Compassion fatigue as bruises in the soul: A qualitative study on nurses

Examining Relationships Among Nursing Students' Views of Suffering, Positive Thinking, and Professional Quality of Life

BACKGROUND

Exposure to suffering can lead to compassion fatigue in undergraduate nursing students.

OBJECTIVE

Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction.

RESULTS

In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F11,145 = 4.121, P < .001), and 21.9% of the variance in burnout (F11,144 = 3.786, P < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (β = 0.349, P = .025; and β = 0.309, P < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (β = -0.280, P < .001; β = -0.392, P = .014; and β = -0.206, P = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (β = 0.232, P = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables.

CONCLUSIONS

Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life.

Compassion fatigue in palliative care: Exploring Its comprehensive impact on geriatric nursing well-being and care quality in end-of-life

BACKGROUND

This study examines the experiences of geriatric nurses in palliative care. It aims to understand how these experiences influence their well-being and the quality of care.

METHODS

Conducted in the Alahsa region of Saudi Arabia, the study employs qualitative methods, utilizing in-depth interviews with 12 geriatric nurses. The analysis employs a thematic approach, enriched by iterative reflections within a multidisciplinary research team.

RESULTS

The analysis reveals main themes: 1) the deep emotional connections between nurses and their patients; 2) the challenges faced, including compassion fatigue, high patient mortality, and communication hurdles; 3) the impact of these challenges on the quality of care, highlighting issues like diminished empathy; 4) the coping strategies used by nurses, such as self-care practices and continuous education.

CONCLUSIONS

The study concludes that coping strategies, including self-care and ongoing professional development, are vital for sustaining the nurses' well-being and ensuring the continued provision of high-quality care to Older Adults patients.

Effectiveness of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults: A systematic review and meta-analysis

AIM

This study aims to investigate the efficacy of the aged simulation suit on undergraduate nursing students' attitudes and empathy toward older adults.

BACKGROUND

A new approach to teaching to enhance nursing students' attitudes toward and empathy for older adults involves the use of an aging simulation suit.

DESIGN

This systematic review and meta-analysis seeks to determine the efficacy of the aged simulation suit on the attitudes and empathy of undergraduate nursing students toward older adults. This protocol for a systematic review and meta-analysis was registered as CRD 42023393879 on the PROSPERO database.

METHODS

In February-March 2023, a systematic review with meta-analysis of randomized controlled and quasi-experimental studies was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Population, Intervention, Control, Outcomes, Study Design (PICOS) structure was used for search strategy. Databases CINAHL, Cochrane Library, PubMed, PsycINFO, and Web of Science, as well as ULAKBIM, Turkish Medline, Turkiye Klinikleri, and YOK National Thesis Center, were searched for the articles. The Joanna Briggs Institute Critical Appraisal Tools were used to evaluate the methodological quality of a study and the extent to which its design, conduct, and analysis addressed the possibility of bias.

RESULTS

The meta-analyses of attitudes toward older adults included six studies (including 535 nursing students). The intervention group's attitudes toward older adults were found to be similar to those of the control group (SMD: 15.84, Z= 1.98, p= 0.05). The subgroup analyses revealed similarities between intervention group's and the control group's mean score on attitudes toward older adults (SMD: 4.85, Z=0.70, p=0.48, for RCT; SMD: 23.05, Z= 2.02, p=0.04, for quasi-experimental). Three studies (involving 207 nursing students) revealed significantly higher mean empathy score for the control group compared with the intervention group following the intervention (SMD: 7.08, Z=4.82, p=0.00001). The subgroup analyses revealed statistically significantly higher mean level of empathy for the control group compared with the intervention group was after the intervention (SMD: 7.49, Z=3.15, p=0.002, for RCT; SMD: 6.83, Z= 3.65, p=0.0003, for quasi-experimental).

CONCLUSIONS

Nursing students should be aware of older adults' feelings and experiences aging-related changes and aged simulation interventions can be a useful intervention to allow students to empathize with an older adult.

Development, validation, and accuracy of ORCHESTRA emotional exhaustion screening questionnaire among healthcare workers during COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing.

METHOD

A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy.

RESULTS

Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses.

CONCLUSION

This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs.

