Compassion Fatigue Research Articles

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study.

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study.

Virtual Wellness Workshop for Medical Students: Effects on Healthy Lifestyle Behavior.

Medical students experience high levels of stress, burnout, depression, suicidal ideation, and compassion fatigue. Mindfulness interventions in this population have demonstrated improvement in psychological outcomes. However, it is unclear if these improvements are maintained. Evaluation of changes in lifestyle behaviors may provide insight into factors that sustain improvements. Specific aims of this study were to (1) assess feasibility and acceptability of an innovative, virtual program involving experiential learning, social support, and motivational interviewing; and (2) evaluate preliminary healthy lifestyle behaviors and psychological outcomes from preprogram to postprogram and 4-week follow-up. We used a mixed-methods approach to investigate feasibility, acceptability, and effects of the virtual program using validated measures and open-ended questions. Participants were 20 first- and second-year medical students at one Midwestern US medical college who participated between October 2020 and December 2020. Participants were enrolled in one of two groups for the 8-week program via Webex. Participants completed surveys at preprogram, postprogram, and 4-week follow-up. They also completed weekly home practice assessments. Nineteen of 20 participants completed the program (95% retention rate). All participants attended six or more sessions. Repeated measures analysis of variance revealed that participants had significant improvements in healthy lifestyle behaviors, burnout, self-compassion, and stress across time. Results were supported by qualitative themes of increased social support, wellness skills, and overall positive experiences. Findings suggest that the virtual program was feasible and acceptable to medical students, and improved healthy lifestyle behaviors and psychological outcomes that were maintained or increased at 4-week follow-up.

Compassion fatigue and the meaning in life as predictors of secondary traumatic stress in nurses during the COVID-19 pandemic.

This study aimed to investigate the relationship among secondary traumatic stress, compassion fatigue, and meaning in life in nurses during the COVID-19 pandemic. Changes in working conditions during the pandemic also changed the needs of nurses. In addition to physical health, the COVID-19 pandemic led to many psychosocial health problems such as sleep disturbances, depression, and traumatic stress. This makes nurses vulnerable to psychological side effects of the pandemic. A cross-sectional study was conducted. This study was conducted with 166 nurses. Data were collected online at May-June 2021. A Personal Information Form, the Secondary Traumatic Stress Scale, Compassion Fatigue Scale, and Meaning in Life Scale were used. The STROBE reporting checklist was followed. As secondary traumatic stress levels increase, compassion fatigue increases, meaning in life decreases, and the search for meaning in life increases. Predictors of secondary traumatic stress were shown to be compassion fatigue, change in sleep habits, meaning in life, marital status, and having a chronic illness. This suggested that working during the pandemic posed significant risks in terms of manifesting negative consequences on mental health in the long term.

The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study

BackgroundCompassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing. ObjectiveTo explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care. DesignLongitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework. Setting(s)Three United Kingdom universities. ParticipantsPre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8. MethodsWork package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26. ResultsQualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification. ConclusionsThere is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education. RegistrationN/A.Tweetable abstractInsufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R

A Self-Care and Wellness Framework in Educator Preparation to Address Burnout, Compassion Fatigue, and Secondary Traumatic Stress

ABSTRACT As a result of stress, burnout, and attrition, the U.S. has perpetual teacher shortages. While systemic changes are necessary to improve the field of education, teaching as a helping profession is stressful, with multiple job responsibilities and roles. In addition to work-related stress and burnout, teachers are also affected by compassion fatigue and secondary traumatic stress (STS). This article provides a self-care and wellness framework for faculty at educator preparation programs to embed across coursework and clinical practice, supporting preservice teachers (PSTs) through a preventative approach. We explain each construct and follow up with case studies to illustrate how signs and symptoms may appear for PSTs. Our wellness framework and self-care lessons are intended to make self-care strategies tangible, applicable, and easily integrated into PSTs’ educational, professional, and personal lives.

