title: Defining compassionate care from the perspective of people who experience problem substance use
Creators: name: Walsh, Nicole
Publisher: name: Edinburgh Napier University
publisherIdentifier: https://ror.org/03zjvnn91
publisherIdentifierScheme: ROR
Year: 2024

description: This thesis outlines a three-stage approach to understanding how people who experience problem substance use define compassionate care. Compassion is a fundamental value of the provision of quality health in universal statutory services of care in the UK. In response to increased public health concern of the rates of drug-related deaths in Scotland, there is a call for a compassionate approach to managing problem substance use (Scottish Government 2023). Stigma creates barriers to accessing care and for the provision of compassionate care by disrupting the three key processes which underpin compassion. It is essential to gain an understanding of how people who experience problem substance use define compassionate care which is defined within this thesis as a process involving recognition of the suffering of another, having an emotional response and taking action to alleviate the subjective suffering of another.
Stage 1: A scoping review was conducted to explore the research question ‘Does the Framework for Compassionate Care (FCC) developed from the Leadership in Compassionate Care Programme provide a representative framework for understanding compassionate care for people with experience of problem substance use?’. Following PRISMA protocol for scoping reviews, 23 studies were included. Results found that compassionate care literature supported the findings of the FCC, however, the perspective of people with experience of problem substance use was absent.
Stages Two and Stage Three of this thesis aimed to address this gap in available empirical research and aimed to answer ‘How do people with experience of problem substance use define compassionate care when accessing care/support services?’ and ‘How do families and professionals who support people who experience problem substance use define compassionate care?’. Stage Two involved semi-structured interviews (n=11) with people with experience of problem substance use. Analysis followed inductive Reflexive Thematic Analysis stages. Stage Three involved three focus groups exploring the resonance of the findings of Stage Two with family members of people who experience problem substance use (n=8) and professionals who support people with problem substance use (n=5). Focus group transcripts were analysis deductively in line with Reflexive Thematic Analysis.
Findings from Stage Two and Stage Three resulted in 6 themes and 22 sub-themes of compassionate care for people with experience of problem substance use. These sat within three underpinning processes of compassionate care; 1) recognition of suffering is underpinned by the theme Hearing and Understanding my Perspective, 2) emotional response is underpinned by Caring About Me and Trusting Relationships and 3) taking action to alleviate suffering is underpinned by the themes of Available When Needed, Safe Environment and Having Options and Being Involved in Decisions.
To best meet the needs of people who experience problem substance to break down barriers to care and tackle the shameful rates of drug-related deaths in Scotland, services at an individual and systematic level should strive to provide compassionate care.