Investigating the relationship between compassion fatigue and moral injury in nurses

Background: Compassion fatigue and professional quality of life are important in health and professional ethics. Aim: This study aimed to determine the relationship between compassion satisfaction, compassion fatigue, secondary traumatic stress, and moral injury in nurses. Research design: This research is a cross-sectional descriptive-analytical study. The research community of this research was all the nurses of the teaching hospitals of Ardabil city. Three questionnaires on demographic characteristics, the Professional Quality of Life Scale (ProQOL), and the Moral Injury Events Scale were used to collect data. SPSS (version 22) software was used for data analysis. Participants and research context: The study recruited 297 nurses randomly selected from five teaching hospitals in Ardabil city. Ethical considerations: Ethical approval was obtained from the Ardabil University of Medical Sciences ethics committee (with the code of ethics IR.ARUMS.REC.1401.198). Informed consent was obtained from the participants. Results: The results showed that the mean compassion satisfaction score of this study's participants was 37.61 ± 8.86, the mean compassion fatigue score of this study's participants was 28.73 ± 7.04, and the mean secondary traumatic stress score of this study's participants was 29.95 ± 7.84. The mean score of moral injury among nurses was 31.19 ± 8.54. The results showed a negative significant relationship between compassion satisfaction and moral injury (p < 0.001). Also, there is a positive significant relationship between compassion fatigue and secondary traumatic stress with moral injury (p < 0.001). Conclusion: The results of this study show a negative relationship between compassion satisfaction and moral injury. According to the results of the present study, nurse managers should implement educational interventions, create ethical processes, and clear ethical guidelines to reduce moral injury and increase compassion satisfaction.

Exploring work readiness: A qualitative descriptive study of self-perceptions among new graduate nurses

Background

Reduced work readiness is associated with elevated turnover rates, necessitating efforts to enhance the positive work readiness of newly graduated nurses to alleviate the shortage in the nursing workforce. Research into the work readiness of recent nursing graduates in China is still in its infancy. Most studies employ quantitative research methods, and further exploration of the self-perception of work readiness among new nurses in China is required.

Objectives

This study aimed to investigate genuine experiences and self-perceptions of work readiness among new graduate nurses.

Design

A qualitative descriptive study.

Methods

Sixteen new nurses from a provincial tertiary hospital in China were included in this study, which adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist for reporting. The data collection process involved conducting semi-structured interviews from September to October 2021. Inductive content analysis was employed to analyze the interview data.

Results

The study identified four themes encompassing new nurses' real-life experiences and self-perceptions of work readiness: psychological stress, emotional conflict, empathy fatigue, and ethical dilemmas. Psychological stress comprised three subthemes: knowledge and skill deficits, communication barriers, and fear. Empathy fatigue was primarily characterized by psychological and physical symptoms. Ethical dilemmas involved conflicts over differences in values and between clinical reality and standardized nursing practice.

Conclusion

Drawing from the self-perceptions of work readiness among new nurses found in this study, nursing administrators and educators must enhance the existing transition support program for new nurses. Additionally, the establishment of individualized training programs is recommended to further improve the work readiness of new nurses.

Effect of compassion fatigue on emotional labor in female nurses: Moderating effect of self-compassion

Emotional labor is common in nursing but may be affected by the mental state of nurses. This study explored the effect of compassion fatigue on emotional labor and whether self-compassion moderates this effect of compassion fatigue.

METHODS

A two-stage survey design with a convenience sample. Participants were female nursing staff recruited from emergency departments, intensive care units, ward nursing units, and outpatient departments of medical centers, regional hospitals, and district hospitals in Taiwan. A total of 300 questionnaire copies in each of the first and second stages were distributed, and 272 pairs of responses were retrieved (valid response rate = 91%). The reliability and validity of the questionnaire were tested, and confirmatory factor analysis was conducted with AMOS 21. The proposed hypotheses were verified using hierarchical regression conducted with SPSS version 25.0.

RESULTS

This study revealed that compassion fatigue positively predicted surface acting (β = 0.12, p < 0.05) and negatively predicted deep acting (β = -0.18, p < 0.01) and expression of genuine emotions (β = -0.31, p < 0.01). In addition, self-compassion negatively moderates the relationships between compassion fatigue and surface acting (β = -0.12, p < 0.05), and positively moderates the relationships between compassion fatigue and expression of genuine emotions (β = 0.15, p < 0.01).

