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Background: Despite being a mandated, foundational value in healthcare, research on compassion remains limited. Studying the individual, patient, clinical, and contextual factors that interfere with compassion—the “barriers”—may clarify our understanding of the origins of compassion and identify potential targets for improving patient-centred care. Studies of the related construct of empathy have suggested that medical students report declines with increasing clinical experience. In contrast, when comparing physicians with medical students, increased clinical experience predicts lower barriers to compassion. Whether—and how—a similar experience-related decline in the factors that interfere with compassion occurs across medical training remains unknown.Aims: To describe how the barriers to compassion vary across clinical training in medical students.Method: New Zealand medical students (N = 351) in their clinical years (Years 4–6) completed measures of the Barriers to Physician Compassion (BPCQ) and potential covariates such as demographics, work burden factors, and dispositional factors. The BPCQ indexes the extent to which barriers in four domains (individual, patient, clinical, and contextual) interfere with a physician/student’s compassion towards patients. Analyses of variance and regression analyses were used to explore the effect of year level on the four types of barriers.Results: Year 4 students reported slightly lower student-related, environmental and patient/family-related (but not clinical) barriers than Year 6 students (effect size: ɷ2 Conclusions: In extending studies of empathy decline, this report suggests that students experience higher barriers to compassion as clinical training progresses. This is in contrast to existing studies contrasting physicians with medical students, where greater experience was associated with lower perceived barriers to compassion. Self-compassion may offset increases in barriers to care.

PurposeThis paper analyses the factors that make fashion-product crowdfunding campaigns successful. The authors argue that crowdfunding is an innovative and functional way of bringing new fashion items to the market. The purpose of this paper is to answer the question whether product innovation, lifecycle and sustainability have a positive effect on the success of fashion crowdfunding campaigns. The findings highlight that the success of the fashion crowdfunding campaigns depends on creators' adherence to the values of the platform which they use to raise capital.Design/methodology/approachA total of 300 fashion crowdfunding projects running between the 17th of October and the 15th of December 2017 were collected from Kickstarter – the world's largest crowdfunding platform based on reward-based all-or-nothing model. Two-step binomial logistic regression was used to analyse the data.FindingsThe model predicted a significant increase in the odds of success for the fashion items crowdfunded during the first-time production, and innovative and environmentally sustainable products with a higher price range of rewards. In line with previous literature, regression analyses predicted a significant effect of the control variables of goal amount (negative) and the number of rewards (positive). Contrary to previous studies, neither the presence of a video nor the campaign length predicted success.Originality/valueThe novel findings of this study contribute to the literature by providing an analysis of success factors of fashion items on crowdfunding platforms. The results show that innovative, environmentally sustainable and higher-priced products produced by early-stage ventures are better welcomed by the audiences.

Objectives:to describe the association between personal and organisational value discrepancies and compassion ability, burnout, job satisfaction, absenteeism, and consideration of early retirement among healthcare professionals.Design:online cross-sectional survey.Setting:primary, secondary, and tertiary care.Participants:1025 current practising clinicians (doctors, nurses, and allied health professionals) in Aotearoa/New Zealand.Main outcome measures:The Sinclair Compassion Questionnaire – Healthcare Provider Ability and Competence Self-Assessment, The Maslach Burnout Inventory - Human Services Survey abbreviated 2-Question Summative Score, 10-item Warr-Cook-Wall Job Satisfaction questionnaire, measures of absenteeism and consideration of early retirement.Results:Perceived discrepancies between personal and organisational values predicted lower compassion ability (B=-0.006, 95% CI [-0.01, -0.00], PB=-0.20, 95% CI [-0.23, -0.17], PB=0.02, 95% CI [0.01, 0.03], PB=0.004, 95% CI [0.00, 0.01], P=0.01 f2=0.01), and greater consideration of early retirement (B=0.02, 95% CI [0.00, 0.03], P=0.04, f2=0.004).Conclusions:Working in value-discrepant environments predicts a range of poorer outcomes among healthcare professionals, including the ability to be compassionate. Scalable organisational and systems level interventions that address operational processes and practices that lead to the experience of value discrepancies are recommended to improve clinician performance and wellbeing outcomes.Study registration: the study was pre-registered on AsPredicted (Registration number 75407)What is already known on this topicCompassion predicts better patient outcomes and clinician quality of lifeBoth personal and perceived organisational values predict variability in clinicians’ ability to show compassion and burnoutPsychological tension associated with possibility of having to behave inconsistently with one’s own values, attitudes, and believes may result in unhelpful defence mechanisms associated with a range of negative outcomesWhat this paper addsWorking in value-discrepant environments is associated with a lower ability to show compassion, lower job satisfaction, and higher burnout, absenteeism, and intention to retire early, even when overall competency is not affectedPsychological tension and a low expectancy of positive outcomes seem likely to contribute to the link between being situated in value-discrepant environments and negative professional outcomesThe findings of this study are non-consistent with the notion of compassion fatigue as reflecting the cost of caring that arises from exposure to repeated suffering. It seems more likely that not being able to practice compassionately due to conflicting personal-organisational values ultimately results in poorer professional wellbeingOrganisational and fiscal level interventions that address operational processes and practices that lead to perceived value discrepancies are recommended and should be more effective for scalable improvement of health professional performance and wellbeing outcomes

