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Pehlivan Sarıbudak T. Compassion Fatigue in Nurses Providing Palliative Cancer Care and Coping Strategies to Prevent and Manage it. Semin Oncol Nurs 2023; 39:151501. [PMID: 37716876 DOI: 10.1016/j.soncn.2023.151501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVES End-of-life care for cancer patients is one of the most challenging experiences encountered by nurses. Cancer nurses providing end-of-life care may experience compassion fatigue due to prolonged exposure to the suffering and intense emotional reactions of patients, death and the dying, and grieving families. However, the development of resilience and effective coping skills can decrease nurse turnover rates and increase the quality of palliative cancer care. This article discusses the concept of compassion fatigue, how it develops, compassion fatigue experienced by nurses providing palliative cancer care, and the Compassion Fatigue Resiliency Program (CFRP) coping method. DATA SOURCES Author experience and journal articles were used. CONCLUSION Compassion fatigue can occur from secondary traumatic stress and burnout after nurses' prolonged and intense exposure to helping suffering patients, resulting in decreased ability to care, expend energy, or exhibit empathy and compassion. The CFRP is a structured, comprehensive training program designed to educate nurses about compassion fatigue and enable them to develop a support network, strengthen their coping skills, and improve resilience. IMPLICATIONS FOR NURSING PRACTICE It is recommended that the CFRP be included in in-service training in institutions and be applied to oncology nurses at regular intervals in a block program format (1-2 days). Newly recruited oncology nurses in particular should be supported with such training in orientation programs. Institutional managers play an important role in organizing such programs and screening for the risk of compassion fatigue in nurses who provide end-of-life care.
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Affiliation(s)
- Tuğba Pehlivan Sarıbudak
- Assistant Professor, Istanbul Arel University, Faculty of Health Sciences, Nursing, Istanbul, Turkey.
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Yeşil A, Polat Ş. Investigation of psychological factors related to compassion fatigue, burnout, and compassion satisfaction among nurses. BMC Nurs 2023; 22:12. [PMID: 36631763 PMCID: PMC9835325 DOI: 10.1186/s12912-023-01174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND While compassion fatigue is evaluated positively in nurses, compassion fatigue and burnout are undesirable from the viewpoint of professionals, service providers, institutions and ultimately society. It is necessary to identify the factors that lead to undesirable results and to reduce their effects. This study aimed to investigate nurses' levels of compassion fatigue, compassion satisfaction, burnout, various psychopathological symptom levels, coping skills, and the relationship between them. METHODS This was a descriptive cross-sectional study. The participants were 356 nurses working in tertiary university hospitals in Istanbul (Türkiye). The Healthcare Professional Information Form, ProQOL-IV, Brief Symptom Inventory, and the Coping Orientations to Problems Experienced scale were used to collect data. Descriptive statistics, correlation analyses, and regression models were used to analyze the data. RESULTS According to the findings, low-level burnout, moderate-high compassion satisfaction, and low-moderate compassion fatigue symptoms were detected. Low-level anxiety, depression, somatization, hostility, and negative self-esteem were found. According to the results of regression analysis, mental disengagement and planning coping strategies positively affect the synergy of compassion fatigue (p < 0.05). Turning religion and restraint coping have a positive effect on compassion fatigue (p < 0.05). While depression has a positive effect on burnout, nurses' positive reinterpretation and growth strategy is effective in coping with burnout (p < 0.05). Positive reinterpretation and growth coping strategies are also effective in increasing job satisfaction (p < 0.05). CONCLUSIONS Nurses showing somatization symptoms are risk factors for compassion fatigue, and nurses showing depression symptoms are risk factors for burnout, so they should be closely monitored and should be given support. Mental disengagement and planning coping strategies can reduce compassion fatigue, and positive reinterpretation and growth methods can reduce burnout and increase compassion satisfaction. It may be useful to provide counseling and training for nurses to use the right coping methods.
