Compassion fatigue in nursing: A concept analysis

Support Needs of Labor and Delivery Nurses After Traumatic Experiences

OBJECTIVE

To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses.

DESIGN

A quantitative cross-sectional survey.

SETTING

Online distribution from January 13, 2021, to February 2, 2021.

PARTICIPANTS

A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171).

METHODS

Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses.

RESULTS

Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience.

CONCLUSION

Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.

How Grounded Are Our Ideals? Rethinking Nursing's Covenant of Care

ABSTRACT

Covenant has been used to describe the special relationship between nurses and patients yet has been misunderstood in nursing literature. Covenantal elements of keeping promises and nurturing relationship resonate with the work of nursing. However, unlimited devotion puts the nurse at risk for exploitation and burnout. One's conceptualization of covenant is important because it impacts beliefs about allegiance, identity, and responsibilities. This article offers a critical analysis of how the conceptualization of covenant in nursing literature compares to a theological understanding of covenant. The covenantal dimension of a nurse's practice is reframed from the nurse-patient relationship to a professional-societal relationship.

Impact of heartfulness meditation practice compared to the gratitude practices on wellbeing and work engagement among healthcare professionals: Randomized trial

OBJECTIVE

To investigate whether Heartfulness meditation practice, compared to Gratitude practice, leads to measurable changes in mental wellbeing among healthcare providers across the US.

METHOD

Participants were randomly assigned to one of the following 6-week interventions: the trainer-guided virtual Heartfulness meditation program or the podcast-based self-guided gratitude practice group. The Professional Quality of Life Scale-5 (ProQOL-5) was used to determine Compassion Satisfaction (CS) and risk for Burnout (BO) and secondary traumatic stress (STS). The Utrecht Work Engagement Scale (UWES) was used to assess vigor, dedication, and absorption at work. Outcomes were collected at baseline and the end of the study period. Qualitative questions regarding the experience of learning and practicing were also offered at the end of the six weeks.

RESULTS

The majority of participants were nurses (50%), followed by allied healthcare professionals (37%) and physicians (13%) (N = 83). There was a general trend towards increases in CS in the Heartfulness group compared to the gratitude group. However, this was not statistically significant. Strong evidence suggests there was a significant improvement in BO for the Heartfulness group between Week 0 and Week 6 (p = 0.002), as well as STS (p = 0.0004) and vigor (p = 0.0392). Qualitative data analysis revealed that the subjects in the Heartfulness arm reported improved sleep and decreased reactivity to stress. Subjects in the gratitude arm reported improved mood and favorable results using gratitude practices at home with family members.

CONCLUSION

In our study, Heartfulness meditation practice was associated with a significant improvement in burnout and vigor at work, with a trend towards compassion satisfaction after six weeks compared with gratitude practices. Qualitative analysis indicates the benefits of both Heartfulness and Gratitude practices. Further randomized trials with a larger sample size are needed to explore these science-based practices for the wellbeing of healthcare workers.

"People suffer and we see this": a qualitative study of the forms of patient psychological distress encountered by physiotherapists

BACKGROUND

Psychological distress is a common response to many conditions physiotherapists treat. It is also common for a person's experience of distress to be associated with multiple stressors.

OBJECTIVE

This qualitative study explored physiotherapists' perceptions of the types of patient psychological distress they encountered in their clinical practice.

METHODS

A qualitative research approach was adopted. Twenty-three physiotherapists were recruited through purposive maximum variation sampling. To participate, physiotherapists had to self-report having encountered at least one patient they perceived to be experiencing psychological distress in the last 12 months. Data analysis was completed using Iterative Thematic Inquiry.

RESULTS

Five themes were identified in the study: 1) distress extends beyond physical health issues; 2) fear of the future; 3) the emotional toll of loss; 4) trauma is often part of the story; and 5) losing hope.

CONCLUSION

The results of this study highlight that patient psychological distress presents in a variety of forms and appears to be multifaceted and multifactorial in nature. As patients' experiences of psychological distress are relevant to physiotherapy practice, mental health capabilities need to be embedded within physiotherapy training.

Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses

OBJECTIVES

This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses.

METHODS

A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses.

RESULTS

So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition.

CONCLUSION

the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care.

IMPLICATIONS FOR NURSING PRACTICE

CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.

Contributors to fatigue among nurses working in critical care units: A qualitative study

BACKGROUND

Fatigue is a growing concern among nurses who provide care to unstable and critically ill patients in critical care wards. It has various negative consequences for both nurses and patients.

AIM

To explore and describe contributors to fatigue among nurses working in critical care units.

STUDY DESIGN

A qualitative content analysis.

RESULTS

Participants were 21 nurses chosen using purposeful sampling. They were working in different critical care units at different hospitals in nine urban areas of Iran. Semi-structured interviews were used to collect data, and conventional content analysis was used to develop categories and subcategories. The analysis of data on the nurses' perspectives and experiences led to developing nine categories as contributors to fatigue: 'compassion fatigue', 'extensive network of interactions', 'sound and alarm fatigue', 'psychological tensions', 'managerial and organizational tensions', 'lack of motivation and incentives', 'individual characteristics of nurses', 'physical and mental pressure', and requirements of special care and situational complexity'.

CONCLUSIONS

Understanding the factors that influence the experience of fatigue among nurses working in critical care units is essential for maintaining a reliable and high-quality health care environment within health care facilities.

RELEVANCE TO CLINICAL PRACTICE

The experience of fatigue by critical care nurses can increase the possibility of practice errors, reduce patient safety and quality of care, and enhance staff burnout and turnover. Proactive policies should be formulated to assess nurses' fatigue levels and implement strategies for effective fatigue management. This approach aims to enhance both patient safety and job satisfaction in the workplace.

Nurses' Well-Being: An Amazing Recipe, But What Ingredients Remain Missing?

The term "system well-being" can move forward a new vision, meaning the result coming from the addition of the well-being of persons belonging to different institutions and organizations, which are all parts of the "health care system." Beginning with this "new definition," with the aim of analyzing the multifaceted issues related to nurses' well-being, we could use the "classical nursing metaparadigm" composed of 4 concepts: "health," "nursing," "environment," and "person." We briefly describe this conceptual map and provide some focused suggestions for further reflection on topics such as physical and psychological well-being, economic gain and career opportunities, work climate, burnout, low job satisfaction, moral distress, compassion fatigue, and a joyful work environment. This view may help organizations to focus on interventions to prevent or eliminate stress, which may be more proactive and effective than interventions to manage stress. Moreover, it offers a multidimensional map to analyze the different aspects influencing the well-being issue, keeping in mind that a concrete solution can be obtained only if all the components of health care systems and society do their part. Some solutions proposed by authors and organizations to increase nurses' well-being are mindfulness based, such as meditation, yoga, acupuncture, gratitude, journaling, choirs, coaching, workload reduction, job crafting, and peer networks. Other reflections on work organization, expected professional behaviors, nurses' retention, and education should be added to the discussion on this multidimensional issue.

