What comes to mind when kids think about compassion? Knowing both that compassion is in the eye of the beholder and how much kids hate ‘hand-me-downs’ (whether they are clothes from older siblings or models of compassion based on the perspective of adults) we decided to go the bedside to get the perspective of the real experts—kids. We interviewed pediatric cancer patients directly, along with parents and healthcare providers (HCPs) in order to develop a model of compassion that was kid-friendly and child-oriented. While the pediatric model of compassion bears a strong resemblance to the adult patient compassion model, kids shared some unique, inspiring, and diverse perspectives.
Model solar systems, model cars, and the plum-pudding model of the atom are all visual representations that can help us to understand larger fuzzy concepts that fail words or serve to illustrate complex theories in a bite-sized format. Likewise, a model of compassion provides us a thumbnail sketch of the components of compassion and how these parts work together in unison.
From interviews with patients, parents, and HCPs, four key components of the pediatric compassion model emerged. In broad strokes – the model identified beneficence (the virtues or good qualities igniting an initial response to a situation involving suffering), human relating (approaching the person and situation from a place of shared humanity), seeking to understand (proactively coming to an in-depth understanding of the person’s uniqueness and individual needs), and the keystone of compassion, attending to needs (small and extraordinary acts of kindness aimed at alleviating another person’s suffering). Each of these key components contained a number of sub-components, which when taken together, provide a comprehensive understanding of compassion.
So, what sort of building supplies could we use to construct a pediatric model of compassion? How can we visualize compassion in a manner that is both integral to the science behind it and to the kids?
While we briefly considered commandeering the paper mache of science fair volcanoes and the styrofoam and toothpicks of yesteryear’s model solar systems, what better way to depict the basic building blocks of compassion according to kids than through Lego
Each of the components of the pediatric compassion model are illustrated through different coloured Lego blocks – red for beneficence, green for seeking to understand, blue for human relating, and yellow for attending to needs. Beyond, providing a comprehensive model of compassion, our research also showed that a child’s age was associated with preferences for certain Lego blocks (components of the compassion model). Younger patients focused most on the red blocks of beneficence or “virtuous qualities”, such as being kind, accepting, and loving when describing HCPs who were compassionate. Older kids, while mentioning the red blocks of beneficence in an equal measure, added on additional coloured blocks such as the blue blocks of human relating that were not as readily identifiable to younger kids.
Well as you get older, you know the base of it and you can keep kind of adding onto the piece. It can be like building blocks …it’s not like “oh a 12-year-old immediately knows what it is”; it’s, you know, “this is the base” and as you get older you might be able to add more building blocks on to make them help them understand as they get older and understanding the different concepts (Billy,13 y.o.).
Although we know that the four main ingredients to our compassion “pie” are beneficence, human relating, seeking to understand, and attending to needs, not everyone has the same taste. While patients, parents, and HCPs all agreed that you couldn’t omit any one ingredient (after all you can’t have a pie without its crust!), the portions of sugar, spice and everything nice varied slightly for each individual and circumstance. For example, in a pain crisis, kids might prefer an extra amount of attending to needs with only a dash of human relating. On the contrary, in having their pain and symptoms well managed, kids warmly welcomed a heaping spoon of human relating and an extra pinch of seeking to understand when their healthcare providers were interacting with them or providing routine care.
Personal taste preferences also persisted across participant groups. In general, kids and their parents had a sweet tooth for the virtuous qualities (beneficence)of their HCPs – the ‘being’ of compassion associated with qualities such as kindness,sincerity and love. HCPs on the other hand emphasized communication (human relating) and clinical tasks (attending to needs), associated with the‘doing’ of compassion. Why is this difference important? While we know compassion relies on all four of these ingredients, knowing what the other person considers to be important in compassion allows us to include a generous helping in our recipe and to modify the recipe based on patient preferences.
If you would like to read more about this research and how kids think about compassion, you can download the original open-access article here.
Sinclair, S., Bouchal, S. R., Schulte, F., Guilcher, G., Kuhn, S.,Rapoport, A., Punnett, A., Fernandez, C. V., Letourneau, N., & Chung, J.(2021). Compassion in pediatric oncology: a patient, parent and healthcare provider empirical model. Psycho-oncology, 10.1002/pon.5737. Advance online publication. https://doi.org/10.1002/pon.5737
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