Compassion Fatigue and Satisfaction: Influence on Turnover Among Oncology Nurses at an Urban Cancer Center

Perceived Dying Experience and Compassion in Oncology Patients and Nurses Following Implementation of the Forever Heart Program: A Pilot Study

This pilot study explored the feasibility of a Forever Heart Program and the impact it has on oncology nurses' perception of the dying experience and their own compassion competence. Guided by Kubler-Ross's framework, the Forever Heart Program consists of a gemstone keepsake offered to patients and families during end-of-life care to support the grieving process. A mixed-methods approach utilized pretest/posttest design in a convenience sample of oncology nurses in an academic medical center over a 3-month period. The study collected demographics, Compassion Competence Scale scores, and qualitative responses via survey and an optional focus group. Twenty-five nurses participated in the presurvey, and 14 participated in the postsurvey. Seven nurses attended the focus groups. Overall, compassion competence scores were high, both pre and post. Qualitative themes included appreciation, connection, positive nursing, patient and family experience/relationships, grieving guidance, program benefits, and process opportunities. Although the study did not show statistically significant differences in compassion, it did show program feasibility and the potential positive impact that keepsakes like the Forever Heart Program can have on nurses and their role in the dying experience.

Nursing Work Engagement, Professional Quality of Life, and Intent to Leave: A Structural Equation Modeling Pathway Analysis

BACKGROUND

Work engagement, professional quality of life (ProQOL), and intent to leave (ITL) significantly impact organizational behaviors and outcomes. Understanding the complex interrelationships among nurse work engagement, ProQOL, and ITL is essential for improving nurse retention, job satisfaction, and patient outcomes. In previous investigations, work engagement, ProQOL, and ITL relationships have primarily been analyzed individually. A more integrated approach is needed to gain a comprehensive understanding of these factors in the nursing profession.

PURPOSE

This study was designed to evaluate the interrelationships among work engagement, ProQOL (compassion satisfaction [CS], burnout, and secondary traumatic stress [STS]), and ITL in nurses using structural equation modeling path analysis.

METHODS

This was a quantitative descriptive study. Data were collected from registered nurses in the United States ( n = 900) using the Utrecht Work Engagement Scale, the ProQOL-5 (CS, burnout, and STS), and a demographics datasheet (including a one-item ITL question). The proposed theoretical model, incorporating major constructs, was tested using structural equation modeling.

RESULTS

Level of work engagement in nurses impacts ITL through ProQOL. Among the mediating variables, burnout (0.31) had the largest total effect on ITL, followed by STS (0.12) and CS (-0.12). Burnout and STS were found to correlate with ITL directly, whereas CS was found to correlate with ITL indirectly.

CONCLUSIONS

Promoting work engagement, addressing burnout and STS, and fostering CS can positively influence nurse retention and job satisfaction, ultimately improving patient care quality. Healthcare leaders and policymakers should implement strategies to enhance nurse engagement, reduce burnout, and cultivate compassion satisfaction to increase nurse retention and improve organizational outcomes.

Attachment styles and empathy in trainee nurses: the mediating and moderating roles of attitudes toward death

Aim

A growing body of evidence has shown that attachment styles and death attitudes have a significant impact on empathy. This study aimed to explore the precise role of death attitudes in the relationship between attachment styles and empathy levels among trainee nurses.

Methods

A total of 626 Chinese trainee nurses with different attachment types were enrolled, and their attachment styles, death attitudes, and empathy levels were assessed using the Revised Adult Attachment Scale, the Death Attitude Profile-Revised, and the Jefferson Scale of Empathy-Healthy Professionals, and finally, data from 566 participants were included for statistical analysis.

Results

We found that among trainee nurses with secure attachment type, fear of death, approach acceptance, escape acceptance, and neutral acceptance (-) mediated the relationships between attachment-related avoidance/anxiety and their overall empathy levels and all its dimensions; in the preoccupied type, only neutral acceptance (-) mediated the relationships between attachment-related avoidance and their overall empathy levels and compassionate care; and in the fearful type, only fear of death mediated the relationship between attachment-related avoidance and compassionate care. Furthermore, in the secure type, neutral acceptance attenuated the negative predictions of attachment-related avoidance on overall empathy level and perspective taking.

Conclusion

Attitudes toward death played different mediating and moderating roles in the relationship between attachment styles and empathy among trainee nurses with different attachment types. In addition to acculturated empathy-specific training, targeted education related to death for trainee nurses with different attachment types is needed to prevent their compassion fatigue.

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.

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.

A Scoping Review of Compassion Fatigue Among Oncology Nurses Caring for Adult Patients

BACKGROUND

Oncology nurses have frequent contact with oncology patients during their cancer journey. This long-term, recurrent contact can impact the health and well-being of the nurse through the development of compassion fatigue (CF).

OBJECTIVES

To identify what contributes to CF and what individual, interpersonal, and organizational factors mitigate CF among oncology nurses caring for adult patients.

METHODS

A scoping review framework by Arksey and O'Malley guided this review. Electronic databases were searched for relevant studies. A blinded screening process was undertaken by the authors using the following inclusion criteria: English language published from January 2011 to December 2021, primary research peer-reviewed studies, and focusing on CF within oncology nurses caring for adult patients in any practice setting.

RESULTS

Nineteen studies (21 articles) were identified. The review found nurses' personal beliefs around nursing care being provided, and personality traits of psychological inflexibility, neuroticism, passive coping, and avoidance contributed to CF. Workplace conflict and lack of a healthy work-life balance also contributed to CF. However, nurses' personal resilience, ability to positively reflect upon their work, a supportive team environment, and continuing education were found to mitigate CF.

CONCLUSIONS

Levels of CF vary among oncology nurses caring for adult patients. Oncology nurses may benefit from personal and organizational resources aimed at improving oncology nurses' professional quality of life while decreasing CF.

IMPLICATIONS FOR PRACTICE

Consideration and future research of effective interventions are needed to sustain a future health workforce and mitigate CF among oncology nurses.

Professional Quality of Life and Turnover Intention in Forensic Nurse Program Coordinators: Implications to Forensic Nurse Workforce Development

BACKGROUND

Significant barriers to forensic nurse workforce development exist, affecting patient care access. Retention of forensic nurses is a persistent problem, and turnover of forensic nurses can be attributed to many factors related to professional quality of life, including compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS).

PURPOSE

The aim of this study was to identify the effect of an educational session on the topic of professional quality of life and strategies for mitigating the impact of stressors within the forensic nurse role on Professional Quality of Life Scale-5 and Turnover Intention Scale-6.

METHODS

A convenience sample of forensic nurse program coordinators was surveyed using a pretest-posttest quasi-experimental survey design. Correlation between professional quality of life indicators and turnover intention was explored.

