Psychology Department, University of Bath, Bath, UK.
University of Exeter, Exeter, UK.
Health Expect. 2024 Feb;27(1):e13953. doi: 10.1111/hex.13953.
Compassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient-reported measure, one that captures the observable actions of compassionate care delivery or 'compassionate healthcare in action' by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout.
A multistage mixed-methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two-round modified online Delphi process.
Consensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development.
This item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process.
This study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages.
关怀护理是当今医疗保健的一个基本组成部分；然而，许多关怀护理的衡量标准都是主观的，不清楚在实践中关怀护理是什么样子。这些衡量标准主要与身体医疗保健环境有关，忽视了精神保健。它们也没有让有医疗服务体验的人（PLE）在其发展过程中发挥重要作用。本研究旨在开始开发一个新的患者报告衡量标准，该标准通过任何在任何护理环境中工作的医疗保健专业人员的可观察行为来捕捉关怀护理的提供，即“关怀护理在行动”。该研究涉及整个过程中PLE 的医疗服务提供，包括患者和工作人员。
采用多阶段混合方法量表开发过程。首先，从患者和临床医生关于关怀护理对他们意味着什么的访谈的反思性主题分析中归纳出条目（n=8），并从现有关怀护理措施的文献综述中推导出其他条目。接下来，招募了一组在关怀护理方面有患者、临床医生和研究人员专长的专家（第一轮：n=33，第二轮：n=29），他们在两轮修改后的在线德尔菲过程中对这些条目进行了精炼。
在与六个方面有关的关怀护理行动的 21 个项目上达成了共识：理解、沟通、关注、行动、情感敏感性和联系。这些条目将构成进一步发展量表的基础。
这项条目开发工作为一种新的潜在工具奠定了基础，以系统地衡量患者眼中的关怀护理行动是什么样子。正在进行进一步的研究，以制作这种拟议的新测量工具的有效和可靠版本。我们详细概述了这些初始阶段，希望在测量工具开发中提高透明度和可重复性，并强调在整个过程中让 PLE 参与的重要性。
在新措施的开发过程中，包括项目最初的概念化以及参与条目生成和精炼阶段，本研究涉及身体和精神保健的 PLE（作为工作人员、患者和服务使用者）。
