International on-line compassion survey

Background and methodology

The survey was created by Professor Irena Papadopoulos. It was based on published literature on compassion and on-line discussions forums and blogs around compassion.

The aim of the survey was to investigate cultural similarities and differences in the way that compassion in nursing is understood and promoted. It consisted of both open ended and closed questions.

The survey was initially piloted with a sample of South Korean nurses. The initial design of the study intended to involve a cross-sectional comparison study between South Korea and the UK. However it was decided to broaden out the survey to an international audience. Slight modifications were done to improve the clarity of the questions; the revised questionnaire asked participants to provide the ethnicity.

The lead researcher recruited two volunteer co-researchers from each of the following participating countries:

  1. Australia
  2. Cyprus: a) Greek Cypriots, b)Turkish Cypriots
  3. Colombia
  4. Czech Republic
  5. Greece
  6. Hungary
  7. Italy
  8. Israel
  9. Norway
  10. Philippines
  11. Poland
  12. South Korea
  13. Spain
  14. Turkey
  15. United Kingdom
  16. USA

The role of the co-researchers included the translation and back translation of the questionnaire in their language to assure the quality and accuracy of the translation. In addition co-researchers were to translate the participant invitation/information letter, as well as the collected qualitative data.

The invitation letter informed potential participants of the aim of the survey, the name of the ethics committee/s which provided ethics approval for the study and emphasised that their participation was anonymous, confidential and voluntary. Web-based electronic survey software was used to collect data in each country.

Recruitment was consecutive and snowball sampling was used. Each researcher/co-ordinator distributed the survey questionnaire to their network of nurses. Participants were emailed a link and completed the survey in their home or place of work. The electronic survey was presented in the host country’s language. For participants who could not access the online survey, paper questionnaires were used.

Participants were eligible to take part in the study if they were a qualified nurse, final year student nurse, nurse educator, or manager of nurses.  The initial goal was to recruit 50 participants from each country. However soon after the commencement of data collection it became clear that some countries were going to exceed the target, and therefore the goal was extended to 100 for each country.

After data collection, the responses to the open-ended questions were collated together and one of the co-researchers/co-ordinators from each country undertook the translation whilst the second checked the translation for accuracy and meaning. All data were sent to the lead researcher for analysis.


The data of all countries were aggregated together. Data was also compared between countries.

  • Qualitative analysis: Data were imported into NVivo software. Thematic analysis (Braun and Clarke, 2006) was used to analyse the data. One researcher coded the text piece by piece with initial descriptive codes. The codes were then grouped into themes and a coding manual was developed. The codes and themes were discussed with between the research team at Middlesex University and any discrepancies were discussed, and the coding scheme was re-adjusted. Each country was sent the analysis of their own data.
  • Quantitative data: Data were entered onto SPSS and descriptive analysis was undertaken. The results of this analysis was sent to all countries.

Inferential analysis was also conducted and a structural equation modelling approach was used in order to investigate whether responses to one question would predict the response to another question on the survey.


The international on-line Compassion Questionnaire

  1. How would you define the term compassion?
    1. Empathy and kindness
    2. Deep awareness of the suffering of others
    3. Deep awareness of the suffering of others and a wish to alleviate it
    4. Other (please specify below)
  1. How important is compassion in nursing?
    1. Not very important
    2. Important
    3. Very important
  1. Do you believe that compassion can be taught to nurses?
    1. Yes
    2. No
    3. Don’t know
  1. Do you believe that compassion is being taught to nurses?
    1. The correct amount and level of teaching is provided
    2. Some teaching is provided
    3. Not enough teaching is provided
    4. Don’t know
  1. How is compassion demonstrated in practice? Please give examples.
  1. Do you think patients prefer to be nursed by:
    1. Knowledgeable nurses with good interpersonal skills
    2. Knowledgeable nurses with good technical skills
    3. Knowledgeable nurses with good management skills
  1. In your view, which is the most important influence for developing compassion?
    1. The person’s family
    2. The person’s cultural values
    3. The person’s personal experience of compassion
  1. Please select the statement you most agree with
    1. [Country’s name] patients value efficiency more than compassion
    2. [Country’s name] patients value the use of medical technology more than the use of compassion
    3. [Country’s name] patients value medical treatment more than compassionate caring
  1. Please select the statement you most agree with
    1. Nurses in [country] experience compassion from their managers
    2. Nurses in [country] experience compassion from their colleagues
    3. Nurses in [country] experience compassion from their patients
  1. Please select the option which applies to you
    1. I am a final year student nurse
    2. I am a qualified practicing nurse
    3. I am a nurse educator

10a). Finally please A) state your ethnic origin, B) offer any comments, advice views or stories which can shed light on the meaning and use of compassion by [country]  nurses.