High Risk For Compassion Fatigue Research Articles

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling

BackgroundClinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses.MethodsA total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson’s or Spearman’s correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue.ResultsThe results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%.ConclusionsOur findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses’ social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

Quantifying Compassion Fatigue in Ancillary and Clinical Staff in an Adult Emergency Department.

Emergency department (ED) staff are at a high risk for compassion fatigue (CF) due to a work environment that combines high patient acuity, violence, and other workplace stressors. This multifaceted syndrome has wide-ranging impacts which, if left untreated, can lead to adverse mental health conditions including depression, anxiety, and substance use disorders. However, the majority of studies examining CF look solely at clinicians; as a result, there is little information on the impact of CF across other roles involved in supporting patient care. We conducted this study to establish the prevalence of CF across both clinical and non-clinical roles in the adult ED setting. For this single institution, cross-sectional study, all full- and part-time ED staff members who worked at least 50% of their shifts in the ED or within the adult trauma service line were eligible to participate. Using the Professional Quality of Life Scale, which measures CF via compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS), we assessed for group differences between roles using non-parametric one-way ANOVA. A total of 152 participants (response rate = 38.0%) completed the survey. This included attending physicians (n = 15, 9.7%), resident/fellow physicians (n = 23, 15.1%), staff nurses (n = 54, 35.5%), emergency technicians (n = 21, 13.8%), supportive clinical staff (n = 28, 18.4%), and supportive ancillary staff (n = 11, 7.2%). Across all roles, the majority of respondents had average levels of BO (median = 25.0, interquartile range [IQR] 20.0-29.0) and STS (median = 23.0, IQR 18.0-27.0) coupled with high levels of CS (median = 38.0, IQR 33.0-43.0). There was a difference in CS by role (P = .01), with nurses reporting lower CS than attending physicians. Secondary traumatic stress also differed by role (P = .01), with attending physicians reporting lower STS than both emergency technicians and nurses. Group differences were not seen in BO. Rates of compassion fatigue subcomponents were similar across all ED team members, including non-clinical staff. Programs to identify and mitigate CF should be implemented and extended to all roles within the ED.

Compassion fatigue in a health care worker treating COVID-19 patients: a case report

BackgroundDoctors treating COVID-19 are under extreme stress. It was reported that healthcare workers providing palliative care could present elevated levels of compassion fatigue. We herein report a case if the attending doctor of severe COVID-19 cases who felt extreme psychological difficulty and suffered from compassion fatigue.Case presentationA 29-year-old female doctor presented with anxiety and insomnia. Her stress from overwork was exacerbated during the treatment of two related COVID-19 patients, a 47-year-old man with COVID-19 and his 76-year-old mother, who suffered acute stress disorder after the death of her son. The mother first refused treatment, but with psychiatric intervention she was able to recover and be discharged. In the course of these cases of COVID-19, their attending physician felt psychological distress and presented with insomnia and anticipatory anxiety due to the poor prognosis of the mother. After being presented with a systematic approach to improve her work situation by the hospital executive staff and undergoing psychotherapy for compassion fatigue, she recovered and was able to return to work.ConclusionsWe report a physician in charge of severe cases of COVID-19, who suffered an adverse impact on her mental health. Excessively empathic engagement in the care of patients who do not survive and their relatives provides high risk for compassion fatigue. The stress-related distress of HCWs should be more widely recognized in order to improve support systems for them.

A Wellness Program to Decrease Pediatric Postanesthesia Care Unit Staff Compassion Fatigue.

Health care workers, especially those in pediatrics, have a high risk for compassion fatigue (CF). A wellness program (WP) might help decrease CF and increase compassion satisfaction (CS). This project implemented and evaluated a WP in a pediatric postanesthesia care unit at a large children's hospital. The project evaluated the effectiveness of a WP using pre- and post-WP surveys, which assessed CF (i.e., burnout and secondary traumatic stress), CS, and overall satisfaction with the WP. Overall results demonstrated decreases in CF and increases in CS, self-care, healthy behaviors, and knowledge of CF. The perceived level of teamwork, morale, recognition, social support, and positive coworker interactions also increased. Overall, 77% of the respondents thought the WP helped decrease CF. Implementing a WP that incorporates social support, education, and healthy behaviors had significant benefits, including a reduction in CF.

