Patient Assessment Tool Helps Measure Physician, Nurse Compassion in Hospitals

Findings published in the Journal of General Internal Medicine show researchers validated two five-item tools that can be used to measure patient experience of physician and nurse compassion in inpatient settings and can be used in conjunction with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

“In health care, empathy is a feeling the clinician has, as opposed to compassion, which encompasses positive behaviors which patients can perceive,” authors explained. Clinician compassion is considered a vital element of high-quality care.

Defined as “the emotional response to another’s pain or suffering involving an authentic desire to help,” not only has research shown compassion is associated with better clinical outcomes across conditions, but it may have a financial impact on organizations. A lack of compassion has been linked with increased resource utilization and health care spending.

As evidence points to a suboptimal level of compassion in health care worldwide, researchers set out to psychometrically validate the five-item compassion measure when administered with the HCAHPS survey for inpatient hospital care. The current study also assessed if the compassion measure is valid and reliable when it comes to quantifying physician and nurse compassion for hospitalized patients.

A total of 91 community hospitals within 16 states participated in the study which took place between July 1 and July 31, 2020. All participants were aged 18 or older, had at least one overnight stay in a hospital as an inpatient, and completed the HCAHPS survey. “Each of the five items of the original measurement tool were modified to specifically elicit separate responses for interactions with physicians and nurses,” researchers said.

Of the 24,600 HCAHPS surveys delivered, a total of 4,756 patient responses were assessed. Analyses revealed:

• Confirmatory factor analysis found all five items loaded well on separate single constructs for both the physician and the nurse measures.
• Both models had a good fit to the observed data.
• Internal reliability was excellent for both the physician and nursing five-item compassion measures (Cronbach’s alpha = 0.96 and 0.95, respectively).
• The physician five-item compassion measure had only a moderate correlation with the nurse five-item compassion measure (i.e., while they trend in the same direction, they are discrete and not redundant) (r = 0.68, P < .001).
• Both measures demonstrated good convergent validity.

“Mediation testing found that while there were important associations between compassion, communication, and overall hospital rating, the physician and nurse five-item compassion measures allow for specific assessments of compassion, which are distinct from, and add additional information to, the HCAHPS questions,” researchers explained.

The two compassion measures are novel in that they are completed by patients as opposed to third parties or self-assessments, they are brief, and allow for distinct assessments as opposed to an overall measure of clinician compassion.

According to authors, being compassionate can be taught and a validated measurement tool can allow for rigorous testing of interventions aimed at increasing this trait among clinicians.

Future research is needed to better understand the relationship between compassion and communication among patients and clinicians. In addition, future studies should also “examine the impact of patient-clinician concordance/discordance in gender, race, and age on patient perception of compassionate care, as well as to validate the five-item compassion measure in other languages,” authors said.

Low response rates and a majority non-Hispanic white study population mark limitations.