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The Importance of Compassion in Healthcare

Introduction

Having to access healthcare can be worrying and scary for some people and can cause them stress and anxiety. They may be vulnerable or in physical or psychological pain, may not understand what is happening, and may have concerns about their health, well-being and future. A lack of compassion from healthcare professionals can make patients feel that they are not respected, included or valued, eroding the relationship and negatively impacting patients and their families.

Statistics show that compassion in healthcare needs improvement. According to Statista, 45% of the public agreed that nursing in NHS was less compassionate than previously. During a Care Quality Commission (CQC) inspection of GP services, patients had CQC comment cards to complete, and ten out of 21 had negative comments. Some common themes included patients not being treated with dignity and respect, feeling the doctor was not caring, and not feeling listened to.

Compassion is not just desirable but fundamental to providing effective and person-centred care. It is associated with positive impacts on the patient experience and a variety of patient-reported outcomes, such as reduced symptoms and improved quality of life (Malenfant, et al. 2022). It can also prevent health problems and hasten recovery (Royal College of Psychiatrists).

This blog post will explore the significance of compassion in healthcare and its impact on patients, healthcare professionals, and the overall healthcare system.

The Importance of Compassion in Healthcare

Defining Compassion in Healthcare

There are many definitions of compassion, but no universally accepted ones. Here are a couple that can help to understand what it means in the context of healthcare.

Perez-Bret, et al. 2016 – Definition of compassion in healthcare: a systematic literature review:

“The sensitivity shown in order to understand another person’s suffering, combined with a willingness to help and to promote the wellbeing of that person, in order to find a solution to their situation. This should be a duty in healthcare professionals’ daily work.

Cummings, 2012 – Compassion in Practice Strategy, the 6Cs:

“How care is given through relationships based on empathy, respect and dignity. It can also be described as intelligent kindness and is central to how people perceive their care.”

Compassion is recognised as crucial in many sectors, especially healthcare, as it is one of the six Cs of care. These values are essential to compassionate care that all patient-facing health and social care staff should understand and follow (NHS Professionals).

To be compassionate goes beyond mere sympathy, which is to recognise when someone is suffering. It also means being:

  • Aware of people’s suffering.
  • Resonating emotionally with their suffering, i.e. having empathy.
  • Doing something or wanting to do something to relieve their suffering.

When healthcare professionals have compassion, they actively want to understand and address the suffering of patients. Deep down, they want to help their patients and actually care about what happens to them.

The Dalai Lama once said, “Love and compassion are necessities, not luxuries. Without them, humanity cannot survive”. This is especially true in a healthcare setting where patients suffer from various ailments and are in discomfort, pain and distress. They need healthcare professionals to understand what they are going through and want to help them improve their health, well-being and quality of life.

The Importance of Compassion in Healthcare

The Healing Power of Compassion

Research has shown that compassion can have many positive impacts on healthcare. When a patient is shown compassion by healthcare professionals, it makes them feel less anxious and more relaxed. For example, research conducted by Fogerty et al. 1999, found that when randomised cancer patients had a short ‘enhanced compassion’ segment, it effectively reduced their anxiety.

Compassion has the power to improve a patient’s physical and emotional well-being in many ways, such as:

Here are some real-life examples of stories of patients who experienced healing through compassionate care:

The Importance of Compassion in Healthcare

Enhancing Patient Trust and Satisfaction

The Cambridge Dictionary definition of trust is “to believe that someone is good and honest and will not harm you, or that something is safe and reliable”. Trust is essential in healthcare, as there can be risks and uncertainty surrounding care, treatments and interventions. Vulnerable patients rely on healthcare professionals to have good intentions and competence and do what is in their best interests.

Healthcare professionals have a moral duty to build trust with patients and maintain it, which can be quickly lost. Compassionate care helps build trust between patients and healthcare professionals in many ways, such as:

  • It creates a positive and supportive environment, which patients need when they are vulnerable and more likely to engage in their care and treatment.
  • When patients are shown kindness and treated with dignity and respect, they feel listened to, validated and valued.
  • Healthcare professionals spend time with their patients, actively listen to them, show a genuine interest, understand their needs and help resolve their problems, demonstrating to patients that they care about their health and well-being.
  • It encourages improved communication and enhanced cooperation to empower patients to be involved in making decisions about their care and treatment, as they are ‘active partners’. It promotes patient autonomy and shared-decision making.
  • Patients are more likely to feel satisfied with the patient experience and have confidence in the healthcare provider because they perceive they treat them compassionately.

