 more
The prevalence of burn out among internal medicine residents in a single university-based program is evaluated and the relationship of burnout to self-reported patient care practices is evaluated.
American Journal of PsychiatryPhysician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty
1,320 Citations2002Mohammadreza Hojat, Joseph S. Gonnella +4 more
Three meaningful factors emerged (perspective taking, compassionate care, and standing in the patient's shoes) to provide support for the construct validity of the empathy scale that was found to be internally consistent with relatively stable scores over time.
British Journal of General PracticeEffectiveness of empathy in general practice: a systematic review
1,010 Citations2012Frans Derksen, Jozien M. Bensing +1 more
There is a good correlation between physician empathy and patient satisfaction and a direct positive relationship with strengthening patient enablement, and empathy lowers patients' anxiety and distress and delivers significantly better clinical outcomes.
Frontiers in PsychologyGender Differences in Personality across the Ten Aspects of the Big Five
892 Citations2011Yanna J. Weisberg, Colin G. DeYoung +1 more
The nature of gender differences in personality is clarified and the utility of measuring personality at the aspect level is highlighted, with significant gender differences appearing in both aspects of every Big Five trait.
Journal of Emergency NursingCompassion Satisfaction, Burnout, and Compassion Fatigue Among Emergency Nurses Compared With Nurses in Other Selected Inpatient Specialties
644 Citations2010Crystal Hooper, Janet Craig +3 more
Understanding the concepts of compassion satisfaction, burnout, and compassion fatigue, recognizing the signs and symptoms, and identifying best practice interventions, will help nurses maintain caring attitudes with patients and contribute to patient satisfaction.
Journal of Clinical OncologyCan 40 Seconds of Compassion Reduce Patient Anxiety?
549 Citations1999Linda Fogarty, Barbara Curbow +3 more
The enhanced compassion segment was short, simple, and effective in decreasing viewers' anxiety and is needed to translate these findings to the clinical setting, where reducing patient anxiety is a therapeutic goal.
PLoS ONEEmpathy in Clinical Practice: How Individual Dispositions, Gender, and Experience Moderate Empathic Concern, Burnout, and Emotional Distress in Physicians
541 Citations2013Ezequiel Gleichgerrcht, Jean Decety
Physicians who have difficulty regulating their negative arousal and describing and identifying emotions seem to be more prone to emotional exhaustion, detachment, and a low sense of accomplishment, while the ability to engage in self-other awareness and regulate one’s emotions, seem to contribute to the sense of compassion that comes from assisting patients in clinical practice.
BMJDignity and the essence of medicine: the A, B, C, and D of dignity conserving care
485 Citations2007Harvey Max Chochinov
Kindness, humanity, and respect—the core values of medical professionalism—are too often being overlooked in the time pressured culture of modern health care, says HarveyChochinov, and the A, B, C, and D of dignity conserving care can reinstate them.
Journal of Loss and TraumaCompassion Fatigue, Compassion Satisfaction, and Burnout: Factors Impacting a Professional's Quality of Life
482 Citations2007Ginny Sprang, James J. Clark +1 more
JAMAPreserving the Physician-Patient Relationship in the Era of Managed Care
413 Citations1995Ezekiel J. Emanuel
The shift to managed care may improve the choice of practice settings, especially in sections of the country that currently lack managed care; increase choice of preventive services; make quality assessments more routine; and improve communication by making greater use of primary care physicians and nonphysician providers.
Journal of Vocational BehaviorPersonality and Vocational Behavior: A Selective Review of the Literature, 1993–1997
404 Citations1998David M. Tokar, Ann R. Fischer +1 more
Health AffairsAn Agenda For Improving Compassionate Care: A Survey Shows About Half Of Patients Say Such Care Is Missing
353 Citations2011Beth A. Lown, Julie Rosen +1 more
It is recommended that national quality standards include measures of compassionate care; that such care be a priority for comparative effectiveness research to determine which aspects have the most influence on patients' care experiences, health outcomes, and perceptions of health-related quality of life.