RESULTS

Cohort ( n = 38) preintervention CS levels were average to high (mean = 41.42), BO levels were average to low (mean = 22.53), and STS levels were average to low (mean = 22.89). Statistically significant positive correlations were noted between each Professional Quality of Life Scale indicator and turnover intention (CS: r = 0.59, p < 0.0001; BO: r = 0.98, p < 0.0000; STS: r = 0.67, p < 0.0000). A statistically significant decrease in BO level (α = 0.05, p = 0.0454) was noted postintervention.

IMPLICATIONS

BO and STS had a strong positive correlation to turnover intention. BO levels decreased to a significant degree when reassessed 3 months after the educational intervention. Increased awareness of the impact of CS, BO, and STS could decrease BO in forensic nurses with potential reduction in turnover.

Effect of COVID-19 response work experience on turnover intention among employees of dedicated COVID-19 hospitals in Seoul

BACKGROUND

According to previous studies, stress and job burnout among medical personnel increased during the COVID-19 pandemic. This study analyzed the effect of the experience of COVID-19 response work on the intention of municipal hospital staffs to leave their workplaces during the pandemic.

METHODS

The 3556 employees who had worked for more than 1 year at one of the eight Seoul Municipal Hospitals that either provided inpatient treatment for quarantined COVID-19 patients or operated as screening clinics were taken as the study population. In total, 1227 employees completed a web or mobile survey between October 21 and November 18, 2020. A chi-squared test was performed to confirm the difference in the distribution of turnover intention depending on whether the employees performed COVID-19 response tasks. Multiple logistic regression analyses were performed to determine the factors that affected the intention to leave.

RESULTS

Of the 1227 respondents, 761 (62.0%) were frontline workers who were the first line of response to COVID-19. Experience with COVID-19 response tasks (OR = 1.59, p = 0.003) was significantly associated with the intention to leave. Additionally, the probability of turnover intention was significantly higher among workers aged 20-29 years (OR = 2.11, p = 0.038) and 40-49 years (OR = 1.57, p = 0.048), unmarried individuals (OR = 1.66, p = 0.005), doctors (OR = 2.41, p = 0.010), nurses (OR = 1.59, p = 0.036), and technical staff members (OR = 2.22, p = 0.009). High turnover intention was found among those who experienced high levels of burnout (OR = 2.03, p < 0.001) and those working in non-directly managed municipal hospitals (OR = 1.87, p = 0.018).

CONCLUSION

Employees directly involved in COVID-19 response work displayed higher turnover intention. Various personal, job, and organizational factors significantly influenced employees' intentions to leave their positions in dedicated COVID-19 hospitals. These findings suggest the necessity of introducing management programs to aid workers who have experienced sudden changes in their duties and loss of autonomy while performing COVID-19 response tasks.

Exploring key job demands and resources in Norwegian child mental health services: a cross-sectional study of associations with and relationship between compassion satisfaction, burnout, secondary traumatic stress and turnover intention

Background

Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health.

Methods

We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics (n = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand.

Results and discussion

Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.

Comparison of Compassion Fatigue, Burnout and Compassion Satisfaction of Oncology-Hematology & Dialysis Nurses

Background: It is known that health professionals who work with chronic patients for a long time are at risk in terms of compassion fatigue and burnout. Purpose: The study aims to compare the levels of compassion fatigue, burnout, and compassion satisfaction of nurses working on oncology-hematology and dialysis and determine the predictors. Methods: This study was carried out using descriptive and correlational research design. The research was conducted with 278 nurses. Participants were enrolled using a convenience sampling technique from the oncology-hematology inpatient services, outpatient chemotherapy units, and bone marrow transplant units and dialysis nurses of purposively selected hospitals in Istanbul, Turkey. Personal information form and Professional Quality of Life-IV. Potential predictors were analyzed using univariate analysis. We conducted multiple stepwise linear regression analyses to reveal the outcome variables. Results: A sub-analysis comparing the dialysis specialty with the oncology-hematology revealed that dialysis nurses report significantly higher compassion fatigue scores than oncology nurses. Working willingly in the current unit and the level of received social support were determined as predictors for all outcome variables. Conclusions: This is the first study comparing compassion fatigue, burnout, and compassion satisfaction levels of oncology-hematology and dialysis nurses. This study indicates the need for nurse managers to be aware of compassion fatigue and plan compassion fatigue prevention programs. In addition, this study guides the interventional studies to be conducted in the future.

An intervention to manage compassion fatigue in oncology nurses in Durban, South Africa

Background

Oncology nurses are involved through the often protracted and potentially traumatic continuum of diagnosis and treatment of their patients, which places them at high risk of developing compassion fatigue.

Aim

The aim of the study was to develop and implement an in-facility intervention to manage compassion fatigue among oncology nurses in Durban, South Africa.

Setting

The study was conducted with oncology nurses at state, private (private health insurance) and non-governmental oncology facilities (Hospice).

Methods

The Self-Care Intervention for Oncology Nurses was developed and implemented using action research with a mixed methods sequential explanatory design. It involved an integrative review, Professional Quality of Life (ProQOL) v 5 questionnaires (n = 83) and in-depth individual interviews (n = 8).

Results

Developed from the findings of the integrative review, quantitative and qualitative data, the Self-Care Intervention for Oncology Nurses comprised three components, namely psycho-education on risks (booklet), practices of remembrance (remembrance tree) and support structures (support group and follow-up family call). Overall, the participants enjoyed reading the booklet and engaging in the support group. There were varied responses to the remembrance tree and hesitancy to partaking in the follow-up phone call.

Conclusion

The developed intervention could encourage awareness of compassion fatigue amongst oncology nurses' engagement in self-care practices such as symbolic remembrance of patients and recognition of the value of support structures.

Contribution

The intervention may assist oncology nurses in the provision of compassionate caring for their patients and potentially minimise compassion fatigue.

Prevalence and predictors of compassion satisfaction, secondary traumatic stress, and burnout among Chinese hospice nurses: A cross-sectional study

AIM

To explore the prevalence and predictors of compassion satisfaction, secondary traumatic stress, and burnout among Chinese hospice nurses.

BACKGROUND

Because of prolonged and continual contact with suffering, deaths, and grief, hospice nurses may be vulnerable to emotional burdens and have difficulty maintaining their professional quality of life.

METHODS

A cross-sectional study was conducted. A total of 478 hospice nurses were selected from 24 medical institutions in Sichuan province. Demographic, work-related information and work-related trauma questionnaire, the Chinese version of the Interpersonal Reactivity Index, the Chinese version of the Emotion Regulation Questionnaire, and the Chinese version of the Professional Quality of Life Scale for Nurses were used for collecting data.

