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Enactment of compassionate leadership by nursing and midwifery managers: results from an international online survey
  1. Irena Papadopoulos1,
  2. Steve Wright1,
  3. Runa Lazzarino1,
  4. Christina Koulouglioti1,2,
  5. Magdeline Aagard3,
  6. Özlem Akman4,
  7. Lise-Merete Alpers5,
  8. Paraskevi Apostolara6,
  9. Julieta Araneda7,
  10. Sylvia Biglete-Pangilinan8,
  11. Orit Eldar-Regev9,
  12. Maria Teresa González-Gil10,
  13. Christiana Kouta11,
  14. Radka Krepinska12,
  15. Małgorzata Lesińska-Sawicka13,
  16. Miroslava Liskova14,
  17. Lucero Lopez-Diaz15,
  18. Maria Malliarou16,
  19. Ángel Martín-García17,
  20. Mara Muñoz-Salinas7,
  21. Małgorzata Nagórska18,
  22. Roinah Nkhensani Ngunyulu19,
  23. Sara Nissim20,
  24. Line Nortvedt21,
  25. Florinda Oconer-Rubiano8,
  26. Cristina Oter-Quintana10,
  27. Candan Öztürk22,
  28. Katalin Papp23,
  29. Blanca Piratoba-Hernandez15,
  30. Elena Rousou11,
  31. Maria Ymelda Tolentino-Diaz24,
  32. Valerie Tothova25,
  33. Akile Zorba26
  1. 1Research Centre for Transcutural Studies in Health, Department of Mental Health and Social Work, School of Health Social Care & Education, Middlesex University, London, UK
  2. 2University Hospitals Sussex NHS Foundation Trust, Worthing, UK
  3. 3School of Health Sciences, Walden University, Minneapolis, Minnesota, USA
  4. 4Nursing Department, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, İstanbul, Turkey
  5. 5Faculty of Health Studies, VID Specialized University, Oslo, Norway
  6. 6Faculty of Nursing, University of West Attica, Egaleo, Attica, Greece
  7. 7School of Medicine, Universidad Diego Portales, Santiago, Santiago, Chile
  8. 8College of Nursing and Midwifery, Bataan Peninsula State University, Bataan, Philippines
  9. 9Independent Researcher, Tel Aviv, Israel
  10. 10Nursing Department, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
  11. 11Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
  12. 12School of Nursing, SZŠ a VOŠZ Havlíčkův Brod, Havlickuv Brod, Czech Republic
  13. 13Department of Nursing, State University of Applied Sciences in Piła, Pila, Poland
  14. 14Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
  15. 15Faculty of Nursing, Universidad Nacional de Colombia, Bogotá, Colombia
  16. 16Nursing Department, School of Health Sciences, University of Thessaly, Larissa, Thessaly, Greece
  17. 17San Blas Primary Healthcare Centre (Southern Area), Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
  18. 18Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
  19. 19Department of Nursing, Department of Nursing, University of Johannesburg, Johannesburg, South Africa
  20. 20Nursing School, Tel Aviv University, Tel Aviv, Israel
  21. 21Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
  22. 22Faculty of Nursing, Near East University, Nicosia, Cyprus
  23. 23University of Debrecen, Debrecen, Hungary
  24. 24ASL Roma 2, Roma, Italy
  25. 25Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
  26. 26Department of Psychology, Faculty of Arts and Science, Eastern Mediterranean University, Famagusta, North Cyprus, Cyprus
  1. Correspondence to Professor Irena Papadopoulos, Middlesex University School of Health and Education, London, UK; r.papadopoulos{at}


Aim To explore the views of an international sample of nursing and midwifery managers concerning attributes that they associate with compassionate management.

Method A cross-sectional online survey. Using a snowballing sampling method, 1217 responses were collected from nursing and midwifery managers in 17 countries. A total of complete 933 responses to a question related to which actions and behaviours indicated that a manager was exercising compassionate leadership were analysed for this paper. First, content analysis of the responses was conducted, and second, a relative distribution of the identified themes for the overall sample and for each participating country was calculated.

Results Six main themes were identified describing the attributes of a compassionate leader: (1) Virtuous support, (2) Communication, (3) Personal virtues of the manager, (4) Participatory communication, (5) Growth/flourishing/ nurturing and (6) Team cohesion. The first three themes mentioned above collectively accounted for 63% of the responses, and can therefore be considered to be the most important characteristics of compassionate management behaviour.

Conclusion The key indicators of compassionate management in nursing and midwifery which were identified emphasise approachability, active and sensitive listening, sympathetic responses to staff members’ difficulties (especially concerning child and other caring responsibilities), active support of and advocacy for the staff team and active problem solving and conflict resolution. While there were differences between the countries’ views on compassionate healthcare management, some themes were widely represented among different countries’ responses, which suggest key indicators of compassionate management that apply across cultures.

  • behaviour
  • clinical leadership
  • multi-professional

Data availability statement

Data are available upon reasonable request. Please contact the corresponding author for more information about the availability of deidentified participant data.

Statistics from

Data availability statement

Data are available upon reasonable request. Please contact the corresponding author for more information about the availability of deidentified participant data.

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  • Contributors IP contributed to conception and study design. All authors contributed to data collection. IP, SW contributed to data analysis and interpretation. IP, SW, RL, CK contributed to manuscript drafting. IP contributed to critical revisions for important intellectual content. All authors contributed to final approval of the version to be published and consent to be accountable for all aspects of the work.

  • Funding This study received no external funding and was conducted on a voluntary basis, under the lead of Research Centre for Transcultural Studies in Health at Middlesex University, London, UK.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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