A strategic solution to preventing the harm associated with ambulance handover delays

Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors' acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays. The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention.

Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality

Introduction

Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality.

Methods

The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working.

Results

The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology.

Discussion

This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.

Assessing the professional quality of life in the context of pediatric care

Background

This study examines the professional quality of life (ProQOL), including compassion satisfaction (CS) and compassion fatigue (CF), burnout (BO) and secondary traumatic stress (STS) among registered nurses in the context of pediatric care in Riyadh city in Saudi Arabia.

Methods

This study utilised a random multistage sampling method and a survey to collect data from 250 participants on personal characteristics, work-related aspects, lifestyle, and professional quality of life.

Results

The study participants were all female. Only 2.0% were under 25, with 27.2% aged between 25 and 30 years, 24.0% aged between 31 and 35, and 26.4% over 40 years old. The majority, 74%, were non-Saudis. The participants reported low compassion satisfaction (CS) and compassion fatigue (CF) levels. The CS, burnout (BO), and secondary traumatic stress (STS) scores were 3.23 ± 0.764, 2.75 ± 0.68, and 2.69 ± 0.54, respectively. The study found a significant difference in ProQOL level based on factors such as age, nationality, previous experience, department, shift length, overtime work, state of overtime (mandatory versus optional), and salary.

Conclusions

Working with vulnerable groups poses unique challenges for pediatric nurses. The nationality, salary, and state of overtime were found to be significantly different when compared to CS scores. Additionally, age, department, previous experience, shift length, and overtime work were very different compared to CF scores. However, lifestyle factors did not affect CS and CF scores significantly.

Implications

To improve their well-being and interest in activities, pediatric nurses should practice self-compassion and utilise available educational resources such as workshops. They should also strive to achieve a work-life balance and adopt healthy habits to reduce CF.

Areas of work-life, psychological capital and emotional intelligence on compassion fatigue and compassion satisfaction among nurses: A cross-sectional study

AIM

To examine the impact of six areas of work-life, emotional intelligence and psychological capital on compassion fatigue and compassion satisfaction among Canadian Registered Nurses and licensed practical nurses.

DESIGN

A cross-sectional survey study.

METHODS

A convenience sample of 296 Registered Nurses and 110 licensed practical nurses answered a self-administered questionnaire measuring areas of work-life, psychological capital, emotional intelligence, compassion satisfaction and compassion fatigue in September 2019. The association between variables were analysed with descriptive and correlational analyses, while the hypothesized models were tested using multiple regression analyses.

RESULTS

This study identified several areas of work-life and intrapersonal resources that impacted compassion satisfaction and compassion fatigue. Among Registered Nurses, compassion satisfaction was predicted by psychological capital, rewards, values and workload. Compassion fatigue was predicted by psychological capital, workload, control and community. Among licensed practical nurses, compassion satisfaction was predicted by psychological capital and emotional intelligence. Compassion fatigue was predicted by workload and psychological capital. Study results also revealed significant differences in Registered Nurses' and licensed practical nurses' perceptions of workload, rewards and fairness at work, and both compassion satisfaction and compassion fatigue. Registered Nurses perceived their workload to be more manageable and perceived greater rewards and greater fairness at work than licensed practical nurses. Compassion fatigue was higher for Registered Nurses than licensed practical nurses, while compassion satisfaction was higher for licensed practical nurses than Registered Nurses. Future studies should investigate the nature and span of these differences to suggest relevant strategies to mitigate compassion fatigue and promote compassion satisfaction for each of these nursing roles.

CONCLUSION

The results of this study underscore the need to create nursing work environments that foster a manageable workload and positive social relationships, where nurses have professional autonomy, decision-making capacities and access to adequate resources to do their job effectively. The nursing work environment should also provide recognition of nurses' contributions and an alignment between personal and organizational values. Investments in the development and improvement of nurses' psychological capital and emotional intelligence should be prioritized since they are malleable and impactful intrapersonal resources on compassion satisfaction and compassion fatigue.

REPORTING METHOD

This study adhered to the STROBE guidelines.

PUBLIC CONTRIBUTION

A total of 406 nurses were involved in this study by answering a self-administered study survey.

Compassion satisfaction, burnout, and secondary traumatic stress among nurses after the second wave of the COVID-19 pandemic

Background

Nurses frequently experience compassion fatigue and burnout, which impact their personal lives and patient care. The COVID-19 pandemic additionally caused stress, uncertainty, and fear of death among healthcare professionals.

Aim

To assess professional quality of life (ProQoL) among nurses after the second wave of the COVID-19 pandemic.

Material and Methods

A web-based cross-sectional study was conducted among 203 nurses using a purposive sampling technique in the month of September to December 2021. Data were collected using a self-administered ProQoL scale version 5.

Statistical Analysis

Descriptive and inferential statistics were used. Kolmogorov-Smirnov test, Mann-Whitney U, and Kruskal-Wallis H test were used. Bivariate correlations were used to correlate the main variables. Multiple linear regression analysis was also performed.

Results

The majority of the nurses reported a moderate level of compassion satisfaction (CS) (62.6%), burnout (BO) (66.0%), and secondary traumatic stress (STS) (63.1%). Residence and education emerged as a factor whether the nurses experienced BO or STS, respectively. Additionally, CS negatively correlated with BO (r = -0.732: P < 0.001) and STS (r = -0.141: p-0.04).

Conclusions

The majority of the nurses experienced moderate levels of CS, BO, and STS after the second wave of the COVID-19 crisis and nurse patient-ratio emerged as a significant factor to predict CS, BO, or STS. Hence, effective measures need to be implemented by hospital administration to enhance the nurses' satisfaction and reduce fatigue and burnout.

Latent profiles of nurses' moral resilience and compassion fatigue

BACKGROUND

Compassion fatigue is often associated with moral distress in the nursing practice among registered nurses. Moral resilience is an important ability to maintain, restore, or promote their physical and mental health in response to ethical dilemmas in nursing. Moral resilience can be utilized as a potential solution to aid registered nurses in effectively managing compassion fatigue.

AIM

To identify latent profiles of moral resilience among registered nurses and to explore the relationships of these profiles with compassion fatigue.

RESEARCH DESIGN

From August 2022 to December 2022, 569 nurses were recruited in two general hospitals, in China. A Rushton Moral Resilience Scale and the Chinese version of Compassion Fatigue-Short Scale were given to the participants. A latent profile analysis was conducted to explore moral resilience latent profiles. Predictors of profiles membership was evaluated using multinomial logistic regression analysis, and the compassion fatigue scores of each latent profile were compared using a one-way analysis of variance.

ETHICAL CONSIDERATIONS

We obtained ethical approval from the Institution Review Board of Xiangya School of Nursing, Central South University (IRB No. E202293, approved 15/July/2022).

