Barriers and facilitors to compassionate care: A systematic review and qualitative meta-analysis.

Abstract

BackgroundThe importance of compassion and compassionate care, as an indicator for quality care, has been well acknowledged in recent years within health care. However, there are some international concerns about the state of compassion in the contemporary healthcare systems. There are many factors that facilitate or inhibit the provision of compassion in clinical settings.ObjectiveThis meta-synthesis of qualitative studies aimed to explore healthcare providers' perceived barriers and facilitators to compassion in healthcare settings.MethodsA systematic review and meta-synthesis of qualitative studies were used in this study. Five electronic databases including Scopus, Web of Science, PubMed/Medline, CINAHL, and PsycINFO were searched to identify relevant studies. In this meta-synthesis, Thomas and Harden's thematic analysis approach was undertaken to synthesize the findings of the qualitative studies.ResultsA total of 20 papers were selected for meta-synthesis. The data analysis resulted in the development of three main themes for barriers to compassion: (a) organizational or systemic challenges, (b) personal and individual factors, and (c) patient and family-related factors. Moreover, three main themes for facilitators to compassion emerged from data analysis: (a) supportive organizational culture, (b) personal capacity for compassion, and (c) patient and family reactions.ConclusionThis meta-synthesis showed some barriers and facilitating factors for developing high-quality compassionate care. Understanding factors that influence compassionate care delivery may improve the cultivation of compassionate care. Moreover, identifying these challenges and facilitators provides a comprehensive framework through which healthcare providers, policy makers, and healthcare organizations can assess their own strategies to identify how compassion could be cultivated and developed in healthcare settings. It may inform practical strategies and interventions tailored to foster the delivery of compassionate care in each healthcare setting and improve the quality of care and health outcomes.