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Affiliation(s)
- Aslı Yeşil
- grid.448598.c0000 0004 0454 8989Faculty of Humanities and Social Sciences, Department of Psychology, Bursa Technical University, Bursa, Türkiye
| | - Şehrinaz Polat
- grid.9601.e0000 0001 2166 6619Faculty of Nursing, Istanbul University, Istanbul, Türkiye
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Cañas‐Lerma AJ, Campos‐Vidal JF, Verger S. "Our focus is on illness and loneliness": Volunteer work engagement, compassion satisfaction, compassion fatigue, self-care and motivations to volunteer. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6631-e6644. [PMID: 35894113 PMCID: PMC10087707 DOI: 10.1111/hsc.13934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 05/30/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
They are participating as a volunteer implies active personal positioning accompanying others. Evidence supports that experiences of those who experience an illness, who are hospitalised or feel lonely, impact the volunteers: positive emotions like engagement and Compassion Satisfaction (CS) or, the reverse, Compassion Fatigue (CF). Motivations help us understand why volunteers spend their time on these activities. And self-care practices will be a challenge to counteract the exhausting emotions of volunteering. This research presents a mixed, exploratory and sequential design study on the island of Majorca (Spain). The first phase (n = 216) was quantitative, gathering data from November 2018 to April 2019. Then, the second phase (two focus groups) started with qualitative data collection (July 2019). Firstly, the study determines CS and work engagement levels and examines the relationship between self-care, CF and motivations. Secondly, the study finds out how they recognise their positive and negative emotions, their relationship with self-care and what motivates them to be volunteers. The results show that the volunteers report highly positive feelings associated with their volunteering (CS and engagement) and are backed up by a good level of personal Self-Care. The Understanding and Enhancement motivational functions generate even more positive feelings for the volunteers themselves, who attach a positive value to their experience of caring for others. Despite the positive results collected, we must not ignore the phenomenon of CF in relational volunteering and pain support because it occurs. After all, that could lead to abandonment by volunteers.
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Affiliation(s)
- Ana J. Cañas‐Lerma
- Department of Philosophy and Social WorkUniversitat de les Illes BalearsPalmaSpain
| | | | - Sebastià Verger
- Department of Applied Pedagogy and Educational PsychologyUniversitat de les Illes BalearsPalmaSpain
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Yi LJ, Liu Y, Tang L, Cheng L, Wang GH, Hu SW, Liu XL, Tian X, Jiménez-Herrera MF. A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021. Front Psychol 2022; 13:890327. [PMID: 35814110 PMCID: PMC9258720 DOI: 10.3389/fpsyg.2022.890327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Aims A negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic. Methods We identified relevant literature from the Web of Science Core Collection® database using "resilience" and "compassion fatigue" on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1. Results A total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19. Conclusion The results of the present study help us understand the status of the CF and PR field and its recent developments.
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Affiliation(s)
- Li-Juan Yi
- Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China
- Department of Nursing, Universitat Rovira I Virgili, Tarragona, Spain
| | - Yi Liu
- Department of Physical Education, Hunan Traditional Chinese Medical College, Zhuzhou, China
| | - Ling Tang
- Chongqing University Cancer Hospital, Chongqing, China
| | - Liang Cheng
- Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China
| | - Guo-Hao Wang
- Department of Management Engineering, Tangshan Industrial Vocational & Technical College, Tangshan, China
| | - Su-Wen Hu
- Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China
| | - Xiao-Ling Liu
- Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Department of Ultrasound, Chongqing University Cancer Hospital, Chongqing, China
| | - Xu Tian
- Department of Nursing, Universitat Rovira I Virgili, Tarragona, Spain
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Ma H, Huang SQ, We B, Zhong Y. Compassion fatigue, burnout, compassion satisfaction and depression among emergency department physicians and nurses: a cross-sectional study. BMJ Open 2022; 12:e055941. [PMID: 35487521 PMCID: PMC9052053 DOI: 10.1136/bmjopen-2021-055941] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Emergency department physicians and nurses are at high risk of compassion fatigue, burnout and depression. The purpose of this study was to examine the inter-relationship between compassion fatigue, burnout, compassion satisfaction and depression in emergency department physicians and nurses. DESIGN A cross-sectional study. SETTING This study was conducted in five tertiary hospitals in five different cities across the province of Sichuan, China, in 2021. PARTICIPANTS A total of 342 emergency department physicians and nurses participated in the study. MAIN OUTCOME MEASURES Compassion fatigue, burnout, compassion satisfaction and depression scores. RESULTS Among the study participants, 100% were found to have depressive symptoms, 27.8% had low compassion satisfaction, 2.3% had high burnout and 3.8% had compassion fatigue. In the final multiple linear regression model, marital status (p=0.008; 95% CI -5.205 to -0.789), history of chronic disease (p=0.003; 95% CI -6.461 to -1.386), compassion satisfaction (p<0.001; 95% CI 0.593 to 1.274), burnout (p=0.019; 95% CI 0.084 to 0.930) and compassion fatigue (p<0.001; 95% CI -1.527 to -1.053) among emergency department physicians and nurses were considered to be significant predictors of depression. CONCLUSIONS The prevalence of depression among emergency department physicians and nurses is high in the province of Sichuan, China. Compassion fatigue, burnout and compassion satisfaction were significantly associated with depression in emergency department physicians and nurses. Hospital administrations should consider these findings to develop appropriate psychological interventions and strategies, to prevent, alleviate or treat severe depression among emergency department physicians and nurses in the province of Sichuan.
