Agency for Healthcare Research and Quality (AHRQ) Available from: Adult Inpatient Survey: Quality and Methodology Report. Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. Cardiovascular nurses play a key role in improving the treatment outcomes in patients. The variable which has the greatest effect on compassion competence was compassion satisfaction, followed by clinical experience, compassion fatigue, with those 3 variables explaining 34.4% of compassion competence. different cultures. No significant difference was found in perceived barriers between the male and female groups (t = -1.382, P = .149) and perceived barriers among different age groups of respondents (F =1.132, DF=3, P=.171). An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. Data were collected through fieldwork observations and semi-structured deep interviews and field notes. We identify four categories of planning work in which compassion cultivation can be undertaken and four directions for future research on the application of compassion in planning practice and education. Determining facilitators of compassion are essential to holistic care. Implications for nursing and/health policy: Nurs Times. It fosters better relationships between nurses and their patients. Professional nursing may be defined as, “to recognise, analyse, as well as give advice and assistance with regard to actual or threatening consequences of physical and/or mental courses of diseases, handicaps, disorders and their treatments for the benefit of the fundamental activities of daily living of an individual. Background Conclusions: NIH The aim of this research was to explore compassionate behaviour in Iranian nurses. • Nurses report greater work environment-related barriers than physicians. Compassion is an important topic in research and the popular press these days. Results Data collection was performed through observations and interviews. Furthermore, compassion is more than just, the necessary care and includes empathy,, respect, and recognition of personal, organizations, this means to determine, and beliefs. Despite all this, literature has, discussed compassion as the lost art of, patients believed that healthcare providers, do not listen to their words, do not clarify, Moreover, according to the report of the, Care Quality Committee, 3% of patients, may be inuenced by the prevailing culture and religion of a society. Determining the barriers, to providing compassion‑based care would help nurses to plan better and more appropriate, interventions. This study aimed to explore the challenges and, Data collection was performed through observations and interviews. Data analysis was performed, based on Strauss and Corbin’s constant comparative method., themes as the challenges and barriers to compassionate care; challenges and barriers related to. Conclusion: To develop the compassionate care, it is vital to make changes in the dominant philosophy and culture of caring environments. Compassionate fatigue can be a major barrier for nurses to provide compassionate care to their patients. A B S T R A C T. Background: Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. Kemp J, Zhang T, Inglis F, Wiljer D, Sockalingam S, Crawford A, Lo B, Charow R, Munnery M, Singh Takhar S, Strudwick G. J Med Internet Res. To determine the effect of communication training interventions for generalist palliative care providers on patient-reported outcomes and trainee behaviours. © 2008-2020 ResearchGate GmbH. Certainly, the family is a very valuable resource in patient care and plays an important role in maintaining the emotional support and patient’s recovery. There is little understanding about how workplace issues impact provision of compassionate care in nursing practice. Aim: Determining the barriers to providing compassion‑based care would help nurses to plan better and more appropriate interventions. Personalised feedback on recorded patient interactions may be beneficial. 2017 Mar-Apr;22(2):91-96. doi: 10.4103/ijnmr.IJNMR_79_16. eCollection 2020 Jun. The purpose of this study was to explore these facilitators. Iranian J Nursing, non‑commercially, as long as appropriate credit is given and the. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Compassion satisfaction and fatigue influence the quality of nursing care. They should consider compassionate care as an important component of patient-centred care. Results: Results: This study aimed to explore the challenges and barriers to … a barrier to providing compassionate care. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. eCollection 2020 May-Jun. However, a standardized scale measuring compassionate care attributes has been notably absent.Objective: To address this gap and ascertain the importance of compassionate care to patients, a Compassionate Care Assessment Tool (CCAT)© was formulated. Therefore it is necessary to develop specific education programs to improve compassion competence of nurses. Results : Data analysis showed that family’s support can be classified into three levels, including support by the therapeutic alliance (attempts to console and reassure, restoration of selfesteem, diminishing patient’s insensitivity, commitment to the patient, and visiting the patient ), participatory information (obtaining reliable information from the nurse, active role in providing meaningful information about the patient’s prognosis), practical and instrumental support (searching for economic support resources, providing the patient with the necessary equipment, trying to do the right care taking into account the family culture). Thus improving compassionate behaviours is highly significant in nursing. Barriers to empathy-based care: oncology nurses' perceptions. Pearson correlation coefficient showed no significant relationship between the nurses' age, level of education, work experience, and monthly working hours and scores of compassion satisfaction, burnout, and STS, and total compassion fatigue score (p > 0.05). Research objects are 233 nurses working in three general hospitals located in Chungnam province, and who understand the purposes of this research and agree to, Join ResearchGate to discover and stay up-to-date with the latest research from leading experts in, Access scientific knowledge from anywhere. Background: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. 