RESULTS

The mean scores of compassion satisfaction, secondary traumatic stress, and burnout were 34.89 ± 6.21, 26.35 ± 5.24, and 24.49 ± 5.01, respectively. Job satisfaction, perspective-taking, empathic concern, working in tertiary hospitals, and adopting cognitive reappraisal strategy were positively associated with compassion satisfaction, while personal distress was a negative factor, all variables explaining 50.7 % of the variance. Higher burnout was found among nurse who had higher personal distress, worked in secondary or primary hospitals, worked >8 h per day and caring for >10 dying patients last month. In addition, job satisfaction, social support, perspective-taking, empathic concern, and cognitive reappraisal were identified as significant protectors, explaining 50.1 % of the variance. We also found that lower job satisfaction, higher personal distress, higher expressive suppression, lack of social support, senior nurses, and cared for >10 dying patients last month, were positively related to secondary traumatic stress. However, cognitive reappraisal had negative associations. These seven factors explained 32.0 % of the variance.

CONCLUSIONS

Hospice care has specific characteristics and hospice nurses may suffer from more work-related stressors compared with other nurses. Our study may provide clues to help nursing administrators identify hospice nurses who are at higher risk of compassion fatigue and design targeted interventions focused on potential risk factors and protectors to improve hospice nurses' compassion satisfaction, while reducing compassion fatigue.

A Scoping Review of Vicarious Trauma Interventions for Service Providers Working With People Who Have Experienced Traumatic Events

Health and human service providers who aid traumatized individuals frequently experience vicarious trauma (VT). Although VT plays a critical role in service providers' mental health and well-being, as well as in the quality of their service provision, little information is available concerning the development and implementation of VT interventions for service providers. To advance the development of evidence in this area, we undertook a scoping review in which we reviewed existing interventions intended to address VT among service providers working with traumatized clients. Searches of electronic databases were conducted to identify studies published in peer-reviewed journals, with no date restrictions. Over 1,315 citations were reviewed, and a total of 27 studies were included in the final review. The findings show that VT interventions in the literature can be divided broadly into four categories: psychoeducation, mindfulness intervention, art and recreational programs, and alternative medicine therapy. The VT interventions reviewed generally showed promise in their key outcomes, including reductions in secondary trauma stress, compassion fatigue, burnout, and other mental health outcomes. However, the current body of research is lacking both in rigor and in specificity regarding the definition of VT. Furthermore, existing VT interventions are generally self-care based and tend to focus on general stress management rather than addressing the specific effects of VT. Therefore, we call for an increase in efforts to tailor VT interventions to different service settings and participant characteristics, as well as greater attention to developing primary VT interventions at the organizational level.

The effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses: A randomized controlled trial

PURPOSE

This study evaluated the effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses.

DESIGN AND METHODS

A randomized controlled trial was conducted. A total of 48 clinical nurses were randomly allocated to intervention or control groups. The nurse-led intervention program was based on a cognitive-behavioral approach. The study outcomes were compassion fatigue, burnout, compassion satisfaction, and psychological distress.

FINDINGS

It was determined that the psychological distress scores of the nurses participating in the program at the first follow-up were significantly lower than the control group. There was no significant difference between the groups in terms of compassion fatigue, burnout, and compassion satisfaction.

PRACTICAL IMPLICATIONS

To reduce the psychological distress of nurses, cognitive behavioral approach-based programs can be useful.

Compassion Satisfaction, Occupational Stress, Burnout Syndrome, and Resilience Among Experienced Audiologists

OBJECTIVE

The aim of the research was to provide insight into compassion satisfaction (CS), resilience, burnout syndrome (BOS), and overall occupational stress levels of experienced audiologists.

DESIGN

This study was based on a four-part online questionnaire consisting of the Audiology Occupational Stress Questionnaire, the Professional Quality of Life Scale (Version 5), the Connor-Davidson Resilience Scale-10, and demographic questions.

STUDY SAMPLE

Fifty-nine audiologists with more than 5 years of experience completed the survey. Clinicians were from New Zealand, Australia, South Africa, the United States, Hong Kong, Israel, Singapore, and the United Kingdom.

RESULTS

The findings illustrate that no audiologists experienced high BOS or low CS scores. Positive correlations existed between resilience and CS and between BOS and overall occupational stress. Negative correlations were found between resilience and BOS, BOS and CS, CS and overall occupational stress, and resilience and overall occupational stress. Resilience (p = .015), CS (p < .001), and overall occupational stress (p < .001) were identified as being significant predictors of BOS. The top five occupational stressors for audiologists were reported as being staff shortages, administration duties, paperwork and patient reports, patient or family expectations to fix a client's hearing, and the amount time available with each patient. The differences in occupational stress experienced by private versus public audiologists were minimal, always being below 1 Likert point.

CONCLUSIONS

Although audiologists do not report high levels of BOS, they report stress in their workplace. As stress was a significant predictor of BOS, audiologists could benefit from interventions aimed at reducing workplace stress.

More than a feeling? What does compassion in healthcare 'look like' to patients?

OBJECTIVE

Compassion is important to patients and their families, predicts positive patient and practitioner outcomes, and is a professional requirement of physicians around the globe. Yet, despite the value placed on compassion, the empirical study of compassion remains in its infancy and little is known regarding what compassion 'looks like' to patients. The current study addresses limitations in prior work by asking patients what physicians do that helps them feel cared for.

METHODS

Topic modelling analysis was employed to identify empirical commonalities in the text responses of 767 patients describing physician behaviours that led to their feeling cared for.

RESULTS

Descriptively, seven meaningful groupings of physician actions experienced as compassion emerged: listening and paying attention (71% of responses), following-up and running tests (11%), continuity and holistic care (8%), respecting preferences (4%), genuine understanding (2%), body language and empathy (2%) and counselling and advocacy (1%).

CONCLUSION

These findings supplement prior work by identifying concrete actions that are experienced as caring by patients. These early data may provide clinicians with useful information to enhance their ability to customize care, strengthen patient-physician relationships and, ultimately, practice medicine in a way that is experienced as compassionate by patients.

PUBLIC CONTRIBUTION

This study involves the analysis of data provided by a diverse sample of patients from the general community population of New Zealand.

A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021

Aims

A negative association between the lower level of psychological resilience (PR) and increased risk of compassion fatigue (CF) and higher Coronavirus disease 2019 (COVID-19) stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic.

Methods

We identified relevant literature from the Web of Science Core Collection® database using "resilience" and "compassion fatigue" on September 30, 2021. All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1.

Results

A total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19.

Conclusion

The results of the present study help us understand the status of the CF and PR field and its recent developments.

