Compassion Fatigue Research Articles

Weathering the Storm

The provision of palliative care has been seen to have a significant impact on the interprofessional health care team. Being emotionally present to support patients and families at their most stressful points in life can result in compassion satisfaction or compassion fatigue. Providing palliative care through the COVID-19 pandemic added another layer of complexity to this professional caregiving experience. Although efforts have been made by employers to support health care providers in the practices of self-care and mindfulness, the true experience of care providers was not known. This study was conducted from June 2020 to October 2020 to better understand the experiences of physicians, nurses, social workers, and spiritual care providers who were providing palliative care during the first wave of the pandemic. Twenty-five participants completed the Professional Quality of Life (The Concise ProQOL Manual: The Concise Manual for the Professional Quality of Life Scale) measure and open-ended questions to evaluate their experiences as health care providers. The findings resulted in an overarching theme of “Weathering the Storm” with 6 themes describing the experiences of the interprofessional team.

Validation of the scale compassion fatigue inventory in health professional Spanish-speaking: a cross-sectional study

Validation of the scale compassion fatigue inventory in health professional Spanish-speaking: a cross-sectional study

The dual roles of empathy in mediating structural empowerment and compassion fatigue among Chinese nurses.

Nurses in dynamic healthcare environments face escalating challenges that impact their efficacy and well-being. These challenges arise from both the increasing complexity of medical procedures and the intense emotional demands of caregiving, often leading to compassion fatigue. A global prevalence of burnout at 30.0% was observed over the past decade. This study examines the relationship between structural empowerment, empathy (cognitive and affective), and compassion fatigue among Chinese nurses. Understanding these relationships is crucial for developing strategies to mitigate compassion fatigue. It also contributes to enhancing nurses' well-being. Conducted at a public hospital in Shanghai, this cross-sectional study surveyed 305 nurses, with 277 valid responses. Structural empowerment was measured using the Conditions for Work Effectiveness Questionnaire-II, empathy with the Kiersma-Chen Empathy Scale, and compassion fatigue with the Compassion Fatigue Short Scale. We performed correlation and mediation analyses to explore the direct and indirect effects of structural empowerment on compassion fatigue through empathy. A significant negative direct effect of structural empowerment on compassion fatigue was evidenced by a coefficient of -0.165 (confidence interval: [-0.311, -0.013]). Further analysis revealed a negative indirect effect through cognitive empathy, indicated by an effect of -0.103 (confidence interval: [-0.220, -0.008]). Increased structural empowerment was linked to higher levels of cognitive empathy, which correlated with decreased compassion fatigue. Conversely, the mediation through affective empathy showed a positive indirect effect, indicated by an effect of 0.126 (confidence interval: [0.047, 0.229]). This suggests that higher structural empowerment was associated with increased affective empathy, leading to higher levels of compassion fatigue. The study illuminates the dual role of empathy within the framework of structural empowerment and its impact on compassion fatigue. Cognitive empathy serves as a protective factor, reducing susceptibility to compassion fatigue, while affective empathy appears to heighten vulnerability. These findings provide direct evidence supporting the dual processing pathways of empathy. It is recommended that healthcare policies integrate organizational support with targeted empathy training, such as cognitive reappraisal, emotion regulation, and peer support, to effectively counteract compassion fatigue among nurses. However, due to the cross-sectional nature and the single-hospital setting, the findings should be interpreted cautiously.

Moral sensitivity, spiritual care perception, and compassion fatigue of nurses caring for earthquake victims.

