Developing a Holistic Framework for Compassionate Care in Nursing Practice

Thesis Abstract

In the contemporary healthcare environment, the provision of compassionate care remains a critical determinant of patient satisfaction, safety, and overall health outcomes, yet there is a significant gap in the theoretical and practical understanding of how to systematically implement and sustain such care within nursing practices. This study aims to develop a comprehensive holistic framework that explicates the core principles, dimensions, and contextual factors influencing compassionate nursing care, thereby filling the existing lacuna in nursing theory and practice. The specific objectives are to identify the key components of compassionate care from the perspectives of nurses and patients, explore the underlying cultural, organizational, and individual factors that facilitate or hinder compassionate practices, and synthesize these insights into a cohesive theoretical framework that can guide practice, education, and policy. A mixed-methods research design was employed comprising a qualitative phase followed by a quantitative phase. The qualitative component involved semi-structured interviews with 30 registered nurses and 30 patients recruited through purposive sampling within two tertiary hospitals. Thematic analysis, facilitated by NVivo software, was used to identify emergent themes related to the attributes, perceptions, and barriers of compassionate care. The quantitative phase consisted of a cross-sectional survey administered to 300 nurses selected through stratified random sampling across multiple hospital units, utilizing validated instruments such as the Compassionate Care Scale (CCS) and the Organizational Compassion Climate Questionnaire (OCCQ). Data analysis involved descriptive statistics, multiple regression analysis to identify predictors of compassionate care, and structural equation modeling (SEM) to test the hypothesized relationships within the proposed framework. It is anticipated that the findings will reveal core dimensions of compassionate care, including emotional support, genuine presence, cultural sensitivity, and interpersonal communication, as well as organizational and personal facilitators and barriers. The structural model is expected to demonstrate how individual nurse characteristics, organizational culture, and patient factors collectively influence compassionate behavior, establishing a dynamic, context-sensitive framework rooted in the Theory of Human Caring (Watson, 1979) and the Global Compassion Framework (Lown & Manning, 2010). The study will also identify specific antecedents that predict sustained compassionate practice, such as emotional resilience, organizational support, and cultural competence. This research will substantially contribute to the body of nursing knowledge by providing a validated, multidimensional framework that integrates psychological, cultural, and organizational factors influencing compassionate care. It offers a practical tool for nurse educators and healthcare administrators to design targeted interventions aimed at fostering compassionate environments, thus enhancing patient outcomes and staff well-being. The framework intends to serve as a foundation for future empirical testing, curriculum development, and policy formulation aimed at embedding compassion as a core organizational value. The study concludes that cultivating a holistic understanding of compassionate nursing requires an integrated approach addressing individual competencies, organizational climate, and cultural sensitivities. Recommendations include the incorporation of compassion-focused training within nursing curricula, organizational policies to support staff well-being and emotional resilience, and ongoing assessment of compassionate practices through validated measurement tools. Future research should explore longitudinal effects of targeted interventions based on the developed framework and extend the model to diverse healthcare settings and cultural contexts. This work aims to advance the theoretical basis of compassionate nursing, providing a scalable and adaptable model that aligns with contemporary global healthcare imperatives for person-centered, humanistic care.