Oncology Healthcare Professionals’ Mental Health during the COVID-19 Pandemic

The paper begins by reviewing the literature on oncology healthcare professionals’ (HCP) mental health. We summarize and present the current data on HCP mental health in order to understand the baseline state of oncology HCPs’ mental health status prior to the COVID-19 pandemic. At each juncture, we will discuss the implications of these mental health variables on the personal lives of HCPs, the healthcare system, and patient care. We follow by reviewing the literature on these parameters during the COVID-19 pandemic in order to better understand the impact of COVID-19 on the overall mental health of HCPs working in oncology. By reviewing and summarizing the data before and after the start of the pandemic, we will get a fuller picture of the pre-existing stressors facing oncology HCPs and the added burden caused by pandemic-related stresses. The second part of this review paper will discuss the implications for the oncology workforce and offer recommendations based on the research literature in order to improve the lives of HCPs, and in the process, improve patient care.

Compassion satisfaction and compassion fatigue in haematology cancer nurses: A cross‐sectional survey

Aim

This study aimed to investigate compassion satisfaction (CS) and compassion fatigue (CF) in haematology nurses and their associated factors.

Design

A cross‐sectional survey.

Methods

The survey was conducted on 336 haematology nurses from 21 hospitals in Sichuan, China. The CS and CF were assessed by the Professional Quality of Life Scale version 5. The CF was determined by burnout and secondary traumatic stress.

Results

Haematology nurses in China had moderate levels of CS and moderate‐to‐low CF. Better nursing competence of teaching/consultation and communication/coordination and the percentage of critically ill patients >60% predicted higher CS. The permanent nurse, better nursing competence of communication/coordination and specialized clinical practice predicted less burnout, while working >40 hr per week or more nurse‐patient conflict events predicted more burnout. In addition, working >40 hr per week, more nurse‐patient conflict events and having the need of psychological support predicted higher secondary traumatic stress.

Dealing with Emotional Vulnerability and Anxiety in Nurses from High-Risk Units-A Multicenter Study

Compassion fatigue and anxiety derived from continued exposure to trauma and death greatly impact nurses’ quality of care and quality of life, increasing their desire to leave work. The aim of the study is to assess compassion fatigue and anxiety prevalence and their association with secondary variables. A multicenter, cross-sectional study in nurses from four high-risk units, Emergency, Intensive Care, Oncology, and Pediatrics, was carried out in 14 hospitals in Catalonia (Spain) between 2015 and 2016. The primary endpoints were compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress), which were assessed by Professional Quality of Life (ProQOL), and anxiety, assessed with the State-Trait Anxiety Inventory (STAI). Multivariable logistic regression analyzed the association of sociodemographic, training, working, and psychological factors. Of a total of 1302 nurses, 18.6% presented low compassion satisfaction; 19.7%, high burnout; and 36.4%, high secondary traumatic stress. Trait anxiety scored high in 7.2%. Although compassion satisfaction was present, it did not protect sufficiently against the high level of compassion fatigue or anxiety present in nurses in all centers. The working conditions in the units and variables showed a strong association with nurses’ desire to leave. This corroborates the global challenge of healthcare professionals’ shortage. Participants expressed the need for better training in emotional management.

Associations among professional quality of life dimensions, burnout, nursing practice environment, and turnover intention in newly graduated nurses

BACKGROUND

Professional quality of life affects nurses' well-being and the quality of care. However, little attention is paid to the relationships among professional quality of life dimensions, burnout, nursing practice environment, and intention to leave this job in newly graduated nurses.

AIMS

To assess the levels of professional quality of life dimensions and turnover intention, to examine the predictors for turnover intention, and to explore the mediating roles of professional quality of life dimensions on the associations between these predictors and turnover intention in Chinese newly graduated nurses.

METHODS

This was a cross-sectional study with 315 newly graduated nurses selected from five tertiary hospitals and five secondary hospitals in Sichuan province, China. Multiple regression analysis was used to examine the effects of demographic characteristics and work-related factors on intention to leave this job. Structural equation modeling technique was performed to explore the mediating effect of each domain of professional quality of life on the relationships between the predictors and turnover intention.

RESULTS

The prevalence of average levels of burnout, secondary traumatic stress, and compassion satisfaction was 43.2%, 57.1%, and 81.3%, respectively. Moreover, 43.8% and 0.6% of the participants reported high and exceptionally high intention to leave this job. Nursing practice environment, social support, and empathy indirectly and significantly affected turnover intention via the mediating roles of burnout and compassion satisfaction, respectively. However, no significant mediating effect of secondary traumatic stress was found between these predictors and turnover intention.

LINKING EVIDENCE TO ACTION

Perceptions of greater nursing practice environment, social support, and empathy result in lower turnover intention via reducing burnout and facilitating compassion satisfaction. Strategies such as developing a supportive work and family environment, and cultivating empathic capacity can be effective methods to mitigate against intention to leave this job in newly graduated nurses.

Cumulative Stress Debriefings to Combat Compassion Fatigue in a Pediatric Intensive Care Unit

BACKGROUND

Nurses working in pediatric intensive care units report high levels of compassion fatigue from exposure to critical and traumatic events. Cumulative stress debriefings can reduce compassion fatigue.

OBJECTIVE

To evaluate the use of cumulative stress debriefings to alleviate symptoms of compassion fatigue and promote job satisfaction in nurses.

METHODS

In this quality improvement study, a survey modified from the Self-Reporting Questionnaire-20 was distributed to pediatric intensive care unit nurses at a large, tertiary, freestanding children's hospital on the US West Coast to measure compassion fatigue and job satisfaction. The survey revealed widespread symptoms of compassion fatigue. Subsequently, monthly 1-hour cumulative stress debriefing sessions were initiated in the pediatric intensive care unit. Between 149 and 168 nurses were eligible to participate across time points. Interprofessional team members were trained and paired to facilitate the debriefings. Follow-up surveys were distributed at 6, 9, and 12 months after implementation of the intervention.

RESULTS

Survey response rates ranged from 22.6% to 49.7%, with responses declining over time. Nurses who attended 1 or more cumulative stress debriefings reported fewer symptoms of compassion fatigue and negative personal effects from work and were less likely to consider leaving their current position and the nursing profession. Results indicated a high level of acceptability of the intervention, with nearly 90% of participants at 9 and 12 months indicating that they were likely to attend a future session.

CONCLUSION

Initiation of cumulative stress debriefings may reduce compassion fatigue and improve job satisfaction in nurses.

Prevalence and factors associated with compassion satisfaction and compassion fatigue among Chinese oncology healthcare professionals: A cross-sectional survey

Objective

This cross-sectional study examined the prevalence and factors associated with compassion satisfaction and fatigue among oncology healthcare professionals (doctors and nurses) in mainland China.

Methods

A total of 337 subjects were recruited via convenience sampling from the oncology departments of five general hospitals in Guangzhou, Guangdong, China. They were invited to complete a survey that included demographic characteristics, the Profession Quality of life Scale, the Brief Cope Questionnaire, and the Connor-Davidson Resilience Scale.

