Background Although a growing body of work is detailing the barriers to compassion in healthcare, few studies have examined how providers sustain compassion over time. Prior studies have predominantly been qualitative. Objective Extend prior studies by assessing the structure and likely efficacy of compassion-maintaining strategies. Design Secondary analysis of cross-sectional physician data gathered as part of a larger project (Consedine et al. J Gen Intern Med, 40(9), 2080-2086,<CitationRef CitationID="CR26">26</CitationRef>). Participants In the parent study, 1065 patients nominated a primary care physician. Of 575 doctor invitations sent, 219 unique doctors (38.1% of invitees) responded. Main Measures Participants provided demographic and training/work data, before completing measures of burnout, trait compassion, compassion strategy use, social desirability, and compassionate behaviour. Key Results Principal components analysis revealed two broad classes of compassion-sustaining strategies—compassion-specific (focused directly on the generation and/or maintenance of compassion) and general (focused on general self-care as a means to sustain compassion). Correlations showed that while compassion-specific strategy use was closely linked to greater trait compassion and compassionate behaviour, general self-care strategy use was more closely tied to workload and burnout variables. Conclusions Although compassion is routinely challenged in healthcare, providers use an array of strategies to sustain their compassion for patients. In identifying potential targets for intervention, the current report suggests that while some strategies appear more directly tied to compassion, others are focused on sustaining compassion through self-care. Preparing healthcare trainees and doctors for the challenges to compassion may be supplemented by training in the different ways evidence suggests compassion can be enhanced. Summary The known: Evidence suggests that compassion in healthcare is routinely challenged and can be interfered with by a range of personal, patient, clinical, and environmental factors. The new: Doctors also engage in strategies to sustain compassion, with two broad types in evidence—psychological, compassion-specific strategies and strategies to sustain compassion through self-care. These different strategies have distinct links to patient-facing and occupational health outcomes (e.g., burnout). The implications: Providers use an array of strategies to sustain compassion for patients. In identifying targets for intervention, these data suggest we should target different strategies depending on the outcomes of interest.

How Do Doctors Sustain Compassion in Healthcare? A Structural Analysis of Compassion-Maintaining Strategies

期刊论文
发表日期：

2026年1月5日

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Nathan S. Consedine,
Nina Akulova,
Sofie I. Baguley

摘要

Background

Although a growing body of work is detailing the barriers to compassion in healthcare, few studies have examined how providers sustain compassion over time. Prior studies have predominantly been qualitative.

Objective

Extend prior studies by assessing the structure and likely efficacy of compassion-maintaining strategies.

Design

Secondary analysis of cross-sectional physician data gathered as part of a larger project (Consedine et al. J Gen Intern Med, 40(9), 2080-2086,²⁶).

Participants

In the parent study, 1065 patients nominated a primary care physician. Of 575 doctor invitations sent, 219 unique doctors (38.1% of invitees) responded.

Main Measures

Participants provided demographic and training/work data, before completing measures of burnout, trait compassion, compassion strategy use, social desirability, and compassionate behaviour.

Key Results

Principal components analysis revealed two broad classes of compassion-sustaining strategies—compassion-specific (focused directly on the generation and/or maintenance of compassion) and general (focused on general self-care as a means to sustain compassion). Correlations showed that while compassion-specific strategy use was closely linked to greater trait compassion and compassionate behaviour, general self-care strategy use was more closely tied to workload and burnout variables.

Conclusions

Although compassion is routinely challenged in healthcare, providers use an array of strategies to sustain their compassion for patients. In identifying potential targets for intervention, the current report suggests that while some strategies appear more directly tied to compassion, others are focused on sustaining compassion through self-care. Preparing healthcare trainees and doctors for the challenges to compassion may be supplemented by training in the different ways evidence suggests compassion can be enhanced.

Summary

The known: Evidence suggests that compassion in healthcare is routinely challenged and can be interfered with by a range of personal, patient, clinical, and environmental factors.

The new: Doctors also engage in strategies to sustain compassion, with two broad types in evidence—psychological, compassion-specific strategies and strategies to sustain compassion through self-care. These different strategies have distinct links to patient-facing and occupational health outcomes (e.g., burnout).

The implications: Providers use an array of strategies to sustain compassion for patients. In identifying targets for intervention, these data suggest we should target different strategies depending on the outcomes of interest.