title: Measuring Compassion in Healthcare: A Comprehensive and Critical Review.
abstract: There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings.
  
  
  
  PubMed, MEDLINE, CINAHL and PsycINFO databases and grey literature were searched to identify studies that report information on instruments that measure compassion or compassionate care in clinicians, nurses, healthcare students and patients. Textual qualitative descriptions of included studies were prepared. Instruments were evaluated using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool.
  
  
  
  Nine studies containing information on the Compassion Competence Scale, a self-report instrument that measures compassion competence among Korean nurses; the Compassion Scale, the Compassionate Care Assessment Tool©, and the Schwartz Center Compassionate Care Scale™, patient-reported instruments that measure the importance of healthcare provider compassion; the Compassion Practices Scale, an instrument that measures organisational support for compassionate care; and instruments that measure compassion in educational institutions (instructional quality and a Geriatric Attitudes Scale), were included. Each instrument is associated with significant limitations. Most only measure certain aspects of compassion and lack evidence of adaptability to diverse practice settings. The EMPRO of self-report instruments revealed a lack of psychometric information on measurement reliability, validity, responsiveness and interpretability, respondent, administrative and scoring burden, and use in subpopulations.
  
  
  
  The findings of this narrative synthesis identified an unmet need for a psychometrically validated instrument that comprehensively measures the construct of compassion in healthcare settings.
authors.affiliation: Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. sinclair@ucalgary.ca.
authors.forename: Shane
authors.initials: S
authors.lastname: Sinclair
authors.affiliation: School of Nursing, University of Victoria, Victoria, BC, Canada.|Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, BC, Canada.
authors.forename: Lara B
authors.initials: LB
authors.lastname: Russell
authors.affiliation: Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, MB, Canada.|Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hack
authors.affiliation: Faculty of Nursing, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
authors.forename: Jane
authors.initials: J
authors.lastname: Kondejewski
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, BC, Canada.|School of Nursing, Trinity Western University, Langley, BC, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Sawatzky
mesh_terms: D004645:Empathy; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D011361:Professional Competence; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D011795:Surveys and Questionnaires / Q000592:standards*