5. Introduction Nursing has four main concepts upon which it’s based open; client, … These people want people to feel sorry for them. Determining the barriers to providing compassion-based care would help nurses to plan better and more appropriate interventions. Karen has over thirty years of diverse healthcare administration and consulting experience and has held top-level nursing and hospital administration positions in the US and abroad. This study explored final year nursing students’ perceptions of compassion and practising compassion before and after studying an online compassion module. The number of participants was 20, including 5 nurses, 8 family members, and 7 patients. All rights reserved. 2020 Jun 1;9(2):80-86. doi: 10.34172/jcs.2020.012.  Compassion is the heart of nursing care. Barriers to compassion in nursing, Challenges, compassion, ethnography, Iran, nursing, barriers of compassionate care nurses during daily care. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Therefore, it is important to address the workplace issues and organizational factors which may hinder compassionate care delivery within nursing practice. Background: Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. Implications for nursing practice and policy -. Conclusion: For compassionate care to flourish, policy makers, managers, and healthcare providers must foster an organizational atmosphere conducive to compassionate care. However, it had no significant relationship with compassion satisfaction and burnout (p > 0.05). This cross-sectional, descriptive study was conducted with a single-stage design on 200 cardiovascular nurses who were randomly selected from among nurses working in four educational hospitals in Isfahan, Iran, in July-October 2018. Negative effects of compassion fatigue include physical symptoms such as nausea, headaches, and insomnia, to psychological distress such as depression or anxiety. The aim of this study was to explain the family members’ supporting behaviors of the patient admitted to the cardiac special units. Dewar B, Nolan M. Caring about caring: Developing a model to implement compassionate relationship centered care in an older people care setting. Zamanzadeh V, Valizadeh L, Rahmani A, van der Cingel M, Ghafourifard M. Scand J Caring Sci. Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. An exploratory, descriptive qualitative approach guided data collection and analysis. Research design: The study used a qualitative exploratory design, and data were analyzed by conventional content analysis. Materials and Methods Background: As expected, medical students reported greater barriers to compassion than physicians and nurses, with both professions generally reporting lower barriers. Peer review Thus improving compassionate behaviours is highly significant in nursing. You’ve probably experienced at least some of those barriers, like a lack of resources (time, support, and staff), paperwork and productivity requirements, and a negative workplace culture. Discussion: Organizational barriers to development of compassionate in clinical practice were identified in this study. Commentary on : Bramley L, Matiti M. How does it really feel to be in my shoes? This ethnographic study was performed in 2014-2016. Burnell L. Compassionate care: Can it be defined and measured? However, and also consistent with hypotheses, nurses reported greater work-environment-related barriers relative to physicians. I know that we should not, discriminate between patients, but I feel these patients do, In this study, most of the participants emphasized their, therapeutic role without considering the mental and, most participants, sharing feelings, intimate and friendly, connection, physical closeness, touching, and eye contacts, is mostly considered a healer and caregiver and his/her. It is useful to improve relationships between nurses and patients to give them more confidence in the care process. Conclusions The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Three sub topics will be looked at over the course of this essay and a conclusion will be made to evaluate these essays findings and to provide some input into battling these barriers so that patients can receive high standards of patient care. Learn 5 tips for compassionate care. Results of the present study showed four cultural themes; love expression and compassion in the form of non-verbal emotional behaviours, empathy with others, emotional supports of patients at bedside and non-caring behaviours. Another study explored barriers to compassion among nursing managers and found that key bar-riers were related to the managers’ values and personality, the culture of the organization where they worked and the staff they worked with (Singh et al. not acceptable in our society. Compassion fatigue in nursing occurs when a caregiver experiences what experts call “secondary traumatic stress” in