Compassionate care is the wish of every patient, health professionals, the public and loved ones (John, 2016). Interestingly, the presence or absence of compassion leaves an indelible impression that patients and their relatives have about their experiences of care in the health facilities. Compassion is the main factor which adds to patient satisfaction with nursing care and it enhances nurses’ job satisfaction (Royal College of Nursing 2012). Most patients and family members agree that improving patients’ satisfaction around their experience of care brings out an outcome that is valued. Literature reveals that there is a universal interest in compassion as it relates to care (Adamson & Dewar, 2015;Dewar, Adamson, Smith, Surfleet, & King, 2014). According to Bivins, Tierney and Seers (2017), entreaties for additional compassionate care have become serious discussion at international level resulting in initiatives such as Schwartz Rounds established in America, Hearts in Healthcare in New Zealand, and the Asia Pacific Healthcare Hub of Charter for Compassion. In the United Kingdom, a policy document called Compassion in Practice outlined six ‘Cs’ associated with compassionate care (care, compassion, courage, communication, commitment and competence).Compassion connotes empathizing with the patient and also empowering them through efficient and effective nursing care (Dewar & Cook 2014). Competence means that all involved in caring roles must have adequate information about individual’s health and social needs including expert understanding of technical and clinical knowledge. This would ensure effective care and treatment which are evidence-based (Department of Health, 2012). There is no evidence of assessing compassion competence among undergraduate nursing students focusing on multi countries in literature. Therefore, carrying out this study is crucial to highlight areas of deficiency in compassion competence among undergraduate nursing students so that that an intervention can be instituted for corrections since they are still at the formative stage. The study will also fill the paucity of literature on compassion competence.
Purpose: The main purpose of the study was to assess compassion competence among undergraduate nursing students from different cultures. Specifically, the following study objectives will be achieved:
- To determine compassion competence of nursing students in communicating with patients
- To ascertain compassion competence among nursing students in terms of sensitivity to patients’ needs
- To evaluate the level of compassion competence in relation to insight into patients’ problems
- To identify determinants of compassion competence among nursing students
Methods and Materials
The study was a descriptive cross-sectional survey involving four countries – Nigeria, South Korea, Oman and Iraq. A total of 1158 undergraduate nursing students participated in the study which included both generic and direct entry students.A stratified random sampling method was used to select participants from 200 level of study to 400 or 500 (as applicable in each of the institutions) because of their exposure to clinical experience. Data were collected using Compassion Competence Scale (CCS) developed by Lee and Seomun (2016) to measure communication, sensitivity, and insight. The instrument contain 17 items on a 5- point Likert scale (strongly agree =5, agree =4, neutral =3, disagree=2, strongly disagree=1). The 17 items are divided into eight (8) items on communication, five (5) items on sensitivity and four (4) items on insight. The total score is calculated as the mean of the scores for each question; it ranges from 1 to 5. The instrument was pilot tested on nursing students not used in the study. The Cronbach's alpha estimates were: .90 for the whole instrument; .80 for communication; .79 for sensitivity .70 for insight. Ethical approval was given by the Health Research Ethics Committee of each institution involved in the study. Data were computer analyzed by using SPSS for Windows version 21. Descriptive statistics, analysis of variance (ANOVA) and regression were used to analyze the data.
Results and Discussion : Nursing students who completed the survey numbered 1,158 in four countries. The socio-demographic characteristics of the sample shows that 70.6% were female; 87.7% were single, and average age was 22.25 (SD=3.44, minimum 18 to maximum 47). The biggest proportion of the respondents was from South Korea (31.3%), whereas the lowest was from Oman (18.3%). Overall, compassion competence was 3.96 (SD=0.56), showing a sequentially high level of sensitivity (mean = 4.10; SD = 0.63), communication (mean = 3.92; SD = .60), and insight (mean = 3.86; SD = .66).
In terms of the CCS sub-factors, sensitivity domain was perceived as the highest CCS dimension among nursing students in Iraq (mean = 4.20, SD = 0.52), Nigeria (mean = 4.14, SD = 0.83), Oman (mean = 4.01, SD = 0.71) and South Korea (mean = 4.01, SD = 0.49), respectively.With regards to sensitivity, the respondents asserted their recognition of the need for sensitivity and demonstrated it to patients’ with discomforts and suffering thereby easing their problems and increasing relief is which is an art of compassion in nursing. This findings is supported Lee and Seomun (2016) assertion that nurses’ behaviour showing sensitivity comprises of being able to accommodate, and focused on the patients and families and other significant people around the patient, spending quality time with patients and being genuinely and candidly concerned about patients. Sensitivity skills must be cultivated and displayed by nurses such as paying rapt attention to patients and observing the patients. Nurses must attend to patient’s needs on time, listen to them actively and be willing to make suitable emergency plans to help in possible future problems. Level of study and country of residence showed statistically significant multivariate effects.
Limitations: Different cultural background of the respondents, duration of the nursing programme (4 or 5 years); mode of students' entry (generic and direct entry) and the sample size may limit the generalization of the results
In conclusion, the respondents’ sensitivity to patients needs was high across all countries that participated in the study. Therefore, there is need to emphasize and develop effective communication skills and insights which are important aspects of compassion competence during the undergraduate programme and these can increase the quality of nursing care.