Compassionate care and patient satisfaction go hand in hand, as demonstrated by the following:

  • GP Patient Survey – patients’ experience of healthcare services provided by GP surgeries.
  • 71% of patients had a good overall experience of their GP practice.
  • Patients felt the healthcare professional they saw was good at:
  • Treating them with care and concern (84%).
  • Listening to them (85%).
  • Giving them enough time (84%).
  • 93% said they had confidence and trust in the healthcare professional they saw.
  • Adult inpatient survey 2022 – considers the experiences of people who were an inpatient in hospital and stayed at least one night.
  • 81% and 79% of respondents said they ‘always’ had confidence and trust in doctors and nurses.
  • 82% of respondents felt they were treated with dignity and respect.
  • Urgent and emergency care survey 2022 – looks at the experiences of people using type 1 and type 3 urgent and emergency care services.
  • 79% of Type 3 patients ‘definitely’ had confidence and trust in health professionals, although lower than 82% in 2020.
  • 84% of patients who used Type 3 services said health professionals ‘definitely’ listened to what they had to say.
  • 71% of Type 1 patients ‘definitely’ had confidence and trust in staff examining and treating them, compared with 77% in 2020.
  • 72% of Type 1 patients felt they were treated with dignity and respect ‘all of the time’, compared with 81% in 2020.

Further statistics are on NHS England National Patient and Staff Surveys here.

There is also evidence of the correlation between compassionate care and patient satisfaction in research, for example:

  • Sinclair, et al. 2022 What is the Most Valid and Reliable Compassion Measure in Healthcare? An Updated Comprehensive and Critical Review – highlights that research has demonstrated that compassion enhances the overall quality of healthcare and patient outcomes, including patient quality of life and satisfaction with care.
  • Habib, et al. 2023Understanding compassionate care from the patient perspective: Highlighting the experience of head and neck cancer care – highlight the benefits of compassionate care, including improved patient satisfaction.y
  • Babaei & Taleghani. 2019 – Compassionate Care Challenges and Barriers in Clinical Nurses: A Qualitative Study – highlight the importance of compassion-based care in increasing patient satisfaction.
The Importance of Compassion in Healthcare

The Psychological Benefits for Healthcare Professionals

While compassion is essential in providing person-centred care and beneficial for patient outcomes, healthcare professionals can also derive many emotional and psychological benefits from practising compassion. Some of these benefits include:

  • Improved psychological and emotional well-being – showing compassion to others can be pleasurable and extremely rewarding. It can make healthcare professionals feel good and happier and give them a sense of purpose and self-worth. It can also reduce stress and anxiety and improve their overall well-being.
  • Better physical health – compassion can help speed up recovery from illnesses and may even lengthen a person’s lifespan, keeping healthcare professionals fit and healthy to do their role effectively.
  • Improved relationships – compassion can help healthcare professionals build and maintain trusting relationships with patients. It helps them provide better care, which can boost self-esteem and confidence, especially if their patients improve.
  • Improve staff efficiency – compassion can enhance communication and cooperation between individuals and teams and between healthcare professionals and patients, improving staff efficiency (Royal College of Psychiatrists). Increased efficiency can reduce stress and improve productivity.
  • Higher job satisfaction and job retention – compassion positively impacts healthcare professionals, and they are likely to feel more satisfied in their jobs and want to stay in their roles if they feel happier (Baguley, et al. 2020).

Working in healthcare is stressful, demanding and challenging. According to a survey conducted by the NHS in 2022, more than a third of healthcare staff report feeling burnt out at work, with staff in clinical roles found to be most vulnerable (the Society of Occupational Medicine). Compassionate care can help prevent burnout and improve job satisfaction for the above reasons and also encourages healthcare professionals to practice self-compassion to manage stress.