An effective in-hospital chaplaincy-led care program for nurses: Tea for the soul a qualitative investigation

Tea for the Soul (TFS) is an understudied care model, addressing bereavement and other emotional needs of nurses related to impactful patient care experiences. Nurses are at high risk for compassion fatigue, moral distress, and burnout. Facilitated by a Chaplain, the TFS program provides participants a venue to express their feelings and explore ways of adapting effectively with the death of a patient, and other traumatic workplace experiences. In this qualitative grounded theory study, hospital nurses (N = 7) who participated in TFS were interviewed. IRB approval was obtained. Questions were constructed within the context of the medical center research council and asked if TFS: (a) was personally beneficial, (b) helped nurses feel better about their work, and (c) affected job satisfaction. Four core themes emerged: (a) Nurses’ Self-Care, (b) Professional Practice, (c) Community, and (d) Improved Patient Care Outcomes. The Roy Adaptation Model, Group Identity Mode was applied to the content analysis. Overarching themes were Compassionate Service, Ministry of Presence, Reflective Practice, and Sacred Encounters. Nurses reported that TFS facilitated a spiritual respite and a sense of enhanced community and was a source of strength and coping, thus may aid in the promotion of nurse well-being and the amelioration of moral distress, compassion fatigue, and burnout.

Impact of chromotherapy on professional quality of life in intensive care unit nurses: a randomized controlled trial

ABSTRACT Background: Professional quality of life (ProQOL) comprises two aspects: compassion satisfaction and compassion fatigue. Although intensive care unit (ICU) nurses obtain professional satisfaction from their work, their repeated exposure to the aftermath of critical illness puts them at high risk for compassion fatigue. Aim: This study aimed to investigate the impact of chromotherapy-based interventions on the ProQOL in ICU nurses. Methods: In this randomized controlled trial, 80 ICU nurses were assigned into 2 groups (experiment and control). A demographic form and ProQOL questionnaire were used for data collection. The interventions included three parts; (A) changing color of decoration in experimental ICU, such as the installation of color panels in ICU ward, (B) providing a mobile cover and a pencil case in yellow, orange, and green colors based on the principles of chromotherapy, for each of experimental group nurses, and (C) in addition, three educational sessions on chromotherapy were held and then participants received individualized consulting sessions weekly on chromotherapy applying in their personal life for 3 months. Results: Applying chromotherapy increased ProQOL score in all of its dimensions (satisfaction of compassion, fatigue due to compassion, and secondary post-traumatic stress) in the experimental group (p < .05). Conclusion: Chromotherapy may enhance ProQOL in ICU nurses. Interventions such as chromotherapy can be implemented easily to combat compassion fatigue and secondary post-traumatic stress in ICU nurses. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT2017101431588N3.

Oncology nurses\u2019 compassion fatigue, burn out and compassion satisfaction

BackgroundFor oncology nurses, compassion fatigue, burn out and compassion satisfactions are frequently experienced psychosocial consequences of the oncology work environment. Surveying such phenomena helps to understand how nurses feel and behave when cancer care is provided. Besides, tracking the evolving nature of those three concepts can lend a hand for the early detection of personal and professional suffering of nurses while offering some healing remedies to their struggling bodies and souls.PurposeThe purpose of this study was to explore the level of compassion fatigue, burn out and compassion satisfaction among a group of specialized oncology nurses. Besides, this study aimed to detect some probable interesting inferences between compassion satisfaction and the concept of rest and leisure. Correlations between compassion fatigue, burn out and compassion satisfaction were investigated. Correlations between oncology nurses’ scores on the three subscales and a group of demographic, organizational and leisure-related variables were examined.MethodsThis study adopted a descriptive correlation design to survey compassion fatigue, burn out and compassion satisfaction among a convenient sample of 100 oncology nurses who work in a specialized cancer care centre. Participants completed compassion fatigue self-test developed by Figely (Compassion fatigue, New York: Brunner/Mazel. B. HudnallStamm, Traumatic Stress Research Group; 1995–1998. http://www.dartmouth.edu/~bhstamm/index.htm, 1995) and a literature-based demographic survey. Analysis of data included descriptive statistics and Pearson correlation co-efficient.ResultsNurses reported a low level of compassion satisfaction, moderate risk for burn out and an extremely high risk for compassion fatigue. Results revealed significant negative relationships among compassion satisfaction and the number of dependents per nurse. Additionally the correlation between compassion satisfaction and the nurses’ number of hours slept was positive. Only two components of the concept rest and leisure yielded statistical significance when correlated to the concept of compassion satisfaction. A significant negative relationship was observed between compassion satisfaction and compassion fatigue while a strong positive relationship was observed between compassion fatigue and burn out.ConclusionsThe studied oncology nurses sample had evidently low level of compassion satisfaction when contrasted to the significantly increased risks of burn out and compassion fatigue. Thus, health authorities and management are advised to care, in a holistic approach, for nurses who work in oncology departments. Staff-oriented services that offer comfort, reward, leisure, screening, consultation and support are urgently recommended.

