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Article

Alistair Hewison, Yvonne Sawbridge and Laura Tooley

The purpose of this study was to explore compassionate leadership with those involved in leading system-wide end-of-life care. Its purpose was to: define compassionate

Abstract

Purpose

The purpose of this study was to explore compassionate leadership with those involved in leading system-wide end-of-life care. Its purpose was to: define compassionate leadership in the context of palliative and end-of-life care; collect accounts of compassionate leadership activity from key stakeholders in end-of-life and palliative care; and identify examples of compassionate leadership in practice.

Design/methodology/approach

Four focus groups involving staff from a range of healthcare organisations including hospitals, hospices and community teams were conducted to access the accounts of staff leading palliative and end-of-life care. The data were analysed thematically.

Findings

The themes that emerged from the data included: the importance of leadership as role modelling and nurturing; how stories were used to explain approaches to leading end-of-life care; the nature of leadership as challenging existing practice; and a requirement for leaders to manage boundaries effectively. Rich and detailed examples of leadership in action were shared.

Research limitations/implications

The findings indicate that a relational approach to leadership was enacted in a range of palliative and end-of-life care settings.

Practical implications

Context-specific action learning may be a means of further developing compassionate leadership capability in palliative and end-of-life care and more widely in healthcare settings.

Originality/value

This paper presents data indicating how compassionate leadership, as a form of activity, is envisaged and enacted by staff in healthcare.

Details

Leadership in Health Services, vol. 32 no. 2
Type: Research Article
ISSN: 1751-1879

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Article

Tina Maschi, Suzanne Marmo and Junghee Han

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date…

Abstract

Purpose

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is known about the extent to which palliative and end-of-life care is infused within global prison health care systems. The purpose of this paper is to fill a gap in the literature by reviewing and critically appraising the methods and major findings of the international peer-reviewed literature on palliative and end-of-life care in prison, identify the common elements of promising palliative and end-of-life services in prison, and what factors facilitate or create barrier to implementation.

Design/methodology/approach

A content analysis was conducted of the existing peer-reviewed literature on palliative and end-of-life care in prison. English-language articles were located through a comprehensive search of peer-reviewed journals, such as Academic Search Premier Literature databases using differing combinations of key word search terms, “prison,” “palliative care,” and “end-of-life care.” A total of 49 studies published between 1991 and 2013 met criteria for sample inclusion. Deductive and inductive analysis techniques were used to generate frequency counts and common themes related to the methods and major findings.

Findings

The majority (n=39) of studies were published between 2001-2013 in the USA (n=40) and the UK (n=7). Most were about US prison hospice programs (n=16) or barriers to providing palliative and end of life care in prisons (n=10). The results of the inductive analysis identified common elements of promising practices, which included the use of peer volunteers, multi-disciplinary teams, staff training, and partnerships with community hospices. Obstacles identified for infusing palliative and end-of-life care in prison included ethical dilemmas based on custody vs care, mistrust between staff and prisoners, safety concerns, concern over prisoners’ potential misuse of pain medication, and institutional, staff, and public apathy toward terminally ill prisoners and their human rights to health in the form of compassionate and palliative care, including the use of compassionate release laws.

Research limitations/implications

Implications for future research that foster human rights and public awareness of the economic and moral costs of housing the sick and dying in prisons. More research is needed to document human rights violations as well as best practices and evidence-based practices in palliative and end-of-life care in prisons. Future studies should incorporate data from the terminally ill in prison, peer supports, and family members. Future studies also should employ more rigorous research designs to evaluate human rights violations, staff and public attitudes, laws and policies, and best practices. Quantitative studies that use experimental designs, longitudinal data, and multiple informants are needed. Qualitative data would allow for thick descriptions of key stakeholders experiences, especially of the facilitators and barriers for implementing policy reform efforts and palliative care in prisons.

Practical implications

This review provides a foundation on which to build on about what is known thus far about the human right to health, especially parole policy reform and infusing palliative and end-of-life care for the terminally ill and dying in prisons. This information can be used to develop or improve a new generation research, practice, policy, and advocacy efforts for that target terminally ill and dying in prison and their families and communities.