Two major earthquakes occurred within 10hours in Kahramanmaraş on February 6, 2023, which resulted in thousands of deaths and injured people within Turkey. To determine the relationship between moral sensitivity, spiritual care perception, and compassion fatigue among nurses caring for earthquake victims. The study population consisted of 483 nurses working in public, private, and university hospitals in earthquake-affected areas in Turkey. The sociodemographic characteristics form, moral sensitivity questionnaire, spirituality and spiritual care rating scale, and compassion fatigue short scale were used for data collection. There was a statistically significant negative relationship between nurses' moral sensitivity and compassion fatigue; in other words, as compassion fatigue increases, nurses' moral sensitivity decreases. A statistically significant negative relationship was found between nurses' perception of spiritual care and their compassion fatigue; in other words, as compassion fatigue increases, nurses' perception of spirituality and spiritual care decreases. This study provides valuable insights into moral sensitivity, perceptions of spiritual care, and compassion fatigue among nurses caring for earthquake victims. Minimizing nurses' compassion fatigue improves quality patient care, increases patient and employee satisfaction, and maintains commitment to the profession. To achieve this goal, it is essential to offer in-service training, conferences, or seminar programs to nurses focused on fostering a sense of compassion. Nurses should be provided with environments that will improve their self-care, and institutional policies and strategies should be developed to cope effectively with this situation.

Influencing Factors of Nurses' Well-Being in Critical Care During Pandemic Era: A Systematic Review.

To identify factors protecting and hindering the well-being of critical care nurses during the COVID-19 pandemic. The unique work challenges of critical care nurses can undermine their professional and mental well-being; as evidenced by the prevailing literature on burnout, compassion fatigue, and moral distress. The COVID-19 pandemic has seen these professionals on the front lines and has raised many questions about professional well-being. Identifying the factors that protect and hinder the well-being of critical care nurses would help to develop the strategies necessary to reduce worrying phenomena associated with professional malaise. A systematic review was conducted using electronic databases including PubMed, CINAHL, Scopus, Cochrane, PsycINFO, and Web on Science. After full text analysis, 25 papers were included in the current systematic review. Factors influencing the well-being of critical care nurses have been grouped into "Protective" and "Hindering." This review shows that critical care nurses' well-being is influenced by factors like personal resilience and supportive work environments, which enhance their experience. Challenges include sociodemographic issues and the COVID-19 pandemic's impact. Addressing these factors is crucial for their well-being and the effectiveness of healthcare systems. The well-being of nurses is intricately linked to the quality and security of patient care, ultimately influencing clinical outcomes. This review delves deeply into the multifaceted factors that affect the professional well-being of critical care nurses during the COVID-19 pandemic. Recognizing these elements is critical for directing health policy toward the development of initiatives that bolster healthcare workers' welfare. Prioritizing the professional well-being of nurses is imperative, as it is fundamental in mitigating the increasing inclination towards job turnover, a challenge that is profoundly impacting the healthcare sector.

The effect of perceived organizational support and ego-resilience on the relationship between occupational stressors and compassion fatigue in COVID-19 frontline nurses: a cross-sectional study in Sichuan, China.

To investigate the level of compassion fatigue among frontline nurses during the COVID-19 pandemic and to explore the relationship between occupational stressors and compassion fatigue among frontline nurses based on structural equation modelling. Three years into the COVID-19 pandemic, nurses on the frontlines of the battle were overwhelmed by affective and emotional inputs while caring for patients, and they generally experienced varying degrees of psychological problems. High levels of compassion fatigue can affect nursing quality and patient safety and therefore should be taken seriously by nursing managers. A cross-sectional survey of 1432 frontline nurses in Sichuan Province, China, was conducted from January to March 2023 via convenience sampling methods. The General Information Questionnaire, the Nurses' Occupational Stressors Scale, the Ego-Resilience Scale, the Chinese version of the Compassion Fatigue Brief Scale, and the Perceived Organizational Support Scale were used to collect the data. Hypotheses were tested using structural equation models and bootstrapping methods. Nurse occupational stressors had a significant direct effect on compassion fatigue (B = 2.429, p < 0.001). Perceived organizational support exerted a mediating effect of 11.36% between occupational stressors and compassion fatigue. In addition, ego-resilience had a moderating role in the relationship between nurses' occupational stressors and compassion fatigue, between nurses' occupational stressors and perceived organizational support, and between perceived organizational support and compassion fatigue. Multiple linear regression analysis revealed that the most influential dimension of occupational stressors on compassion fatigue was work-family conflict (β = 0.253, p < 0.001), followed by organizational issues (β = 0.153, p < 0.001), work demands (β = 0.103, p < 0.001) and difficulty taking leave (β = 0.102, p < 0.001). Nurse occupational stressors are positively associated with compassion fatigue and influence nurse compassion fatigue through the mediating effect of perceived organizational support and the moderating mechanism of ego-resilience. Managers can reduce nurses' compassion fatigue levels by reducing occupational stressors, promoting nurses' perceived organizational support, and fostering ego-resilience. This study further integrated the external and internal factors affecting compassion fatigue and constructed a structural equation model of the mechanism of compassion fatigue in frontline nurses, which has implications for the early identification and intervention of compassion fatigue in nurses.