Occupational Health of Animal Shelter Employees by Live Release Rate, Shelter Type, and Euthanasia-Related Decision

ABSTRACTApproximately a quarter of dogs and cats in animal shelters in the United States are euthanized. The stress associated with having to care for animals they subsequently euthanize puts animal shelter workers at a high risk for compassion fatigue, burnout, and even suicide. The aim of the present study was to assess the relationship between a shelter’s Live Release Rate (LRR; defined as the percent of animals that leave the animal shelter with a positive outcome) and the involvement in euthanasia-related decision-making on employees’ mental health. An online nationwide survey was administered to 153 municipal and private shelter workers consisting of the Impact of Event Scale-Revised, the Professional Quality of Life Questionnaire, the Moral Injury Event Scale, and questions relating to their work environment. A multivariate regression model found that compassion satisfaction (p < 0.00001), secondary traumatic stress (p = 0.008), moral injury (p = 0.037), and burnout (p = 0.002) were positively correlated with LRR. This suggests that although job satisfaction is greater in shelters with more positive outcomes, trauma may also be greater. A t-test revealed that employees who euthanize have higher moral injury scores compared with those who do not (t(152) = –2.96, p = 0.0036). A second multivariate regression model found that deciding which animal to euthanize predicted increased secondary traumatic stress (r(151) = –0.058, p = 0.016). Overall, the data show that LRR and decisions surrounding euthanasia play a role in occupational trauma; furthermore, the data provide support for further exploration of moral injury in animal shelter workers.

A survey of compassion satisfaction, burnout and compassion fatigue in nurses practicing in three oncology departments in Durban, South Africa

PurposeProlonged and continual contact with grief and recurrent deaths, observing patients undergoing unrelenting medication therapies which could prove unsuccessful, and a constant atmosphere of hopelessness put the oncology nurse at high risk of developing compassion fatigue and burnout. This study conducted a survey of compassion satisfaction, burnout and compassion fatigue in nurses practicing in three oncology departments in Durban, South Africa. MethodA quantitative non-experimental descriptive survey using purposive sampling. ResultsResults revealed that 55% (n = 83) of participants had high compassion satisfaction, 61% (n = 83) had average burnout and 75% (n = 83) had average compassion fatigue. Only three participants scored high risk for compassion fatigue. ConclusionsThe results from this study are in contrast to previous international and national studies where compassion fatigue and burnout were reported at high-risk levels. This study revealed average to high levels of compassion satisfaction.

Who is at risk for compassion fatigue? An investigation of genetic counselor demographics, anxiety, compassion satisfaction, and burnout.

Compassion fatigue is a state of detachment and isolation experienced when healthcare providers repeatedly engage with patients in distress. Compassion fatigue can hinder empathy and cause extreme tension. Prior research suggests 73.8% of genetic counselors are at moderate to high risk for compassion fatigue and approximately 1 in 4 have considered leaving the field as a result Injeyan et al. (Journal of Genetic Counseling, 20, 526-540, 2011). Empirical data to establish a reliable profile of genetic counselors at risk for compassion fatigue are limited. Thus the purpose of this study was to establish a profile by assessing relationships between state and trait anxiety, burnout, compassion satisfaction, selected demographics and compassion fatigue risk in practicing genetic counselors. Practicing genetic counselors (n = 402) completed an anonymous, online survey containing demographic questions, the State-Trait Anxiety Inventory, and the Professional Quality of Life scale. Multiple regression analysis yielded four significant predictors which increase compassion fatigue risk (accounting for 48% of the variance): higher levels of trait anxiety, burnout, and compassion satisfaction, and ethnicity other than Caucasian. Additional findings, study limitations, practice implications, and research recommendations are provided.