RESULTS

A four-profile moral resilience model best fit the data. Different levels and shapes differentiated the four profiles: high moral resilience (28.7%), moderate moral resilience (52.3%), low responses and high efficacy (16.2%), and low moral resilience (2.8%). Nurses with bachelor's degrees were more likely to belong to the high moral resilience (OR = 0.118, p = .038) and moderate moral resilience (OR = 0.248, p = .045); Nurses who were divorced or separated (OR = 11.746, p = .025) and very dissatisfied with their work (OR = 0.001, p = .049) were more probably belonging to low moral resilience. Nurses who had received ethical training in the hospital were more likely involved in high moral resilience (OR = 5.129, p = .003) and low responses and high efficacy (OR = 5.129, p = .003). In each profile of moral resilience, compassion fatigue was experienced differently by the participants (F = 13.05, p < .001).

CONCLUSIONS

Developing and implementing interventions tailored to each nurse's moral resilience profile would maximize interventions' effectiveness and reduce nurses' compassion fatigue.

Need and benefit of communication training for NICU nurses

Objectives

To assess the effects of a new communication course for neonatal intensive care unit (NICU) nurses on nurses' confidence in communicating with families, and to explore communication-related issues experienced by the nurses and their relationship to burnout.

Study design

Twenty-nine nurses participated in an interactive course based on communication cases from the NICU. Participants' experience of communication with parents was assessed. They completed the Maslach Burnout Inventory. Self-reported communication skills were assessed before and after the course and at four-month follow-up.

Results

Only one nurse reported previous nursing-related communication training. High burnout scores were associated with communication-related difficulties, especially lack of time for communication. The course improved participants' confidence in their communication skills in challenging situations, including those where parents express distress or ask questions the nurse cannot answer. Participants found the course highly interesting, useful and necessary for their work.

Conclusion

Interactive, learner-centered training addressing issues specific to communication at the NICU was effective and highly appreciated.

Innovation

The course centered on a unique variety of reality-based communication cases from the NICU, relevant to the nurses' work and stimulating their reflection. An innovative feature was the emphasis on nurses' perspective and the importance of communication for their coping.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic

Background

Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue.

Aim

This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue.

Methods

A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue.

Results

A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue.

Conclusion

The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

Moral courage, burnout, professional competence, and compassion fatigue among nurses

BACKGROUND

Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses.

AIM

This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses.

RESEARCH DESIGN

Correlational, cross-sectional design following the STROBE guidelines.

PARTICIPANTS AND RESEARCH CONTEXT

Convenience sampling was used to recruit nurses (n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses' Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data.

ETHICAL CONSIDERATIONS

The ethics review committee of a government university in Ha'il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured.

RESULTS

The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue.

CONCLUSION

Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses.

The mediating role of empathy in the impact of compassion fatigue on burnout among nurses

Background

The burnout levels of nurses, who have an important place in the delivery of health services, are increasing day by day. As the burnout levels of nurses increase, there may be undesirable situations such as compassion fatigue specific to them, their patients and their institutions.

Purpose

The aim of this study is to determine the effect of compassion fatigue seen in nurses on burnout and the mediating role of empathy in this effect.

Methods

The research was conducted on nurses working in three public hospitals operating in Sakarya, Turkey, between 2 January and 16 April 2019. Since the research was conducted in more than one hospital, the minimum number of participants was determined for each hospital using the stratified sampling method in the first stage. In the second stage, the participants were selected by convenience sampling method. Descriptive statistics, linear regression and process macro regression analysis were used to analyse the data.

Results

The results showed the effect of nurses' compassion fatigue on burnout and empathy (β = 0.673). In addition, empathy has a mediating role in the effect of compassion fatigue on burnout (β = 0.251).

Conclusions/implications for practice

Reducing the burnout levels of nurses, who have a very important place in the delivery of health services, is important for both themselves and patients. It is recommended that the results of this study, which may contribute to the development of the awareness of nurse managers, should be made with the ability to understand the symptoms of compassion fatigue and burnout, teaching coping methods and providing support by experts when necessary.

Sexual Assault Nurse Examiner Education Needs in Texas

ABSTRACT

Background: As with many areas of the nation, Texas lacks a robust sexual assault nurse examiner (SANE) workforce. A program in Texas offers courses to educate and expand SANE skills to better provide trauma-informed care to vulnerable populations. Methods: A survey to stakeholders of a SANE educational program, as part of a planned program evaluation, elicited not only barriers to providing care but also specific program needs to better expand access to sexual assault and domestic violence medical forensic examinations in Texas. Results: In January 2022, a total of 40 stakeholders, all registered nurses in the state of Texas, provided vital information on their current program. Analysis of written survey responses provided themes regarding barriers to providing SANE care and suggestions for expanded education. Discussion: The survey provided valuable feedback and comments on the perceptions of the current SANE program. Written responses offered direction for additional learning desires of SANEs associated with the program as well as areas for the program to expand to meet the needs of the learners. This stakeholder guidance has implications beyond this one SANE education program to enhance and expand other programs based on learner needs.

Analysis of the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals

This article examines the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals. A longitudinal, before-and-after study was conducted with nursing professionals working in the frontline in the pre-pandemic and pandemic periods. Our study applied the Brazilian versions of the Professional Quality of Life Scale and the Utrecht Work Engagement Scale. High levels of compassion satisfaction (≥43.0), low levels of burnout (<23.0) and secondary traumatic stress (<23.0), as well as high levels of vigor (≥4.0 and ≤4.99), absorption (≥4.0 and ≤4.99), and overall score (≥4.0 and ≤4.99) were observed. Moderate, negative, and significant correlations of burnout with vigor (r: -0.505; p-value: <0.001), in the pre-pandemic period; and with overall score, in the pre-pandemic (r: -0.543; p-value: <0.001) and pandemic periods (r: -0.458; p-value: <0.001), were also observed. No changes in levels of work engagement were found. Professionals with compassion fatigue showed decreased vigor, absorption, and overall score, rated as medium in the pandemic period (≥2.0 and ≤3.99), and an increased dedication, which was low (≥1.0 and ≤1.99) in the pre-pandemic period. It was concluded that there is no harmful association between compassion fatigue and work engagement with COVID-19 in nursing professionals.

Compassion fatigue in the community nursing workforce: a scoping review

BACKGROUND

compassion fatigue is a phenomenon in areas of nursing practice such as oncology, ICU, palliative care, hospice, and dementia care, but less so among community nurses (Joinson, 1992). A gap in enquiry exists around CN and compassion fatigue around end-of-life patient care.

METHODS

a scoping review with narrative analysis of selected literature on compassion fatigue in nursing using CINHAL, ProQuest, Science Direct, and the Cochrane Library.

FINDINGS

whilst no specific studies were located on compassion fatigue and UK community nurses. Australian, Spanish, and Taiwanese studies report of environment, care relationship duration, resources and poor organisational support being linked to a likelihood of developing compassion fatigue.