Results

The findings showed medium levels of compassion satisfaction, burnout, and secondary traumatic stress among oncology healthcare professionals in China, reaching rates of 78.34%, 63.50% and 75.96%, respectively. Multiple regression analyses suggested that active coping, positive reframing, and strength were the significant factors of compassion satisfaction, explaining 48.6% of the total variance (P ​< ​0.001). Substance use and self-blame were the significant factors of burnout, explaining 45.1% of the total variance (P ​< ​0.001). Venting, denial, substance use, self-blame, and strength were the significant factors of secondary traumatic stress, explaining 37.6% of the total variance (P ​< ​0.001).

Conclusions

The high prevalence of compassion fatigue warrants the attention of the hospitals' senior management. The effective coping styles identified may be considered when developing strategies to improve the professional quality of life among oncology healthcare professionals.

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

BACKGROUND

Nurses who are constantly being exposed to patients' suffering can lead to compassion fatigue. There is a gap in the latest research regarding nurses' experiences of compassion fatigue. Little is known about how compassion fatigue affects the nurse as a person, and indications of how it affects the profession are scarce.

AIM

The aim of this study was to explore compassion fatigue experienced by nurses and how it affects them as persons and professionals.

RESEARCH DESIGN, PARTICIPANTS, AND RESEARCH CONTEXT

A qualitative explorative approach was used. The data consisted of texts from interviews with seven nurses in various nursing contexts. Content analysis was used.

ETHICAL CONSIDERATION

Ethical approval was sought and granted from an ethics committee at the university where the researchers were based, and written, informed consent was obtained from all the participants.

FINDINGS

Five themes were discovered: Compassion as an empathic gift and compassion fatigue as a result of compassion overload, Compassion fatigue as exhausting the nurse as a professional and private person, Compassion fatigue as a crisis with potentially valuable insights, Compassion fatigue can be handled by self-care and focus on self, and Compassion fatigue is affected by life itself and multifaceted factors.

DISCUSSION

Compassion stress and overload can lead to compassion fatigue. Compassion fatigue affects the nurse's ability to compassion, and the caring is no longer experienced in the same way; the nurses experienced it as being deprived of the gift of compassion. Compassion fatigue implicates a crisis with potentially valuable insights.

CONCLUSION

Compassion fatigue can be symbolized as bruises in the soul, hurtful, but with time it can fade away, although it leaves a sense of caution within the nurse, which can affect the suffering patient.

Grief as a mediator of the relationship between empathy and compassion fatigue

OBJECTIVE

Oncology nurses are at high risk of developing compassion fatigue (CF) because of the persistent exposure to patients' suffering and death. Empathy is a prerequisite cognitive reaction for CF. Nurses with greater empathy levels are more prone to develop an emotional connection with patients. However, it is this kind of close bonds that led nurses to experience a deep sense of grief. Cumulative grief may eventually develop into CF. This study examined the levels of grief, empathy and CF, evaluated the correlation among empathy, grief and CF, and verified the role grief as a mediator of the relationship between empathy and CF.

METHODS

Participants were 794 Chinese oncology nurses in a cross-sectional study. We measures consisted a demographic questionnaire, the Interpersonal Reactivity Index, the Texas Revised Inventory of Grief-Present, and the Professional Quality of Life Scale.

RESULTS

Oncology nurses showed moderate levels of empathy and grief, moderate to high levels of CF. Perspective taking was negatively related to grief and secondary traumatic stress (STS). Empathic concern was negatively related to burnout (BO). Personal distress was positively related to grief, STS and BO. Grief was positively related to STS and BO. Grief played a partial mediating role between empathy and STS.

CONCLUSIONS

Oncology nurses commonly experience CF. There is a need to provide interventions and effective supports for oncology nurses to improve their empathy ability, and help them cope with grief and CF.

Workplace violence and turnover intention among the Bangladeshi female nurses after a year of pandemic: An exploratory cross-sectional study

During the COVID-19 pandemic, workplace violence was widespread against healthcare personnel. Workplace violence (WPV) against nurses exhilarates their turnover intention (TI). The objective of this study was to investigate the association between workplace violence and turnover intention and also identify other factors associated with TI among Bangladeshi female nurses. An exploratory cross-sectional study was carried out among 881 female nurses between April 26 and July 10, 2021. The TI of the female nurses was the outcome variable of this study. The primary exposure variable was WPV faced by the nurses. Workplace Violence Scale (WPVS) was used to measure the WPV, and Turnover Intention Scale-6 (TIS-6) was used to measure the TI of the nurses. Multiple linear regression model was fitted to find the adjusted association of TI with WPV and other study variables. A stratified analysis by type of job (government vs. private) was also performed. The majority of the nurses (74.46%) faced low to high levels of WPV. The overall mean score of TIS was found 16.33 (± 4.72). Multiple linear regression analysis revealed that compared to government jobholders, the mean score of TIS (15.81 vs. 17.20) was found significantly higher among the private jobholders (p < 0.001). Nurses exposed to the intermediate and high level of WPV had a significantly higher TI score (β = 4.35, 95% CI: 3.36, 5.34) than the non-exposures. The TI of private jobholders was found significantly higher (β = 2.04, 95% CI: 1.09, 3.00) than the government jobholders. Compared to diploma degree holders, significantly higher TI was observed among the B.Sc. degree holders (β = 0.86, 95% CI: 0.22, 1.55) and M.Sc. degree holders (β = 1.46, 95% CI: 0.58, 2.34). Besides, the nurses who did not get timely salaries scored higher TI (β = 1.17, 95% CI: 0.12, 2.22). Moreover, the nurses who did not receive any training against WPV scored significantly higher TI (β = 1.89, 95% CI: 1.03, 2.74). The stratified analysis by type of job also revealed significant factors of TI in government and private settings. This study found a high prevalence of WPV and a high rate of TI among Bangladeshi female nurses. Moreover, this study explored an association between WPV and TI. The study findings could help policymakers facilitate a comfortable working environment by preventing WPV and addressing the factors to reduce nurses' frequent TI.

Nursing and Midwifery Students’ Mental Health Status and Intention to Leave During Covid-19 Pandemic

Introduction

COVID-19 has not only affected the physical health of people but it has also had a major impact on their mental health.

Objective

To investigate the nursing, midwifery, and operating room students’ mental health and intention to leave during COVID-19 pandemic.

Methods

This cross-sectional study was conducted at the nursing and midwifery school of Tabriz, Iran. Over a period of three months (February–May 2021) and through random sampling, 284 students were selected. The research tool consisted of three parts including demographic information, Depression Anxiety Stress scales, and a questionnaire on intention to leave.

Results

More than 20% of the students experienced some degrees of depression, anxiety, and stress. Nearly one-third of participants mentioned a high level of intention to leave. Nursing students had a higher level of a turnover tendency than other students (p = .004). Male students and who experienced moderate to high level of depression displayed greater intention to leave (p = .005).