The professional quality of life of flight nurses: a cross-sectional study

Background The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses experience their work as more fulfilling, they are more inclined to remain within a role for an extended period. One of the ways to determine the lived experience of nurses is to measure their Professional Quality of Life. This is the first study to look at the Professional Quality of Life of Flight Nurses who work in public sector Aeromedical Retrieval Services in New Zealand. Aims The aim of this study was to determine the Professional Quality of Life of Flight Nurses working in the public sector in New Zealand. Design A survey based cross-sectional design was employed, using the Professional Quality of Life (ProQOL) V Health survey tool. Methods Online survey data was collected from a convenience sample of 169 Flight Nurses working in public sector Aeromedical Retrieval services in New Zealand. Results Of the 88 respondents, all reported either high or average levels of Compassion Satisfaction (High 48.86%, Average 51.13%) and Perceived support (High 44.31%, Average 55.68%). The majority reported Low to Average scores for Secondary Traumatic Stress (Low 30.68%, Average 67.04% and High 2.27%), Burnout (Low 4.54%, Average 89.77% and High 5.68%) and Moral Distress (Low 23.86% and Average 76.13%). Conclusion This study highlights that Flight Nurses in New Zealand’s public sector generally experience a positive Professional Quality of Life, but that there are also instances of Burnout and Secondary Traumatic stress. Impact statement The finding of this study indicates that Flight Nurses who work in the public sector in New Zealand, have an average to high degree of the positive Professional Quality of Life – Compassion Satisfaction and Perceived Support, and a lower degree of the negative aspects of their work – Burnout, Secondary Traumatic Stress and Moral Distress.

The Influence of Emotional Intelligence on Psychiatric Nurses' Care Behavior, and the Chain Mediating Role of Compassion Fatigue and Perception of Management.

To investigate psychiatric nurses' emotional intelligence and its effect on care behavior, while also examining the mediating effect of compassion fatigue and perception of management. This cross-sectional study was conducted in several specialized psychiatric hospitals with 360 psychiatric nurses. Self-report surveys were administered, which included the Caring Factor Survey-Caring of Manager, Caring Behaviors Inventory, Compassion Fatigue Short Scale, and Wong Law Emotional Intelligence Scale. Data were analyzed using descriptive, correlation, and path analyses. Mean score for care behavior was 4.78 (SD = 0.83), which was at a moderate level. Compassion fatigue exhibited negative correlations with other variables. Results of mediation effect analysis showed that emotional intelligence directly predicted care behavior (p < 0.001). Emotional intelligence also indirectly affected care behavior through the mediating roles of perception of management and compassion fatigue, and affected care behavior through the chain mediation effect of perception of management and compassion fatigue. Nurse managers should pay attention to the influence of emotional intelligence on care behavior and improve care behavior by strengthening leadership and alleviating compassion fatigue. [Journal of Psychiatric Nursing and Mental Health Services, xx(xx), xx-xx.].

Compassion fatigue and palliative care in neonatal nurses.

