Bakgrund: Medkänsla är en viktig del av omvårdnaden och en egenskap sjuksköterskan förväntas ha. Medkännande omvårdnad innebär ett moraliskt agerande där aktiva handlingar avser att lindra lidande, vilket möjliggör ett partnerskap grundat på tillit mellan patienten och sjuksköterskan. Trots att medkännande omvårdnad innebär samhälleliga vinster saknas det ibland i vården. Om medkänsla betraktas som en huvudkompetens kan den bli ett kraftfullt stöd i förverkligandet av god omvårdnad. Syfte: Att beskriva sjuksköterskors erfarenheter av medkännande omvårdnad för vuxna patienter i en somatisk slutenvårdskontext. Metod: En litteraturstudie genomfördes där tio kvalitativa artiklar analyserades genom tematisk analys. Resultat: Analysen visade att utövandet av medkännande omvårdnad förfinas i takt med ökad arbetslivserfarenhet. Förmågan att utöva medkännande omvårdnad ansågs bero på personliga faktorer såväl som förhållandet mellan patienten och sjuksköterskan. Organisatoriska aspekter såsom arbetsmiljö, där tid ansågs vara en avgörande faktor, kan påverka den medkännande omvårdnaden. Slutsats: Sjuksköterskor behöver erfarenhet och stöd för att utföra medkännande omvårdnad och därmed öka omvårdnadens kvalitet. Mängden disponibel tid är en viktig arbetsmiljöfaktor som påverkar partnerskap och sjuksköterskans förmåga att ha ett holistiskt synsätt. Vidare forskning rekommenderas. Det finns behov av att implementera medkännande omvårdnad som kunskapsområde i sjuksköterskeutbildningen. / Background: Compassion is fundamental in nursing care and is also a trait the nurse is expected to have. Compassionate nursing care defines as a moral act where the actions aim to relieve suffering. It is an important facilitator for the patient’s trust towards the nurse. Lack of compassion can partly explain health care deficiencies. Defining compassion as a main competence would enhance the realization of compassionate nursing care. Aim: The aim of the study was to describe nurses’ experiences of compassionate nursing care for adults in a somatic hospital setting. Method: A literature study based on ten qualitative articles was conducted with a thematic analysis. Results: Compassionate nursing care refines as experience grows. Compassion is influenced by the nurse’s traits. Furthermore, a holistic approach is needed for compassionate nursing care. Organizational aspects such as the work environment may also have an impact. Conclusion: To perform compassionate nursing care and thereby enhancing the quality of care, nurses need experience and support. The amount of available time affects the creation of partnership and the nurse’s holistic viewpoint. Further research is recommended. There is a need for implementation of compassionate nursing care as a competence area in the nursing education.

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Using the Compassionate Music Teaching (CMT) framework as a lens, in this study I explored the ways that teachers of adults learning recreationally in music lessons may align their teaching approaches to learners’ adult-specific needs. Adult education scholars have accentuated the need for facilitators of adult learning to consider adult learners’ life experiences, circumstances, and identities (Merriam & Baumgartner, 2020). Researchers studying adults learning music have similarly identified the ways in which adults appreciate opportunities to ask questions, share in discussions, and be a part of the decision-making processes related to their music learning (Creech et al., 2020; Creech et al., 2014; Rohwer, 2012). In alignment with adult education and music education scholarship, the CMT framework offers an approach through which teachers may connect with learners as people to support their musical and personal growth (Hendricks, 2018). However, as Roulston et al. (2015) identified, an approach has not yet been proposed specifically for the teaching and learning of adult music learners. Whereas one might assume that a lack of adult-specific teaching techniques may not pose an issue in a one-on-one setting, there is evidence that even when teachers make efforts to meet adult learners’ needs in lessons, they are not always successful (Leahy & Smith, 2021). Therefore, the purpose of this study was to explore the ways, if any, that teachers of adults engaged and empowered adults learning in recreational music lesson settings. Through the process of narrative inquiry, I engaged with participants in guided conversations to explore their processes of becoming musicians and educators and the ways they engaged compassionately with their adult students. I share the findings of the narrative inquiry through a series of re-storied vignettes. The findings of this study highlighted adult-specific needs that arose from the participants’ narratives and the ways that the teachers enacted qualities of CMT (trust, empathy, patience, inclusion, community, authentic connection) as they worked to meet those needs. I explore these needs under four categories: (a) following learner goals and objectives, (b) acting as a guide, (c) respecting learners’ full humanity, and (d) supporting musical belonging. The results of this study contribute to extant research by offering further insight into adults’ music learning needs, offering teachers of adults approaches through which may better meet learner needs, and expanding the CMT framework to include the experiences of adults learning recreationally.