CONCLUSIONS

To avoid excessive consumption of emotional resources, nurses with high compassion fatigue may employ surface acting by engaging in emotional labor without making an effort to adjust their feelings. Nurses need also be sympathized with, and such sympathy can come from hospitals, supervisors, colleagues, and, most crucially, the nurses themselves. Hospital executives should propose improvement strategies that can prevent the compassion fatigue on nurses, such as improving nurses' self-compassion.

Unveiling the burden of compassion fatigue in nurses

BACKGROUND

The COVID-19 pandemic has placed an unprecedented burden on nurses who have been at the forefront of patient care. The continuous exposure to suffering, death, and overwhelming demands has the potential to lead to compassion fatigue, a state of emotional, physical, and cognitive exhaustion.

RESEARCH AIM

The study aimed to explore and understand the phenomenon of compassion fatigue in nurses as the effect of the COVID-19 pandemic.

RESEARCH DESIGN

A constructivist grounded theory design was used.

PARTICIPANTS AND RESEARCH CONTEXT

The research data were collected from 20 nurses who had been employed in pandemic clinics in Turkey for a minimum of 6 months. Data were collected using a two-step approach: purposeful sample selection followed by theoretical sample selection. Individual interviews were conducted via an online platform with participants who consented to participate in the study from January 16th to April 28th, 2022. The collected data underwent initial, focused, and theoretical coding for analysis. The research findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.

ETHICAL CONSIDERATIONS

Ethical approval for the study was received from Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.

FINDINGS

The study identified a core category, namely the desire to provide the best care, which was accompanied by five main categories: causes, symptoms, consequences, coping methods, and the benefits of coping methods.

CONCLUSION

During the pandemic process, nurses have experienced compassion fatigue due to various factors and have seen its symptoms. Nurses have developed various coping mechanisms individually. However, they have not indicated any institutional-level support. It has become necessary to plan nurse-centered comprehensive interventions that will reduce compassion fatigue.

Clinical nurses' compassion fatigue psychological experience process: a constructivist grounded theory study

BACKGROUND

Clinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses.

METHODS

Charmaz's Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes.

RESULTS

The data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period.

CONCLUSION

Clinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses' compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.

Agent-Regret in Healthcare

For healthcare professionals and organizations, there is an emphasis on addressing moral distress and compassion fatigue among clinicians. While addressing these issues is vital, this paper suggests that the philosophical concept of agent-regret is a relevant but overlooked issue in healthcare. To experience agent-regret is to regret your harmful but not wrongful actions. This person's action results in someone being killed or significantly injured, but it was ethically faultless. Despite being faultless, agent-regret is an emotional response concerning one's agency in a situation that results in death or significant harm. In healthcare, many clinicians are likely to experience regret for faultless actions that significantly harm or cause the death of a patient. The recognition of agent-regret in healthcare is significant because it differs, conceptually and practically, from moral distress and compassion fatigue. Building on the work of Wojtowicz (2022), we should strive to understand clinicians' agent-regret by recognizing their agency in the situation, not lessening or removing it.

Investigating compassion fatigue and predictive factors in paediatric surgery nurses

BACKGROUND

Nurses provide care to meet the complex needs of patients in the increasing workload in the health system and are at risk of compassion fatigue. The concept of compassion fatigue has begun drawing attention in the last decade, as it negatively affects nurses' physical and mental health, job performance and satisfaction, and therefore patient care quality.

OBJECTIVES

This study was to examine compassion fatigue and predictive factors in paediatric surgery nurses.

PARTICIPANTS AND RESEARCH CONTEXT

The study was cross-sectional, predictive and quantitative. It was conducted with the 135 paediatric surgery nurses. The data were sent to the email addresses of the members via Google Survey. Research data were collected with the Nurse Information Form, Compassion Fatigue Scale, Life Satisfaction Scale and Multidimensional Perceived Social Support Scale.

ETHICAL CONSIDERATIONS

After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent.

RESULTS

There was a difference between the level of compassion fatigue according to the paediatric surgery unit that worked the longest and the thought of changing their profession. Burn unit nurses and nurses who were considering changing professions have higher compassion fatigue scores. When the predictors of compassion fatigue were examined, the thought of changing the nursing profession and life satisfaction were significant predictors of compassion fatigue. The thought of changing the nursing profession and life satisfaction explained 22% of compassion fatigue. The same variables and the longest working period of the paediatric surgery unit were the estimators of the level of occupational burnout; explaining 29% of occupational burnout.

