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      Compassion in healthcare: an updated scoping review of the literature

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          Abstract

          Background

          A previous review on compassion in healthcare (1988-2014) identified several empirical studies and their limitations. Given the large influx and the disparate nature of the topic within the healthcare literature over the past 5 years, the objective of this study was to provide an update to our original scoping review to provide a current and comprehensive map of the literature to guide future research and to identify gaps and limitations that remain unaddressed.

          Methods

          Eight electronic databases along with the grey literature were searched to identify empirical studies published between 2015 and 2020. Of focus were studies that aimed to explore compassion within the clinical setting, or interventions or educational programs for improving compassion, sampling clinicians and/or patient populations. Following title and abstract review, two reviewers independently screened full-text articles, and performed data extraction. Utilizing a narrative synthesis approach, data were mapped onto the categories, themes, and subthemes that were identified in the original review. Newly identified categories were discussed among the team until consensus was achieved.

          Results

          Of the 14,166 number of records identified, 5263 remained after removal of duplicates, and 50 articles were included in the final review. Studies were predominantly conducted in the UK and were qualitative in design. In contrast to the original review, a larger number of studies sampled solely patients ( n = 12), and the remainder focused on clinicians ( n = 27) or a mix of clinicians and other (e.g. patients and/or family members) ( n = 11). Forty-six studies explored perspectives on the nature of compassion or compassionate behaviours, traversing six themes: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Four studies reported on the category of educational or clinical interventions, a notable decrease compared to the 10 studies identified in the original review.

          Conclusions

          Since the original scoping review on compassion in healthcare, while a greater number of studies incorporated patient perspectives, clinical or educational interventions appeared to be limited. More efficacious and evidence-based interventions or training programs tailored towards improving compassion for patients in healthcare is required.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12904-022-00942-3.

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          Most cited references103

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          PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

          Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.
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            Scoping studies: towards a methodological framework

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              Interrater reliability: the kappa statistic

              The kappa statistic is frequently used to test interrater reliability. The importance of rater reliability lies in the fact that it represents the extent to which the data collected in the study are correct representations of the variables measured. Measurement of the extent to which data collectors (raters) assign the same score to the same variable is called interrater reliability. While there have been a variety of methods to measure interrater reliability, traditionally it was measured as percent agreement, calculated as the number of agreement scores divided by the total number of scores. In 1960, Jacob Cohen critiqued use of percent agreement due to its inability to account for chance agreement. He introduced the Cohen’s kappa, developed to account for the possibility that raters actually guess on at least some variables due to uncertainty. Like most correlation statistics, the kappa can range from −1 to +1. While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations. Judgments about what level of kappa should be acceptable for health research are questioned. Cohen’s suggested interpretation may be too lenient for health related studies because it implies that a score as low as 0.41 might be acceptable. Kappa and percent agreement are compared, and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
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                Author and article information

                Contributors
                sinclair@ucalgary.ca
                Journal
                BMC Palliat Care
                BMC Palliat Care
                BMC Palliative Care
                BioMed Central (London )
                1472-684X
                18 May 2022
                18 May 2022
                2022
                : 21
                : 80
                Affiliations
                [1 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Compassion Research Lab, , University of Calgary, ; 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
                [2 ]GRID grid.413574.0, ISNI 0000 0001 0693 8815, Section of Palliative Care, Department of Family Medicine, , Alberta Health Services, ; Zone, Calgary, Canada
                [3 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Faculty of Nursing, , University of Calgary, ; 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
                [4 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Libraries and Cultural Resources, , University of Calgary, ; Calgary, Alberta Canada
                [5 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Division of Palliative Medicine Department of Oncology, , Cumming School of Medicine, University of Calgary, ; 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
                Article
                942
                10.1186/s12904-022-00942-3
                9116004
                35585622
                eae2e40d-e18c-4cc3-a23e-9659eaec6be8
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 2 September 2021
                : 5 April 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Anesthesiology & Pain management
                compassion,healthcare,patients,healthcare providers,scoping review,intervention

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