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Affiliation(s)
- Huan Ma
- Department of Nursing, Sichuan Vocational College of Health and Rehabilitation, Zigong, Sichuan, China
| | - Shuang Quan Huang
- Department of Emergency, The People's Hospital of Neijiang Dongxing District, Neijiang, Sichuan, China
| | - Bo We
- Department of Emergency, The People's Hospital of Neijiang Dongxing District, Neijiang, Sichuan, China
| | - Ying Zhong
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic. Appl Nurs Res 2021; 61:151476. [PMID: 34544570 PMCID: PMC8448586 DOI: 10.1016/j.apnr.2021.151476] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 12/21/2022]
Abstract
Background Nurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic. Aims This study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality. Design An online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines. Results Overall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = −0.145, p = 0.019), lower job satisfaction (β = −0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = −0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = −0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001). Conclusion Frontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.
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Cao X, Chen L. The impact of resilience on turnover intention in dialysis nurses: The mediating effects of work engagement and compassion fatigue. Jpn J Nurs Sci 2021; 18:e12414. [PMID: 33682287 DOI: 10.1111/jjns.12414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/12/2021] [Accepted: 02/05/2021] [Indexed: 02/05/2023]
Abstract
AIM To describe the levels of turnover intention, and to explore the mediating effects of work engagement and compassion fatigue on the relationship between resilience and turnover intention in dialysis nurses. METHODS A descriptive cross-sectional study was conducted to recruit 496 dialysis nurses in 25 tertiary hospitals in Sichuan province, China. Structural equation modeling technique was used to examine the mediating roles of work engagement and compassion fatigue on the association between resilience and turnover intention. RESULTS The prevalence of high and exceptionally high levels of turnover intention in dialysis nurses were 56.8% (282 nurses) and 8.7% (43 nurses), respectively. Resilience was a significant and direct contributor to work engagement (standardized direct effect = 0.62, p < .001) and compassion fatigue (standardized direct effect = -0.35, p < .001), respectively. However, resilience had no direct and significant effect on turnover intention (standardized direct effect = 0.15, p > .05). Work engagement and compassion fatigue had direct and significant effects on turnover intention (standardized direct effect = -0.40, p < .001; standard direct effect = 0.31, p < .001). Resilience affected turnover intention indirectly and significantly via the whole mediating effects of work engagement and compassion fatigue (standardized indirect effect = -0.36, p < .001). CONCLUSION Higher resilience leads to lower turnover intention via enhancing work engagement and reducing compassion fatigue in dialysis nurses. Nursing policies should be established to promote resilience training, enhance work engagement and reduce compassion fatigue in order to alleviate turnover intention in dialysis nurses.
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Affiliation(s)
- Xiaoyi Cao
- Hemodialysis Center, Department of Nephrology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, People's Republic of China
| | - Lin Chen
- Hemodialysis Center, Department of Nephrology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, People's Republic of China
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Prevalence and predictors for compassion fatigue and compassion satisfaction in nursing students during clinical placement. Nurse Educ Pract 2021; 51:102999. [PMID: 33639606 DOI: 10.1016/j.nepr.2021.102999] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/29/2021] [Accepted: 02/15/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Compassion fatigue and compassion satisfaction affect clients' care satisfaction and nurses' well-being. However, little attention is paid to compassion fatigue and satisfaction in nursing students during clinical placement. OBJECTIVES To explore the relationships between social support, empathy, resilience, coping strategies, and compassion fatigue and satisfaction in nursing students during clinical placement in China. DESIGN A cross-sectional study was performed from May 1 to May 31, 2020. SETTINGS and participants: A total of 972 nursing students from 15 universities or colleges in Sichuan province, who received clinical training for at least 10 months were investigated. METHODS The instruments included Perceived Social Support Scale, Jefferson Scale of Empathy, Connor-Davidson Resilience Scale, Simple Coping Style Questionnaire and Professional Quality of Life Scale. Descriptive, correlation and regression analyses of these variables were conducted. RESULTS The prevalence of low, moderate and high risk of burnout were 1.3%, 97.8% and 0.9%, respectively. The prevalence of low, average and high levels of secondary traumatic stress were 43.6%, 55.3% and 1.1%. Moreover, 9 (0.9%), 316 (32.5%) and 647 (66.6%) respondents reported low, moderate and high levels of compassion satisfaction. Cognitive empathy and resilience were significant protectors from compassion fatigue, and significant contributors to compassion satisfaction. Less compassionate care and more passive coping were significant risk factors for compassion fatigue. Adaptive coping predicted burnout significantly and negatively, and predicted compassion satisfaction significantly and positively. Family support was a significant contributor to compassion satisfaction. CONCLUSION It is essential to develop strategies to increase empathy and resilience, avoid passive coping and enhance adaptive coping, and improve family support in order to reduce compassion fatigue and facilitate compassion satisfaction in nursing students during clinical clerkship.
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