reaction to caring for those who are themselves suffering from traumatic events. The effect on trainee behaviours in simulated interactions (SMD=0.50, 95%CI 0.19-0.81) was greater than in real patient interactions (SMD=0.21, 95%CI -0.01-0.43); moderate heterogeneity (Chi(2)=8.90, df=5, p=0.11; I(2)=44%; Chi(2)=5.96, df=3, p=0.11; I(2)=50%, respectively). Conclusions: Ethical consideration: Ethical approval of this study was gained from the Ethical Review Board of Tabriz University of Medical Sciences. Journal. Patients were asked to rate (a) the importance of these items to compassionate care and (b) the extent to which nurses made this type of care apparent to them.Results: Four categorical segments illustrated compassion from the patients’ perspective: the ability to establish meaningful connections, meet expectations, exhibit caring attributes, and function as a capable practitioner.Conclusions: The provision of compassionate care requires a holistic approach. 2019 Nov;75(11):2340-2351. doi: 10.1111/jan.14088. Then, the data were analyzed by Graneheim and Lundman’s qualitative content analysis method. Family's Supportive Behaviors in the Care of the Patient Admitted to the Cardiac Care Unit: A Qualitative Study. . Compassion satisfaction and fatigue influence the quality of nursing care. Coffey A, Saab MM, Landers M, Cornally N, Hegarty J, Drennan J, Lunn C, Savage E. J Adv Nurs. Conclusions Implications for nursing and/health policy: Nurses provide high-quality care with compassion. Nurses, instructors and policy-makers can use the results of this study. Organizational barriers to development of compassionate in clinical practice were identified in this study. The results indicated the high mean (SD) score of 41.39 (5.54) for compassion satisfaction and the moderate mean (SD) scores of 26.93 (4.62) and 26.69 (5.90) for burnout and STS, respectively, in more than two-thirds of the nurses. This study described the challenges and barriers to compassionate care. Conclusion : Understanding family’s supportive behaviors can help improve counseling and planning for quality care of patients admitted to the cardiac care units (CCUs). Nursing also means influencing individuals in such a way that human potential is used for maintaining and promoting health.” (RCN, 2010). Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. In this three-part series David Hunter and colleagues explore compassion in emergency departments (EDs) from nursing students’ point of view. It is important to consider how compassion is demonstrated by nurses and to explore different compassionate behaviours in, Background Participants were selected by purposive sampling. Background Methods Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. J Clin Nurs 2014;23:2790–9. Three key themes related to compassion‐giving obstacles emerged across countries: 1. related to the managers’ personal characteristics and experiences; 2. system‐related; and 3. staff‐related. 11 August 2016 | Nursing Ethics, Vol. imposition of caring duties on nurses in a task‑oriented, organizational climate decreased compassion toward, of their patients. Bolster and Manias stated that during, nurse–patient interactions, while prescribing drugs, nurses, were mostly focused on their task rather than caring for, Papathanasiou, nurses’ focus on their duties suggests that, their duties are more important to them than the patients., The results of this study showed that gender was a, care measures in Iran are based on Islamic standards and, Zaidi showed that when the nurse and patient have the, between patients and nurses was considered an important. This ethnographic study was conducted with 20 nurses and 12 patients in six medical and four surgical wards in Iran in 2014-2015. Seeing the person in the patient: The Point of Care review paper. The most communication barriers from patients viewpoint including: heavy work load of the nurses, age , sex and language difference between patient and nurse and the spicy morality of nurses. The study participants consisted of 40 nurses, 16 patients, and 8 family members in medical and surgical wards. How can we ensure that patients in hospital are treated with respect and compassion? Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system-related obstacles to compassion-giving. A growing body of evidence indicates that compassion can be intentionally cultivated, with potentially transformative impacts at the individual, organizational, and process levels. Therefore, to eliminate these barriers and challenges, corrective action should be taken by managers. The results indicated the high mean (SD) score of 41.39 (5.54) for compassion satisfaction and the moderate mean (SD) scores of 26.93 (4.62) and 26.69 (5.90) for burnout and STS, respectively, in more than two-thirds of the nurses. The findings revealed that workload on the part of nurses and anxiety, pain and physical discomfort of the patient were the main perceived barriers to therapeutic communication. believed that nurses treat them without, care is associated with a lack of respect, Proctor (2008), in the National Health, Services (NHS), nurses try to provide, However, in accordance with professional, standards, compassionate care was less, a large and complicated organization,, such as healthcare services, the patient’s. Themes and subthemes of barriers to compassionate care Themes Subthemes Challenges and barriers related to the contextual environment of hospital Inconsistency between the workload and its allocated time Inattention to the needs of the nurse by the organization, © 2019 Iranian Journal of Nursing and Midwifery Research | Published by Wolters Kluwer - Medknow, Compassion is the basic characteristic in, has become important between nurse and, patient in recent decades. In literature,. Methods: Barriers to nurse/nursing aide communication: the search for collegiality in a southeast Ohio nursing home. Background: Compassion has not been universally defined or understood, nonetheless is recognized as a component of nursing excellence. This cross-sectional, descriptive study was conducted with a single-stage design on 200 cardiovascular nurses who were randomly selected from among nurses working in four educational hospitals in Isfahan, Iran, in July-October 2018. Care Quality Commission. Attention to teaching the concept of compassion and patient-centered care and increasing the number of nurses and positive attitude toward the nursing profession in clinical environment can be effective in providing compassionate care. This is a descriptive correlation research to examine converged factors affecting compassion competence of clinical nurses. The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Data collection was conducted using the Professional Quality Of Life Scale (version 5) (ProQOL- version 5) with 30 items in the three subscales of compassion satisfaction, burnout, and Secondary Traumatic Stress (STS). Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. 1 However, compassion has become the focus of much research and … Methods: Data were analyzed using SPSS software (version 16). Results: -, Davison N, Williams K. Compassion in nursing 1: Defining, identifying and measuring this essential quality. Determining the barriers to providing compassion‑based care would help nurses to plan better and more appropriate interventions. Yet many people fear compassion. The results of this study showed that the greatest barriers of nurse-patient communication were characteristics of nursing job with an average score of 71.05 ± 10.18. Methods: Determining the barriers to providing compassion-based care would help nurses to plan better and more appropriate interventions. Since the explaining power of three variables to compassion competence is 34.4%, it is necessary to add more meaningful variables to explain compassion competence of clinical nurses. This ethnographic study was conducted in 2014–2015, Background: Factors facilitating nurses to deliver compassionate care: a qualitative study. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Registration number: Compassion is a topical issue in clinical nursing practice, nurse education and policy, but a review of the literature reveals that nursing students’ experiences of compassionate care receives little attention. The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. 2016 Sep;63(3):388-94. doi: 10.1111/inr.12296. The study participants consisted of 40 nurses, 16 patients, and 8 family members in medical and surgical wards. Aim Data were collected through fieldwork observations and semi-structured deep interviews and field notes. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. • Greater experience as a healthcare professional generally … doi: 10.7748/en.2018.e1775. Determining facilitators of compassion are essential to holistic care. Training can improve clinicians' ability to show empathy and discuss emotions, at least in simulated consultations. Patients' experiences of compassion within nursing care and their perceptions of developing compassionate nurses. [OpenUrl][1][CrossRef][2][PubMed][3] Compassion is not a new concept within healthcare . with patients of any age and social class.  |  Emergency Nurse. The registered nurses are bound to behave in a professional way t… How fundamental aspects of nursing care are defined in the literature: A scoping review . Nurse-patient communication has a key role in improving nursing care and increasing patient's satisfaction of health care system. It fosters better relationships between nurses and their patients. Conclusions: The study employed a descriptive study design using a quantitative approach to collect data. Methods: Cross-sectional, exploratory, international online survey involving 1 217 participants from 17 countries. The results were analyzed using descriptive and inferential statistics in SPSS software. As most end of life care is provided by healthcare providers who are generalists rather than specialists in palliative care, effective communication skills training for generalists is essential. The study was carried out in 15 months. is payed to all the patients and their families. Compassionate Care Challenges and Barriers in Clinical Nurses: Compassionate care challenges and barriers in, clinical nurses: A qualitative study. One or all of these issues can affect a nurse’s ability to show compassion. We analysed data using constant comparison based on Strauss and Corbin method. Non-verbal, verbal and written communication: listening, questioning, record … Meta-analysis showed little effect on patient outcomes (SMD=0.10, 95%CI -0.05 to 0.24) and high levels of heterogeneity (Chi(2)=21.32, df=7, p=0.003; I(2)=67%). Results of the present study showed four cultural themes; love expression and compassion in the form of non-verbal emotional behaviours, empathy with others, emotional supports of patients at bedside and non-caring behaviours. Compassion is the heart of nursing care. Journal of Nursing Management, 17(7), pp.822-832. This study described the challenges and barriers to compassionate care. Clipboard, Search History, and several other advanced features are temporarily unavailable. It found factors including staff shortages, time pressures and pen-pushing … Based