CONCLUSIONS

Compassion fatigue, life satisfaction and perceived social support of paediatric surgery nurses are moderate. Compassion fatigue is affected by working time, the thought of changing the profession, life satisfaction and perceived social support.

Psychiatric nurses' perception of dignity in patients who attempted suicide

BACKGROUND

Maintaining the dignity of patients who attempted suicide is one of the caregivers' main ethical duties. Yet, in many cases, these patients are not treated with dignity. The concept of dignity is abstract, and there is no research on the dignity of suicidal patients. So, the present study is done to investigate psychiatric nurses' perception of dignity in patients who attempted suicide.

OBJECTIVE

The present study explores the concept of dignity in patients who attempted suicide from the perspective of psychiatric nurses.

RESEARCH DESIGN

The present study is a qualitative, descriptive work of research.

PARTICIPANTS AND RESEARCH CONTEXT

A total of 20 psychiatric nurses from 2 hospitals affiliated with a university of medical sciences in the southeast of Iran were selected via purposeful sampling.

ETHICAL CONSIDERATIONS

The Research Ethics Committee of the Hamadan University of Medical Sciences approved the study's protocol, and ethical principles were followed in general.

FINDINGS

From the findings of the study, three main themes, namely " respect for personal; identity," "management of psychological tension," and "compassion-focused therapy," with 12 sub-themes were extracted.

DISCUSSION AND CONCLUSION

In the perspective of caregivers, patients who attempted suicide need to be cared for in supportive environments with compassionate and respectful behaviors to control their psychological tensions. These conditions would maintain such patients' dignity and result in appropriate behavioral outcomes. Policy-makers and administrators can use the present study's findings to create an appropriate clinical environment in which the dignity of patients who attempted suicide is properly maintained.

The Design and Validation of a Compassion Fatigue Scale in Peruvian Nurses

The objective of this study was to design and validate the Compassion Fatigue Scale (EFat-Com) in Peruvian nurses.

METHODS

A 13-item scale was designed using qualitative procedures and expert judgment. This version was administered to 201 nursing professionals using an electronic form along with two other measures: the Patient Health Questionnarie-2 and the Satisfaction with Life Scale.

RESULTS

Exploratory factor analysis supported the existence of two factors with factor loadings > 0.54. Confirmatory factor analysis of the two-factor model yielded satisfactory fit indices after the elimination of two items. Regarding concurrent validity, a positive relationship was obtained between the EFat-Com and the measure of depression; however, no correlation was found with the measure of life satisfaction. The internal consistency was 0.807 for the total scale, 0.79 for Factor 1, and 0.83 for Factor 2.

CONCLUSIONS

The EFat-Com showed adequate psychometric properties with respect to content-based validity evidence, internal structure, and reliability. Therefore, the instrument can be used in research and professional settings. However, it is essential to continue studying the validity evidence in other contexts.

Ethical sensitivity and compassion in home care: Leaders' views

BACKGROUND

With an increasing older population, the pressure on home care resources is growing, which makes it important to ensure the maintenance of quality care. It is known that compassion and ethical sensitivity can improve the quality of care, but little is known about care leaders' perceptions on ethical sensitivity and compassion in home care and how it is associated with staff competence and thus quality of care.

AIM

The aim of the study was to explore home care leaders' perceptions of ethical sensitivity and compassion associated with care quality in home care.

RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT

A hermeneutical approach with a qualitative explorative design was used. The data consists of texts from 10 in-depth interviews with home care leaders. Content analysis was used as a method.

ETHICAL CONSIDERATIONS

The study was conducted following the ethical guidelines of the Declaration of Helsinki and the Finnish Advisory Board of Research Ethics. Research ethics permission was applied for from a Research Ethics Board.

FINDINGS

One overall theme and four subthemes were found. The overall theme was: "Compassion provides deeper meaning and ethical sensitivity provides means for knowing how to act".

DISCUSSION

If nurses fail to be sensitive and compassionate with patients, good and high qualitative home care cannot be achieved. Ethical sensitivity and compassion can be seen as resources in home care but the organization and the care leaders need to provide the support for these to develop.