However, it is also important to note that it can negatively impact healthcare professionals, such as compassion fatigue. A study by Kinman & Grant (2020) found that compassion fatigue was a significant risk factor for well-being. However, they found some evidence that compassion satisfaction and self-compassion buffer the negative effects of emotional demands on mental health.

The Importance of Compassion in Healthcare

Compassion as a Pillar of Person-Centred Care

Compassion is needed to provide person-centred care and is a vital pillar, which is why it is in the six Cs of care. A healthcare professional’s role is to decide on the most appropriate care, treatments and interventions, but they must also consider their patient’s emotional needs and concerns, fears or vulnerabilities. It is about not just seeing a patient as their symptoms or diagnoses but understanding that they are unique with their own personal histories, life stories and needs.

A crucial part of patient-centred care is respecting and responding to patient’s specific needs, beliefs, values and preferences, which should guide clinical decisions (Frampton, et al. 2013). It is about putting patients at the centre of their care, who are actively involved and supported to make informed decisions regarding their care and treatments.

Healthcare professionals must be compassionate, which means actively listening to patients, being empathetic and sympathetic, understanding what is important to them and being sensitive to their wishes and values. It should be at the core of patient care, as it also involves finding ways to comfort patients and relieve their pain, distress and suffering while treating them with dignity and respect.

Healthcare professionals need to collaborate on patient care to do what is in the best interests of their patients. It is also important to involve patients in shared decision-making and respect patient autonomy.

Shared decision-making is:

“A joint process in which a healthcare professional works together with a person to reach a decision about care” (NICE).

Patient autonomy is

“The right of competent adults to make informed decisions about their own medical care” (British Medical Association).

Shared decision-making and respecting patient autonomy are essential parts of person-centred care and are important for the following reasons:

  • Both are in legal and ethical frameworks, which all healthcare professionals must follow to comply with the law, standards and guidelines and to retain registration and membership with professional bodies and associations.
  • Sharing information and having open discussions with patients about treatments and tests helps ensure they understand the benefits, risks, alternatives and potential consequences and outcomes. Any tests and treatments selected are evidence-based and align with a patient’s needs, values, beliefs and preferences.
  • Patients have appropriate and sufficient information to make informed decisions about their care and treatment that meets their needs.
  • Autonomy requires healthcare professionals not to influence a patient’s decision and requires their capacity, consent or an informed agreement before investigations and treatments occur.
  • Shared decision-making and respecting autonomy can help healthcare professionals have better relationships with patients.
  • Patients are given a choice of care and treatments that align with their wishes, beliefs, values and preferences, thus empowering them to be active participants.
  • Patients can decide how much they want to be involved in making decisions regarding their care. Some patients may have a more active role, and others may not.
  • Care and treatments are agreed upon and consented to by patients before they are undertaken, with the support of healthcare professionals.
  • Patients have improved healthcare experiences as their health literacy and education are enhanced, leading to better patient outcomes.

Where patients lack capacity to make informed decisions regarding their care and treatments, the Mental Capacity Act will apply. Healthcare professionals must balance patient autonomy with the risks, costs and what is in the patient’s best interests, i.e. beneficence. They should still involve patients in decisions ‘so far as practicable’.

The Importance of Compassion in Healthcare

Overcoming Challenges in Compassionate Care

While compassion is essential in person-centred care and can have many benefits, healthcare professionals face challenges when providing compassionate care, such as compassion fatigue, time constraints and religious & cultural.

Compassion fatigue

Providing care to patients can result in compassion fatigue in some healthcare professionals, a unique form of burnout (Royal College of Nursing). NHS Keeping Well defines it as the:

“Emotional cost of caring for others or their emotional pain, whereby the individual struggles emotionally, physically and psychologically from helping others as a response to prolonged stress or trauma.”

Compassion fatigue, also known as secondary or vicarious trauma, can happen to any healthcare professional, and it develops over time. It usually occurs in those who neglect their own self-care, take on extra shifts and do not have sufficient days off.

