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Health Expect. 2015 Oct;18(5):1672-85. doi: 10.1111/hex.12160. Epub 2013 Dec 4.

In search of compassion: a new taxonomy of compassionate physician behaviours.

Author information

1
Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester Medical Center, SC, USA.
2
School of Nursing, Clemson University, Clemson, SC, USA.
3
Department of Medicine, James Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
4
Departments of Family Medicine, Psychiatry, Oncology, and Nursing, Center for Communication and Disparities Research, University of Rochester Medical Center, Rochester, NY, USA.

Abstract

BACKGROUND:

Compassion has been extolled as a virtue in the physician-patient relationship as a response to patient suffering. However, there are few studies that systematically document the behavioural features of physician compassion and the ways in which physicians communicate compassion to patients.

OBJECTIVE:

To develop a taxonomy of compassionate behaviours and statements expressed by the physician that can be discerned by an outside observer.

DESIGN:

Qualitative analysis of audio-recorded office visits between oncologists and patients with advanced cancer.

SETTING AND PARTICIPANTS:

Oncologists (n = 23) and their patients with advanced cancer (n = 49) were recruited in the greater Rochester, New York, area. The physicians and patients were surveyed and had office visits audio recorded.

MAIN OUTCOME MEASURES:

Audio recordings were listened to for qualitative assessment of communication skills.

RESULTS:

Our sensitizing framework was oriented around three elements of compassion: recognition of the patient's suffering, emotional resonance and movement towards addressing suffering. Statements of compassion included direct statements, paralinguistic expressions and performative comments. Compassion frequently unfolded over the course of a conversation rather than being a single discrete event. Additionally, non-verbal linguistic elements (e.g. silence) were frequently employed to communicate emotional resonance.

DISCUSSION AND CONCLUSIONS:

This study is the first to systematically catalogue instances of compassionate communication in physician-patient dialogues. Further refinement and validation of this preliminary taxonomy can guide future education and training interventions to facilitate compassion in physician-patient interactions.

KEYWORDS:

communication; compassion; oncology; patient suffering

PMID:
24305037
PMCID:
PMC4051859
DOI:
10.1111/hex.12160
[Indexed for MEDLINE]
Free PMC Article

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