CONCLUSION

compassion fatigue is under-researched in community nursing and merits further enquiry to understand the challenges posed by providing end-of-life care.

Secondary traumatic stress and posttraumatic growth in newly graduated nurses: the mediating role of compassion satisfaction

BACKGROUND

Nurses' secondary traumatic stress, compassion satisfaction and posttraumatic growth are closely related, but for newly graduated nurses, there are few reports to evaluate the specific path between these three. The aim of this study was to investigate examine the mediating role of compassion satisfaction in secondary traumatic stress and posttraumatic growth among newly graduated nurses.

METHODS

From March 2021 to May 2021, a total of 330 newly graduated nurses from five tertiary hospitals in China were enrolled, and asked to complete questionnaires regarding secondary traumatic stress, compassion satisfaction and posttraumatic growth. Descriptive statistics, independent-samples T-test, one-way analysis of variance (ANOVA), Pearson correlation analysis and structural equation model were used in this study. A STROBE checklist was used to report findings.

RESULTS

The scores of secondary traumatic stress, compassion satisfaction and posttraumatic growth of newly graduated nurses were 27.11 ± 4.94 (score range: 10-50), 31.89 ± 6.22 (score range: 10-50) and 56.47 ± 20.41 (score range: 0-100), respectively. Additionally, structural equation modeling showed that compassion satisfaction mediated the relationship between secondary traumatic stress and posttraumatic growth with the partial mediating effect of 0.089.

CONCLUSIONS

Newly graduated nurses may experience moderate secondary traumatic stress, but their posttraumatic growth is at a low level, and compassion satisfaction significantly affects the relationship between the two. Nursing managers should strengthen psychological evaluation, and promote their posttraumatic growth by improving their level of compassion satisfaction.

Turkish version of the 5-item Compassion Measurement Tool: A validity and reliability study

The aim of this methodological study with a cross-sectional design study was to examine the validity and reliability of the Turkish form of the 5-item Compassion Measurement Tool. The sample was 402 patients in a university hospital. The Content Validity Index was 0.96. Total item correlation values were between 0.559 and 0.685. Cronbach's alpha coefficient was 0.83. The scale could be used as five items, under a single factor as in the original version. A high correlation was found between patients' compassion perception and nursing care satisfaction scores. Turkish version of the 5-item Compassion Measurement Tool is a valid and reliable tool.

Compassion fatigue and compassion satisfaction among Romanian emergency medicine personnel

Background

Contemporary scientific literature has emphasized two specific aspects of healthcare professionals: compassion satisfaction and compassion fatigue. In the context of the COVID-19 pandemic, which has placed significant strain on health systems and healthcare workers, the Russian-Ukrainian crisis appears to have a magnifying effect, particularly on mental health.

Methods

The aim of the present study was to investigate the relationship between threat perception, daily worries, and professional quality of life in a sample of Emergency Medicine Personnel during two major events mentioned above. The sample included 372 participants (56.7% nurses and 43.3% physicians) from emergency units in five county hospitals in the Eastern region of Romania.

Results

The study revealed that threats related to the pandemic were positively linked to secondary traumatic stress, and daily worries were positively linked to both secondary traumatic stress and burnout. Threats generated by the war did not manifest a direct relation with any of the indicators of professional quality of life, but daily worries generated by war positively predicted both secondary traumatic stress and burnout.

Conclusion

Both the pandemic, which involved cumulative exposure, and the war, which involved a lower and more distant level of exposure, had the potential to generate worries and predict a low quality of life. However, our results did not reveal any association between threats, worries, and compassion satisfaction. As a result, this positive indicator of quality of life remained stable despite the presence of threats and worries.

The Impact of Loving-Kindness Meditation on Compassion Fatigue of Nurses Working in the Neonatal Intensive Care Unit: A Randomized Clinical Trial Study

Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P = .002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P = .034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses.

How Workplace Challenges Affect the Risk of Substance Use Disorders in a Health Care Environment

Health care environments have historically faced stressful situations that place those working in those environments at risk for substance use disorders. Over the past several years, the rates of burnout, workplace violence, diverse population stigmatization, and mental health concerns (including suicide) during the Covid-19 pandemic have increased, further challenging and contributing to development of negative coping skills, including use of substances to reduce the side effects and emotions from work. This article introduces the problem of substance use disorders, pathophysiology, and how the challenges contribute to the development of turning to substances to cope.

Piloting Peer Support to Decrease Secondary Traumatic Stress, Compassion Fatigue, and Burnout Among Air Medical Crewmembers

OBJECTIVE

The current research was performed to assess professional quality of life; identify factors associated with secondary traumatic stress, burnout, and compassion satisfaction; and evaluate the effectiveness of a peer support pilot intervention among air medical crewmembers.

METHODS

Quantitative research methods were used to assess secondary traumatic stress, compassion satisfaction, and burnout among flight nurses and paramedics. Demographic variables and secondary traumatic stress, burnout, and compassion satisfaction scores using the Professional Quality of Life Scale were assessed. A comparison of survey scores obtained before and 16 months after the implementation of a piloted peer support program was performed.

RESULTS

Crewmembers with less experience within an air medical program and those without a support system are at the highest risk of developing secondary traumatic stress, burnout, and impaired compassion satisfaction. Observed scores for secondary traumatic stress, burnout, and compassion satisfaction suggest that peer support may be an effective intervention among air medical crewmembers. No statistically significant differences in secondary traumatic stress, burnout, or compassion satisfaction were observed by clinical role, marital status, or years in their profession.

CONCLUSION

Peer support after emotionally challenging or stressful transports may combat secondary traumatic stress, compassion fatigue, and burnout. This intervention would be most beneficial for crewmembers who are newer to the transport organization and lack social or familial support.

The effect of spiritual well-being on compassion fatigue among intensive care nurses: A descriptive study

OBJECTIVES

This study aimed to determine the effect of spiritual well-being of intensive care nurses on compassion fatigue.

METHODS

It is a descriptive study. The sample of the study was composed of 167 nurses who were working in the intensive care units of the hospitals in Turkey. Data were collected by using "Personal Information Form", "The Spiritual Well-Being Scale" and "The Compassion Fatigue-Short Scale" between July and October 2022. Descriptive statistics, t-tests, correlation, and simple regression analysis were used to analyse data.

FINDINGS

35% (n = 59) of the participants were between 22 and 27 years old; 73% (n = 122) were females; 67% (n = 112) had an undergraduate degree; 57% (n = 96) had an experience of 1 to 5 years in the intensive care. It was determined that intensive care nurses had a moderate level of compassion fatigue and a high level of spiritual well-being. Although especially the educational levels of the nurses contributed to their level of spiritual well-being, a younger age and being single and less experienced in the nursing profession and intensive care were identified as significant factors in determining compassion fatigue. Nurses' Spiritual Well-Being Scale mean score was 113.89 ± 15.50. The mean score of the Compassion Fatigue Scale was 60.15 ± 29.24. A positive correlation was found between the Spiritual Well-Being and the Compassion Fatigue Scales (ß = 0.358, p = 0.000).