Yes / A program of Compassionate City or Community (CC) has been designed and developed in the City of Vic (43,964 habitants, Barcelona, Spain), based on The Compassionate City Charter and other public health literature and experiments, with the joint leadership of the City Council and the Chair of Palliative Care at the University of Vic, and as an expansion of a comprehensive and integrated system of palliative care. Methods: The program started with an assessment of needs of the city as identified by 48 social organizations with a foundational workshop and a semi-structured survey. After this assessment, the mission, vision, values and aims were agreed. The main aims consisted in promoting changes in social and cultural attitudes toward the end of life (EoL) and providing integrated care for people with advanced chronic conditions and social needs such as loneliness, poverty, low access to services at home, or conflict. The selected slogan was “Living with meaning, dignity, and support the end of life”. Results: The program for the first year has included 19 activities (cultural, training, informative, and mixed) and followed by 1,260 attendants, and the training activities were followed by 147 people. Local and regional sponsors are funding the initiative. After a year, a quantitative and qualitative evaluation was performed, showing high participation and satisfaction of the attendants and organizations. In the second year, the care for particular vulnerable people defined as targets (EoL and social factors described before) will start with volunteers with more organizations to join the project. Conclusions: The key identified factors for the initial success are: the strong joint leadership between social department of the Council and the University; clear aims and targets; high participation rates; the limited size of the geographical context; which allowed high participation and recognition; and the commitment to evaluate results.

Yes / The Dying to Talk project in Bradford, UK aimed to build resilience in young people around the topic of death, dying and bereavement. Starting conversations early in life could buttress people’s future wellbeing when faced with bereavement and indeed their own mortality. Research indicates that a key feature in young people’s experience of bereavement is ‘powerlessness’ (Ribbens McCarthy, 2007). Drawing on the principles of co-production, young people led the development of the project aimed at encouraging young people to talk about death, using archaeology as a facilitator to those conversations. The partnership between the University of Bradford, the voluntary sector and the young people proved to be a positive and empowering one. It laid the foundations for future collaboration and developed a framework for engaging young people in talking about death, building their resilience for dealing with death and dying in the future – a step towards building a ‘compassionate city’ for young people (Kellehear, 2012) / University of Bradford, Higher Education Innovation Fund; AHRC

Yes / People in the Global North often have a problem talking about — and processing — the inevitability of death. This can be because death and care of the dying has been professionalised, with encounters of death within our families and communities no longer being ‘normal and routine’ (Kellehear 2005). Young people are particularly excluded from these conversations, with implications for future mental health and wellbeing (Ainsley-Green 2017). Working in Wolverhampton and Bradford, the Dying 2 Talk (D2T) project aimed to build young people’s future resilience around this challenging topic. We recruited over 20 young people as project ambassadors to co-produce resources that would encourage talk about death, dying and bereavement. The resources were used as the basis of ‘Festivals of the Dead’ which were taken to schools to engage wider audiences of young people (aged 11 +). The project aimed to use alternative ‘ways in’ to open discussion, beginning with archaeology, and ultimately using gaming, dance, creative writing and other creative outputs to facilitate discussion, encourage compassionate relationships and build resilience. The resources succeeded in engaging young people from ages 11–19 years, facilitating a comfortable and supportive environment for these vital conversations. Project evaluations and observations revealed that the Festivals, and the activities co-created by the young ambassadors helped to facilitate spontaneous conversations about death, dying and bereavement amongst young people by providing a comfortable and supportive environment. The project was funded by the Arts and Humanities Research Council (AH/V008609/1), building on a pilot project funded by the Higher Education Innovation Fund at the University of Bradford. / The project was funded by the Arts and Humanities Research Council (AH/V008609/1), building on a pilot project funded by the Higher Education Innovation Fund at the University of Bradford.