Conclusion

Students suffered from some degrees of stress, anxiety, and depression during the COVID-19, and it strengthened the participants’ intention to leave. Relevant authorities are recommended to improve mental health of the students by providing psychological counseling sessions, reducing their direct contact with patients, and providing personal protective equipment.

The Influence of Burnout on Patient Safety Management Activities of Shift Nurses: The Mediating Effect of Compassion Satisfaction

This study aims to investigate the levels of burnout, compassion satisfaction (CS), and patient safety management activities (PSMA) among nurses on shift work in general hospitals and to examine the mediating effect of CS on the relationship between burnout and PSMA. This was a descriptive-correlational study, conducted with a convenience sample of 301 nurses from four general hospitals. Data were collected from 1 August to 4 September 2021, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Tukey test, Pearson's correlation coefficient, and multiple regression analyses. Mediation analysis was performed according to the Baron and Kenny, and Sobel Tests. Significant relationships were found between shift nurses' burnout and CS (r = -0.66, p < 0.001), burnout and PSMA (r = -0.32, p < 0.001), and PSMA and CS (r = 0.32, p < 0.001). Compassion satisfaction showed partial mediating effects on the relationship between burnout and PSMA (Z = -3.21, p = 0.001). The higher the burnout of shift-working nurses, the lower the patient safety management activity. Therefore, an effective support system at the organizational level as well as individual efforts are necessary to enhance CS and reduce burnout of shift-working nurses.

Prevalence of oncology nurses' compassion satisfaction and compassion fatigue: Systematic review and meta-analysis

AIM

To systematically review and comprehensively analyse findings of studies reporting oncology nurses' compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS), measured by the professional quality of life (ProQOL) scale, and explore CS and CF related factors.

DESIGN

Systematic review and meta-analysis of cross-sectional and interventional studies.

METHOD

Electronic databases were searched using keywords, and the review followed PRISMA guidelines. The prevalence of CS, BO and STS and their instrumental ratings were pooled using random effects meta-analyses. Meta-regression studies explored the effects of variables.

RESULTS

Fifteen studies (sample size 2,509) were reviewed, and nine were in the meta-analysis. The prevalence of CS, BO, and STS were 22.89%, 62.79% and 66.84%, respectively. No substantial correlation was found for independent variables, possibly due to sample size. There was a weak negative correlation between CS and BO [-0.06(0.90)] and a weak positive correlation between CS and STS [0.20(0.70)].

Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic

BACKGROUND

Nurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic.

AIMS

This study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality.

DESIGN

An online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines.

RESULTS

Overall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = -0.145, p = 0.019), lower job satisfaction (β = -0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = -0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = -0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001).

CONCLUSION

Frontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.

Psychosocial Well-Being: An Exploratory Cross-Sectional Evaluation of Loneliness, Anxiety, Depression, Self-Compassion, and Professional Quality of Life in Oncology Nurses

BACKGROUND

In addition to heavy workloads, oncology nurses are confronted with emotionally demanding caregiving moments with little training or institutional support for coping and emotional well-being.

OBJECTIVES

The aim of this study was to explore the associations and potential predictors among self-compassion, loneliness, anxiety, depression, and professional quality of life in oncology nurses.

METHODS

Participants were recruited throughout central Texas. Descriptive statistics, bivariate correlations, and multivariate regression analyses were conducted on survey data.

FINDINGS

Burnout and compassion satisfaction were strongly related to loneliness, self-compassion, and depression. Compassion fatigue was most highly related to anxiety and depression. Loneliness made the strongest unique contribution to burnout and compassion satisfaction, and depression was the only statistically significant predictor of compassion fatigue.

Compassion fatigue, burnout and compassion satisfaction among emergency nurses: A path analysis

AIMS

To verify a hypothesized model of the relationships between compassion fatigue, burnout and compassion satisfaction, as well as their influencing factors and consequences, among emergency nurses.

DESIGN

A descriptive, cross-sectional design.

METHODS

A hypothesized model was proposed on the basis of the current literature. A convenience sample was conducted of nurses working in the emergency departments of six hospitals in Shanghai, China, from July to September 2020. A total of 445 valid data points were collected using various self-designed and well-validated instruments. Descriptive statistics and correlations were computed, and a path analysis was used to assess model fitness and to investigate direct and indirect effects.

RESULTS

The final model reported a desirable fit with significant paths. Compassion satisfaction and compassion fatigue directly and inversely affected burnout, and compassion satisfaction positively influenced compassion fatigue. Perceived social support directly improved compassion satisfaction and protected against compassion fatigue. Compassion satisfaction and compassion fatigue directly affected mental health, and burnout directly influenced physical health. Compassion fatigue, burnout and compassion satisfaction had complicated effects on turnover intention.

CONCLUSION

Emergency nurses' compassion satisfaction and compassion fatigue may be two coexisting constructs, and both affect burnout. Perceived social support acts as a protector of the three dimensions, and their effects on health status and turnover intention can be significant and complicated.

IMPACT

Emergency nurses may experience high levels of compassion satisfaction and compassion fatigue simultaneously, which can help to explain why compassion fatigue did not directly increase emergency nurses' turnover intention. The direct effects of compassion fatigue and burnout on emergency nurses' health status and working engagement were significantly different. Support from significant others, professional psychological intervention and emergency nursing system reforms are required to tackle emergency nurses' compassion fatigue and burnout and improve their compassion satisfaction.

Compassion fatigue among haemodialysis nurses in public and private hospitals in China

AIM

This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics.

METHODS

A descriptive study was conducted using a self-designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018.

RESULTS

The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant.

CONCLUSION

Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals.

The impact of personality on intention to leave the nursing profession: A structural equation model

AIMS AND OBJECTIVES

To test a mediating effect of compassion satisfaction on the relationship between personality traits (Big Five) and intent to leave.

BACKGROUND

Nursing professionals work in high-stress environments and exhibit more emotional distress and mental health disorders than other hospital professionals. This translates to increased intention to leave their profession. Evidence suggests that compassion satisfaction reduces intention to leave. Research also indicates that personality factors are associated with compassion satisfaction and intent to leave.

DESIGN

Using a cross-sectional design, we collected data from 536 nurses in a maximum-care hospital in Germany via questionnaires; the analyses included 518 participants.

METHOD

We applied the structural equation model and followed the STROBE checklist.

RESULTS

30% of our study participants reported high intent to leave. Compassion satisfaction mediated the relationship between agreeableness and intent to leave. Openness to experience and neuroticism had positive direct effects on intent to leave.

CONCLUSIONS

The results suggest that high compassion satisfaction levels may decrease intention to leave levels. Personality traits impact compassion satisfaction and intention to leave.