on existing research and qualitative studies with patients and families, hospital staff and board members, this report looks at some of the problems that patients experience with their care and at the factors that shape that experience. It is important to consider how compassion is demonstrated by nurses and to explore different compassionate behaviours in different cultures. There is little understanding about how workplace issues impact provision of compassionate care in nursing practice. Findings: The main theme which emerged from data analysis was “unsupportive organizational culture.” This theme had two main categories including “excessive workload alongside inadequate staffing” and “the lack of value on compassionate care.” Introduction: Introduction : A life-threatening illness can cause the involvement of family members and the imposition of psychological and physical stress on them. Data collection was performed through observations and interviews. Results Both nurse and the patient recognizes the need for these three concepts in the nursing field to better provide a better health care environment for both individuals. Compassionate behaviours of clinical nurses in Iran: an ethnographic study. Two interventions with medium effects on showing empathy in real patient interactions included personalised feedback on recorded interactions. Therefore, it is important to address the workplace issues and organizational factors which may hinder compassionate care delivery within nursing practice. Original Article, Obstacles to compassion-giving among nursing and midwifery managers: an international study, Family’s Supportive Behaviors in the Care of the Patient Admitted to the Cardiac Care Unit: A Qualitative Study, Compassion Satisfaction and Fatigue in Cardiovascular Nurses: A Cross-sectional Descriptive Study. HHS Compassion is an important part of nursing. In providing an introductory understanding of general Islamic beliefs on the definition of life, the use of palliative care, etc., I hope this reflection can offer insight into the general background of Muslim patients and spark interest in further reading and research. ... [15] The previous studies have shown that nurses who work in overly stressful conditions are more prone to mental and physical exhaustion. The hospital authorities should ensure that nursing workload is reduced in order to facilitate effective therapeutic communication. This study was performed to determine compassion satisfaction and fatigue in cardiovascular nurses. Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. Nurses do not want to update their information. Int Nurs Rev. Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. Conclusions J ... Nurse’s perceptions of organisational barriers to delivering compassionate care: A qualitative study. … The Development of the Compassionate Care Assessment Tool, Evaluation of Barriers Contributing in the Demonstration of an Effective Nurse-Patient Communication in Educational Hospitals of Jahrom, 2014, Nurse's perceptions of organisational barriers to delivering compassionate care: A qualitative study, Comparison of patient’s Satisfaction from two surgical methods for breast cancer, Mastectomy and Lumpectomy, Mass Caualty Incidents distribution and models by using Machine learning Techniques, Converged Influencing Factors on Compassion Competence in Clinical Nurses. This study aimed to explore the challenges and barriers to compassionate care in nurses. Methods. J Caring Sci. This was cross-sectional study, carried out in 2014, with a sample of 200 nurses and patients drawn from two educational hospitals in jahrom city. Sir Robert Francis QC. Author information: (1)Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences , Isfahan, Iran. 2018). Citation. sympathy along with action and caress. Conclusions: Obstacles to compassion-giving among managers vary across countries. The importance of communication and remaining compassionate Respect and dignity The centrality and complexity of communication in the therapeutic relationship 2 Essential Communication Skills: Building Blocks for Good Communication. Obstacles to compassion-giving among nursing and midwifery managers: an international study. Policymakers should identify training and mentoring needs to enable the development of managers’ practical wisdom. Available from. It is useful to improve relationships between nurses and patients to give them more confidence in the care process. Data analysis was performed using constant comparison based on Strauss and Corbin. Michigan State University Extension says that there are many barriers to developing empathy. cultural barrier to effective communication. Challenges; Iran; compassion; ethnography; nursing. Semistructured interviews were conducted for data collection. Delivery of Compassionate Mental Health Care in a Digital Technology-Driven Age: Scoping Review. Results: Three key themes related to compassion-giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system-related; and 3. staff-related. care in increasing patient satisfaction,, facilitating the process of returning, there are some barriers associated with, nurse–patient communication could also, be affected by the culture of the society, In Iranian societies, a nurse is mostly, considered a healer and caregiver and, such as lack of cooperation among the, [Downloaded free from http://www.ijnmrjournal.net on Monday, April 22, 2019, IP: 37.212.31.181], medical team, lack of motivation in nurses, lack of a, holistic approach, and lack of support organizations, of compassion‑based care could also be affected by, although nurses and