Det finns överlag en brist på compassion-inriktade interventioner för vård- och omsorgspersonal. Tidigare studier tyder på att dessa interventioner ger goda resultat, men fler studier behövs. Hittills har exempelvis inga svenska studier undersökt effekter av Compassionate Mind Training (CMT) på individnivå eller med samvetsstress som utfallsmått. Studien syftade följaktligen till att undersöka om en internetbaserad CMT-kurs var en hjälpsam metod för att minska samvetsstress och arbetsrelaterad stress, samt öka självmedkänsla och professionell livskvalitet hos svensk vård- och omsorgspersonal. Studien var designad som en inomindividsstudie och utgick från en Single-Case Experimental Design (SCED), med vissa anpassningar. Totalt sex deltagare mötte inklusionskriterierna och deltog i en för- och eftermätning med självskattningsformulären Stress of Conscience Questionnaire (SCQ), Copenhagen Psychosocial Questionnaire II (COPSOQ-II), Self-Compassion Scale (SCS) och Professional Quality of Life Measure (ProQOL-5) samt fyra veckovisa mätningar under kursens gång. Slutsatsen var att CMT-kursen har varit hjälpsam i att minska samvetsstress och arbetsrelaterad stress samt i att öka självmedkänsla och professionell livskvalitet. Vidare forskning med starkare experimentell kontroll och uppföljningsmätningar behövs dock för att bekräfta resultaten. / There is overall a lack of compassion-based interventions for healthcare personnel. Previous studies suggest these interventions lead to good outcomes, however there is a need for more research. There are for example no Swedish studies that have yet examined the effect of Compassionate Mind Training (CMT) either on an individual level or with stress of conscience as outcome measure. Hence, the study aimed to evaluate whether a CMT-course is a helpful method for reducing stress of conscience and work-related stress, as well as increasing self-compassion and professional quality of life for healthcare personnel. The study had a within-subject design and used a Single-Case Experimental Design (SCED) with some adjustments. Six participants met the inclusion criteria and completed Stress of Conscience Questionnaire (SCQ), Copenhagen Psychosocial Questionnaire II (COPSOQ-II), Self-Compassion Scale (SCS) and Professional Quality of Life Scale (ProQOL-5) before and after the CMT-course in addition to four weekly questionnaires during the course. The conclusion was that CMT was helpful in reducing stress of conscience and work-related stress as well as increasing self-compassion and professional quality of life. However, research with more experimental control and follow up measurements are needed to confirm the results. / ICOP