Social implications

There are significant social implications to this review. From a human rights perspective, the right to freedom from torture and cruel and unusual punishment is a fundamental human right along with prisoners’ rights for an appropriate level of health care. These rights should be guaranteed regardless of the nature of their crime or whether they are in a prison placement. The information provided in this review can be used to educate and possible transform individual's and society's views toward the terminally ill and dying who are involved in the criminal justice system.

Originality/value

This paper extends the extant literature by using both quantitative and qualitative analysis methods to organize, summarize, and critically analyze the international literature on palliative care and end of life care in prison. This review is designed to increase awareness among the international community of the pain and suffering of the terminally ill in prison and the facilitators and barriers to providing them compassionate care while in custody.

Details

International Journal of Prisoner Health, vol. 10 no. 3
Type: Research Article
ISSN: 1744-9200

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Article

Timothy J. Vogus, Laura E. McClelland, Yuna S.H. Lee, Kathleen L. McFadden and Xinyu Hu

Health care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to…

Abstract

Purpose

Health care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to suffering. However, compassion is typically seen as an individual rather than a more systemic response to suffering and cannot match the scale of the problem as a result. The authors develop a model of a compassion system and details its antecedents (leader behaviors and a compassionate human resource (HR) bundle), its climate or the extent that the organization values, supports and rewards expression of compassion and the behaviors and practices through which it is enacted (standardization and customization) and its effects on efficiently reducing suffering and delivering high quality care.

Design/methodology/approach

This paper uses a conceptual approach that synthesizes the literature in health services, HR management, organizational behavior and service operations to develop a new conceptual model.

Findings

The paper makes three key contributions. First, the authors theorize the central importance of compassion and a collective commitment to compassion (compassion system) to reducing pervasive patient and care provider suffering in health care. Second, the authors develop a model of an organizational compassion system that details its antecedents of leader behaviors and values as well as a compassionate HR bundle. Third, the authors theorize how compassion climate enhances collective employee well-being and increases standardization and customization behaviors that reduce suffering through more efficient and higher quality care, respectively.

Originality/value

This paper develops a novel model of how health care organizations can simultaneously achieve efficiency and quality through a compassion system. Specific leader behaviors and practices that enable compassion climate and the processes through which it achieves efficiency and quality are detailed. Future directions for how other service organizations can replicate a compassion system are discussed.

Details

Journal of Service Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1757-5818

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Article

Joy M. Rooney

This paper aims to systematically review the current literature on compassion in mental health from a historical, service user and carer (SUAC)/academic researcher…

Abstract

Purpose

This paper aims to systematically review the current literature on compassion in mental health from a historical, service user and carer (SUAC)/academic researcher perspective with respect to the current paradigm/biomedical model.

Design/methodology/approach

Searches were conducted in CIANHL Complete, Academic Search Complete, British Education Index, ERIC, MEDLINE, PsycArticles, Scorpus, Proquest Central using a simplified PRISM approach.

Findings

In the UK, the SUAC-movement facilitated the adoption of more compassionate mental health in statutory services. Across the world, compassion-based approaches may be viewed as beneficial, especially to those experiencing a biomedical model “treatment”. Health-care workers, suffering burnout and fatigue during neoliberal economics, benefit from compassion training, both in their practice and personally. Randomised control trials (RCTs) demonstrate compassion-type interventions are effective, given sufficient intervention timing, duration and design methodology. Psychology creates outcome measures of adequacies and deficiencies in compassion, demonstrating their importance statistically, with reservations. The effective protection of mental health by self-compassion in both SUACs and health care professionals is evident. It is clear from qualitative research that SUACs prefer compassionate mental health. It also makes a large difference to mental health in general populations. Implications for practice and suggestions for future research are given, including a necessity to fund RCTs comparing compassionate mental health interventions with the biomedical model. Unless statutory mental health services adopt this emerging evidence base, medics and their SUACs will continue to rely on pharmaceuticals.

Originality/value

This is the first integrated literature review of compassion in mental health from a historical, SUAC/academic researcher viewpoint using all research methodologies.