Changes in harm reduction service providers professional quality of life during dual public health emergencies in Canada

BackgroundHarm reduction (HR) is a critical response to the pronounced toxicity deaths being experienced in Canada. HR providers report many benefits of their jobs, but also encounter chronic stress from structural inequities and exposure to trauma and death. This research study sought to quantify the emotional toll the toxicity emergency placed on HR providers (Cycle One; 2019). Study objectives were later expanded to determine the impact of the ongoing toxicity as well as the pandemic’s impact on well-being (Cycle Two; 2021).MethodsStandardized measures of job satisfaction, burnout, secondary traumatic stress, and vulnerability to grief were used in an online national survey. Open-ended questions addressed resources and supports. HR partners across Canada validated the findings and contributed to alternative interpretations and implications.Results651 respondents in Cycle One and 1,360 in Cycle Two reported moderately high levels of job satisfaction; they reported finding great meaning in their work. Yet, mean levels of burnout and secondary traumatic stress were moderate, with the latter significantly increasing in Cycle Two. Reported vulnerability to grief was moderate but increased significantly during COVID. When available, supports lacked the quality necessary to respond to the complexities of HR workers’ experiences, or an insufficient number of sessions were covered through benefits. Respondents shared that their professional quality of life was affected more by policy failures and gaps in the healthcare system than it was by the demands of their jobs.ConclusionBoth the benefits and the strain of providing harm reduction services cannot be underestimated. For HR providers, these impacts are compounded by the drug toxicity emergency, making the service gaps experienced by them all the more critical to address. Implications highlight the need for integration of HR into the healthcare system, sustainable and reliable funding, sufficient counselling supports, and equitable staffing models. Support for this essential workforce is critical to ensuring the well-being of themselves, the individuals they serve, and the health of the broader healthcare system.

How Mental Health Nurses Report Their Compassion Fatigue and Compassion Satisfaction: A Cross-Sectional Study and the Implications for Healthcare Leaders

Compassion fatigue is the cost of caring for others in emotional pain where the helping professional absorbs the trauma of those they help and cannot detach emotionally at the end of the day. Stressful and perceived unsupportive work environments may leave the caregiver at a heightened risk for compassion fatigue. To study the level of compassion fatigue and compassion satisfaction experienced by mental health nurses. A descriptive, cross-sectional, electronic survey design was utilized. The Professional Quality of Life Scale-5 was used. The study was conducted at a large, urban hospital that exclusively treats patients with mental health and addiction issues located in Ontario, Canada. The sample included all nurses who were listed on the hospital’s Email list. All nurses who are displayed on this list are mental health nurses. Analyses were conducted to assess for differences between the characteristics and the subscales of professional quality of life. One hundred and forty-eight mental health nurses completed a questionnaire. The response rate was 21%. Seventy-six percent reported moderate levels of burnout, 59% reported moderate levels of secondary traumatic stress, and 21% reported high levels of compassion satisfaction. Predictors were seen for the characteristics of gender, ethnicity, marital status, area, exposure to violence and support felt. Compassion fatigue has clear implications. Organizations willing to invest in reducing it, have the potential to improve patient outcomes and the well-being of nurses. The majority of mental health nurses reported moderate levels for each of the subscales.

A Scoping Review of Compassion Fatigue and Compassion Satisfaction in Burn Therapists.

Occupational and physical therapists who routinely provide potentially painful and distressing rehabilitation to burn survivors are at risk for developing compassion fatigue. Burn therapists may also experience compassion satisfaction based on the successes their patients accomplish. The purpose of this review was to synthesize the literature related to compassion fatigue and satisfaction in therapists who work with burn survivors, explore previously reported predictors and mediators of (and responses to) these constructs, and to identify gaps in the literature. Original, peer-reviewed papers published from journal inception to May 2023 were obtained from five electronic bibliographic databases: CINAHL, Embase, PsycINFO, PubMed, and Web of Science. Studies were eligible if they a) reported compassion fatigue or its related concepts and b) focused on occupational or physical therapists who work with burn survivors directly or as a member of a multidisciplinary burn treatment team. The initial search revealed 284 articles, two of which met inclusion criteria and are summarized in this scoping review. Neither article focused solely on burn therapists but examined the experiences of multidisciplinary burn team members working in single burn centers in North America. Both studies used a cross-sectional survey-based design to assess concepts related to compassion fatigue and compassion satisfaction. This scoping review uncovered important gaps in the literature related to compassion fatigue or satisfaction in burn therapists. More research is needed to better understand the interplay between concepts as well as their relationship to burn therapists' outcomes.

