Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
Division of Palliative Medicine Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
BMC Med Educ. 2021 Aug 28;21(1):455. doi: 10.1186/s12909-021-02863-w.
Patients and families want their healthcare to be delivered by healthcare providers that are both competent and compassionate. While compassion training has begun to emerge in healthcare education, there may be factors that facilitate or inhibit the uptake and implementation of training into practice. This review identified the attributes that explain the successes and/or failures of compassion training programs offered to practicing healthcare providers.
Realist review methodology for knowledge synthesis was used to consider the contexts, mechanisms (resources and reasoning), and outcomes of compassion training for practicing healthcare providers to determine what works, for whom, and in what contexts.
Two thousand nine hundred ninety-one articles underwent title and abstract screening, 53 articles underwent full text review, and data that contributed to the development of a program theory were extracted from 45 articles. Contexts included the clinical setting, healthcare provider characteristics, current state of the healthcare system, and personal factors relevant to individual healthcare providers. Mechanisms included workplace-based programs and participatory interventions that impacted teaching, learning, and the healthcare organization. Contexts were associated with certain mechanisms to effect change in learners' attitudes, knowledge, skills and behaviors and the clinical process.
In conclusion this realist review determined that compassion training may engender compassionate healthcare practice if it becomes a key component of the infrastructure and vision of healthcare organizations, engages institutional participation, improves leadership at all levels, adopts a multimodal approach, and uses valid measures to assess outcomes.
患者及其家属希望医护人员既有能力又有同情心，为其提供医疗服务。虽然关爱培训已开始在医疗保健教育中出现，但可能存在一些促进或阻碍培训纳入实践的因素。本综述旨在确定能够解释面向执业医护人员的关爱培训计划成功或失败的属性。
采用知识综合的现实主义综述方法，考虑了面向执业医护人员的关爱培训的背景、机制（资源和推理）和结果，以确定哪些因素有效、针对哪些人群以及在哪些背景下有效。
2991 篇文章进行了标题和摘要筛选，53 篇文章进行了全文审查，从 45 篇文章中提取了有助于制定方案理论的数据。背景包括临床环境、医护人员特征、医疗保健系统的现状以及与个别医护人员相关的个人因素。机制包括基于工作场所的方案和参与式干预措施，这些措施影响教学、学习和医疗组织。背景与学习者态度、知识、技能和行为以及临床过程发生变化的某些机制相关。
总之，本现实主义综述确定，如果关爱培训成为医疗保健组织的基础设施和愿景的重要组成部分、吸引机构参与、改善各级领导、采用多模式方法并使用有效的措施来评估结果，那么关爱培训可能会产生富有同情心的医疗保健实践。