Psycho-OncologyA systematic review of the associations between empathy measures and patient outcomes in cancer care
291 Citations2012Sophie Lelorain, Anne Brédart +2 more
This review investigates the links between physicians' or nurses' empathy and patient outcomes in oncology.
Journal of Hospice and Palliative NursingPredicting the Risk of Compassion Fatigue
262 Citations2006Maryann Abendroth, Jeanne Flannery
Trauma, anxiety, life demands, and excessive empathy were key determinants of compassion fatigue risk in the multiple regression model that accounted for 91% (P < .001) of the variance in compassionate fatigue risk.
Journal of Career AssessmentPersonality and Medical Specialty Choice: A Literature Review and Integration
250 Citations2002Nicole J. Borges, Mark L. Savickas
This review examines the literature on personality and medical specialty choice and suggests a loose association between a few personality factors and particular medical specialties and integrates results using the framework provided by the Five-Factor Model of personality.
JAMATrends in Career Choice by US Medical School Graduates
244 Citations2003Dale A. Newton
Distribution of medical students' career choices among specialties varied considerably from 1987 to 2002, with emergency medicine and plastic surgery increased as a match choice, while anesthesiology, pathology, and psychiatry were more variable over time.
Health Services ResearchPhysician, Practice, and Patient Characteristics Related to Primary Care Physician Physical and Mental Health: Results from the Physician Worklife Study
202 Citations2002Eric S. Williams, Thomas R. Konrad +7 more
These findings support the notion that workplace conditions are a major determinant of physician well-being and are particularly important as physicians are more tightly integrated into the health care system that may be less clearly under their exclusive control.
Journal of General Internal MedicineTeaching compassion and respect
181 Citations1999Jeffrey H. Burack, David M. Irby +3 more
Attending physicians were reluctant to respond to perceived disrespect, uncaring, or hostility toward patients by members of their medical team, and to respond in ways that avoided moral language, did not address underlying attitudes, and left room for face-saving reinterpretations.
International Journal of Social PsychiatryStress, Burnout, Coping and Stress Management in Psychiatrists: Findings from a Systematic Review
166 Citations2004Anne Fothergill, Deborah Edwards +1 more
A systematic review of the current literature into stress and stress management within the profession of psychiatry found several stressors in psychiatrists' professional and personal lives, including patient suicide.
PubMedStress, burnout, and strategies for reducing them: what's the situation among Canadian family physicians?
164 Citations2008F Joseph Lee, Moira Stewart +1 more
Regardless of demographic factors, family physicians are at risk of having high levels of stress and burnout, and scores on the Family Physician Stress Inventory correlated highly with score on the Maslach Burnout Inventory.
Frontiers in Behavioral NeuroscienceThe relationship between different facets of empathy, pain perception and compassion fatigue among physicians
162 Citations2014Ezequiel Gleichgerrcht, Jean Decety
Professional experience seems to desensitize physicians to the pain of others without necessarily helping them down-regulate their own personal distress.
Communication MonographsConceptualizing Compassion as Recognizing, Relating and (Re)acting: A Qualitative Study of Compassionate Communication at Hospice
125 Citations2012Deborah Way, Sarah J. Tracy
Anxiety Stress & CopingPersonal factors related to compassion fatigue in health professionals
120 Citations2013Moshe Zeidner, Dafna Hadar +2 more
Major findings indicate that both self-report “trait” emotional intelligence and ability-based emotion management are inversely associated with compassion fatigue; adaptive coping is inversely related to compassion fatigue'; and differences exist between mental and medical professions in emotional intelligence, coping strategies, and negative affect.
Journal of Pain and Symptom ManagementBeyond Compassion Fatigue: The Transactional Model of Physician Compassion
119 Citations2014Antonio Fernando, Nathan S. Consedine
A view in which physician compassion stems from the dynamic but interrelated influences of physician, patient and family, clinical situation, and environmental factors is offered, which allows for targeted interventions to promote compassion in both education and practice as well as to reduce the barriers that impede it.