CONCLUSION

This study provides an understanding of the meaning of ethical sensitivity and compassion as sources of strength and their link to quality of care in a home care context. Further studies could focus on how to build compassion and ethical sensitivity into home-based care and how to ensure adequate support for healthcare professionals' compassion and ethical sensitivity.

Mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19: a cross-sectional study

AIMS

To examine the mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19.

BACKGROUND

Compassion fatigue has become exceedingly common among intern nursing and midwifery students, especially during the COVID-19 pandemic. Social support and resilience can help intern nursing and midwifery students control their negative emotions, reduce compassion fatigue, and increase their well-being. However, the mediating effect of resilience between social support and compassion fatigue remains unclear.

DESIGN

A multicentre cross-sectional survey.

METHODS

A total of 307 intern nursing and midwifery students were recruited from November 2020 to February 2021 in tertiary grade A hospitals in China. Structural equation modelling was applied to analyse the mediating effects of resilience between social support and compassion fatigue. The Social Support Rating Scale, the 10-item Connor-Davidson Resilience Scale, and the Chinese version of the Compassion Fatigue Short Scale were used to collect data. The hypothetical path model was tested by using IBM SPSS version 26.0 and AMOS version 26.0 software.

RESULTS

Intern nursing and midwifery students had moderate compassion fatigue. Social support positively affected resilience (β = 0.514, p < 0.01). Social support negatively affected compassion fatigue (β = - 0.310, p < 0.01), while resilience negatively affected compassion fatigue (β = - 0.283, p < 0.01). Resilience played a mediating role between social support and compassion fatigue.

CONCLUSION

Social support can directly affect the compassion fatigue of intern nursing and midwifery students during COVID-19 and indirectly through resilience. Stronger resilience can reduce compassion fatigue. Accordingly, resilience-based interventions should be developed to reduce compassion fatigue.

Compassion, emotions and cognition: Implications for nursing education

Compassion is often understood as central to nursing and as important to ensure quality nursing and healthcare. In recent years, there has been a focus on strategies in nursing education to ensure compassionate nurses. However, it is not always clear how the concept of compassion is understood. Theoretical conceptualisations that lie behind various understandings of compassion have consequences for how we approach compassion in nursing education. We present some ways in which compassion is often understood, their philosophical underpinnings and the consequences these understandings can have for nursing education. We argue that it is useful for nursing education to understand compassion as a cognitive emotion and discuss how such an understanding can inform educational approaches to compassion.

Moral Distress, Health and Intention to Leave: Critical Care Nurses' Perceptions During COVID-19 Pandemic

Introduction

Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.

Aims

To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.

Method

Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.

Results

Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.

Conclusions

Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.

The Cost of Caring: Compassion Fatigue among Peer Overdose Response Workers in British Columbia

Background: The drug toxicity crisis has had dramatic impacts on people who use drugs. Peer overdose response workers (peer responders), i.e., individuals with lived/living experience of drug use who work in overdose response settings, are particularly susceptible to negative physical and mental health impacts of the crisis. Despite that, the mental health impacts on peer responders have yet to be studied and measured. Methods: The Professional Quality of Life survey (Version 5) was completed by 47 peer responders at two organizations in British Columbia between September 2020 and March 2021 to assess compassion satisfaction and compassion fatigue. The Likert scale responses were converted into numerical values and scores were calculated for each sub-scale. The mean score was calculated for each sub-scale and categorized as low, medium, or high, based on the instructions for Version 5 of the instrument. Results: Our study uncovered a high mean score for compassion satisfaction, low mean score for burnout, and medium mean score for secondary traumatic stress among peer responders. These results may be due to the participants' strong feelings of pride and recognition from their work, as well as the low number of participants that felt they had too much to do at work. Conclusion: Although peer responders derive pleasure and fulfillment from their jobs, i.e., compassion satisfaction, they also sometimes face burnout and stress due to continuous exposure to the trauma of the people they support. These results shed light on the areas that need to be targeted when creating supports for peer responders.

