ADSARPS: A Hypothetical Model

for Reproducible and Efficient

Compassionate Care
Multiple Sclerosis:
An Illness Narrative
300,000individualswithMSinNorthAmerica
Ageofonsetpeaksbetweenages2030,F>M
Challengingtodiagnose
4subtypesofdiseasewithvariablecourseand
possiblydieringpathophysiology
HistoricallypoortreatmentmodaliBesmostly
centeredaroundprevenBonofrelapseand
symptomaBcreliefa]eraNacks
Anindividualizedillness
MarkeduncertaintyinfutureQualityofLife

A Model for Caregiving

RushMedicalCollege
May2015

Patients View
of Compassion1

Compassion as
a Resident

Respect

Beingcompassionate
andpayingaNenBonto
needshighestratedin
surveyofResident
professionalism2
Gainingtrust,treaBng
theindividualsasa
humanandshowing
respectratedmosthighly
important;Understanding
emoBonalneedsleast
frequentlydemonstrated3
MindfulnessandSelf
compassioncorrelated
bestwithcondencein
providingcompassionate
care4

Estbalishempathic
connecBon:understand
experiences,concerns,
andaNempttoconnect
RecognizeHumanness
MeetpaBentneedsby
invesBngagreatdealof
aNenBonandBme

CommunicaBon

Interpersonaland
InformaBonal
Wearehere.Weare
takingcareofyou.
formethatwas
compassion

The Story of My CAPSTONE

MSwaschosenbecauseitaectsmany,has
interesBngpathophysiology,everexpanding
research,andIhadnocloseconnecBontoit
IniBallyusedasanadjuncttoschoolmaterial
Wrotepapersonphysiology,anatomy,
pathophysiology,researchmethods,
diagnosBcworkup,FDAapprovalprocess
WroteonepaperonlivingwithMS
MSbecamepersonalduringendofM2year
DuringM3,Ibegantohaveaninterestinthe
challengeofdeliveringcompassionatecare
despitethebarrierstothisinclinicalpracBce
ANendedatalkbyDr.ArthurKleinman,
worldrenownedpsychiatristandmedical
anthropologist,onincludingCaregivingin
medicaleducaBoncurricula
MadeCaregivingtheul0matefocusofmy
project,usingwhatIhadlearnedtopropose
amodelfordeliveringcompassionatecare
Thismodelisintendedtoberepeatable,
accurateandeasytoimplementinprac0ce

DavidS.Burstein

CompetentCare

The ADSARPS Model

AssumethatthepaBentissuering*
DeterminethesourceofthepaBentssuering
SeparateyourselffromthepaBentscondiBon
Donotconfusethepa.entssueringwithyourownsuering
Arm&AcknowledgethepaBentssuering
Arm:Tosaythatsomethingistrueinacondentway
Acknowledge:Tosaythatyouacceptthetruthofsomething
ReectorLabelthepaBentsemoBonalstate
Present:Beinginvieworathand*
Onemustbetakencareofinordertotakecareofothers

Influences Behind This Model

SeriesonCaregivingpublishedbyDr.
ArthurKleinmaninLancet,20082014
AtalkbyDr.LarryGoodman*Ancient
AdvicefromanOldFriendatRush,2014
ThebookHouseofGodbySamuelShem,
M.D.published1978
CapstonesubmissionM2IIIonEmpathy
Physicianship
Remaining Questions
Howmightempathybeincluded?
Howdoeshopetin?
Canweprovethatthisworks?
1. Badger K, Royse D. Describing compassionate care: The Burn Survivors Perspective. J Burn Care Res 2012;33:772-780.
2. Wiggins M, Coker K, Hicks E. Patient perceptions of professionalism: implications for residency. Med Edu 2009; 43:28-33.
3.LownBA,MuncerSJ,ChadwickR.Cancompassionatehealthcarebemeasured?TheSchwartzCenterCompassionateCareScale.
Pa.entEducCouns.2015Apr2Epubaheadofprint
4.OlsonK,KemperKJ.Factorsassociatedwithwellbeingandcondenceinprovidingcompassionatecare.JEvidBasedComplemntary
AlternMed.2014Oct;19(4):2926.