Understanding Compassion Fear in Nursing: A Literature Review

Öz

Compassion, traditionally an integral part of nursing, is now often conflated with the growing evidence that nurses experience fear of giving and receiving compassion. While compassion has long been recognised as one of the cornerstones of nursing care, recent literature points to a growing phenomenon in which nurses experience fear in giving and receiving compassion. Socio-demographic characteristics, psychological factors, and childhood trauma experiences are considered as factors influencing fear of compassion. The negative correlations between fear of compassion and mental health and physiological responses that this fear has a far-reaching impact on nursing professionals. Furthermore, the association of fear of compassion with professional commitment, burnout, empathy, and patient care satisfaction emphasises its complexity as a personal and professional challenge. Understanding compassion and compassion fear is essential for fostering an empathetic healthcare environment and promoting a holistic, patient-centred approach to healthcare, aligning with the core values of nursing. The review emphasises the need to acknowledge compassion and compassion fear as a nursing problem. It calls for further research to explore interventions, assess the impact of compassion fear on patient outcomes, and develop strategies to enhance compassionate care within the nursing profession.

Anahtar Kelimeler

• Compassion
• compassion fear
• nursing profession

Kaynakça

1. 1. Strauss, C., Taylor, B. L., Gu, J., Kuyken, W., Baer, R., Jones, F. and Cavanagh, K. What is compassion and how can we measure it? A review of definitions and measures. Clinical psychology review 2016 ; 47: 15-27. google scholar
2. 2. Bayar, Ö., & Dost, M. T. Üniversite öğrencilerinde öz-şefkatin yordayıcıları olarak bağlanma tarzı ve algılanan sosyal destek. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi 2018; 33(3): 689704. google scholar
3. 3. Cornelius, E. The motivation and limits of compassion. HTS: Theological Studies, 2013; 69(1), 1-7. google scholar
4. 4. Van Der Cingel, M. Compassion and professional care: exploring the domain. Nursing Philosophy 2009; 10(2), 124-136. google scholar
5. 5. Kabat-Zinn, J. (2010). Letting everything become your teacher: 100 lessons in mindfulness. Delta, 2010. google scholar
6. 6. Ferrari, M., et al. Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness 10, 2019; 1455-1473. google scholar
7. 7. Türk Dil Kurumu Sözlükleri. https://sozluk.gov.tr/. Erişim Tarihi 2023. google scholar
8. 8. Bonaz, Bruno, Thomas Bazin, and Sonia Pellissier. The vagus nerve at the interface of the microbiota-gut-brain axis. Frontiers in neuroscience 12, 2018: 336468. google scholar