Predictors of Compassion Fatigue and Compassion Satisfaction in Social Workers (A Quantitative Study from India)

ABSTRACT Heightened stress levels are experienced and reported by social work practitioners worldwide and issues such as secondary traumatic stress, burnout and compassion fatigue are terms increasingly being used in the context of social work practice. This study sought to investigate factors that influence compassion fatigue as well as compassion satisfaction in social workers. It was conducted in two cities in south India with a sample of 73 social workers. Standardized instruments were administered to assess compassion fatigue as well as compassion satisfaction besides measures to identify the manifestation of stress and resilience in the respondents. Findings indicate high levels of stress and resilience and significant manifestation of compassion fatigue and burnout levels in the sample studied. It was also observed that the interaction effect between resilience and stress significantly explained the manifestation of compassion fatigue but not that of compassion satisfaction. Implications of these findings have been discussed in terms of influencing individual and organizational factors to enhance resilience, deal more effectively with work-related stress, and reduce burnout and compassion fatigue. This will in the long run bode well for the wellbeing of social workers besides potentially impacting the quality-of-service provision.

Building emotional resilience to foster well‐being by utilising reflective practise in the sonography workplace

AbstractReflection and reflective practise are well recognised tools that are utilised by healthcare professionals to support self‐awareness and self‐care. In turn, self‐care is a critical component of the wellbeing and the capacity for resilience of healthcare professionals in response to day‐to‐day exposure to emotionally and psychologically challenging situations. Affective reflection, the process of considering and analysing thoughts, feelings and emotions though written dialogue (the act of reflective writing), has been shown to be beneficial for promoting and building resilience in healthcare professionals. Despite the known benefits of these strategies for maintaining wellbeing and avoiding compassion fatigue and burnout, the discourse on the use of affective reflection and reflective writing in the sonography profession is limited. Interventions such as reflection, reflective practise and reflective writing should not be underestimated as tools to promote the adaptive abilities and the degree of individual emotional resilience of sonographers. Long term positive outcomes supported by utilising and practising reflection include the maintenance of emotional stability and an increase in the scope for empathy and subsequently, an enhancement of quality of practise and patient care. This article aims to provide a broad discussion on the practise of affective reflection and showcase the process of reflective writing using written reflective dialogue guides with practical examples relevant to sonography practise. In addition, this paper outlines how these strategies can be incorporated and enacted in the sonography workplace to build resilience.

Compassion Fatigue in Out of Home Care Workers: A Systematic Review

ABSTRACT Evidence suggests that providing out-of-home care to children is associated with high levels of compassion fatigue, possibly due to various work-related factors. This review examined the existing literature to determine the extent to which out of home care work results in compassion fatigue. To do so, it established which out of home care settings compassion fatigue has been measured in, how, and what factors contribute to developing compassion fatigue in this work. The study conducted a comprehensive search of five electronic databases (CINAHL, MEDLINE, PsycINFO, PubMED, and CENTRAL) for full-text articles examining compassion fatigue in out-of-home care workers caring for children aged 0–18 years. Out of the 2,759 articles initially identified, 14 articles were included. Studies were assessed against the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for risk of bias. The findings suggest that compassion fatigue is prevalent in various out-of-home care settings and has been measured using validated quantitative and qualitative measures. Out of home care workers caring for children reported symptoms consistent with compassion fatigue, but a range of protective factors were also identified that may reduce its negative impact. This review highlights the need for further research in this area, using larger sample sizes and including a more comprehensive range of out-of-home care workers, settings, and countries.

A Reliability Generalization Meta-Analysis of Scores on the Professional Quality of Life (ProQOL) Scale Across Sample Characteristics

The Professional Quality of Life Scale (ProQOL) has an extensive history of use that often relies on inductions of reliability from precedent literature. We completed a systematic of the literature and extracted sample-specific reliability estimates for ProQOL subscale scores. Random effects meta-analytic modeling was implemented to identify mean estimates of reliability. Secondary analyses were completed to depict generalization across samples and possible scores in future studies. Our analyses detected mean internal consistency estimates for the Compassion Satisfaction (.875), Secondary Traumatic Stress (.808), and Burnout (.754) similar to those reported in the ProQOL manual. However, secondary analyses revealed statistical variations associated with the professional identity and proportions of ethnicity represented within samples. ProQOL score reliability has remained fairly stable over time with scores for Compassion Satisfaction and Secondary Traumatic Stress supporting use in basic research, but not clinical decision making, the Burnout scale was associated with more questionable precision.