Neonatal intensive care units (NICUs) emerge as one of the areas where palliative care is most needed. This study was conducted to examine the attitudes and compassion fatigue levels of NICUs nurses working in Şanlıurfa, where the fertility rate and infant mortality are highest in Turkey, toward palliative care. This study was conducted in descriptive type. The research was carried out with 204 (85%) nurses who agreed to participate in the research between October 2022 and February 2023, out of 240 neonatal intensive care nurses working in the NICU of 2 training and research hospitals and a university hospital in Şanlıurfa. The data of the study were collected using an Introductory Information Form, the Neonatal Palliative Care Attitude Scale, and the Compassion Fatigue Short Scale. Nurses; compassion fatigue scale mean score was 61.46 ± 26.64, palliative care scale mean score was 3.13 ± 0.74 for organization subdimension, 2.85 ± 0.73 for resources subdimension, and 3.08 ± 0.89 for clinician subdimension. In the results of the study, 8 barriers (parents do not participate in decisions, there is not enough staff, lack of time to spend with the family, lack of policies/rules in institutions for palliative care, lack of education and communication, society's beliefs, nurses' personal attitudes toward death, and lack of appreciation of past experiences with palliative care) and 6 facilitators (Nurses' ability to express their perceptions, views and beliefs about palliative care, to participate and support palliative care, to inform parents, to provide counseling, adequate physical conditions) for palliative care were determined. While it was determined that nurses had a slightly below moderate level of compassion fatigue and a close attitude toward organization and resources toward palliative care, it was determined that ethical conflict toward palliative care was high in clinical subdimension scores. It is recommended that all nurses working in the NICU obtain certificates, improvements in resources such as personnel and equipment, improvements in the shift work system and development of policies/rules in institutions for palliative care.

Towards a Clinically Relevant Appreciation of the Cost of Caring: A Study of Palliative Care Physicians in Malaysia.

Background: The cost of caring for patients and their families in the midst of interconnected resource, ethical, moral, legal and practical considerations compromises a physician's emotional and physical well-being and therefore patient care. Whilst the cost of caring is historically best associated with compassion fatigue, data has suggested that this may extend to other related concepts, such as vicarious trauma, secondary traumatic stress and burnout. In particular, palliative care physicians are especially vulnerable as they witness and encounter more cases of death and dying. Methods: This study aims to provide a more clinically relevant notion of the cost of caring amongst palliative care physicians in Malaysia. 11 physicians underwent semi-structured interviews as part of the Systematic Evidence-Based Approach (SEBA) for prospective studies. Results: Analysis of the interview transcripts revealed the following domains: (1) conceiving the costs of caring; (2) risk factors; and (3) support mechanisms. Conclusion: This SEBA-guided study into the cost of caring amongst Malaysian palliative care physicians suggests that the costs of caring extend beyond encapsulating moral distress, compassion fatigue, vicarious trauma, secondary traumatic stress and burnout. Rather, the data suggests a personalized notion that varies with individual and contextual factors which are in flux and change over time. A longitudinal, personalized and holistic mentoring program is therefore proposed to counter this cost.

Empathy fatigue among physicians and its influencing factors: a cross-sectional survey from Southwest China

BackgroundEmpathy fatigue refers to the excessive empathy required of medical staff in the process of helping patients, which can produce traumatic experiences and emotional exhaustion. Severe empathy fatigue can even lead to medical disputes and errors, exacerbating increasingly tense doctor–patient relationships. Most studies on empathy fatigue focus on nurses, with few studies on physicians.MethodsA cross-sectional questionnaire was used to assess empathy fatigue among physicians in public tertiary general hospitals in southwest China using convenience sampling.ResultsA total of 562 physicians participated in the survey; average empathy satisfaction scores were 32.1 ± 6.85, 28.2 ± 5.30, and 26.2 ± 6.04 for empathy satisfaction disorder, job burnout, and secondary traumatic stress domains, respectively. We identified 291 (51.8%) physicians with severe empathy fatigue. Working two or three night shifts per week was associated with severe empathy fatigue. In total, 424 (75.4%) physicians had thoughts of resigning. Weekly rest time, empathic satisfaction disorder, job burnout, and secondary traumatic stress disorder influenced thoughts of resigning.ConclusionsThe majority of hospital physicians experience empathy fatigue and have considered resigning; this study provides reference data that demonstrate the extent of this issue. Efforts are urgently needed to address empathy fatigue in physicians and, therefore, increase physician retention.