Conectarnos con la compasión para preservar el cuidado humanizado

Este artículo revisa la compasión como requerimiento esencial para la atención humanizada, abordando elementos definitorios desde sus raíces filosóficas y su vínculo con la práctica de la enfermería. Objetivo: reflexionar sobre la compasión como un atributo inherente al cuidado humanizado, según lo reportado en la literatura. Materiales y métodos: artículo de reflexión, para el cual se realizó una búsqueda y la revisión de literatura en bases de datos científicas especializadas, con descriptores y operadores boleanos relacionados con el tema. Resultados: se presentan elementos conceptuales útiles para adoptar la compasión como un rasgo ético que se debe promover en la formación y el trabajo académico en las áreas de ciencias de la salud y, en especial, en enfermería.

Development and Reliability of a Questionnaire Assessing Stress, Coping, and Empathy (SCOPE) in Occupational Settings: Preliminary Evidence from Veterinarians

Workplaces can be associated with occupational stress, detrimental consequences in terms of loss of health and reduced psychosocial well-being. Importantly, employees may be particularly at risk of poorer well-being during times of adversity at work, when not able to apply adaptive coping strategies and adopt a more empathetic approach. This study aimed to develop a scale to estimate occupational stress both in terms of situational and individual components, by performing item selection, internal reliability assessment, and investigation of the ceiling/floor effect. The target population consisted of veterinarians (n = 116), based on evidence of high risk of occupational stress and related mental distress. Out of twenty initial candidate entries, exploratory factor analysis retained fifteen items consisting of three domains related to occupational stress, copying strategies, and empathy (SCOPE). The SCOPE scale demonstrated good internal consistency as a whole (Cronbach’s alpha = 0.79) and when considering the three subscales (stress, 0.85; coping, 0.77; and empathy, 0.71). On a possible range from 15 (worst adjustment) to 75 (best adjustment), the sample mean performance was 51.68 (SD, 8.50). Preliminary evidence indicated that the SCOPE questionnaire may reveal differential effects of type of work on levels of occupational stress and related coping and empathy skills.

Ethos in Time: Nurse Theorist Katie Eriksson as Remembered by Dr. Jessica Hemberg

The year 2022 is Nursing Science Quarterly's 35th year in publication, and we are dialoging with nurse theorists. We hope to uncover influences and origins of their theoretical thinking and hear about their current projects related to nursing science. In this scholarly dialogue column, we dialogue with Dr. Jessica Hemberg, a former nursing student of nurse theorist Dr. Katie Eriksson who was internationally known for her theory of caritative caring. In 1986, Professor Eriksson was invited to create a caring science academic program at Åbo Akademi University in Vaasa, Finland, which drew graduate students from all Nordic countries.Eriksson's work highlighted the uniqueness and dignity of the human being and the importance of protecting the vulnerable suffering human being. Dr. Eriksson passed away in 2019, and we are grateful to spend some time with one of her PhD students.

Spontaneous ethics in nurses' willingness to work during a pandemic

Background: In modern healthcare, the role of solidarity, altruism and the natural response to moral challenges in life-threatening situations is still rather unexplored. The COVID-19 pandemic provided an opportunity to obtain a deeper understanding of nurses’ willingness to care for patients during crisis.

Objective: To elucidate clinical expressions of ontological situational ethics through nurses’ willingness to work during a pandemic.

Research design, participants and context: A qualitative study with an interpretive design was applied. Twenty nurses who worked in intensive care unit at two Swedish hospitals during the first, second, and third waves of the COVID-19 pandemic were interviewed. The analysis was interpretative and applied a theoretical ethics perspective.

Ethical considerations: The study was approved by the Swedish Ethical Review Authority and informed consent was obtained from all participants.

Findings: From a philosophical perspective, the nurses expressed sovereign life expressions of mercy and compassion, which arose spontaneously in response to seeing vulnerable fellow humans. They referenced ‘‘the nurse inside me’’ and their choice of profession as motives to provide care. Ontological situational ethics in culture and norms were noted in the constructs of competence, responsibility, solidarity with colleagues and organization; and interest and learning were driving forces. Ethical demand was evident when nurses expressed ideas of meaningfulness in helping their fellow humans; but themes of ambiguity, exhaustion and unwillingness were also present.

Conclusions: The nurses showed a high willingness to care for patients during a crisis. Responding to the ethical demand and to care for vulnerable human beings while risking their own health and lives could be interpreted as an inter-human vocation. These spontaneous altruistic actions saved the lives of many patients during the pandemic and need to be understood and supported