Compassion: a critical review of peer-reviewed nursing literature

Aims and objectives: To provide a critical review of nursing literature about compassion, identifying major themes, questions arising and directions for future investigation of the topic.

Background: Compassion has emerged as a topic of broad social concern in recent years and is particularly pertinent to nurses.

Design: Critical review was selected as the most appropriate way of analysing literature from both qualitative research studies and conceptual articles.

Methods: An electronic database search was conducted, discovering articles published between 1952 and 2013. The search was then limited to publications since 2000 to capture recent development of the concept. The search was limited to peer-reviewed literature, excluding a large body of editorial material, resulting in 20 relevant articles. Two books were also added that contributed important perspective to the analysis. Critical analysis of the resulting material was undertaken to identify themes, tensions and implications in the literature.

Results: Major themes were compassion as practice and compassion as a moral virtue, holding implications for how nurses can demonstrate compassion in relation to contemporary healthcare values. A third major theme was the influence of institutional environments in facilitating or limiting the expression of compassion.

Conclusions: Compassion is a human experience of deep significance to nursing and needs understanding in the context of healthcare environments dominated by discourses of efficiency and rationalisation. There is an emergent literature about how compassion may be understood, taught and sustained among nurses but it is a topic that requires continued attention.

Relevance to clinical practice: More precise understanding of compassion will support nurses in advocating for compassionate care, participating in interdisciplinary dialogue, and contributing to the design of healthcare environments that are conducive to compassionate care.