Abstract

The patient-provider interaction (PPI) represents a critical dimension of healthcare delivery that significantly influences clinical outcomes, yet the nuanced dynamics of compassionate care remain operationally elusive. This dissertation presents the Compassionate H.E.A.R.T. (Helping Ease, Alleviate, & Relieve Therapeutically) framework—a novel theoretical model for understanding and enhancing relationship-centered care—and examines its validity, reliability, and therapeutic impact.

Through four interconnected studies, this research explores the multifaceted nature of compassionate care. First, a comprehensive literature review excavates the landscape of patient-provider interactions, highlighting terminological inconsistencies, incomplete theoretical frameworks, and methodological challenges in measuring these ethereal qualities. Second, the Compassionate H.E.A.R.T. model is introduced, delineating a structured framework for the patient-provider interaction that progresses from vulnerability/authenticity through clinical knowledge/expertise, emotional intelligence, empathy, compassion, rapport, trust, and culminates in concordance/shared decision-making.

Third, the validation and reliability testing of the Compassionate H.E.A.R.T. Patient Questionnaire (CHPQ) demonstrates strong psychometric properties (Cronbach's alpha = 0.86) and a robust three-factor structure explaining 85.9% of variability. Quantitative findings revealed significant correlations between CHPQ scores and reduced fatigue in patients with persistent pain (r=-.493, p=.001). Finally, qualitative analysis of patient voices illuminates three key themes—Clinical Competence with Connection, Trust and Safety, and Empowerment through Partnership—providing deeper insight into how patients experience compassionate care.

This research establishes the CHPQ as a valid, reliable measure of relationship-centered care and offers a comprehensive framework for healthcare education, practice, and research. By mapping the invisible pathways that transform clinical encounters from transactional exchanges to therapeutic moments, the Compassionate H.E.A.R.T. model provides a blueprint for healthcare providers to enhance patient care through the integration of technical expertise and human connection.

LLU Discipline

Physical Therapy

Department

Physical Therapy

School

School of Allied Health Professions

First Advisor

Everett Lohman

Second Advisor

Lee Berk

Third Advisor

Lida Gharbivand

Fourth Advisor

Andrew Sullivan

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2025

Date (Title Page)

6-2025

Language

English

Library of Congress/MESH Subject Headings

Patient-centered care; Communication in medicine; Medical care—Psychological aspects; Compassion; Empathy; Questionnaires—Design and construction; Psychometrics

Type

Dissertation

Page Count

xii, 131 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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