In search of compassion: A new taxonomy of compassionate physician behaviours

Rachel A. Cameron, Benjamin L. Mazer, Jane M. Deluca, Supriya G. Mohile, Ronald M. Epstein

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Compassion has been extolled as a virtue in the physician-patient relationship as a response to patient suffering. However, there are few studies that systematically document the behavioural features of physician compassion and the ways in which physicians communicate compassion to patients. Objective: To develop a taxonomy of compassionate behaviours and statements expressed by the physician that can be discerned by an outside observer. Design: Qualitative analysis of audio-recorded office visits between oncologists and patients with advanced cancer. Setting and Participants: Oncologists (n=23) and their patients with advanced cancer (n=49) were recruited in the greater Rochester, New York, area. The physicians and patients were surveyed and had office visits audio recorded. Main Outcome Measures: Audio recordings were listened to for qualitative assessment of communication skills. Results: Our sensitizing framework was oriented around three elements of compassion: recognition of the patient's suffering, emotional resonance and movement towards addressing suffering. Statements of compassion included direct statements, paralinguistic expressions and performative comments. Compassion frequently unfolded over the course of a conversation rather than being a single discrete event. Additionally, non-verbal linguistic elements (e.g. silence) were frequently employed to communicate emotional resonance. Discussion and Conclusions: This study is the first to systematically catalogue instances of compassionate communication in physician-patient dialogues. Further refinement and validation of this preliminary taxonomy can guide future education and training interventions to facilitate compassion in physician-patient interactions.

Original languageEnglish (US)
Pages (from-to)1672-1685
Number of pages14
JournalHealth Expectations
Volume18
Issue number5
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Keywords

  • Communication
  • Compassion
  • Oncology
  • Patient suffering

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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