Therapy for Therapists: Design Opportunities to Support the Psychological Well-being of Mental Health Workers

On-demand mental health services-including counseling, crisis hotlines, and peer support programs-are vital to the healthcare system, providing acute and ongoing support through telephone, online chats, and text messaging. Although such services have proven effective at reducing hopelessness, psychological pain, and suicidality, they put the providers of these services at high risk of burnout, secondary traumatic stress, and compassion fatigue. Our interviews with professionals from four mental health organizations revealed that while these workers have a strong motivation to help clients with mental health care needs, they face various challenges themselves, particularly regarding heavy caseloads, difficult crisis clients, and coping with repeated exposure to abuse and harassment. To overcome challenges, participants identify the need to be self-reliant and engage in self-care practices ranging from socializing with coworkers to yoga and meditation. Although organizations spend significant time training workers prior to their involvement with clients, the training typically lacks components on self-compassion and self-care. Designers might see technology as an opportunity to promote such practices; however, while technology is an integral part of their work routine, participants, irrespective of age, had misapprehensions regarding technology use in the mental health care space, including for managing their psychological well-being. We recommend design guidelines for HCI researchers, including developing contextualized just-in-time adaptive interventions to promote self-compassion and educating workers regarding the use of various technologies to manage their well-being.

Virtual support group initiative for mental health professionals in the COVID-19 pandemic.

As a result of the coronavirus pandemic, mental health professionals have faced the challenge of helping their clients cope with pandemic-related distress on top of ongoing therapeutic issues. This article describes a telehealth-delivered peer/mutual support program for mental health professionals during the pandemic and the key themes identified by participants. An interdivisional American Psychological Association task force formed a working group to identify practical ways to provide mental health professionals with direct support during the pandemic. A mutual support program, the Clinician Support Collaborative, was initiated using virtual video technology. This article describes the program and themes that emerged, including the challenges and benefits of using virtual video technology to host mutual support meetings. Mutual support meetings were conducted on a weekly basis in 2020 and 2021, with mental health professionals and trainees in the Americas, Australasia, and India participating. Key themes identified included the logistical, therapeutic, and privacy concerns participants faced when shifting to telehealth, professional isolation, compassion fatigue, moral injury, burnout, stigma, disparities, and the intersection of personal/family stressors and work stressors. Recommendations for future use of virtual video technology to provide mutual support by and for mental health professionals are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Coping in the classroom: A study of Professional Quality of Life (ProQoL) in Australian teachers

Research has shown that teachers are at increased risk for compassion fatigue and low career satisfaction. Compassion fatigue may occur as a result of repeated exposure to traumatic experiences of someone in their care. Utilising a sample of 334 Australian teachers, the present study examined the impact of coping styles on compassion fatigue and compassion satisfaction. Regression analyses revealed that avoidant coping strategies were significant predictors of compassion fatigue. Conversely, teachers who utilised problem-focused coping strategies reported lower levels of compassion fatigue and higher levels of compassion satisfaction than teachers who used other types of coping strategies. These results serve to inform future supports and strategies to promote teacher wellbeing and satisfaction.

Experiences of Informal Caregivers Caring for Individuals With Chronic Schizophrenia in Asia: A Systematic Review and Meta-Synthesis.