9. 9. Pradhan, Elizabeth K., et al. Effect of mindfulness-based stress reduction in rheumatoid arthritis patients. Arthritis Care & Research. 2007 ; 1134-1142. google scholar
10. 10. Van der Cingel, Margreet. «Compassion in care: A qualitative study of older people with a chronic disease and nurses.» Nursing ethics 18.5, 2011; 672-685. google scholar
11. 11. Bloomfield, J., & Pegram, A. Care, compassion and communication. Nursing Standard. 2014; 29(25), 45. google scholar
12. 12. McCaffrey, G., and Shelagh McConnell. Compassion: a critical review of peer-reviewed nursing literature. Journal of Clinical Nursing. 2015;3006-3015. google scholar
13. 13. Bradshaw, Ann. Compassion: what history teaches us. Nursing times. 2011 ; 12-14. google scholar
14. 14. Arşimet, Asima, and Satı Dil. COVID-19 tanılı hastaya NANDA-I ve Joyce Travelbee’nin insan insana ilişki modeline göre verilen hemşirelik bakımı: bir olgu sunumu. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 3.3. 2021 ;229-239. google scholar
15. 15. Özsoy, Süheyla, and Renginar Dönmez. Hemşirelik Mesleginin İlk Etik Kodlari: Geçmişten Günümüze Hemşirelik Andi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi 33.1. 2017 ; 111-122. google scholar
16. 16. Tanrıkulu, Ebru, and Yıldız Denat. «Hemşirelikte Merhametli Bakım.» Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 15.4. 2021 ; 541-556. google scholar
17. 17. Goetz, J. L., Dacher Keltner, and Emiliana Simon-Thomas. Compassion: an evolutionary analysis and empirical review. Psychological Bulletin 136.3.2010;351. google scholar
18. 18. American Nurses Association Code of ethics for nurses with interpretive statements, 2015. google scholar
19. 19. International Council of Nurses. The ICN Code Of Ethics For Nurses, 2020. google scholar
20. 20. Eşref, Nas., and Sak. Ramazan. Merhamet ve meramec odaklı terap. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi 18.1.2020 ; 64-84. google scholar
21. 21. Scott, P. Anne. Emotion, moral perception, and nursing practise. Nursing Philosophy 1.2.2000 ; 123-133. google scholar
22. 22. Uslu, Yasemin, and Fatma Demir Korkmaz. «Yoğun bakımda hemşirenin hissi tarafı “şefkat” ve bakım.» Yoğun Bakım Hemşireliği Dergisi 20.2 .2016 ; 108-115. google scholar
23. 23. Blomberg, Karin, et al. Interventions for compassionate nursing care: A systematic review. International journal of nursing studies 62.2016 ;137-155. google scholar
24. 24. Cole-King, Alys, and Paul Gilbert. Compassionate care: the theory and the reality. Providing compassionate healthcare. Routledge. 2014 ; 68-84. google scholar
25. 25. Papadopoulos, Irena, and Sheila Ali. Measuring compassion in nurses and other healthcare professionals: An integrative review. Nurse education in practise 16.1. 2016 ;133-139. google scholar
26. 26. Von Dietze, Erich, and Angelica Orb. Compassionate care: a moral dimension of nursing. Nursing Inquiry 7.3 .2000 ; 166-174. google scholar
27. 27. Horsburgh, Dorothy, and Janis Ross. Care and compassion: the experiences of newly qualified staff nurses. Journal of clinical nursing 22.7-8.2013 ; 1124-1132. google scholar
28. 28. Sinclair, S., et al. Compassion: a scoping review of the healthcare literature. BMC palliative care.2016 ; 16. google scholar
29. 29. Daştan, Buket, et al. Hemşirelerin profesyonel değerler algısı ve etkileyen faktörlerin incelenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 10.1.2023 ; 16-23. google scholar
30. 30. Compassion in Practise Evidencing the impact, Mayıs 2016. Erişim Tarihi : 2023. Şuradan edinilebilir: https://www.england. nhs.uk/wp-content/uploads/2016/05/cip-yr-3.pdf google scholar
31. 31. Rockliff, Helen, et al. Pilot exploration of variability in heart rate and salivary cortisol responses to compassion-focused imagery. Clinical Neuropsychiatry: Journal of Treatment Evaluation. 2008 google scholar
32. 32. Gilbert, Paul, et al. Fears of compassion and happiness in relation to alexithymia, mindfulness, and self-criticism. Psychology and Psychotherapy: Theory, research and practise 85.4.2012 ; 374-390. google scholar
33. 33. Gilbert, Paul, and Jennifer Mascaro. Compassion: Fears, blocks, and resistances: An evolutionary investigation. Vol. 399. Oxford, UK: Oxford University Press, 2017. google scholar
34. 34. Çevik, Özlem, and Fuat Tanhan. Merhamet korkusu: Tanımı, nedenleri ve önlenmesi. Psikiyatride Güncel Yaklaşımlar 12.3.2020 ;342-351. google scholar
35. 35. Gilbert, Paul, et al. Fears of compassion: Development of three self-report measures. Psychology and Psychotherapy: Theory, research and practise 84.3.2011 ; 239-255. google scholar
36. 36. Bakalım, Orkide, and Faika Şanal Karahan. «Yetişkinlerde şefkat korkusu ve psikolojik esneklik.» IBAD Sosyal Bilimler Dergisi 12 .2022 ; 539-559. google scholar
37. 37. Crocker, Jennifer, and Amy Canevello. «Creating and undermining social support in communal relationships: the role of compassionate and self-image goals.» Journal of personality and social psychology 95.3. 2008 ; 555. google scholar
38. 38. Xavier, Ana, Marina Cunha, and Jose Pinto Gouveia. Deliberate self-harm in adolescence: The impact of childhood experiences, negative affect, and fears of compassion. Revista de Psicopatolog^a y Psicolog^a CHnica 20.1.2015 ; 41-49. google scholar
