International online surveys:

1. Culturally competent compassion in nursing
2. Culturally competent compassion in nursing managers

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.

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.

Background and methodology

The survey was created by Professor Irena Papadopoulos and it stems from the findings of the previous International online survey on culturally competent compassion in Nursing [hyperlink]. The first survey revealed that a few participants (4.3%) felt that they were in receipt of compassion from their managers. This means that a staggering 95.7% of the sample of 1323 nurses and healthcare professionals were not receiving compassion from their managers [hyperlink to the two publications resulting from the first survey]. This is an important finding because the literature suggests that people who receive compassion are more likely to provide compassion. Therefore it can be inferred that if a nurse receives compassion from their manager he/she is more likely to be compassionate to patients.

Based on this result, this second study aimed to explore how managers view, define, recognize and practice compassion and whether they experience any barriers in practicing compassion. Informed by thirty year-long work on cultural competence and compassion in health and social care, this survey sought also to explore the cultural point of view, by looking for similarities and differences between countries.

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

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

Recruitment was consecutive and snowball sampling was used. Each researcher/co-ordinator distributed the survey questionnaire to their network of managers in nursing. Participants were emailed a link and completed the survey in their home or place of work. 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. The questionnaire data have been collected online using the Qualtrics survey software. In order to make the survey as accessible as possible, we will also provide the option for the survey to be done using pen and paper.

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.

Participants were eligible to take part in the study if they met the following criteria:

  1. having a nursing/midwifery background (with a nursing or midwifery qualification)
  2. having managerial responsibility for nurses or midwives.

We define a nurse/midwife manager as somebody with a nursing or midwifery background (and qualification) who has responsibility for overseeing or supervising nurses or midwives. This could be in a hospital setting or in the community. Data from each country have been included if a minimum of 50 respondents completed the questionnaire. The total number of respondents for this study is 1217.

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 one (where present) checked the translation for accuracy and meaning. All data were sent to the lead researcher for analysis.

 

Analysis

Data analysis for this study is still in process. As this survey contains open and closed questions the research team is using a mixture of quantitative and qualitative analysis.

  • 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 will also be conducted and a structural equation modelling approach 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 to Nursing Managers

Q1 Which country do you currently work in?

 

Q2. Please define your ethnic or cultural background

 

Q3. What type of setting do you work in? (Please click the statement that applies to you)

         Hospital

         Community care/ Primary care

         Nursing or Midwifery education

         Other (please specify)

 

Q4. What is your profession? (Please click the statement that applies to you)

         Nursing

         Midwifery

         Other (please specify)

 

Q5. What is your highest educational qualification?

         Bachelor Level or equivalent

         Master level

         Doctoral level

         Other  ____________________

 

Q6. What type of nursing/midwifery manager are you?

Please click on the statement that applies to you.

         Hospital nurse/midwifery manager

         Community/ primary care centre nurse/midwifery manager

         Departmental nurse/midwifery manager

         Ward nurse/midwifery manager

         Care home nursing/midwifery manager

         Joint nurse/midwifery education manager

         Other(please specify)

 

Q7. How many people do you manage?  Select your answer by clicking on one of the options below.

         1-5

         6-10

         11-20

         21-50

         More than 51

 

Q8. How many years of management experience do you have? Select your answer by clicking on one of the options below.

         1-5

         6-10

         More than 11

 

Q9. Please tick the relevant box. I am:

         Male

         Female

         Other(please specify)  ____________________

 

Q10. As a manager, do you feel that you have enough time to spend listening and talking to your staff? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q11. Please give an example of how you spend time listening and talking to your staff. Write your answer in the box below.

 

Q12. As a manager, do you feel that you advocate for your staff and defend their rights? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q13. If you answered yes to question 12 above, please give an example of how you would advocate for your staff and defend their rights. Write your answer in the box below.

 

Q14. As a manager, do you feel that you consider each staff member’s individual characteristics and culture when you interact with them? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q15. If you answered yes to question 14 above, give an example of how you would consider each staff member’s individual characteristics and culture when you interact with them. Write your answer in the box below.

 

Q16. In your opinion, is it necessary to be a compassionate manager? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q17. If you answered yes to question 16 above, please list in the box below the advantages of giving compassion to staff.

 

Q18. What actions and behaviours would indicate to you that a manager is giving compassion to his or her staff? Write your answer in the box below.

 

Q19. What, in your view, stops a manager giving compassion to his/her staff? Write your answer in the box below.

 

Q20. Do you think that front-line nurses and midwives receive compassion from their managers? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q21. If you answered yes to question 20, is this compassion too little, enough, or too much? Select your answer by clicking on one of the options below.

         too little

         enough

         too much

         none

 

Q22. How do you define compassion? Write your answer in the box below.

 

Q23. Who gives you compassion in your workplace? Write your answer in the box below.

 

Q24. Is receiving compassion important to you? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q25. If you answered yes to question 24 above, can you explain why compassion is important to you?

 

Q26. Please add any comments/views regarding compassion and management.