CONCLUSIONS

Although intensive care nurses have a high level of spiritual well-being in general, they experience a moderate level of compassion fatigue. Younger and less experienced nurses should get more attention in intensive care units against compassion fatigue.

IMPLICATIONS FOR CLINICAL PRACTICE

Management of feelings of compassion can be a protective factor for compassion fatigue and can be used as a prevention strategy in the context of improving mental well-being among intensive care nurses. Awareness and knowledge of nurses on spiritual needs should be enhanced.

The Prevalence of Compassion Fatigue among Oncology Healthcare Professionals in Three Public Healthcare Facilities in Kwazulu-Natal, South Africa

Compassion fatigue (CF) is a serious global challenge among healthcare professionals dealing with diseases with poor health outcomes in clinical settings. Chronic exposure to the suffering of others is inevitable in the oncology setting and remains one of the main contributors to CF. Therefore, this study determined the prevalence of CF among oncology healthcare professionals (OHPs) in three public healthcare facilities in KwaZulu-Natal, South Africa. This cross-sectional descriptive study was conducted among 73 OHPs using the Professional Quality of Life Scale version 5 questionnaire, and the data were analysed using the Statistical Package for Social Sciences. More than half (56.2%) of the participants reported average scores for CF, with 43.8% of them scoring low. The participants from Inkosi Albert Luthuli Central Hospital had the highest CF mean score (26.8) compared to those from Addington Hospital (21.2) and Greys Hospital (22.9). Female OHPs had a higher mean score (24.3) for CF, compared to their male counterparts (20.6). The CF scores were positively correlated with older age and longer work experience of the OHPs. The prevalence of CF among OHPs was average, compared to those reported by other local and international studies. Nevertheless, these results cannot be taken lightly, given the straining effects of unmanaged CF on the healthcare system generally and on patient care in particular. The results of this study can potentially contribute to policy development and the planning of intervention strategies towards the effective management of CF among OHPs.

Advance planning for co-caring couples

This article explores joint advance planning for co-caring couples in the community, a group growing in number and need. A health crisis for one, exposes the vulnerability of the other. Lack of planning for this eventuality leaves health and social care struggling to provide an adequate safety net in a short timeframe. This inability to adequately support, can lead to harm to the couple. The authors conducted a formal reflective investigation to discover themes that impacted on their ability to meet the needs of such a couple in their care. The themes were: the need for advanced care planning in co-caring situations; capacity assessed through different lenses; using safeguarding systems appropriately to support questions of capacity; challenges when care is not accepted; and compassion fatigue. These themes were then used to develop an action plan to improve ways of working to reduce risk in these situations.

Nurses' Perception of Caring for Patients With Substance Use Disorder

ABSTRACT

The objective of this research was to explore the perceptions of nurses regarding patients with substance use disorder (SUD), healthcare provided, and desired resources to care for this population properly. This study used a cross-sectional, descriptive design. Data were collected via an anonymous 12-item survey and three open-ended questions. Data were analyzed using descriptive statistics and conventional content analysis. Nurses with less than 1 year of experience reported more significant challenges when caring for patients with SUD. These challenges included difficulties in managing pain, implementing alternative pain management techniques, and knowing who to contact when problems occur. The study revealed many needs of nurses to provide compassionate care for patients with SUD. Findings indicate a need for education for nurses, especially novice nurses, who care for patients with SUD.

Prevalence and factors associated with compassion fatigue, compassion satisfaction, burnout in health professionals

BACKGROUND

Constant exposure of health professionals to the pain and suffering of patients can adversely affect their emotional wellbeing.

AIM

The study aimed to investigate the prevalence and the factors affecting the levels of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) of health professionals working in adult and paediatric Intensive Care Units (ICU) as well as in departments treating patients with serious illness in five hospitals in Crete.

STUDY DESIGN

A descriptive cross-sectional survey with the use of the Professional Quality of Life Scale (ProQOL-CSF-R-IV) questionnaire.

METHODS

We enrolled medical, nursing and support staff working in the adult and paediatric ICU, emergency, oncology, haematology and neurosurgical departments, haemodialysis unit and operating theatre.

RESULTS

598 health professionals completed the questionnaire (response rate 73.2%). Significantly increased levels of STS/CF were observed in non - ICU as compared to ICU staff (p = .009) females compared to males (p < .001), those who have previously experienced a traumatic event (p < .004), nurses and support staff compared to doctors (p = .007 and p = .028 respectively), and people not working in a department by choice (p < .001). CS was higher for older professionals, personnel subjected to stress reduction techniques (p < .019) and professionals working with children or mixed adults and children population (p = .009). Rolling schedule and bad working conditions negatively affected CS (p = .02, p = .001). Increased BO levels were associated with younger age (p = .029) and showed a positive correlation with STS/CF (r = .356, p < .001).

CONCLUSIONS

STS/CF is common in health professionals regardless of their profession, working department or hospital level. Non-ICU staff displayed higher STS/CF levels. Working in a department by choice ameliorates CS, BO and STS/CF.

RELEVANCE TO CLINICAL PRACTICE

Health professionals need to be informed about the risks of projecting patients' suffering on themselves. Hospital managers and department heads are responsible to provide appropriate support.

Compassion fatigue in nurses caring for chronic diseases

Objectives. The purpose of this study was to determine the level of compassion fatigue in nurses caring for chronic diseases and the factors that affect it. Nurses who provide continuous care for chronic diseases are under the risk of facing compassion fatigue. Methods. The descriptive and cross-sectional study took place during January-March 2019. The nurse identification form and the 'compassion fatigue' sub-dimension of the professional quality of life scale were used to determine compassion fatigue. Results. Nurses experience compassion fatigue at a moderate level. Female nurses, those who experience a decrease in their willingness to provide care and those who intend to leave work experience compassion fatigue more. Decrease in the willingness to provide care plays a determinant role on compassion fatigue. Nurses who experience compassion fatigue are unwilling to provide care to their patients. Conclusion. This study indicates the importance of the necessity for development of a compassion fatigue prevention program in the clinical area. Nurses should be trained on compassion fatigue within the scope of in-service training. This subject should be included in the school curriculum to increase the awareness of nursing students' about compassion fatigue.

Healthy and Happy Citizens: The Opportunities and Challenges of Co-Producing Citizens’ Health and Well-Being in Vulnerable Neighborhoods

This explorative study aims to contribute to the debate about citizen involvement in (complex) medical and social issues. Our research goals are: (1) to explore the main opportunities, threats and challenges to co-producing healthcare in vulnerable communities from the perspective of professionals, co-producers (i.e., citizens with a volunteering role) and service users (i.e., patients); (2) to distil lessons for public managers concerning the main issues involved in designing co-production initiatives. We studied co-production initiatives in the Dutch city, The Hague. These initiatives were part of a broader, unique movement named ‘Healthy and Happy The Hague’, which aims to change the way healthcare/social services are provided. Two intertwined research projects combine insights from interviews, focus group meetings and observations. The first project analyzed a variety of existing co-production initiatives in several neighborhoods; the second project involved longitudinal participatory action research on what stakeholders require to engage in co-production. The two research projects showed similarities and differences in the observed opportunities/treats/challenges. The study found that empowering citizens in their role as co-producers requires major changes in the professionals’ outlook and supporting role in the communities. It illustrates the potential of synergizing insights from healthcare governance and public administration co-production literature to benefit co-production practice.