RELEVANCE TO CLINICAL PRACTICE

Nursing professionals' compassion satisfaction needs to be improved, for example by resilience training. As personality factors remain relatively stable over time, caregivers need to consider them when identifying appropriate areas of work and responsibility.

Personal initiative and work environment as predictors of job satisfaction among nurses: cross-sectional study

BACKGROUND

Job satisfaction contributes to better work outcomes and productivity, and reduces nurses' absenteeism and turnover. The contribution of personal initiative to the interaction between these variables needs additional examination. This study aimed to examine the relationships between personal initiative, work environment, and job satisfaction among nurses.

METHODS

This was a cross-sectional study. The convenience sample consisted of 1040 nurses working in hospitals across the country. Data were collected by a structured self-administered questionnaire measuring: (a) personal initiative, (b) nursing work environment, (c) job satisfaction.

RESULTS

Personal initiative and work environment scores, together with demographic and occupational characteristics that univariate analysis showed to be significantly associated with job satisfaction, were included in a logistic regression model to predict job satisfaction. The results of multivariable analysis indicated that female gender, working in emergency room (ER) and pediatric wards, a higher personal initiative, and positive perception of work environment, were significantly associated with higher job satisfaction. Work in the ER and pediatric area of practice was significantly associated with five-fold (OR = 4.97; 95% CI 1.52-16.25) and three-fold higher odds (OR = 2.85; 95% CI 1.17-6.91) for high and very high job satisfaction in comparison with work in oncology. The model explained 32% of the variance in job satisfaction.

CONCLUSIONS

The findings demonstrate that high personal initiative together with positive perceptions of the nursing work environment, contributed significantly to the explanation of job satisfaction. There is a need to invest more efforts in strengthening the organizational climate stimulating initiative behavior and encouraging nurses to be active, share knowledge, and promote innovation.

The importance of understanding burnout: an oncology nurse perspective

The challenges presented by the global COVID-19 pandemic have intensified the stressors placed on nurses, leading to burnout. Oncology nurse burnout is likely to be an increasingly significant issue for cancer services as the true cost of the pandemic is revealed. Delays in diagnosis and treatment of cancers are reported widely, inevitably leading to poor prognosis and more aggressive treatments for patients. Gaining a better understanding of oncology nurse burnout, its prevalence and causes as well as strategies to reduce or prevent it will help to improve patient care and support staff wellbeing during and after the pandemic. Methodology: A search of the literature related to oncology nurse burnout, covering North America and Europe over 5 years (August 2014-January 2020), resulted in 31 articles for review. None of the studies were carried out in the UK, suggesting a need for robust investigations into oncology nurse burnout in the British health service. Summary: The prevalence of burnout among oncology nurses before the COVID-19 outbreak appeared to be high and is likely to have increased as a result of the pandemic. However, the studies investigating oncology nurse burnout are small and cross-sectional, with low-quality methods. The literature suggests the major causes of burnout arise in the workplace, particularly aspects of the environment that prevent nurses from working according to their values. Although burnout is frequently attributed to workplace factors, interventions remain focused on individuals' coping mechanisms and rarely on the workplace factors that are known to cause it.

The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis

BACKGROUND

Compassion fatigue is a consequence of chronic work-related stress exposure among healthcare providers. Nursing is a high-risk, stressful profession which increases nurses' vulnerability to compassion fatigue symptoms compared to other healthcare workers. Compassion fatigue has serious consequences for nursing staff, patients and healthcare organizations. Though several studies on the prevalence of compassion fatigue among nurses have been published, the reported data vary considerably across studies; and few meta-analysis have examined the prevalence of compassion satisfaction and compassion fatigue among nurses with large sample sizes.

OBJECTIVES

To systematically assess the prevalence of compassion satisfaction and compassion fatigue among nurses, and to evaluate the effect of different geographical regions, years and departments on the prevalence of compassion fatigue.

DESIGN

Systematic review and meta-analysis DATA SOURCES: The Cochrane Library, PubMed, EMbase, Web of Science, CINAHL, PsyclNFO, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched in the systematic review. The time frame for the searches included all literature before January 31st, 2020.

REVIEW METHODS

The reviewers independently completed study selection, quality assessments, data extraction and analysis of all included literature. The mean scores and standard deviations of the three subscales of the Professional Quality of Life (ProQOL) scale were pooled using random effects meta-analysis in Stata 16.0 software package. Finally, subgroup analyses were conducted to explore the sources of between-study heterogeneity.

RESULTS

A total of 79 studies were included in the systematic review and meta-analysis, consisting of 28,509 nurses worldwide from 11 countries. In our studies, the pooled mean scores of compassion satisfaction, burnout and secondary traumatic stress were 33.12 (95% CI: 32.22-34.03), 26.64 (95% CI: 26.01-27.27) and 25.24 (95% CI: 24.69-25.79), respectively. In addition, the Asian region had the lowest levels of compassion satisfaction but the highest levels of compassion fatigue symptoms, while the Americas and Europe had the lowest levels of compassion fatigue but highest compassion satisfaction. Levels of compassionate fatigue in nurses increased gradually from 2010 to 2019, reaching the highest level in 2019; and nurses from ICU had the highest levels of compassion fatigue symptoms among all nurses.

CONCLUSION

The levels of compassion satisfaction and compassion fatigue among nurses are moderate. Nurses from the Asian region and in ICUs suffer from severe compassion fatigue symptoms, and the prevalence of compassion fatigue has increased over time. These findings may provide hospital administrators with the theoretical basis for the management and treatment of compassion fatigue.

REGISTRATION NUMBER

PROSPERO [CRD42020164327].

The impact of resilience on turnover intention in dialysis nurses: The mediating effects of work engagement and compassion fatigue

AIM

To describe the levels of turnover intention, and to explore the mediating effects of work engagement and compassion fatigue on the relationship between resilience and turnover intention in dialysis nurses.

METHODS

A descriptive cross-sectional study was conducted to recruit 496 dialysis nurses in 25 tertiary hospitals in Sichuan province, China. Structural equation modeling technique was used to examine the mediating roles of work engagement and compassion fatigue on the association between resilience and turnover intention.

RESULTS

The prevalence of high and exceptionally high levels of turnover intention in dialysis nurses were 56.8% (282 nurses) and 8.7% (43 nurses), respectively. Resilience was a significant and direct contributor to work engagement (standardized direct effect = 0.62, p < .001) and compassion fatigue (standardized direct effect = -0.35, p < .001), respectively. However, resilience had no direct and significant effect on turnover intention (standardized direct effect = 0.15, p > .05). Work engagement and compassion fatigue had direct and significant effects on turnover intention (standardized direct effect = -0.40, p < .001; standard direct effect = 0.31, p < .001). Resilience affected turnover intention indirectly and significantly via the whole mediating effects of work engagement and compassion fatigue (standardized indirect effect = -0.36, p < .001).