It is important to recognise the signs and symptoms of compassion fatigue, which may include:

  • Mental and physical exhaustion.
  • Insomnia.
  • Feeling overwhelmed, detached and numb.
  • A lack of empathy and sensitivity.
  • Indifference towards patients.
  • Feelings of helplessness, powerlessness and guilt.
  • Thinking about patients too much outside of work.
  • Burnout.

A full list of signs is on NHS Keeping Well.

Not dealing with compassion fatigue can cause stress and mental health problems, such as anxiety and depression. To reduce the risk of developing compassion fatigue, healthcare professionals can adopt the following strategies:

  • Ensure they can recognise the signs and symptoms of compassion fatigue, stress and burnout to take the necessary actions.
  • Maintain a healthy work-life balance and have interests and hobbies outside of work.
  • Look after their physical, mental and emotional well-being, e.g.:
  • Try relaxation techniques and activities, e.g. mindfulness, meditation, yoga, breathing exercises, etc.
  • Practice self-care, e.g. eating healthily, exercising, getting enough sleep, etc.
  • Learn to say no to get a decent work-life balance.
  • Have regular breaks and time off.
  • Attend therapy if needed.
  • Being kind to themselves.
  • Have realistic expectations on what they can accomplish with patients.
  • Provide patients with the tools to look after their own well-being rather than trying to take responsibility for them.
  • Do not be afraid to ask for help and support from family, friends and colleagues.

Further tips and coping strategies are on:

Time constraints

One of the most commonly identified challenges in providing compassion within the healthcare setting is time constraints (Malenfant, et al. 2022). Healthcare professionals are extremely busy with heavy workloads and multiple demands, especially in the NHS. Rushing and hurrying to get tasks done can make it difficult for healthcare professionals to spend time with patients and actively listen to their concerns, which can show a lack of compassion and make it hard to develop trusting relationships with patients. It can also lead to anxiety, exhaustion, stress and eventually burnout and mental and physical health issues for healthcare professionals.

Healthcare professionals can adopt the following strategies to help them overcome time-constraint challenges:

  • Be compassionate – as it can actually increase efficiency by improving communication and cooperation between individuals and teams and healthcare professionals and patients.
  • Undertake additional training, e.g. time management – as it may help healthcare professionals improve in organising their workload and managing their time.
  • Prioritise – every task may seem a priority in a healthcare environment, but are they? Healthcare professionals could consider critically assessing their activities, eliminating unnecessary tasks (Govasli & Solvoll, 2020) and prioritising more important ones.
  • Self-reflect – healthcare professionals should be aware of their own limitations and coping mechanisms when facing multiple demands. They should also self-reflect about their entire practice and how they could improve their ways of working to overcome time constraints to provide more compassionate and quality care.
  • Ask for help and support – having time for compassion is fundamental in providing person-centred care. Therefore, if healthcare professionals find that their workload exceeds their working hours, they should speak to their manager, ask for help and seek additional support, e.g. from employee assistance programmes, therapists, etc.

Religious and cultural

The UK is a diverse country with people from all different backgrounds, ethnicities, cultures and religions, which can be a barrier to providing compassionate care due to the following:

  • Language differences can make it difficult for healthcare professionals to communicate and develop relationships with patients and vice versa.
  • Religious beliefs and cultural differences can influence how patients perceive care, their needs, preferences and values and the treatments and interventions permitted. It can also affect how a healthcare professional provides care. A study by Babaei & Taleghani, 2019 found that gender was a determining factor and was considered a cultural barrier to compassionate behaviour by nurses.
  • What it means to be compassionate can differ between cultures, and some patients may find healthcare professionals’ responses inappropriate or not understand their body language or meanings. It can mean accidentally offending a patient and their family.