patients try to form a patient‑oriented, relationship, some factors such as culture, requisitions,, and heavy workload in practice could limit it to, that the barriers to high‑quality care include shortage of, between nurses and patients are associated with the, believe that language, age, and sex differences; heavy, workload; and bad temper of nurses are the barriers., lack of amenities, physical and mental fatigue, and lack, of an appreciative system are the barriers to patient–nurse, culture and religion of a society. In Islamic societies such, as Middle Eastern countries, religion plays an important, barriers to compassion‑based care can help the provision, of more effective interventions. This study aimed to, This was an ethnographic, multimethod study and, nature of ethnography caused exibility in data collection, 10 medical and surgical wards of two teaching hospitals, (Shahid Chamran and Alzahra) in Isfahan, Iran. The, subjects were selected through purposive sampling. The, rst author of the study was invited to the wards to meet, Meetings were held with the nursing staff of each ward, to introduce the study and to invite nurses to participate;, consent forms were distributed at the end of each session., observation and informed them about the study., consent was obtained from 40 nurses, 16 patients, and, nurses who interacted with the researcher and patients, through observations and in‑depth semistructured, interviews from June 2014 to April 2016. The rst author, (interviewer or observer) was a nurse, but not one of the, personnel of the selected wards; therefore, she was an, was a complete observer and did not interact with the, participants during the observations. However, she was, an observing participant in subsequent observations, and, she contributed to some nursing care activities. She also, observed the behavior of nurses in caring situations such, as tone, look, communication skills, touching the patient,, patient, and trying to relieve patient’s pain.To avoid bias,, the researchers observed only friendly and professional, Each observation lasted 6–45 min. Participant observation, was performed during a period of 20 months and for a, 16 patients, and 8 family members from medical and, of wards were interviewed as key informants. Interviews, were semistructured and lasted 25–70 min. The aim of the, interviews was to determine the characteristics, challenges,, of patients. For example, interview questions included:, When you want to show your compassion to your patients,, with you about their problems, pains, and suffering? What, factors affect compassionate care? What are the challenges, Data collection was continued until the researchers were, could be extracted from the data and data saturation had, For data analysis, constant comparative method based on, Corbin and Strauss’s method was used. The use of the, grounded theory in ethnographic studies focuses on the, connection between events with constant comparison of, data during data collection. The grounded theory raises, the authenticity of an ethnographic research and compares, transcription observations and recording of interviews, by the rst author. Then, the texts were read line by, line. Furthermore, the observations and interviews were, and concepts. Labeling of codes was conducted using the, Similar codes were placed in one category and formed, the categorization of codes. The categories with similar, conceptual were located around a common and core axis., Iranian Journal of Nursing and Midwifery Research ¦, To guarantee scientic rigor from criteria credibility, was used. Thus, sampling was conducted three times at, morning, noon, and night. Data credibility was ensured, trough member check. For this purpose, some parts of the, interviews along with their extracted codes and groups, were observed by the participants to evaluate data analysis, and its accuracy.Additionally, data saturation was used to, interviews, coding and categorization of data were used, to evaluate the credibility of the study., conrmability of the study, the researcher recorded and, main researcher, two other academic members also studied, and conrmed the achieved results. Dependability was, achieved through taking notes and reviewing all the data., Furthermore, transferability was achieved by interviewing, The researcher conducted the observations, recording, and, interviewing with the consent of eldwork participation, and participants. Ethical considerations were recorded, The age of the participants ranged from 21 to 78 years., 16 patient, and 8 family members. The demographic, data of the participants are shown in T, main ndings of this study had three themes; challenges, and barriers related to organization and management,, socio‑cultural challenges and barriers, and challenges, and barriers related to staff. The themes of this study are, Challenges and barriers related to the contextual, At the organizational level and in the context of care,, these factors lead to reduction in the quality and quantity, of compassionate‑based care and include the four, subcategories of inconsistency between workload and its, and workload of nurses. These factors reduce the chances, staff is worn out, the number of personnel is not enough, for the number of patients and it is not standard, and the, Nurses of medical and surgical wards had to put up with, conditions caused by organizational culture and lack of, human resources. They had to ignore their personal and, Nurses believed that administrators’ ignorance at the, work place and lack of encouragement decrease nurses’. 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