MHealth Gratitude Exercise Mindfulness App for Resiliency Among Neonatal Intensive Care Unit Staff: Three-Arm Pretest-Posttest Interventional Study.

Health care is highly complex and can be both emotionally and physically challenging. This can lead health care workers to develop compassion fatigue and burnout (BO), which can negatively affect their well-being and patient care. Higher levels of resilience can potentially prevent compassion fatigue and BO. Strategies that enhance resilience include gratitude, exercise, and mindfulness. The purpose of this study was to determine if a 3-week daily resiliency practice, prompted via a gratitude, exercise, and mindfulness smartphone app, impacted the professional quality of life, physical activity, and happiness level of health care workers in a newborn intensive care unit setting. In total, 65 participants from a level III newborn intensive care unit at a regional hospital in the western United States completed this study. The Professional Quality of Life Scale, Physical Activity Vital Sign, and Subjective Happiness Score instruments were used to evaluate the effects of the mobile health (mHealth) intervention. Further, 2-tailed dependent paired t tests were used to evaluate participant pre- and postintervention instrument scores. Multiple imputation was used to predict scores of participants who practiced an intervention but did not complete the 3 instruments post intervention. Dependent t tests using the original data showed that participants, as a whole, significantly improved in BO (t35=2.30, P=.03), secondary trauma stress (STS; t35=2.11, P=.04), and happiness (t35=-3.72, P<.001) scores. Compassion satisfaction (CS; t35=-1.94, P=.06) and exercise (t35=-1.71, P=.10) were trending toward, but did not reach, significance. Using the original data, only the gratitude intervention group experienced significant improvements (CS, BO, and happiness), likely due to the higher number of participants in this group. Analysis using imputed data showed that participants, as a whole, had significant improvements in all areas: CS (t64=-4.08, P<.001), BO (t64=3.39, P=.001), STS (t64=4.08, P<.001), exercise (t64=-3.19, P=.002), and happiness (t64=-3.99, P<.001). Looking at the intervention groups separately using imputed data, the gratitude group had significant improvements in CS, BO, STS, and happiness; the exercise group had significant improvements in STS and exercise; and the mindfulness group had significant improvements in CS and happiness. Phone app delivery of resilience-enhancing interventions is a potentially effective intervention model for health care workers. Potential barriers to mHealth strategies are the technical issues that can occur with this type of intervention. Additional longitudinal and experimental studies with larger sample sizes need to be completed to better evaluate this modality.

Health and Wellness Outcomes of Intimate Partner Violence Support Workers: A Narrative Review.

Workers who support survivors of intimate partner violence (IPV) witness some of the most traumatic acts of violence in their everyday work life. These experiences may cause distress that has implications for health and their ability to cope. This narrative literature review sought to explore what is known about the health, wellness, and coping strategies of IPV workers in diverse settings. A comprehensive academic literature search of five databases for peer-reviewed journal articles, available in English, published between January 2000 and October 2023 was conducted. A total of 34 articles on workers' experiences in relation to health, wellness, and coping strategies were included in the review. Thematic analysis generated the following themes: (a) diversity of IPV workplace settings and roles; (b) meaningful aspects of IPV support work including purpose and fulfillment, compassion satisfaction, rewarding and valuable work; (c) adverse experiences such as psychological distress and physiological discomfort, interpersonal social challenges, environment and organizational challenges, burnout, compassion fatigue and secondary trauma; and (d) coping strategies that considered coping behaviors and self-care, workplace support and accommodation, and meaningful sacrifice and adaptation. While the review provided important insights regarding the meaningful aspects of IPV support work and coping strategies, the adverse experiences of supporting survivors significantly dominated the literature. Unfortunately, the majority of studies did not clarify the context of workplaces, and this represents a gap in understanding workers' experiences. Future research is needed to understand context-related experiences of IPV support workers in relation to health and coping. The current review provides unique insights on diverse IPV support work settings and roles, work-related issues that may influence workers' wellness, and rewarding aspects of IPV support work.