Healthcare professionals can adopt the following strategies to help them overcome religious and cultural challenges:

  • Having an awareness of other people’s cultural, religious and spiritual beliefs and their own to avoid biases.
  • Ask and understand the patient’s needs, preferences, beliefs and values to provide holistic and person-centred care and be culturally sensitive.
  • Working with the patient and adopting shared decision-making to respect their autonomy so they can make informed choices about their care and treatment.
  • Undertaking additional training on compassionate care to understand why it is essential in providing high-quality care.
The Importance of Compassion in Healthcare

Compassion in End-of-Life and Palliative Care

When a person reaches the end of their life, they can be uncomfortable, in pain and have distressing symptoms, which can also be upsetting for families, caregivers and friends. It is also a scary time, and they will go through an array of emotions upon receiving a diagnosis, through their illness and as the end of their life approaches. End-of-life care aims to support patients, their families and friends through this turbulent time.

End-of-life care refers to the last year of a person’s life (NHS England) and is a form of palliative care. When a person is close to the end of their life due to an incurable (terminal) illness, they receive palliative care, which primarily focuses on:

  • Managing their pain and other symptoms.
  • Making them as comfortable as possible.
  • Providing practical, emotional, psychological and spiritual support.
  • Improving their quality of life and also that of their families, caregivers and friends.

Compassion profoundly impacts end-of-life and palliative care settings as healthcare professionals care for and support patients in their last months or years. As it is a distressing time for patients, their families and friends, healthcare professionals must be sensitive to what they are going through and motivated to reduce their suffering by providing personalised, holistic and compassionate care and treatments.

Compassion is seen as an essential aspect of palliative and end-of-life care by patients, families, healthcare professionals and society as a whole. Uncompassionate care in any healthcare setting, but especially in palliative and end-of-life, can result in:

  • Patients suffering and not given the care and support they need in line with their preferences, beliefs and values.
  • Patients not treated with dignity and respect.
  • Patients not actively involved in the decisions regarding their care and treatment.
  • Distress for families and friends if their loved ones do not have their dignity at the end of their lives and do not have a ‘good death’.
  • Financial and legal consequences, i.e. if a patient’s family sues.
  • Reputational damage for healthcare providers and professionals.

Providing emotional support to patients and their families is vital in palliative and end-of-life care. Emotional support can involve healthcare professionals having conversations with them to alleviate their concerns about death and help them feel less lonely. It can also mean helping them practically with day-to-day tasks, supporting them with activities and providing respite care for caregivers. It can make a significant difference to patients and their families if they feel supported and not alone. Marie Curie has further information for healthcare professionals on providing emotional care here.

Ensuring patients are comfortable is also crucial, as they may be uncomfortable due to pain, fatigue, breathing problems, etc. Providing physical comfort to patients can positively impact their well-being and quality of life during this time. It can also help families and friends if they see loved ones are comfortable, cared for and treated with dignity and compassion.

Compassionate care in palliative and end-of-life care can enhance patients’ experiences, help relieve their suffering and help them and their families come to terms with what is happening. It ensures healthcare professionals consider their patients’ needs, wishes, and beliefs and ensure they have comfort, dignity and respect at the end of their lives. Healthcare professionals have a role in helping their patients to live as well as possible until they die and allowing them to die with dignity (NHS).

The Importance of Compassion in Healthcare

Training and Cultivating Compassion

It is in a human being’s nature to be compassionate. However, some are more compassionate than others. Various factors influence compassion, such as upbringing, culture, environment, life experiences, etc., but people can learn and cultivate this important quality and skill through training (Weng, et al. 2013).

Compassion is an essential quality that healthcare professionals must possess to comply with the laws and ethics within their field and also provide high-quality care to their patients. They must undergo training and continuous education to enhance their compassionate skills to improve patients’ outcomes and experiences. Some examples of resources and training programmes they can use to cultivate these skills include (this list does not imply any endorsement of commercial or non-commercial products):

Training and courses

Resources

Healthcare professionals may also find their professional body or any associations they are a member of have training and resources on compassion to help them improve their skills.

Continuous education is vital in fostering compassion, as it provides opportunities for healthcare professionals to reflect on their working practices and how they currently deliver compassionate care to patients so they can make improvements where needed. It also helps them to maintain compassion over time, as it can boost knowledge and skills.

Compassion is an area that is frequently studied and researched in healthcare settings, which can lead to new developments and improvements. Legal and ethical frameworks, professional standards and guidance are also updated frequently. Therefore, continuous education will enhance healthcare professional’s understanding of the latest developments in compassionate care within their sector and role.

