title: Interventions for compassionate nursing care: A systematic review.
abstract: BACKGROUND
  Compassion has been identified as an essential element of nursing and is increasingly under public scrutiny in the context of demands for high quality health care. While primary research on effectiveness of interventions to support compassionate nursing care has been reported, no rigorous critical overview exists.
  
  
  OBJECTIVE
  To systematically identify, describe and analyse research studies that evaluate interventions for compassionate nursing care; assess the descriptions of the interventions for compassionate care, including design and delivery of the intervention and theoretical framework; and to evaluate evidence for the effectiveness of interventions.
  
  
  METHODS
  Published international literature written in English up to June 2015 was identified from CINAHL, Medline and Cochrane Library databases. Primary research studies comparing outcomes of interventions to promote compassionate nursing care with a control condition were included. Studies were graded according to relative strength of methods and quality of description of intervention. Narrative description and analysis was undertaken supported by tabulation of key study data including study design, outcomes, intervention type and results.
  
  
  RESULTS
  25 interventions reported in 24 studies were included in the review. Intervention types included staff training (n=10), care model (n=9) and staff support (n=6). Intervention description was generally weak, especially in relation to describing participants and facilitators, and the proposed mechanisms for change were often unclear. Most interventions were associated with improvements in patient-based, nurse-based and/or quality of care outcomes. However, overall methodological quality was low with most studies (n=16) conducted as uncontrolled before and after studies. The few higher quality studies were less likely to report positive results. No interventions were tested more than once.
  
  
  CONCLUSIONS
  None of the studies reviewed reported intervention description in sufficient detail or presented sufficiently strong evidence of effectiveness to merit routine implementation of any of these interventions into practice. The positive outcomes reported suggest that further investigation of some interventions may be merited, but high caution must be exercised. Preference should be shown for further investigating interventions reported as effective in studies with a stronger design such as randomised controlled trials.
authors: Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden; Faculty of Health Sciences, University of Southampton, UK. Electronic address: karin.blomberg@oru.se.
authors: Karin
authors: K
authors: Blomberg
authors: Faculty of Health Sciences, University of Southampton, UK; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), UK.
authors: Peter
authors: P
authors: Griffiths
authors: Faculty of Health Sciences, University of Southampton, UK; Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden.
authors: Yvonne
authors: Y
authors: Wengström
authors: Faculty of Health Sciences, University of Southampton, UK; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), UK.
authors: Carl
authors: C
authors: May
authors: Faculty of Health Sciences, University of Southampton, UK; National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), UK.
authors: Jackie
authors: J
authors: Bridges
mesh_terms: D004645:Empathy; D006801:Humans; D009732:Nursing Care
keywords: Caring; Compassion; Dignity; Nurses; Professional–patient relations; Systematic review