An Interpretive Phenomenological Analysis of Teachers’ Lived Experiences of Working with Traumatised Children in the Classroom

AbstractThis study illuminates teachers’ lived experiences of working with traumatised children in school environments. Children who experience trauma display a range of behaviours in the classroom which impact on attainment and outcomes. Dealing with childhood trauma in the classroom is challenging and brings risks to teachers’ mental health including secondary traumatic stress and burnout. Interpretative phenomenological analysis (IPA) was employed to understand the lived experiences of teachers working with traumatised children in the classroom. Findings from in-depth semi-structured interviews with six teachers indicate that teachers increasingly support traumatised children in the classroom but there is a need for targeted trauma-informed training and effective support from senior management to support teachers’ mental health and wellbeing.

Understanding the Experiences of Medical Interpreters in Palliative Care: An Exploration of Measurement Tools

Medical interpreters aid in providing culturally sensitive palliative care to patients with limited-English proficiency. However, navigating their complex, and sometimes contradictory, roles and the sensitive nature of the content in palliative care encounters can negatively impact medical interpreters. Compassion fatigue (CF) and secondary traumatic stress (STS) are concepts that have been explored in many healthcare professionals but have not been fully explored in medical interpreters in palliative care. This review examines the psychometric properties of three measures of CF and STS that have been utilized in various populations of healthcare providers. There are no measures of CF or STS that have been shown to be valid and reliable in medical interpreters participating palliative care encounters. Further research is needed to investigate the validity of the reviewed measures in medical interpreters, and it may be beneficial to modify existing tools to measure CF and STS more accurately in this population.

Examination of psychological capital and secondary traumatic stress levels of professionals attended to disaster studies

This research was conducted with the aim of examining the psychological capital and secondary traumatic stress levels of health professionals who have experience working in the field of disaster. It is a descriptive study. The study’s sample consists of 183 health professionals who work in an emergency service or 112 emergency health services of a provincial Health Directorate, who participate in numerous disaster interventions in Turkey, and who have participated in any disaster. As data collecting methods, the “Socio-demographic form” “Secondary Traumatic Stress Scale” and the “Psychological Capital Scale Short Form” were utilized. In the study, it is concluded that the secondary traumatic stress scale mean score and the psychological capital scale mean score of physicians, nurses and paramedics were moderate, and there is a negative significant relationship between both scales. Negative and significant relationships were found between hope, optimism and resilience, which are sub-dimensions of psychological capital, and secondary traumatic stress. It is concluded that the high level of psychological capital reduces the secondary stress level.

First insights into post-pandemic distress in a high secure hospital: correlates among staff and patients

PurposeThis preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.Design/methodology/approachTo discern the connection between COVID-19-related distress and multiple factors, the study involved 31 patients and 34 staff who completed assessments evaluating coping strategies, resilience, emotional reactivity, ward atmosphere and work-related aspects.FindingsResults demonstrated that around a third of staff (31.2%) experienced COVID-19-related distress levels that met the clinical cut-off for possible post-traumatic stress disorder. Emotional reactivity, staff shortages, secondary traumatic stress and coping strategies were all positively correlated with COVID-19-related-distress. Resilience was negatively associated with distress, thus acting as a potential mitigating factor. In comparison, the prevalence of distress among patients was low (3.2%).Practical implicationsThe authors postulate that increased staff burdens during the pandemic may have led to long-term distress, while their efforts to maintain minimal service disruption potentially shielded patients from psychological impacts, possibly lead to staff “problem-focused coping burnout”. This highlights the need for in-depth research on the enduring impacts of pandemics, focusing on mechanisms that intensify or alleviate distress. Future studies should focus on identifying effective coping strategies for crisis situations, such as staff shortages, and strategies for post-crisis staff support.Originality/valueThe authors postulate that the added burdens on staff during the pandemic might have contributed to their distress. Nonetheless, staff might have inadvertently safeguarded patients from the pandemic’s psychological ramifications by providing a “service of little disruption”, potentially leading to “problem-focused coping burnout”. These findings underscore the imperative for further research capturing the enduring impacts of pandemics, particularly scrutinising factors that illuminate the mechanisms through which distress is either intensified or alleviated across different groups. An avenue worth exploring is identifying effective coping styles for pandemics.

Interprofessional collaboration between health professional learners when breaking bad news: a scoping review of teaching approaches.