The Importance of Compassion in Healthcare

Patient Stories and Testimonials

We all seem to hear about the negative news and stories in healthcare. While unacceptable and harrowing in some cases, it is important to appreciate when healthcare providers and professionals go above and beyond in the care they provide to their patients. Here are some firsthand accounts and testimonials from patients who have experienced compassionate care:

  • Patients tell personal stories about the care, support and compassion they receive at St Columba’s Hospice Care.
  • Hen shares her Mum’s story about her time at St Mary’s Hospice and the care and compassion she received.
  • Mark Doughty shares his personal story about the value and power of compassionate care – The King’s Fund.
  • The CHFT and Frailty Team received feedback from relatives of those in the hospital, with one saying, “A shining example of compassionate carers who put the patient truly at the heart of their practice” – Calderdale and Huddersfield NHS Foundation Trust.
  • Leanne has type-1 diabetes and shares her story of how personalised care helped her through her pregnancy – YouTube.
  • The Health Foundation speaks about compassion, dignity and respect in health care and has various testimonials from patients on their positive experiences – YouTube.

Compassion can really make a difference in patients and their family’s lives, as it puts them at the centre of their care and tailors their care to their needs, beliefs and wishes. It treats them with dignity, respect and empathy and makes them feel like someone really cares for them, understands what they are going through, and wants to help them.

No matter the healthcare setting a patient is in or the care, support and treatment they need, compassion should be at the heart of everything a healthcare professional does. Whether it is a small gesture, a conversation or a kind action, it can make a positive difference to vulnerable patients, enhance their experience and even improve their outcomes.

The Importance of Compassion in Healthcare

Encouraging Compassion Beyond Healthcare

Healthcare professionals should practice compassion in their healthcare settings and in everyday life and interactions with friends, family, and strangers. It can have many positive impacts on the giver and receiver of compassion. It gives people a sense of purpose and worth, can have mental and physical health benefits, and can feel good. For example, an older person in the community can feel lonely and isolated. A simple act of compassion, e.g. talking to them, can make a difference to their day and lives.

Being compassionate in everyday life can also help healthcare professionals develop their skills in this area and use it in their working practices to provide the best quality patient care that is person-centred. It can also help them reduce stress and anxiety and have better relationships with their patients, colleagues, friends and family.

If healthcare professionals practice compassion outside of their setting, it can also help them develop self-compassion skills. Self-compassion, i.e. being kind and caring to oneself, is fundamental for healthcare professionals, as it can:

  • Increase optimism, happiness and gratitude.
  • Reduce perfectionism and self-criticism.
  • Provide better job satisfaction and better relationships.
  • Reduce stress, exhaustion and anxiety that can lead to compassion fatigue and burnout.
  • Increase physical and mental health and well-being.
  • Improve emotional resilience, confidence and self-esteem to provide better compassionate care to others.
The Importance of Compassion in Healthcare

Conclusion

Compassion in healthcare is a cornerstone of high-quality, person-centred care and should be embedded in the culture of each healthcare setting. When patients access healthcare services, they may be in physical or psychological pain, fear or distress. They need to feel that people caring for and treating them really care about them, understand what they are going through and have their best interests at heart.

Healthcare professionals can provide compassionate care by seeing their patients as people, not just their diagnoses and conditions. They should understand their patients’ needs, preferences, beliefs and values to provide personalised care, support and treatments. They should also empower their patients by shared decision-making and treating them and their families with dignity, respect and empathy during this vulnerable time.

All healthcare professionals, no matter where they work or what their role entails, have a vital role in promoting compassionate care in their settings and should prioritise compassion in their practice. Not only does it benefit patient experiences and outcomes, but it also has many positive benefits for healthcare professionals themselves. However, they must be mindful of compassion fatigue and ensure they practice self-compassion to reduce the risk of stress, exhaustion and anxiety, as working in healthcare is demanding.

Please use the comments section to share experiences, thoughts, or examples of compassion in healthcare. Use the space to foster a compassionate and empathetic community.

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