Nurse Education TodayThe role of professional education in developing compassionate practitioners: A mixed methods study exploring the perceptions xof health professionals and pre-registration students
113 Citations2013Lucy Bray, Mary O’Brien +3 more
Acting with warmth and empathy, providing individualised patient care and acting in a way you would like others to act towards you were seen as the most common features of compassionate care, but ambiguities and contradictions were evident when considering the role of health professional education in promoting compassionate practice.
Journal of Advanced NursingCompassion fatigue in family caregivers: a Wilsonian concept analysis
112 Citations2012Susan Lynch, Marie L. Lobo
A concept analysis clarified the definition and revealed that the concept of compassion fatigue has potential use with family caregivers, and parallels are drawn between the role of healthcare providers and family caregivers.
International Journal of Social PsychiatryBurnout and Job Satisfaction in New Zealand Psychiatrists: a National Study
90 Citations2007Shailesh Kumar, Jesse Fischer +3 more
The results showed that the prevalence of burnout in New Zealand psychiatrists is cause for concern, and job satisfaction remained relatively high despite the high prevalence ofBurnout, although there was a relationship between burnout and job Satisfaction scores.
Qualitative Health ResearchThe Language of Compassion in Acute Mental Health Care
87 Citations2013Paul Crawford, Paul Gilbert +3 more
A corpus-assisted discourse analysis of 20 acute mental health practitioner interview narratives about compassion finds a striking depletion in the use of “compassionate mentality” words, despite the topic focus.
Psychotherapy ResearchCompassion in psychotherapy: The perspective of therapists nominated as compassionate
85 Citations2008Barbara L. Vivino, B. J. Thompson +2 more
Fourteen therapists nominated by peers as compassionate defined compassion in psychotherapy as connecting with the client's suffering and promoting change through action, indicating that compassion was broader and deeper than empathy, helps clients feel understood, and relieves symptoms.
Current SurgeryCompetent patient care is dependent upon attending to empathic opportunities presented during interview sessions
74 Citations2004David W. Easter, Wayne A. Beach
Individual feedback and training regarding empathic opportunities in recorded patient communication encounters may improve resident and physician core competencies and affect patient satisfaction related to these encounters.
Politics & SocietyWhat Can We Expect from Paid Carers?
69 Citations2006Gabrielle Meagher
It is concluded that paid carers cannot expect to reproduce an idealized private sphere, and can expect “good enough” care, supported by a range of normative resources.
Health ExpectationsIn search of compassion: a new taxonomy of compassionate physician behaviours
61 Citations2013Rachel A. Cameron, Benjamin L. Mazer +3 more
There are few studies that systematically document the behavioural features of physician compassion and the ways in which physicians communicate compassion to patients.
Sociology of Health & IllnessPractical compassions: repertoires of practice and compassion talk in acute mental healthcare
58 Citations2013Brian Brown, Paul Crawford +3 more
An exploratory study of the concept of compassion in the work of 20 mental health practitioners in a UK Midlands facility identifies two contrasting interpretive repertoires in discussions of compassion and explores how the exercise of compassion can afford the more effective exercise of medical power.
The Joint Commission Journal on Quality and Patient SafetyWhat Makes for a Compassionate Patient-Caregiver Relationship?
56 Citations2006Darshak Sanghavi
Advocates for compassionate care should instead treat lack of compassion not as an acute trauma but as a chronic condition requiring a lifetime of continuous support, regular guidance, repeated reinforcement, specific targeted outcomes, and more innovative care programs.
PubMedThe qualities of a compassionate nurse according to the perceptions of medical-surgical patients.
55 Citations2011Diane D. Kret
The complexities of compassion, its effect on patient care, and the historical roots of compassion are explored in this study, which explores the qualities of compassionate nurses as perceived by patients in medical-surgical units.
