title: In search of compassion: a new taxonomy of compassionate physician behaviours.
abstract: BACKGROUND
  Compassion has been extolled as a virtue in the physician-patient relationship as a response to patient suffering. However, there are few studies that systematically document the behavioural features of physician compassion and the ways in which physicians communicate compassion to patients.
  
  
  OBJECTIVE
  To develop a taxonomy of compassionate behaviours and statements expressed by the physician that can be discerned by an outside observer.
  
  
  METHODS
  Qualitative analysis of audio-recorded office visits between oncologists and patients with advanced cancer.
  
  
  METHODS
  Oncologists (n = 23) and their patients with advanced cancer (n = 49) were recruited in the greater Rochester, New York, area. The physicians and patients were surveyed and had office visits audio recorded.
  
  
  METHODS
  Audio recordings were listened to for qualitative assessment of communication skills.
  
  
  RESULTS
  Our sensitizing framework was oriented around three elements of compassion: recognition of the patient's suffering, emotional resonance and movement towards addressing suffering. Statements of compassion included direct statements, paralinguistic expressions and performative comments. Compassion frequently unfolded over the course of a conversation rather than being a single discrete event. Additionally, non-verbal linguistic elements (e.g. silence) were frequently employed to communicate emotional resonance.
  
  
  CONCLUSIONS
  This study is the first to systematically catalogue instances of compassionate communication in physician-patient dialogues. Further refinement and validation of this preliminary taxonomy can guide future education and training interventions to facilitate compassion in physician-patient interactions.
authors.affiliation: Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester Medical Center, SC, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Cameron
authors.affiliation: Center for Communication and Disparities Research, Department of Family Medicine, University of Rochester Medical Center, SC, USA.
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Mazer
authors.affiliation: School of Nursing, Clemson University, Clemson, SC, USA.
authors.forename: Jane M
authors.initials: JM
authors.lastname: DeLuca
authors.affiliation: Department of Medicine, James Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Supriya G
authors.initials: SG
authors.lastname: Mohile
authors.affiliation: Departments of Family Medicine, Psychiatry, Oncology, and Nursing, Center for Communication and Disparities Research, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
mesh_terms: D000328:Adult; D000368:Aged; D026686:Beneficence; D003142:Communication; D003695:Delivery of Health Care; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D010819:Physician's Role; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: communication; compassion; oncology; patient suffering