Dr. Shane Sinclair PhD, Assistant Professor, University of Calgary
Compassionate care has long been identified as an essential feature of quality health care, especially in the context of patient suffering. While the importance of compassion is given credence in clinical health care, there is little understanding of what constitutes compassion and its effect on patients. While a growing body of empirical research has demonstrated the importance of compassion, this work has been largely confined to the social sciences, with little clinical research directly exploring the importance and impact of compassion on patients facing the end of life. Despite its centrality to healthcare, the precise nature of compassion is contested amongst scholars, with definitions identifying it as an attitude, feeling, trait or state that arises in witnessing suffering accompanied by a response aimed at amelioration. An equally remarkable deficiency within the empirical literature is the absence of patient perspectives, the advocates and potential benefactors of compassionate care. While compassionate care is vital across the cancer journey, it is particularly important amongst palliative care patients, where the goal of ameliorating multi-dimensional suffering is both a unique challenge and specific aim of palliative care.
Despite being relegated to the realm of 'touchy feely' or 'soft skills', the importance of compassion to patients cannot be easily dismissed, especially in relation to addressing spiritual needs where features associated with compassionate care are consistently identified by patients as being paramount. Palliative patients have consistently identified the psychosocial and spiritual domains of care as being equally important, and in some cases more important, than other health domains in relation to their quality of life. While patients desire to have their spiritual needs addressed, health care professionals, are challenged to adequately address this vital domain of end of life care. Research investigating patient spiritual needs and patient perceptions of quality spiritual care identify features associated with compassion as being paramount, with more extrinsic or task-based knowledge and skills such as spiritual screening, religious rituals, prayer, playing an important, but secondary role. Attributes associated with compassion have been identified as the quintessential indicator and outcome of authentic spirituality by virtually every major faith tradition. Though having religious antecedents, the language of compassion is embedded within the vernacular of secularized society. As such, it traverses the sacred and the secular, providing a medium for accessing the spiritual needs and experiences of all patients.
This novel study will determine how advanced cancer patients facing the end of life understand and experience compassion as received from health care professionals, with a particular focus on the significance of compassion to patients' spiritual well-being and the delivery of spiritual care by their health care providers. Fifty advanced cancer inpatients from diverse tumour groups will be recruited for this qualitative study. The components of compassion identified in this study will provide the foundation for an empirical and practical model that can be readily incorporated into clinical practice, resulting in reduced burden and enhanced quality of life for advanced cancer patients. The following three research questions will be examined in this grounded theory study:
1. How do advanced cancer patients facing the end of life understand and experience compassion?
2. What is the connection between compassion and spiritual well-being at the end of life?
3. How do patients' perceptions of compassion inform and shape the delivery of spiritual care by health care professionals working at the end of life?