Details

Mental Health and Social Inclusion, vol. 24 no. 4
Type: Research Article
ISSN: 2042-8308

Keywords

Content available
Article

Hooria Jazaieri

The purpose of this paper is to make the case for bringing compassion to students in educational settings, preschool through graduate school (PK-20).

Abstract

Purpose

The purpose of this paper is to make the case for bringing compassion to students in educational settings, preschool through graduate school (PK-20).

Design/methodology/approach

First, the author defines what is meant by “compassion” and differentiates it from the related constructs. Next, the author discusses the importance of bringing compassion into education, thinking specifically about preschool, K-12 (elementary and middle school/junior high/high school), college students, and graduate students (e.g. law, medical, nurses, counselors and therapists-in-training). The author then reviews the scant empirical literature on compassion in education and makes recommendations for future research. In the final section, the author makes specific and practical recommendations for the classroom (e.g. how to teach and evaluate compassion in PK-20).

Findings

While there is a fair amount of research on compassion with college students, and specifically regarding compassion for oneself, as the author reviews in this paper, the field is wide open in terms of empirical research with other students and examining other forms of compassion.

Research limitations/implications

This is not a formal review or meta-analysis.

Practical implications

This paper will be a useful resource for teachers and those interested in PK-20 education.

Social implications

This paper highlights the problems and opportunities for bringing compassion into education settings.

Originality/value

To date, no review of compassion in PK-20 exists.

Details

Journal of Research in Innovative Teaching & Learning, vol. 11 no. 1
Type: Research Article
ISSN: 2397-7604

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Article

Virginia Minogue

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and…

Abstract

Purpose

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As his main carer, the author of the paper was struck, when visiting the hospital, by a small poster, on a notice board near to the entrance to the hospital ward, outlining the staff’s commitment to Compassion in Practice. Compassion in Practice was enshrined in the Compassion in Practice vision and strategy (Department of Health, NHS Commissioning Board, 2012) for building a culture of compassionate care across health and social care. A key element of the strategy was to make the values of care, compassion, courage, communication, competence and commitment, real and visible to patients and the public. The purpose of this paper is to seek to compare the values being stated with the care experience.

Design/methodology/approach

This paper records a personal perspective from a patient and their family carers of compassionate care in practice. This experience is one case study and does not seek to represent the experience of other patients and their families.

Findings

This highlights the importance of communication and demonstrates that care and compassion are human emotions and values that have to be lived in practice and are part of the interaction between patient, clinician and family. Simply believing in those core nursing values does not make them real for the patient in practice.

Originality/value

Both patient and the family carers had extensive experience of working in health and social care including the NHS. This account demonstrates the challenges of turning strategy into actions that can ultimately improve the patient experience of care.

Details

Quality in Ageing and Older Adults, vol. 16 no. 2
Type: Research Article
ISSN: 1471-7794

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Article

Andy Bradley

The paper was written to highlight the common experience of older people in care homes who are often left to deal with loss and grief without the explicit emotional…

Abstract

Purpose –

The paper was written to highlight the common experience of older people in care homes who are often left to deal with loss and grief without the explicit emotional validation and support needed.

Design/methodology/approach –

Beginning with a real world example of an older person who felt suicidal at the prospect of moving into a care home the paper analyses the common culture in care homes and goes onto describe a new paradigm of care giving (“the compassionate community”).

Findings –

The paper highlights the need for a shift of culture and leadership thinking in the care homes.

Practical implications –

Older people need more opportunities to share their losses and grief and staff teams must develop their role so that it moves beyond physical caring to embrace the emotional and spiritual aspects of the lives of the people they care for.

Originality/value –

This paper issues a radical call for an shift in thinking and values and suggests a route map which will enable full expression of the emotional lives of the people being cared for.

Details

Working with Older People, vol. 17 no. 3
Type: Research Article
ISSN: 1366-3666

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Article

Joseph M. Woodside

The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and…

Abstract

Purpose

The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and managerial decision making of organizations, and provide a method to more easily communicate to a variety of stakeholders.