Compassion Fatigue in Liver and Kidney Transplant Nurse Coordinators: A Descriptive Research Study

Because of the nature of the helping professions, nurses are at high risk for compassion fatigue and burnout. In the past, many researchers have studied compassion fatigue and burnout in nurses. However, reports of research assessing liver and kidney transplant nurse coordinators' compassion fatigue and burnout are rare. To assess liver and kidney transplant nurse coordinators' levels of compassion fatigue and burnout. A nonexperimental, exploratory descriptive study was conducted using the Professional Quality of Life Scale Version 5 (ProQOL-V), a 30-item self-report instrument to measure participants' level of compassion satisfaction, burnout, and secondary traumatic stress. This study sampled 14 liver and kidney transplant nurse coordinators from a large multiorgan transplant center in the Southeast region. Transplant nurse coordinators had an average level of compassion satisfaction, an average level of burnout, and an average level of secondary traumatic stress. Within liver and kidney transplant nurse coordinators, a statistically significant relationship was found between education levels of transplant nurse coordinators and the level of burnout, suggesting that education levels may influence burnout.

Sleep Disturbance, Chronic Stress, and Depression in Hospice Nurses: Testing the Feasibility of an Intervention

To test the feasibility of a cognitive-behavioral therapy for an insomnia (CBT-I) intervention in chronically bereaved hospice nurses. Five-week descriptive correlational. Nonprofit hospice in central Texas. 9 agency nurses providing direct patient and family care. Direct care nurses were invited to participate. Two intervention group sessions occurred at the hospice agency and included identification of dysfunctional thoughts and beliefs about sleep, stimulus control, sleep hygiene, and relaxation techniques to promote sleep. Measurements were taken at baseline and three and five weeks postintervention. Sleep quality, depressive symptoms, and narrative reflections on the impact of sleep quality on self-care. Participants reported moderate-to-severe sleep disturbances and moderate depressive symptoms. The CBT-I intervention was well accepted by the participants, and on-site delivery increased participation. Additional longitudinal study is needed to investigate the effectiveness of CBT-I interventions to improve self-care among hospice nurses who are at high risk for compassion fatigue and, subsequently, leaving hospice care. Hospice nurses are exposed to chronic bereavement that can result in sleep disturbances, which can negatively affect every aspect of hospice nurses' lives. Cognitive-behavioral sleep interventions show promise in teaching hospice nurses how to care for themselves by getting quality sleep. Identifying the risks for sleep disturbances and depressive symptoms in hospice nurses will allow for effective, individualized interventions to help promote health and well-being. If hospice nurses achieve quality sleep, they may remain in the profession without suffering from chronic bereavement, which can result in compassion fatigue. A CBT-I intervention delivered at the agency and in a group format was feasible and acceptable by study participants.

Compassion fatigue, burnout and compassion satisfaction among family physicians in the Negev area - a cross-sectional study

BackgroundCompassion fatigue among health care professionals has gained interest over the past decade. Compassion fatigue, as well as burnout, has been associated with depersonalization and suboptimal patient care. Professional caregivers in general are exposed to the risk of compassion fatigue (CF), burnout (BO) and low levels of compassion satisfaction (CS). While CF has been studied in health care professionals, few publications address its incidence among family physicians, specifically. The objectives of this study were to assess the prevalence and severity of CF among family practitioners (FPs) in the Negev (Israel’s southern region), evaluating the correlations between CF, BO and CS and their relations with socio-demographic variables and work related characteristics.MethodsSelf-report anonymous Compassion Satisfaction and Fatigue Test questionnaires (CSFT) measuring CF, BO, and CS were distributed among 194 family physicians at Clalit Health Services clinics in the Negev between July 2007 and April 2008. Correlations between CF, BO and CS were assessed. Multivariable logistic regression models with backward elimination were constructed.Results128 (66%) physicians responded. 46.1% of respondents scored extremely high and high for CF, 21.1% scored low for CS and 9.4% scored high for BO. Strong correlations were found between BO and CF (r = 0.769, p < 0.001), and between BO and CS (r = −0.241, p = 0.006), but no correlation was found between CS and CF. The logistic regression model showed that the only factor associated with a significantly increased risk for CF was former immigration to Israel. Increased risk for BO was associated with female gender, history of personal trauma and lack of academic affiliation. Higher CS was associated with holding management positions and teaching residents.Conclusions and policy recommendationsFamily physicians in the Negev are at high risk for CF, with the potential for CF- associated patient dissatisfaction, compromised patient safety and increased medical error. We propose creation of a CF educational and early intervention treatment program for family physicians and other health care professionals. Such programs would train facilitators of physician well-being and resiliency building. We also recommend analyzing contributing variables and organizational factors related to higher CF. Policy recommendations include integrating such programs within required risk management continuing medical education.