Transforming Nurse Self-Care Through Integration of Spirituality: Lessons From an International Collaboration in Palliative Care

INTRODUCTION

With growing evidence of compassion fatigue and burnout in health care, it is time for a deeper look at the vital practice of self-care among professionals providing palliative care. The purpose of this study was to provide insights into ways empowerment, caring for self, environment, and building relationships impact well-being among palliative care professionals.

METHODS

Interpretative descriptive methods framed focus group interviews, conducted during a conference on palliative care integrative health practices held in Thailand. An interprofessional research team used inductive reasoning processes to analyze the interviews.

RESULTS

Three themes emerged from the four focus groups (N = 22): Buddhist Beliefs and Practices, Community-mindedness, and Empowerment. Aspects of spirituality were consistently woven into self-care practices.

DISCUSSION

Findings suggest that self-care can be reimagined to include highly personal and unique expressions of spirituality. Health care communities are called to integrate ritual in culturally congruent ways, thus supporting health care professionals to find new sources of meaning, enrichment, and empowerment.

Association between coping strategies and professional quality of life in nurses and physicians during COVID-19: A cross-sectional study

AIM

To explore the associations between coping strategies (social support, avoidance strategies, positive attitude, problem orientation, and transcendent orientation) and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress) of nurses and physicians during COVID-19.

BACKGROUND

Little is known about the association between the way health care workers cope with stress and their professional quality of life during the unusual circumstances that the COVID-19 pandemic imposed.

METHODS

A single-centre cross-sectional observational study was conducted with health care professionals (n = 143). The Professional Quality of Life scale Version 5 and the Italian Version of the Coping Orientations to the Problems Experienced measured the professional quality of life and coping strategies, respectively.

RESULTS

Avoidance, problem orientation and social support coping worsened professional quality of life, whereas a positive attitude improved it.

CONCLUSIONS

This study on the relationship between coping strategies and the professional quality of life during health emergencies like the COVID-19 pandemic can inform interventions aiming to foster functional coping strategies in health care personnel to sustain their professional quality of life.

IMPLICATIONS FOR NURSING MANAGEMENT

Identifying people at greater risk of burnout and secondary traumatic stress can guide tailored interventions to improve health care workers' wellbeing. Increased professional quality of life might turn in improved quality of care and reduced absenteeism and intention to leave.

Trajectories and predictors of vicarious traumatization in Chinese college students during the COVID-19 pandemic: A longitudinal study

Objectives

This longitudinal study aimed to identify the trajectories and the predictors among sociodemographic and psychosocial variables at baseline of vicarious traumatization (VT) in Chinese college students during the COVID-19 pandemic.

Materials and methods

A total of 544 Chinese college students enrolled in a public University in central China, majored in Clinical Medicine, Nursing, Musicology, Physics, etc., participated in this longitudinal study lasting 19 months. Three-wave (wave 1: February 2020; wave 2: November 2020; wave 3: September 2021) of data were collected. Resourcefulness Scale and the 10-item Kessler scale (K10) were only assessed in the first-wave survey, and the Event Scale-Revised (IES-R) was repeatedly measured in all three-wave surveys. A link to an online survey created by Questionnaire Star (https://www.wjx.cn/) was sent to the students to collect data. The Growth mixture modeling (GMM) and multiple logistic regression were used to identify the trajectories of VT and predictors for the distinct trajectories.

Results

The incidence of VT at each wave varied from 9.9% at wave 1, 4.0% at wave 2, to 2.6% at wave 3. Three trajectories of VT were the medium-level escalating group (3.0%), medium-level maintaining group (32.3%), and the low-level descending group (64.7%). Seniors (OR = 1.575, 95% CI: 1.059-2.341; OR = 1.161, 95% CI: 1.043-1.293) and those with poor mental health status (OR = 1.101, 95% CI: 1.030-1.177; OR = 1.083, 95% CI: 1.060-1.106) at baseline were more likely to be classified into the medium-level escalating group and medium-level maintaining group, respectively. Additionally, females (OR = 3.601, 95% CI: 1.311-9.887) were more likely to be included in the medium-level escalating group.

Conclusion

Targeted psychological interventions are urgently needed for students vulnerable to VT. Further studies with more representative samples, longer period of follow-up, and predictors based on scientific theoretical framework, are needed to update the findings.

Effects of psychological intervention on empathy fatigue in nurses: A meta-analysis

Objective

The purpose of this meta-analysis is to systematically assess the effects of psychological intervention on empathy fatigue among nursing staff.

Method

Five electronic databases are searched separately from their establishment to April 8th, 2022. The research team independently performs paper selection, quality assessment, data extraction and analysis for all included studies. PRISMA guidelines are used to report this meta-analysis.

Results

A total of seven randomized controlled trials (RCTs) covering 513 nursing staff are included. The meta-analysis results show that the empathy fatigue score (SMD = -0.22, 95% CI: -0.42~-0.02, P = 0.03) and burnout (SMD = -0.37, 95% CI: -0.56~-0.19, P < 0.001) are lower than the control group. The empathy satisfaction score of the psychological intervention group is higher than that of the control group (SMD = 0.45, 95% CI: 0.27-0.63, P < 0.001). The differences are statistically significant (P < 0.05). Subgroup analysis finds significant heterogeneity in the impact of different departments on psychological intervention at ≥6 weeks (I ² = 71%, P = 0.01) and <6 weeks (I ² = 0%, P = 0.75) (P = 0.05). Different departments also show significant heterogeneity in the effects of psychological intervention: ICU (I ² = 73%, P = 0.02), pediatric (I ² = 53%, P = 0.14) and other departments (I ² = 0%, P = 0.63). The differences are statistically significant (P = 0.0007). Besides, the results show that both mindfulness intervention (SMD = 0.50, 95% CI: 0.24-0.77, P = 0.0002) and other interventions (SMD = 0.41, 95% CI: 0.16-0.65, P = 0.001) are statistically significant difference in the level of empathy satisfaction between the psychological intervention group and the control group.

Conclusion

Psychological intervention has a coordinated improvement effect on empathy fatigue, empathy satisfaction and burnout, and can also improve the quality of life of nursing staff.