Nursing Older PeopleConveying compassion through attention to the essential ordinary
54 Citations2009Beth Perry
Paying attention to the little things seemed to send a message to patients that they had value, and when nurses were able to enhance the esteem needs of patients in this way they also found meaning in their work and a sense of professional fulfilment.
The American Journal of SurgeryThe surgical personality: Fact or fiction
53 Citations1997James H. Thomas
There is evidence that suggests that some surgeons are convinced that the surgical personality accurately describes the behavior of the majority of surgeons, and surgeons may unwittingly use an idealized concept of the surgical Personality to identify potential surgical residents.
Medical Entomology and ZoologyCaregiver Stress and Staff Support in Illness, Dying and Bereavement
49 Citations2011Irene Renzenbrink
Four decades of selected research in hospice/palliative care: have the stressors changed?
Medical EducationPatient perceptions of professionalism: implications for residency education
46 Citations2008Michael N. Wiggins, Karen Coker +1 more
The purpose of this study was to explore whether or not resident doctor professional behaviour creates an impression of clinical competence to the degree where patients perceive a decreased need for Attending Physician involvement.
Social Work EducationIntegrating Mindfulness and Reflection in the Teaching and Learning of Listening Skills for Undergraduate Social Work Students in Singapore
43 Citations2011Esther C. L. Goh
Postgraduate Medical JournalDevelopment and initial psychometric properties of the Barriers to Physician Compassion questionnaire
42 Citations2014Antonio Fernando, Nathan S. Consedine
The development and early psychometric data for a self-report questionnaire assessing barriers to compassion among physicians illuminate potential targets for future self- and practice management, interventions and compassion training among physicians.
International Journal of Consumer StudiesMaking compassion count: equal recognition and authentic involvement in mental health care
36 Citations2011Marjorie Lloyd, Alex M Carson
The visibility of compassionate care is discussed and it is argued that compassionate care can be observed in the relationships between practitioners and consumers that are collaborative and use presence and persistence as methods of practice.
British Journal of General PracticeEnhancing compassion in general practice: it’s not all about the doctor
32 Citations2016Antonio Fernando, Bruce Arroll +1 more
Compassionate care should be routine, a daily motivation and practice not unlike antisepsis and hand washing, and empathy without compassion is not only out of step with professional requirements but also is differentially likely to sustain negative outcomes.
Journal of Psychiatric and Mental Health NursingAn inquiry into moral virtues, especially compassion, in psychiatric nurses: findings from a Delphi study
28 Citations2000Alan Armstrong, S. Parsons +1 more
The Delphi method proved adequate for purposes, but problems with regard to accurately understanding the respondents' intended meanings highlighted a major weakness of this technique, in common with other methods relying on questionnaires.
Journal of Osteopathic MedicineComparison of personality styles between students enrolled in osteopathic medical, pharmacy, physical therapy, physician assistant, and occupational therapy programs
11 Citations1998Patrick C. Hardigan, Stanley R. Cohen
Advances in Health Sciences EducationSpecific disgust sensitivities differentially predict interest in careers of varying procedural-intensity among medical students
11 Citations2013Nathan S. Consedine, John A. Windsor
Specific disgust sensitivities appear to differentially deter and/or predispose self-selection into specific trajectories varying in procedural content, which may permit the early identification of specialty fit and provide guidance in career counseling.
PubMedMeasuring compassion in physician assistants.
10 Citations2003Karen O Skaff, Christopher P. Toumey +2 more
A series of studies that generated preliminary information about the compassionate qualities of PAs were described, which dealt with a halo effect related to the wording of the questions and a confounding effect associated with the intimacy of the medical setting.
PubMedSociety's expectation of the role of the doctor in New Zealand: results of a national survey.
8 Citations2011Andrew Old, Brandon Adams +2 more
This comprehensive New Zealand survey provides important information about public perceptions of the role of the doctor and is a basis for workforce planning and future comparisons.