Background Compassion in healthcare provides measurable benefits to patients, physicians, and healthcare systems. However, data regarding the factors that predict care (and a lack of care) are scattered. This study systematically reviews biomedical literature within the Transactional Model of Physician Compassion and synthesizes evidence regarding the predictors of physician empathy, compassion, and related constructs (ECRC). Methods A systematic literature search was conducted in CENTRAL, MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, OvidJournals, ProQuest, Web of Science, and Scopus using search terms relating to ECRC and its predictors. Eligible studies included physicians as participants. Methodological quality was assessed based on the Cochrane Handbook, using ROBINS-I risk of bias tool for quantitative and CASP for qualitative studies. Confidence in findings was evaluated according to GRADE-CERQual approach. Results One hundred fifty-two included studies (74,866 physicians) highlighted the diversity of influences on compassion in healthcare (54 unique predictors). Physician-related predictors (88%) were gender, experience, values, emotions and coping strategies, quality of life, and burnout. Environmental predictors (38%) were organizational structure, resources, culture, and clinical environment and processes. Patient-related predictors (24%) were communication ease, and physicians’ perceptions of patients’ motives; compassion was also less forthcoming with lower SES and minority patients. Evidence related to clinical predictors (15%) was scarce; high acuity presentations predicted greater ECRC. Discussion The growth of evidence in the recent years reflects ECRC’s ongoing importance. However, evidence remains scattered, concentrates on physicians’ factors that may not be amenable to interventions, lacks designs permitting causal commentary, and is limited by self-reported outcomes. Inconsistent findings in the direction of the predictors’ effects indicate the need to study the relationships among predictors to better understand the mechanisms of ECRCs. The current review can guide future research and interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07055-2.

This study analyzes the general public’s framing of ‘mental health’ and critically assesses the implications of these findings. A mismatch between how people think about mental health and what messages are used in mental health campaigns may hinder attempts to improve mental health awareness and reduce stigma. We have conducted frame analysis by using a combination of topic modeling and sentiment analysis, examining 10 years of mental health-related tweets (n = 695,414). The results reveal seven distinctive mental health frames: ‘Awareness’, ‘Feelings and Problematization’, ‘Classification’, ‘Accessibility and Funding’, ‘Stigma’, ‘Service’, and ‘Youth’ (arranged by salience). In analyzing these frames, we have learned that (1) the general awareness about mental health relates to mental illness, while health and well-being framing, although present, is prone to low quality of information, (2) mental health discourse is often used to problematize social issues and externalize personal anxieties, which tends toward trivialization and, possibly, treatment delays, (3) mental health discourse often revolves around popularized mental illness (e.g., depression, anxiety, but not neurocognitive diseases), (4) the mental health ‘Stigma’ frame is not overly pronounced; it revolves around violence, fear, and madness, (5) mental health is frequently politicized, especially concerning gun laws in the US and service accessibility and funding in the UK. Additionally, some narrower frames discovered may warrant further examination. For instance, PTSD is mostly framed around veterans and suicide, ADHD around youth, and substance abuse in relation to women, teens, and impoverished.

This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: The objectives of this review are threefold, as follows. Firstly, to assess service user experiences of emergency care following an episode of SH. Secondly, to understand how service user characteristics (e.g. gender, age, comorbidity with other illness), type of SH (e.g. method, repeated/non‐repeated), and contextual factors (e.g. what service they used, who helped them, and where) affect these experiences. Thirdly, to assess how service users' experiences of clinical service provisions have changed over time.

This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: The objectives of this review are threefold, as follows. Firstly, to assess the content of knowledge, attitudes, and behaviours of first responders, clinicians, and non‐clinical support staff towards service users with SH presentations. Secondly, to understand how service user and staff characteristics (e.g. age, gender, sociodemographic background), type of SH presentation (e.g. method, repetition), and contextual factors (e.g. hospital environment, presence of bystanders) affect the knowledge, attitudes, and behaviours of first responders, clinicians, and non‐clinical support staff in providing acute care. Thirdly, to assess whether clinicians' knowledge, attitudes, and behaviours have evolved over time.

The global burden of mental health disorders has increased steadily during the past decade. Today, mental illness is the leading cause of total years lived with disability. At the same time, global mental health policies and budgets fall short of addressing the societal burden as mental health discourse languishes in the shadows due to stigma. As social media have become an increasingly popular source of information, they create opportunities as well as threats for mental health discourse. On the one hand, social media can help to bring awareness to stigmatized topics as they give marginalized members of society the possibility to share experiences and voice their discontent. On the other hand, mental health discourse on social media may lead to stigmatization. To date, little is known about social media mental health discourse and what drives it. This study addresses these research gaps by (1) mapping the mental health discourse on Twitter and (2) analyzing mechanisms of cultural power through which some mental health topics take prevalence over the others. Drawing on Twitter data, this research employs innovative methods of topic modeling, sentiment analysis, and panel data regression analyses. Theoretically, it combines, in a multidisciplinary fashion, concepts such as emotional energy and cognitive focus from sociology and bandwagon behavior from economics. Our findings show that low-cost attention mechanisms are ineffective in fostering online mental health discourse, whereas emotional energy and discursive variability have a positive influence by engaging audiences, creating online solidarity, and speaking to worldviews of audiences from different walks of life. Social media mental health discourse is also shown to be quite diverse and more stigma-neutral than such discourse in traditional media.

Аннотация В работе рассматривается новые возможности инновационной экспериментальной программы по дисциплине «Физическая культура» в воспитании коммуникативных и лидерских качеств будущих специалистов на основе личностно ориентированного содержания учебного процесса. Нами разработана примерная программа по дисциплине «Физическая культура», основанная на дифференцированном выборе средств физического воспитания с учетом психотипических свойств личности студентов. В экспериментальной программе для студентов первых курсов баскетбол и волейбол в разделе Спортивные игры был заменены бадминтоном. Это связано с тем, что на первом курсе происходит сближение студентов на основе эмоциональной (психологической) совместимости, поэтому наиболее предпочтительными формами физкультурно-спортивной деятельности являются упражнения в парах, занятия одинаковым видом спорта по интересам. Ключевые слова: компетентность, лидерские качества, физическая культура.