Finding Your Calling: An Online Seminar for Undergraduate Nursing Students

ABSTRACT

The aim of this study was to assess if an evidence-based educational program focused on vocation and calling could improve undergraduate nursing students' sense of meaning in life and sense of calling/vocation. Using a mixed-methods, quasi-experimental design, a statistically significant increase occurred in sense of meaning in life and calling/vocation. Qualitative responses revealed growth in self-knowledge, importance of individual pathways, and recognition of nursing as one's calling. Courses on calling may encourage nursing students to commit to nursing as a calling.

The Effects of Motivational Messages Sent to Emergency Nurses During the COVID-19 Pandemic on Job Satisfaction, Compassion Fatigue, and Communication Skills: A Randomized Controlled Trial

INTRODUCTION

During the COVID-19 pandemic, emergency nurses have been adversely affected physically, socially, and psychologically by factors such as increased workload, longer working hours, isolation from family, and limited resources. This study aimed to investigate the effect of motivational messages sent to emergency nurses during the COVID-19 pandemic on their job satisfaction, compassion fatigue, and communication skills.

METHODS

This was a randomized controlled experimental study. The study was conducted with 60 emergency nurses in 2 training and research hospitals in Istanbul between July 31 and August 31, 2021. The participants were randomly assigned to the intervention and control groups. Participants in the intervention group (n = 30) received daily motivational messages to their mobile phones by short message service for 21 days; those in the control group (n = 30) received no motivational messages. The Job Satisfaction Scale, Compassion Fatigue Scale, and Communication Skills Scale were administered before and after the intervention.

RESULTS

The mean age was 29.8 (SD = 7.5) and 28.7 years (SD = 6.9) in the intervention and control groups, respectively. Before the intervention, there were no significant differences in the groups' scores for job satisfaction (P = .561), compassion fatigue (P = .687), or communication skills (P = .355). After the intervention, the intervention group had significantly higher scores for job satisfaction (P < .001) and communication skills (P < .001) and significantly lower compassion fatigue scores than the control group (P < .001).

DISCUSSION

Our results suggest that motivational messages sent to emergency nurses during the COVID-19 pandemic increase job satisfaction and improve communication skills while reducing compassion fatigue.

Compassion satisfaction and compassion fatigue in frontline nurses during the COVID-19 pandemic in Wuhan, China

Aim

The aim of this study is to investigate the compassion satisfaction and compassion fatigue among Chinese frontline nurses during the COVID‐19 pandemic in Wuhan, China and to explore the related factors.

Background

Frontline nurses undertake a huge nursing workload with a risk of infection, causing great pressure on them and making them face a risk of compassion fatigue during the pandemic.

Methods

A cross‐sectional online survey was conducted from 9 March to 15 March 2020. A total of 1582 nurses caring for critical patients with COVID‐19 participated. Compassion satisfaction and compassion fatigue (comprising burnout and secondary traumatic stress) were assessed with the Professional Quality of Life Scale, and resilience was measured with the Chinese 10‐item Connor‐Davidson Resilience Scale.

Results

Moderate levels of compassion satisfaction (36.99 ± 6.71), burnout (24.14 ± 5.33) and secondary traumatic stress (24.53 ± 5.24) were experienced by frontline nurses. Resilience and perceived work pressure were the main predictors.

Conclusions

Frontline nurses demonstrated a moderate level of compassion satisfaction and compassion fatigue.

Implications for nursing management

The compassion fatigue of frontline nurses should be considered. Strategies aiming to reduce stress and enhance resilience, such as training about psychological adjustment, developing professional skills and creating a supportive workplace environment, are several options.

The trial is not registered. This study is a cross‐sectional study, and according to China's clinical trial registration standards, such studies are not required to be registered. So the trial is not registered. However, oral consent was obtained from the ethics committee of the hospital before this study was conducted.

Expressions of Compassion Fatigue by Emergency Department Nurses Caring for Patients With Opioid and Substance Use Disorders

INTRODUCTION

The misuse of and addiction to opioids are a national public health crisis. The complexity of delivering patient care in emergency departments exposes nurses to stressful work situations with complex patient loads and increasing levels of compassion fatigue. Emergency nurses were asked about their feelings of compassion fatigue while caring for patients with opioid use and/or substance use disorders.

METHODS

Twenty-four focus groups with emergency nurses (N = 53) at a level I trauma center were conducted in late 2019 and early 2020 are used in this qualitative study using thematic analysis that identified 1 main theme of compassion fatigue with 3 subthemes (nurse frustration with addicted patients, emotional responses, and job satisfaction).

RESULTS

Findings highlight that emergency nurses working with patients with opioid use and/or substance use disorders are dealing with a number of negative emotional stressors and frustrations, which in turn has increased their levels of compassion fatigue. These nurses repeatedly expressed feelings of increasing frustration with addicted patients, negative emotional responses, and decreasing levels of job satisfaction as components of their compassion fatigue.

DISCUSSION

These emergency nurses identified 3 areas to improve their compassion: improved management support with encouragement across all work shifts, debriefing opportunities, and more education. Fostering a high level of self-awareness and understanding of how the work environment influences personal well-being are necessary strategies to avoid the frustrations and negative emotional responses associated with compassion fatigue.

Compassion fatigue in mental health nurses: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice that may result in negative outcomes for mental healthcare consumers. Compassion fatigue has clear emotional and physical costs and significant impacts on staff recruitment and retention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the first to evaluate the quantitative literature on compassion fatigue in mental health nurses. Research on compassion fatigue in mental health nurses does not accurately account for the unique care relationship between nurse and consumer. Competency-based education, strong mental health nurse leadership, positive organizational cultures, clinical supervision and reflection alongside individual self-care strategies may mitigate compassion fatigue. WHAT ARE THE IMPLICATIONS FOR FUTURE PRACTICE?: Resources are urgently needed for education and workforce development that addresses compassion fatigue in mental health nurses. Interventions addressing the physical, cognitive and emotional demands of care work are needed to ensure mental health nurses have the capability to provide sustainable compassionate care to consumers. ABSTRACT: Introduction Although compassionate care is an essential component of mental health nursing, understandings of the impact of compassion fatigue is poorly understood. Aims/Questions To examine and synthesize available data on the prevalence of compassion fatigue within mental health nurses and consider what variables impact compassion fatigue. Method A search of MEDLINE, EMBASE, PsychINFO, Emcare, Web of Science, Scopus, CINAHL and grey literature for articles published between 1992 and February 2021 was conducted. Data were extracted from articles meeting inclusion criteria and integrated using narrative synthesis. Results Twelve articles were included. Prevalence of compassion fatigue ranged from low to high. Variables were identified that may mitigate the risk of compassion fatigue. Strong leadership and positive workplace cultures, clinical supervision, reflection, self-care and personal well-being may protect mental health nurses against compassion fatigue. Discussion Future research is needed on mental health nurses lived experience of compassion fatigue and their understandings of compassion. Implications for Practice Interventions should focus on increasing awareness of compassion fatigue and building individual and organizational resilience. Both organizations and individuals should be aware of the role they play in maintaining the capacity and capability for mental health nurses to provide sustainable and compassionate mental healthcare.

