Development and initial psychometric properties of the Barriers to Physician Compassion questionnaire.

OBJECTIVE Physicians are expected to be compassionate. However, most compassion research focuses on compassion fatigue--an outcome variable--rather than examining the specific factors that may interfere with compassion in a physician's practice. This report describes the development and early psychometric data for a self-report questionnaire assessing barriers to compassion among physicians. METHODS In 2011, a pilot sample of 75 physicians helped to generate an initial list of barriers to compassion. A final 34 item Barriers to Physician Compassion (BPC) questionnaire was administered to 372 convenience-sampled physicians together with measures of demographics, practice-related variables, stress, locus of control and trait compassion. RESULTS The barriers to physician compassion were not one-dimensional. Principal component analysis revealed the presence of four distinct, face-valid and discriminable factors--physician burnout/overload, external distractions, difficult patient/family and complex clinical situation. All barrier components had adequate internal reliabilities (>0.70) and meaningful patterns of convergent and divergent validity. CONCLUSIONS Remaining compassionate in medical practice is difficult. With the newly developed BPC questionnaire, specific barriers to compassion can be assessed. These barriers illuminate potential targets for future self- and practice management, interventions and compassion training among physicians.