In Asia, many caregivers are culturally obliged to assume the role of taking care of individuals experiencing chronic schizophrenia, even as they grapple with stigma and compassion fatigue. Despite the significance of this phenomenon, the collective experiences of Asian caregivers remain poorly understood. To synthesise qualitative evidence on the experiences of informal caregivers when caring for individuals with chronic schizophrenia in Asia. A search was conducted on seven databases for studies published between 2013 and 2023. The included studies were appraised using the Critical Appraisal Skills Program tool. Data extraction was based on the Joanna Briggs Institute (JBI) Qualitative Extraction Form. The data synthesis was based on the framework by Sandelowski and Barroso. Our review included the experiences of 1345 informal caregivers from 57 included studies. The analysis yielded the overarching theme of 'Navigating Challenges, Forging Resilience'. Three themes were identified: (i) challenges in caregiving, (ii) lack of support and (iii) coping and resilience. Our findings highlighted the Asian caregivers' stressors, particularly cultural and traditional factors, a facet often overlooked in the literature. Mental healthcare practitioners must provide caregivers with comprehensive information. Anticipatory guidance is essential during the initial stages of the diagnosis. To negate geographical limitations, caregiver-training sessions can be pre-recorded and posted to online platforms. Finally, cultural and spiritual beliefs can be integrated into the treatment plans for individuals with schizophrenia in the community. Within the institutional setting, mental healthcare practitioners are encouraged to provide caregivers with comprehensible information or training in person and through written or online platforms, which can transcend geographical limitations. Anticipatory guidance is essential, especially during the initial stages of the diagnosis, when confusion and uncertainties are prevalent. Periodic home visits by mental healthcare practitioners can help ease caregivers' concerns and enhance their caregiving confidence. Finally, cultural and spiritual beliefs should be integrated into the treatment plans for individuals with schizophrenia in the community as it promotes cultural acceptability, encourages referrals to appropriate institutions and reduces the stigma of mental healthcare.

A Longitudinal Multi-Method Inquiry of Educational Workers’ Use of Interventions for Positive Mental Wellbeing

Background and Objectives: Compassion fatigue and burnout are two distinct forms of mental health distress faced by educational workers. Researchers have shown a high level of both phenomena across the field of education; however, a better understanding of what educational workers already do for positive mental and emotional health is needed. Methods: This research study examined three years of data, collected via survey, inquiring into the various interventions, namely supports and resources, that educational workers use to support positive mental health. Results: Quantitative data analysis via descriptive and inferential statistics revealed that educational workers relied heavily on their personal support network followed distantly by medical professionals and other interventions, revealing a gap that needs to be addressed by employers. Qualitative thematic analysis revealed a trend towards increased use of environmental interventions to promote positive mental wellbeing. Conclusions: The data analysis suggested areas of focus required to ensure workplace wellbeing, and that programs too focused on individual or self-directed interventions would not be well received by educators. Suggestions for other interventions that might be helpful for leaders and policy-makers are provided.

The Relationship Between Ethical Attitudes and Compassion Fatigue in Nurses Working in Surgical Intensive Care Units

Aim This study aimed to explore the relationship between ethical attitudes and compassion fatigue experienced by nurses in surgical intensive care units. Methods It is mixed-design research. The study was conducted with 38 nurses working in the surgical intensive care units of a university hospital who agreed to participate in the study. Quantitative data were collected using the Nurse Information Form, the Ethical Attitude Scale for Nursing Care, and the Compassion Fatigue–Short Scale. Qualitative data were collected using a semistructured questionnaire, through individual interviews with 9 volunteer nurses in surgical intensive care units. Results The study revealed that nurses exhibited high levels of ethical attitudes in nursing care along with high levels of compassion fatigue. During the qualitative data analysis, 4 key themes emerged: ethical approaches in surgical intensive care units, professional quality of life in nurses, the reflections of compassion fatigue on ethical behavior, and nurses’ well-being. Conclusions It was concluded that when compassion fatigue increased in nurses in surgical intensive care units, ethical attitudes in nursing care decreased. Therefore, compassion fatigue can be addressed by programs that support nurses’ well-being, such as meditation, deep breathing, self-compassion exercises, and so on. It can be reduced.

Evaluation of meaningful recognition programs in three colleges of nursing

BackgroundThe nursing faculty shortage in the United States presents a challenge to maintaining a robust healthcare workforce. Meaningful recognition (MR) is an evidence-based practice that improved nurse burnout (BO) in the clinical setting. There is limited literature on its impact on nurse faculty. PurposeThree colleges of nursing implemented The DAISY Diseases Attacking the Immune SYstem Award for Extraordinary Nursing Faculty as an MR program to improve compassion satisfaction (CS) and BO among nursing faculty. MethodsThis project employed a pre- and post-survey design to assess changes in faculty CS, BO, and secondary traumatic stress using the ProQOL Professional Quality of Life version 5. DiscussionThe results suggest that while the implementation of MR programs did not significantly alter these metrics, the faculty maintained stable levels of CS despite the stressful COVID-19 pandemic. ConclusionAdditional research is needed to explore the potential for MR to mitigate faculty BO.

