An investigation into compassion fatigue and self-compassion in acute medical care hospital nurses: a mixed methods study

Katherine Valentine Upton

doi:10.1186/s40639-018-0050-x

Abstract

BackgroundIn the acute medical care hospital setting, nursing the sick and dying is both physically and emotionally demanding, making acute medical care hospital nurses more vulnerable to Compassion Fatigue (CF) or Secondary Traumatic Stress (STS). If not addressed in its earliest stages, CF can adversely change the caregiver’s ability to provide compassionate care. It has been shown that Self-Compassion (SC) can be beneficial for the caregiver, with corresponding benefits for the individual needing care. However, the relationship of this attribute to CF in the acute medical care hospital nursing setting has not been intensively studied. This study explores the environmental and psychosocial factors affecting the prevalence and levels of CF in acute medical care hospital nursing staff and whether SC can be used as a coping strategy that enables nurses to mitigate the prevalence and levels of CF.MethodsUsing a mixed-methods study design, acute medical care hospital nurses were surveyed using a demographic/work-related questionnaire, the Secondary Traumatic Stress Scale (used to measure CF), the Self-Compassion Scale, questions requiring a narrative written response and semi-structured informal interviews. One-way ANOVA was conducted to explore the impact of work-related and demographic characteristics on levels of SC and CF. Pearson correlation co-efficient (r value) was used to explore the relationship between CF and SC and lastly, multiple regression was used to discover whether a predictive relationship existed between SC and CF. The interviews were recorded, transcribed verbatim and subjected to thematic analysis.ResultsThe results of this study have exposed the prevalence of CF in acute medical care nurses and it’s damaging effects. And has also confirmed that SC can have a moderating effect on CF and an ability to be predictive of CF. Factors that influence the distress and vulnerability to CF were also identified, as well as the personal approaches used, whether successful or not, to enhance levels of SC and the ‘barrier’s to achieving it.ConclusionThis unique study could lead to care environments encouraging the self-compassion and well-being of their acute medical care nursing staff and become places where threat cultures, weak leadership, an emphasis on task rather than process and a feeling of being undervalued, do not monopolise.

Highlights

In the acute medical care hospital setting, nursing the sick and dying is both physically and emotionally demanding, making acute medical care hospital nurses more vulnerable to Compassion Fatigue (CF) or Secondary Traumatic Stress (STS)
Secondary traumatic stress scale (STSS) Total Stress Scale (STSS) and STSS subscale scores The results revealed that nearly 46% of the respondents had a mean total STSS score that fell within the range of 41 to 57, indicating that they had moderate to very severe levels of STS [82]
In relation to the External Factors that have contributed to CF in the nurses, the study results showed that participants felt that the patient-care they delivered was under the scrutiny of the toxic media, which led them to feeling hyper alert and conscious of the care they gave, leading to what they believed was inauthentic care that was not heartfelt

Summary

Introduction

In the acute medical care hospital setting, nursing the sick and dying is both physically and emotionally demanding, making acute medical care hospital nurses more vulnerable to Compassion Fatigue (CF) or Secondary Traumatic Stress (STS). Advances in medical science have enabled patients with multiple comorbidities to be provided with more active treatment. This has required that patients in hospital care, on average, need more intensive care management [15]. This is of significance in the acute medical care hospital ward setting, where nurses care for the sick and dying in a work environment that faces sustained increasing pressure on health expenditure from an ageing population, the introduction of new technology (which is often complex) and rising public expectations [16]

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