The objective of this scoping review was to examine teaching approaches used to teach interprofessional health professional learners how to break bad news collaboratively. When breaking bad news, health professionals must be equipped to deliver it skillfully and collaboratively; however, the literature shows that this skill receives little attention in program curricula. Consequently, health professionals can feel inadequately prepared to deliver bad news, which may lead to increased burnout, distress, and compassion fatigue. Studies that describe teaching approaches used to teach learners how to break bad news collaboratively were considered for inclusion. Studies must have included 2 or more undergraduate and/or postgraduate learners working toward a professional health or social care qualification/degree at a university or college. Studies including lay, complementary and alternative, or non-health/social care learners were excluded. Due to the primary language of the research team, only English articles were included. The JBI 3-step process was followed for developing the search. Databases searched included MEDLINE (Ovid), CINAHL (EBSCOhost), Embase, Education Resource Complete (EBSCOhost), and Social Work Abstracts (EBSCOhost). The initial search was conducted on February 11, 2021, and was updated on May 17, 2022. Title and abstract screening and data extraction were completed by 2 independent reviewers. Disagreements were resolved through discussion or with a third reviewer. Results are presented in tabular or diagrammatic format, together with a narrative summary. Thirteen studies were included in the scoping review, with a range of methodologies and designs (pre/post surveys, qualitative, feasibility, mixed methods, cross-sectional, quality improvement, and methodological triangulation). The majority of papers were from the United States (n=8; 61.5%). All but 1 study used simulation-enhanced interprofessional education as the preferred method to teach interprofessional cohorts of learners how to break bad news. The bulk of simulations were face-to-face (n=11; 84.6%). Three studies (23.1%) were reported as high fidelity, while the remainder did not disclose fidelity. All studies that used simulation to teach students how to break bad news utilized simulated participants/patients to portray patients and/or family in the simulations. The academic level of participants varied, with the majority noted as undergraduate (n=7; 53.8%); 3 studies (23.1%) indicated a mix of undergraduate and graduate participants, 2 (15.4%) were graduate only, and 1 (7.7%) was not disclosed. There was a range of health professional programs represented by participants, with medicine and nursing equally in the majority (n=10; 76.9%). Simulation-enhanced interprofessional education was the most reported teaching approach to teach interprofessional cohorts of students how to break bad news collaboratively. Inconsistencies were noted in the language used to describe bad news, use of breaking bad news and interprofessional competency frameworks, and integration of interprofessional education and simulation best practices. Further research should focus on other interprofessional approaches to teaching how to break bad news, how best to incorporate interprofessional competencies into interprofessional breaking bad news education, whether interprofessional education is enhancing collaborative breaking bad news, and whether what is learned about breaking bad news is being retained over the long-term and incorporated into practice. Future simulation-specific research should explore whether and how the Healthcare Simulation Standards of Best Practice are being implemented and whether simulation is resulting in student satisfaction and enhanced learning.

Compassion Satisfaction and Compassion Fatigue: Experiences of Rehabilitation Healthcare Workers in Rural and Remote Locations in Australia

Purpose. This study sought to gain an understanding of rural and remote rehabilitation healthcare workers’ perceptions and experiences of compassion satisfaction and compassion fatigue. Method. Sixteen rehabilitation workers from four national providers of rehabilitation services to rural and remote communities participated in semistructured interviews conducted by telephone over a four-month period in 2018-2019. Braun and Clarke’s six-phase framework guided the thematic analysis. Findings. Quality of work life, organisational and workplace culture, and organisational management practices, particularly key performance indicators (KPIs), were reported as impacting compassion satisfaction and compassion fatigue. Sources of compassion satisfaction were also common to the development of compassion fatigue, suggesting that it is unlikely for compassion satisfaction to be experienced without risk of compassion fatigue. Conclusion. Although there are similarities in experiences of compassion satisfaction and compassion fatigue with other remote healthcare workers, for rehabilitation workers, KPIs were a unique concern, mainly due to their uniformity regardless of geographic location. Participants’ concerns about meeting KPIs increased their work-related pressures, normalised unsafe work practices, and were a cause of recruitment and retention concerns. These perceived influences suggest that rehabilitation workers have a lower likelihood of developing and maintaining compassion satisfaction and a heightened risk of developing compassion fatigue than other rural or remote healthcare workers.