title: Compassion in Health Care: An Empirical Model.
abstract: BACKGROUND
  Compassion is frequently referenced as a hallmark of quality care by patients, health care providers, health care administrators, and policy makers. Despite its putative centrality, including its institution in recent health care reform, an empirical understanding based on the perspectives of patients, the recipients of compassion, is lacking-making compassion one of the most referenced yet poorly understood elements of quality care.
  
  
  OBJECTIVE
  The objective of this study was to investigate palliative cancer patients' understanding and experiences of compassion to provide a critical perspective on the nature and importance of compassion.
  
  
  METHODS
  This grounded theory study used semi-structured interviews to investigate how patients understand and experience compassion in clinical care. Using convenience and theoretical sampling, 53 advanced cancer inpatients were recruited over a seven-month period from a specialized palliative care unit and hospital-wide palliative care service within a Canadian urban setting. Data were analyzed by four members of the research team through the three stages of Straussian grounded theory.
  
  
  RESULTS
  Qualitative analysis yielded seven categories, each containing distinct themes and subthemes. Together, they constitute components of the compassion model-the first empirically based clinical model of compassion. The model defines compassion as a virtuous response that seeks to address the suffering and needs of a person through relational understanding and action.
  
  
  CONCLUSIONS
  The components of the compassion model provide insight into how patients understand and experience compassion, providing the necessary empirical foundation to develop future research, measures, training, and clinical care based on this vital feature of quality care.
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address: sinclair@ucalgary.ca.
authors.forename: Shane
authors.initials: S
authors.lastname: Sinclair
authors.affiliation: Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: McClement
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Shelley
authors.initials: S
authors.lastname: Raffin-Bouchal
authors.affiliation: Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada; College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hack
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Hagen
authors.affiliation: Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Shelagh
authors.initials: S
authors.lastname: McConnell
authors.affiliation: Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada; Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Harvey Max
authors.initials: HM
authors.lastname: Chochinov
mesh_terms: D002170:Canada; D004645:Empathy; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D036301:Qualitative Research; D014505:Urban Population
keywords: Compassion; empirical; model; oncology; palliative care; qualitative research