An exploration of the experience of compassion fatigue in clinical oncology nurses

Compassion fatigue (CF) is "debilitating weariness brought about by repetitive, empathic responses to the pain and suffering of others" (LaRowe, 2005, p. 21). The work performed by oncology nurses, and the experiences of the people they care for, place oncology nurses at high risk for CF (Pierce et al., 2007; Ferrell & Coyle, 2008). Thus oncology nurses were chosen as the study focus. This paper details a descriptive exploratory qualitative research study that investigated the experience of CF in Canadian clinical oncology registered nurses (RNs). A conceptual stress process model by Aneshensel, Pearlin, Mullan, Zarit, and Whitlatch (1995) that considers caregivers' stress in four domains provided the study framework (see Figure 1). Nineteen study participants were recruited through an advertisement in the Canadian Oncology Nursing Journal (CONJ). The advertisement directed potential participants to a university-based online website developed for this study. Participants completed a questionnaire and wrote a narrative describing an experience with CF and submitted these through the secure research website. Data were analyzed thematically. Five themes include: defining CF, causes of CF, factors that worsen CF, factors that lessen CF, and outcomes of CF. Participants had limited knowledge about CF, about lack of external support, and that insufficient time to provide high quality, care may precipitate CF. The gap between quality of care nurses wanted to provide and what they were able to do, compounded by coexisting physical and emotional stress, worsened CF. CF was lessened by colleague support, work-life balance, connecting with others, acknowledgement, and maturity and experience. Outcomes of CF included profound fatigue of mind and body, negative effects on personal relationships, and considering leaving the specialty. Recommendations that may enhance oncology nurse well-being are provided.

The Experience of Secondary Traumatic Stress Upon Care Providers Working Within a Children's Hospital

This study examined the impact of routine occupational exposure to traumatic aspects of child illness, injury, and medical treatment upon care providers working within a children's hospital. Three hundred fourteen providers completed a demographic data sheet and four questionnaires. Results suggested overall that the level of Compassion Fatigue in this sample was similar to a trauma worker comparison group. In addition, 39% of the sample was at moderately to extremely high risk for Compassion Fatigue, and 21% was at moderate to high risk for Burnout. Burnout and Compassion Fatigue were related to type of profession and length of employment. Various dimensions of empathy were related to both Burnout and Compassion Fatigue. Regression analyses indicated that years in direct care and greater blurring of caregiver boundaries were predictive of greater Burnout and Compassion Fatigue. There is a need to further refine the assessment of occupational exposure to potential traumatic aspects of care within pediatric hospital settings and link assessment to prevention and intervention efforts.

Predicting the Risk of Compassion Fatigue

• There is a growing interest in the clinical phenomenon of compassion fatigue and its impact on healthcare providers; however, its impact on hospice nurses is basically unknown. This study investigated the prevalence and the relationships between nurse characteristics and compassion fatigue risk. It also provided a model for predicting compassion fatigue risk. A non-experimental descriptive design using cross-sectional data and descriptive and inferential statistics was used. Nurses (N = 216) from 22 hospices across the state of Florida participated in the study. Findings revealed that 78% of the sample was at moderate to high risk for compassion fatigue, with approximately 26% in the high-risk category. Trauma, anxiety, life demands, and excessive empathy (leading to blurred professional boundaries) were key determinants of compassion fatigue risk in the multiple regression model that accounted for 91 % (P< .001) of the variance in compassion fatigue risk. Knowledge of these variables may help organizations identify nurses at risk and provide interventions and preventions to maintain optimal nursing care. K W O R D