Professional quality of life profiles and its associations with turnover intention and life satisfaction among nurses: a prospective longitudinal study

BackgroundNursing shortage is a global issue. Turnover intention and life satisfaction are significant predictors of turnover. The specific nature of nursing and stressful work schedules lead to impaired professional quality of life (ProQOL), and existing studies have confirmed the effect of a dimension of ProQOL (such as secondary trauma stress, burnout and compassion satisfaction) on turnover intention and life satisfaction. Yet the heterogeneity of ProQOL across individuals is not known. A lack of research on the relationship between potential ProQOL subgroups and turnover intention and life satisfaction, and the mechanisms underlying this relationship remain understudied. The study aimed to determine different ProQOL profiles, and their cross-sectional and longitudinal effects on turnover intention and life satisfaction, while exploring the mediating roles of job satisfaction and work engagement within the relationship.MethodsData were collected at a tertiary hospital in a northeastern province of China. An online questionnaire was administered twice over the course of six months. 1832 and 900 participates provided cross-sectional and longitudinal data respectively. We used latent profile analysis (LPA) and K-means clustering to identify ProQOL profiles, and used the PROCESS macro program to conduct mediation analysis.ResultsThe LPA results supported a 4-profile solution, including balanced protection, good quality, traumatic satisfaction and burnout problem. ProQOL profiles directly predicted nurses’ current and subsequent turnover intention and life satisfaction. In addition, job satisfaction and work engagement mediated the effects of ProQOL profiles on turnover intention and life satisfaction in cross-sectional sample, and mediated the effects of ProQOL profiles on turnover intention in longitudinal sample.ConclusionThe findings suggest that nurses’ ProQOL has distinct categorical characteristics and is strongly associated with turnover intention and life satisfaction. Hospital administrators should implement individualized, join management and interventions according to each profile. Furthermore, more attentions should focus on improving nurses’ job satisfaction and work engagement levels to promote good work and life outcomes.

Understanding the interplay of compassion fatigue and moral resilience on moral distress in ICU nurses: a cross-sectional study.

Intensive Care Unit (ICU) nurses frequently confront significant psychological challenges, including compassion fatigue, moral distress, and diminished moral resilience. These issues not only affect their well-being but also impact the quality of care provided to patients. The interplay of these factors is complex and not fully understood, particularly how compassion fatigue influences the relationship between moral resilience and moral distress. To explore the complex interplay between compassion fatigue and moral distress among ICU nurses, and to elucidate how compassion fatigue influences the protective role of moral resilience against moral distress. A cross-sectional study was conducted using a nationwide random sample of ICU nurses in China. Latent profile analysis identified subgroups based on levels of compassion fatigue. Moderation analysis examined whether compassion fatigue moderated the association between moral resilience and moral distress. Among 612 ICU nurses, latent profile analysis revealed three distinct groups with high, moderate, and low levels of compassion fatigue. Being female was protective against high compassion fatigue, while ages 30-49 yrs., lack of bachelor's degree, and dissatisfaction with salary increased compassion fatigue risk. Moderation analysis showed compassion fatigue significantly moderated the relationship between moral resilience and moral distress. Nurses with higher compassion fatigue exhibited a stronger association between low moral resilience and high moral distress. Compassion fatigue and moral distress are interconnected phenomena among ICU nurses. Demographic factors like gender, age, education, and income satisfaction impact compassion fatigue risk. High compassion fatigue impairs moral resilience, exacerbating moral distress. Comprehensive interventions targeting both compassion fatigue and moral resilience, tailored to nurses' demographic profiles, are needed to support this workforce.