COVID-19 patient care predicts nurses' parental burnout and child abuse: Mediating effects of compassion fatigue

BACKGROUND

Nurses who are also parents may be at risk not only for professional compassion fatigue, but also parental burnout - a reliable and valid predictor of child abuse and neglect. In support, recent research reveals that parents' COVID-19 related stressors predicted elevated potential for child abuse (Katz and Fallon, 2021).

OBJECTIVE

We explored the harmful effects of the COVID-19 pandemic on nurses' parental burnout, child abuse, and child neglect, as mediated by compassion fatigue (i.e., a combination of job burnout and secondary traumatic stress).

PARTICIPANTS AND SETTING

Participants were 244 nurses (M age = 32.4; 87% female) who were parents of young children (age 12 or under) recruited via chain referral sampling.

METHODS

Participants completed an anonymous survey assessing the extent to which they care for COVID-19 patients, are exposed to patients suffering and dying from COVID-19, and have lost family income due to COVID-19. We also measured their compassion fatigue, compassion satisfaction, substance abuse, spouse conflict, parental burnout, child abuse, and child neglect.

RESULTS

As hypothesized, direct care of COVID-19 patients, exposure to patient death and suffering due to COVID-19, and family income loss due to COVID-19 predicted greater compassion fatigue, which in turn, predicted greater parental burnout, child abuse, child neglect, spouse conflict, and substance abuse, (IEs ≥ 0.06, all ps < 0.05). Also, as compassion satisfaction increased, parental burnout, child abuse, child neglect, spouse conflict, and substance abuse decreased, rs ≥ -0.203, ps < 0.01.

CONCLUSIONS

Theoretical implications and practical implications for medical practice and child abuse prevention are discussed.

The Relationship Between Nurse’s Professional Quality of Life, Mindfulness, and Hardiness: A Cross-Sectional Study During the COVID-19 Outbreak

Background

In the pandemic of Coronavirus Disease 2019 (COVID-19) disease, various factors, such as workplace factors, and psychological variables, can affect the occupational status of nurses. This study aimed to assess the relationship between nurses’ professional quality of life, mindfulness, and hardiness during the outbreak of COVID-19.

Methods

This cross-sectional study included 239 nurses from two medical centers in Rafsanjan, Iran. Quota sampling was performed from August to November 2020. A demographic form, the Professional Quality of Life Scale (ProQOL), the Freiburg Mindfulness Questionnaire-Short Form (FMI-SF), and the Occupational Hardiness Questionnaire (OHQ) were used to collect data.

Results

The mean age of the participants was 33.20 ± 6.85 years. The majority of the participants were female, married, and employed. Compassion Satisfaction (CS), Secondary Traumatic Stress (STS), and Burnout (BO) were all moderate among nurses. Hardiness was the best predictor of compassion satisfaction. Mindfulness was the best predictor of both secondary traumatic stress and burnout. Psychological hardiness and mindfulness had the greatest impact on nurses’ quality of professional life during the COVID-19 pandemic.

Conclusion

Caring for COVID-19 patients may lead to BO, CF, and STS; identifying predictors of these can inform the development of interventions to mitigate or minimize BO, CF, and STS in nurses caring for these patients. Furthermore, in order to improve nurses’ quality of professional life, psychological hardiness, and mindfulness, necessary psychological programs and interventions should be designed and implemented.

Measuring Professional Quality of Life in Nurses: A Realist Review

Oncology nurses are at risk for compassion fatigue, which is often assessed using the Professional Quality of Life Scale (ProQOL). Nursing researchers and leaders use the ProQOL to determine risk for compassion fatigue or effectiveness of interventions to reduce compassion fatigue. However, the ProQOL was designed for social workers, and research has shown it to be less suitable to assess the work of nurses. This article synthesizes a realist review of the literature about instruments measuring nurses' professional quality of life (QOL). The following three themes emerged: (a) a robust body of literature aimed at defining professional QOL, (b) a limited historical context of the ProQOL instrument, and (c) newer instruments. Findings suggest that the ProQOL-21 and the Risk Factors for Compassion Fatigue Inventory are more specific to nursing and better suited to measure nurses' perceived professional QOL.

Vicarious trauma in nursing professionals: A concept analysis

AIM

To explore the concept of vicarious trauma (VT) and clarify its fundamental meaning and distinctiveness as a psychological phenomenon experienced by nurses.

BACKGROUND

The current coronavirus disease 2019 (COVID-19) pandemic has incited significant psychological distress on nursing professionals worldwide. There is growing knowledge of the negative outcomes of this distress including the manifestation of nursing burnout syndrome, compassion fatigue, and vicarious traumatization (VT). These concepts have often been used interchangeably throughout nursing discourse creating confusion surrounding their uses and unique attributes.

DESIGN

Walker and Avant's method of concept analysis.

RESULTS

VT is a psychological phenomenon that causes a permanent cognitive shift in the inner experience and world views of nurses after prolonged empathetic engagement with a patient's trauma. VT manifests as physical and emotional symptoms of distress, which can disrupt a nurses ability to provide competent care. Contradictions within the literature exist when defining VT, burnout syndrome, and compassion fatigue, creating difficulty identifying attributes and consequences unique to VT.

CONCLUSION

More empiric rigor is needed to adequately operationalize VT. Given the traumatic nature of the COVID-19 pandemic, immediate policy and education attention should be directed towards understanding the relationship between nurses working during the COVID-19 pandemic and the prevalence of VT.

Hearing the patient voice: a qualitative interview study exploring the patient experience of a nurse-led initiative to integrate and enhance primary and secondary healthcare pathways

Objective

The Transitional Care Nursing Service was a 2-year proof-of-concept trial exploring local health system readiness for incorporating integrated, person-centred models of care into existing health service structures within a provincial New Zealand context. Improved patient experience remains a priority in international and local healthcare policy directives. This qualitative study aimed to investigate patient experience by exploring the effectiveness of this integrated care person-centred service from the patients’ perspective.

Methods

Qualitative, semistructured, face-to-face interviews with 12 patients purposively sampled to achieve maximum variation of patient characteristics within the trial cohort. Interviews were audio-recorded and transcribed verbatim before analysing the data using thematic analysis supported by a general inductive approach.

Results

Findings demonstrated that patient interactions with the transitional care nurse positively influenced patient experience, self-reported outcomes and quality of life following hospitalisation and during the transition period between hospital and home. Participants perceived the nurse to be highly skilled in displaying kindness, empathy, accessibility and responsiveness, and communication skills with participants and their families. They perceived that their interactions with this individual team member working from an integrated care paradigm had a positive impact on their overall experience of care and recovery.

Conclusion

This study supports the use of integrated care principles to deliver person-centred care. The findings emphasise the need to place kindness, compassion and respect at the heart of care delivered to patients, and suggest these core values are an essential factor in improving patient experience and thus the effectiveness of our healthcare systems.