Understanding Compassion: A Constructivist Grounded Theory Study to Explore the Perceptions of Individuals Who Have Experienced Nursing Care

Background: It has been suggested that compassion is aspirational, rather than a reflection of the reality of contemporary nursing practice. This notion is reflected through reported negative experiences of nursing care, encountered by individuals across a range of age groups and care contexts. In response, a political and professional reaffirmation has ensued to declare that compassion remains a core philosophy of nursing, although this provides limited articulation of what compassion entails. Furthermore, there is limited empirical research to explore compassion exclusively through the perceptions of individuals who have experienced nursing care, highlighting a gap in existing knowledge. Aim: The aim of the research was to address this gap in knowledge and develop a more comprehensive understanding of compassion in nursing. Specifically, the research aimed to explore compassion, exclusively, through the perceptions of individuals who had personal experience of nursing care. Methodology and Methods: A constructivist grounded theory methodology was implemented, influenced by the theoretical perspectives of symbolic interactionism and social constructionism. The target sample population comprised a group of individuals who were in an established role to contribute to teaching and learning strategies to undergraduate health students within the university setting. Applying a theoretical sampling strategy, data was collected via eleven individual interviews, a focus group discussion with three participants and three additional individual interviews. Data was analysed using initial, focused and advanced coding techniques, supported by constant comparative analysis. Findings: Five data categories were generated from analysis. This comprised the four major categories of Self-Propensity for Compassion, Attributes for Compassion, Socialising for Compassion, Conditions for Compassion and the core category of Humanising for Compassion. Advancing reflexivity to consider these data categories at a more conceptual level identified that compassion was fundamentally characterised by experiences of humanising approaches to nursing care, which were dependent upon the equilibrium of five interrelated elements of compassion. These elements comprised Character for Compassion, Competence for Compassion, Motivation for Compassion, Connecting for Compassion and Action for Compassion. The five elements of compassion were subject to further influence by three overarching principal dimensions of compassion, which comprised Compassionate Self, Compassionate Interactions with Others and Compassionate Situational Contexts. In order to reflect participant perceptions of the complex nature of compassion, a grounded theory was constructed and assimilated into The Model of Compassion for Humanising Nursing Care. The new theoretical insight gained from this model provides a more comprehensive understanding of what compassion in nursing involves, offering an original contribution to the existing knowledge base and a foundation from which to address emerging implications for practice and opportunities for future research