Nesta pesquisa, objetivou-se discutir o tema brinquedoteca hospitalar, como um recurso para a humanização da assistência à saúde nos hospitais pediátricos que atendem crianças em regime de internação. Tendo, como objetivo principal, verificar a situação da brinquedoteca hospitalar na cidade de São Paulo, antes e após a Lei n. 11.104/2005 que obriga a instalação desse equipamento, considerando como hipótese de pesquisa a necessidade de que a Lei seja ampliada, inserindo a presença do profissional do brincar na brinquedoteca hospitalar para garantir o bom funcionamento desse espaço. No procedimento metodológico, qualificado como pesquisa qualitativa, foi utilizada a revisão integrativa da literatura, sendo analisados os dados de 324 trabalhos publicados no Brasil; e 43, no exterior, no período de 1994 a 2014. Efetuou-se uma pesquisa exploratória em 20 brinquedotecas de hospitais internacionais, a fim de verificar como funcionam as brinquedotecas fora do Brasil, fez-se uma pesquisa de campo, sendo aplicado um questionário em 11 profissionais que atuam em brinquedotecas na cidade de São Paulo e adicionalmente, uma atividade exploratória de escuta das crianças em situação de brincar. Os resultados mostram que a maior parte das pesquisas nacionais e internacionais voltadas para o brincar na saúde estão concentradas na área da Enfermagem. Os dados das pesquisas em brinquedotecas internacionais apontam que há uma preocupação na diversidade de atividades lúdicas para o acolhimento da criança. Após análise dos resultados provenientes da investigação in loco, verificou-se que há necessidade de formação dos profissionais para atuarem nas brinquedotecas hospitalares paulistanas e de reconhecimento destes espaços como parte inerente ao tratamento das crianças hospitalizadas. As vozes das crianças evidenciam o maior propósito da existência da brinquedoteca que é o direito de brincar no hospital. Observou-se que, após a Lei 11.104/2005, apesar do aumento do número de brinquedotecas instaladas, na cidade de São Paulo, esses espaços foram-se constituindo de maneira inadequada para atender as necessidades da infância e ser de fato uma estratégia de humanização. Os achados nesta pesquisa apontam a necessidade de ampliar o texto da Lei 11.104/2005 e fazer cumprir integralmente o direito da criança brincar no hospital. / The research focused on discussing toy libraries in hospitals as an asset for compassionate healthcare in pediatric hospitals with long-term children patients. The main objective is to determine the situation of hospital toy libraries in the city of Sao Paulo before and after the Federal Law n. 11.104/2005 which states their implementation as mandatory, considering as a research hypothesis that this law should be broadened so as to include the presence of a toy library specialist, a play professional at the toy library to guarantee its full and fair use. With regards to methodology, the research is categorized as qualitative and it used a full integrative literature review, analyzing 324 published essays or books in Brazil and 43 abroad, ranging from 1994 to 2014. An exploratory research was conducted in 20 toy libraries in international hospitals to determine how toy libraries work outside Brazil. In national territory a field research was conducted with the use of a questionnaire filled in by 11 professionals who work in toy libraries in Sao Paulo and, finally, an exploratory activity to listen to childrens opinion about the play situation was also conducted. The results show that the majority of national and international researches aimed at understanding play in healthcare contexts are concentrated in the area of Nursery. Research data in international toy libraries show a concern about a diversity in play activities for children. After analyzing the results from the in loco research it was clear that there is a real demand for professional education for the staff who work at toy libraries in Sao Paulo and also the perception of such spaces as an inherent part of hospitalized childrens treatment. The voices of the children make it evident that the purpose of the existence of the toy library is the right to play in the hospital context. It was observed that after the implementation of the Federal Law n. 11.104/2005, despite the increase on the number of installed toy libraries in the city of Sao Paulo, such spaces were constituted in an inadequate way in terms of supplying the demands of childhood and being an effective compassionate healthcare strategy. The findings on this research demonstrate that broadening the text of the Federal Law n. 11.104/2005 is needed and it to make the childrens right to play at the hospital integral.

Pharmaceuticals have benefitted countless lives. New therapies are being developed every day—many prove effective, but many do not. In order to ensure only safe and effective drugs enter the market, the United States' Food and Drug Administration (FDA) approves each treatment based on data garnered from clinical trials. Clinical trials take time, however, and investigational new drugs (INDs) can demonstrate signs of efficacy long before approval. These cases introduce a fundamental question: should the government limit patient access to a drug that has yet to be proven safe and effective? Or do patients have the right to freedom from governmental intervention in their medical decision-making? In this paper, the history of IND regulation will be explored, followed by an examination of the freedom to access from constitutional, ethical, and infrastructural perspectives. Changes to the current system will then be proposed.