39. 39. Kelly, A. C., et al. Self-compassion and fear of self-compassion interact to predict response to eating disorders treatment: A preliminary investigation. Psychotherapy Research 23.3. 2013 ; 252-264. google scholar
40. 40. Harris, D. The relationship between fear of compassion, attitudes towards emotional expression and subjective well-being among a community adult sample. Diss. University of Essex, 2017. google scholar
41. 41. Kurtoğlu, Mustafa, and Şaziye Senem Başgül. Koruyucu faktör olarak öz-şefkat üzerine bir derleme çalışması. Journal of Cognitive-Behavioural Psychotherapy and Research 10.1.2021 ; 56-65. google scholar
42. 42. Sayar, K. Merhamet, 4. baskı. İstanbul, Kapı Yayınları, 2019. google scholar
43. 43. Liotti, Giovanni. Trauma, dissociation, and disorganised attachment: three strands of a single braid. Psychotherapy: Theory, research, practise, training 41.4.2004 ; 472. google scholar
44. 44. Miron, Lynsey R., et al. The potential indirect effect of childhood abuse on post-traumatic pathology through self-compassion and fear of self-compassion. Mindfulness 7.(2016 ; 596-605. google scholar
45. 45. Joeng, Ju Ri. Mediating roles of fear of compassion from self and others, self-Compassion, and perceptions of social support on the relationships between self-criticism and depressive symptoms.2014. google scholar
46. 46. Kirby, James N., Jamin Day, and Vinita Sagar. The ‘Flow’of compassion: A meta-analysis of the fears of compassion scales and psychological functioning.Clinical Psychology Review 70 .2019 ; 26-39. google scholar
47. 47. Duarte, Joana, et al. Do therapeutic imagery practises affect physiological and emotional indicators of threat in high self-critics?. Psychol Psychother: Theory, Research and Practise 88.3. 2015 ; 270-284. google scholar
48. 48. Dias, Bernardo Santos, Claudia Ferreira, and Ines A. Trindade. Influence of fear of compassion on body image shame and disordered eating. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 25.2020 ; 99-106. google scholar
49. 49. Basran, Jaskaran, et al. Styles of leadership, fears of compassion, and competing to avoid inferiority. Frontiers in psychology 9 .2019 ;416714. google scholar
50. 50. Ebert, Andreas, et al. Endogenous oxytocin is associated with the experience of compassion and recalled upbringing in Borderline Personality Disorder. Depression and Anxiety 35.1. 2018 ; 50-57. google scholar
51. 51. Lown, Beth A., Julie Rosen, and John Marttila. An agenda for improving compassionate care: a survey shows that about half of patients say such care is missing. Health Affairs 30.9. 2011 ; 1772-1778. google scholar
52. 52. McClelland, Laura E., Allison S. Gabriel, and Matthew J. DePuccio. Compassion practises, nurse well-being, and ambulatory patient experience ratings. Med Care 2018;56.1:4-10. google scholar
53. 53. Higashibata, Takahiro, et al. Work environmental factors associated with compassion satisfaction and end-of-life care quality among nurses in general wards, palliative care units, and home care settings: A cross-sectional survey. International Journal of Nursing Studies 143.2023 ; 104521. google scholar
54. 54. Department of Health (2015). The NHS constitution. https:// www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england google scholar
55. 55. McVicar, Andrew, et al. Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training. J Clin Nursin google scholar
56. 56. Konal Korkmaz, Ebru, et al. Hemşirelerde aleksitimi ve aleksitiminin tükenmişlik, öfke ve somatizasyon ile ilişkisi. Psikiyatri Hemşireliği Dergisi 11.4.2020 ; 284-291. google scholar
57. 57. Karaismailoğlu, Demet, Nurşen Kulakaç, and Dilek Çilingir. Ameliyathane hemşirelerinde aleksitimi düzeyi ve iletişim becerilerine etkisi: Doğu Karadeniz örneği. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10.1.2021 ; 81-87. google scholar
58. 58. Kolay, Nuray. Yoğun bakım hemşirelerinde merhamet ile bakım davranışları arasındaki ilişki. MS thesis. Sağlık Bilimleri Enstitüsü, 2019. google scholar
59. 59. Khanjani, Sajad, et al. Burnout, compassion for others and fear of compassion: a quantitative study in Iranian nurses. Trends in psychiatry and psychotherapy 43. 2021 ; 193-199. google scholar
60. 60. Özdelikara, Afitap, and Serpil Babur. Hemşirelik öğrencilerinin merhamet düzeyi ve empatik eğilim ilişkisi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 .2020 ;342-349. google scholar
61. 61. Boellinghaus I, Jones FW, Hutton J. Cultivating self-care and compassion in psychological therapists in training: the experience of practising loving-kindness meditation. Train Educ Prof. Psychol. 2013;7(4):267-277. doi:10.1037/a0033092 google scholar
62. 62. Delaney, Martin C. Caring for the caregivers: Evaluation of the effect of an eight-week pilot mindful self-compassion (MSC) training programme on nurses’ compassion fatigue and resilience. PloS one 13.11.2018 ; e0207261 google scholar
63. 63. Heffernan, Mary, et al. Self-compassion and emotional intelligence in nurses. International journal of nursing practise 16.4 .2010 ; 366-373. google scholar
64. 64. Scarlet, Janina, et al. The effects of Compassion Cultivation Training (CCT) on health-care workers. Clinical Psychologist 21.2 .2017 ;116-124. google scholar