Design/methodology/approach

A text analytics process is run to evaluate the mission statements from the largest hospitals by revenue in each of the 50 states of the USA and District of Columbia to identify the types of metaphor-based organizational health management methods.

Findings

A cluster analysis is generated to evaluate primary mission-based metaphors, and metatriangulation is used to evaluate output, develop theory and provide practical implications for healthcare management.

Originality/value

Key contributions include a review of healthcare metaphors, an analysis for understanding commonly utilized metaphors, a theory building process for developing a new integrated value-based care management metaphor, and a value-based process is developed for providing healthcare managers an easy to follow and repeatable process for improving organizational communication.

Details

Journal of Health Organization and Management, vol. 32 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

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Article

Sue Holttum

The purpose of this paper is to focus on students, trainee nurses, early career psychologists, and other mental health professionals and their response to mental distress…

Abstract

Purpose

The purpose of this paper is to focus on students, trainee nurses, early career psychologists, and other mental health professionals and their response to mental distress or the stresses of working in mental health.

Design/methodology/approach

Three journal articles are summarised. The first highlights mental distress in university students and their reluctance to seek counselling. The second paper focuses on addressing the impact that the work of mental health workers can have on them and how this can jeopardise compassionate care. The third paper presents a model of inclusive and caring nurse education.

Findings

University students may be more likely to seek counselling for mental distress if they have information about its usefulness and it is normalised rather than stigmatised. Mental health workers including early-career psychologists need to know about “compassion fatigue” and “compassion satisfaction” and need safe places to reflect on the personal impact of hearing about their clients’ traumatic experiences. A whole-organisation model of nurse education that emphasises belonging and inclusiveness may increase nurse retention and nurses’ personal resilience.

Originality/value

The paper on students’ help-seeking is the first meta-analysis of several studies on this topic (involving similar variables and measures) in several years. The paper on mental health workers and compassion fatigue and compassion satisfaction is rare in looking at this across different professions in one setting. It highlights important ways of maintaining workers’ ability to deliver compassionate care. The model of nurse education is based on recent research evidence and may help increase retention and foster reflection, self-awareness, and resilience in nurses.

Details

Mental Health and Social Inclusion, vol. 19 no. 2
Type: Research Article
ISSN: 2042-8308

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Article

Emma Dowling

The purpose of this paper is to propose to expand the political economic understanding of a “fix”, that is, capital’s ability to overcome crises of profitability through a…

Abstract

Purpose

The purpose of this paper is to propose to expand the political economic understanding of a “fix”, that is, capital’s ability to overcome crises of profitability through a displacement of its crisis tendencies, to include an analytical attention to the gendered, sexualised and racialised unwaged and underpaid (caring) labour that reproduces labour power within a capitalist economy.

Design/methodology/approach

A “care fix”, the author argues, involves attempts to manage a crisis of care in ways that do not resolve but merely displace the crisis, perpetuating the systemic imperative of capital to off-load the cost of social reproduction and care, thereby constituting a crucial dynamic of capitalist development and restructuring and resulting in the reorganisation of gendered and racialised class relations and historically contingent regimes of reproduction.

Findings

The maceration of the Fordist regime of reproduction under neoliberalism has given way to a new post-Fordist arrangement that, having exhausted its care fix, is now once again in crisis. A new care fix is currently under way, while at the same time it is being contested and redirected by the contemporary struggles over social reproduction, care and democracy.

Research limitations/implications

Consequently, the author discusses the emergence of the notion of “caring capitalism” and contrasts this with proposals for democratising care, in turn investigating these developments in the context of an ongoing crisis of political representation in Europe and offering a notion of “care municipalism” as a possible way forward.

Practical implications

The practical implications concern the possibility of democratising the care sector.

Social implications

The social implications pertain to the questions of how social, political and economic institutions shift when care is placed on their agenda.

Originality/value

The value of this paper is to make a theoretical contribution to the analysis of changing configurations of care, social reproduction and society in relation to questions of democracy.

Details

Equality, Diversity and Inclusion: An International Journal, vol. 37 no. 4
Type: Research Article
ISSN: 2040-7149

Keywords

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