CONCLUSION

Higher resilience leads to lower turnover intention via enhancing work engagement and reducing compassion fatigue in dialysis nurses. Nursing policies should be established to promote resilience training, enhance work engagement and reduce compassion fatigue in order to alleviate turnover intention in dialysis nurses.

Prevalence and predictors for compassion fatigue and compassion satisfaction in nursing students during clinical placement

BACKGROUND

Compassion fatigue and compassion satisfaction affect clients' care satisfaction and nurses' well-being. However, little attention is paid to compassion fatigue and satisfaction in nursing students during clinical placement.

OBJECTIVES

To explore the relationships between social support, empathy, resilience, coping strategies, and compassion fatigue and satisfaction in nursing students during clinical placement in China.

DESIGN

A cross-sectional study was performed from May 1 to May 31, 2020.

SETTINGS

and participants: A total of 972 nursing students from 15 universities or colleges in Sichuan province, who received clinical training for at least 10 months were investigated.

METHODS

The instruments included Perceived Social Support Scale, Jefferson Scale of Empathy, Connor-Davidson Resilience Scale, Simple Coping Style Questionnaire and Professional Quality of Life Scale. Descriptive, correlation and regression analyses of these variables were conducted.

RESULTS

The prevalence of low, moderate and high risk of burnout were 1.3%, 97.8% and 0.9%, respectively. The prevalence of low, average and high levels of secondary traumatic stress were 43.6%, 55.3% and 1.1%. Moreover, 9 (0.9%), 316 (32.5%) and 647 (66.6%) respondents reported low, moderate and high levels of compassion satisfaction. Cognitive empathy and resilience were significant protectors from compassion fatigue, and significant contributors to compassion satisfaction. Less compassionate care and more passive coping were significant risk factors for compassion fatigue. Adaptive coping predicted burnout significantly and negatively, and predicted compassion satisfaction significantly and positively. Family support was a significant contributor to compassion satisfaction.

CONCLUSION

It is essential to develop strategies to increase empathy and resilience, avoid passive coping and enhance adaptive coping, and improve family support in order to reduce compassion fatigue and facilitate compassion satisfaction in nursing students during clinical clerkship.

The levels, prevalence and related factors of compassion fatigue among oncology nurses: a systematic review and meta-analysis

BACKGROUND

Compassion fatigue is described as the phenomenon of exhaustion and dysfunction in healthcare workers resulting from prolonged exposure to work-related stress and compassion stress. Oncology nurses are at high risk for compassion fatigue.

AIMS

Our study aims to estimate the levels, prevalence and related factors of compassion fatigue dimension in oncology nurses.

DESIGN

Systematic review and meta-analysis.

METHOD

Ten electronic databases were conducted in the systematic review and meta-analysis. Time frame of the searches is from inception up to 31 January 2020. The research team independently conducted study selection, quality assessments, data extractions and analysis of all included studies. The means, standard deviations and prevalence of three dimensions of compassion fatigue were pooled using random-effects meta-analysis. The PRISMA guideline was used to report the systematic review and meta-analysis. PROSPERO registration number: CRD42020205521.

RESULTS

The systematic review included 21 studies, involving 6533 oncology nurses across 6 different countries. In our studies, the pooled mean scores of compassion satisfaction (CS), burnout (BO) and secondary traumatic stress (STS) were 35.47 (95% CI: 33.54-37.41), 24.94 (95% CI: 23.47-26.41) and 24.48 (95% CI: 23.36-25.60), respectively; the pooled prevalence of "low" rates of CS, "high" rates of BO and STS were 20% (CI 13%-28%), 22% (CI 18%-26%) and 22% (CI 17%-28%), respectively; furthermore, geographical regions (Asia) significantly affect the prevalence of compassion fatigue among oncology nurses. The compassion fatigue variables considered were demographic (age, marital status, education background, health condition and gender), work-related (job satisfaction, income satisfaction, years of working experience, professional title, position and work environment) and other variables (social support, coping strategy, self-compassion, professional cognition and psychological training).

CONCLUSION

Oncology nurses were at "moderate" level of compassion satisfaction, burnout and secondary traumatic stress, and 22% of oncology nurses suffered from "high" risk of compassion fatigue. Hospital administrators should develop interventions to address compassion fatigue phenomenon, and enhance the mental health of oncology nurses and nursing care results.

RELEVANCE TO CLINICAL PRACTICE

Oncology unit warrants special attention, and oncology nurses are at high risk for compassion fatigue. However, the reported prevalence rates and oncology nurses with different characteristics vary considerably. The review provides a preliminary framework for nursing administrators to develop interventions to address compassion fatigue phenomenon, and enhance the psychological health of oncology nurses.

Relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in haemodialysis nurses: A cross-sectional study

AIM

To explore the relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in Chinese haemodialysis nurses.

BACKGROUND

Although several studies explored nurses' turnover intention in multiple hospital wards, fewer studies focused on turnover intention and its predictors among nurses in dialysis care.

METHODS

We conducted a cross-sectional study and adopted a two-stage sampling method to recruit 528 Chinese haemodialysis nurses. Multiple regression analysis was performed to explore the effects of resilience, empathy, compassion fatigue and work engagement on turnover intention.

RESULTS

The prevalence of high and exceptionally high levels of turnover intention was 59.1% and 9.0%. Compassion fatigue had the strongest significant effect on turnover intention (β = 0.276), followed by work engagement (β = -0.256) and resilience (β = 0.193). Haemodialysis nurses in tertiary hospitals reported significant higher levels of turnover intention than those in secondary hospitals (β = 0.127).

CONCLUSIONS

Higher levels of compassion fatigue and lower levels of resilience and work engagement can result in higher turnover intention in haemodialysis nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Strategies such as resilience training programme, mindfulness-based intervention and establishing a positive work environment may be effective methods to improve resilience, reduce compassion fatigue, promote work engagement and decrease turnover intention.

The Troubled Nurse: A Qualitative Study of Psychoemotional Effects of Cancer Care on Nurses in A Nigerian Cancer Care Setting

Objective

Nurses who care for cancer patients are exposed to varying degrees of psychological pressure. These psychological issues among nurses are thought to have some consequences relating to professional satisfaction, quality of care, and patient outcome. This study aimed to explore the psychological and emotional impact of caring for persons among cancer care nurses.

Methods

A qualitative, descriptive approach was employed, and a purposive sampling technique was used to select seven nurses who were interviewed one-on-one. Interview data were coded and analyzed using NVivo 12 to generate the final themes and patterns. The EQUATOR's COREQ guideline for qualitative studies was adhered to.

Results

Data analysis yielded two major themes and four sub-themes. Participants expressed concerns about their frequent encounter with dying patients on the ward which affects their own mental well-being as persons. Sometimes, the health-care professionals used emotional distance to mitigate the emotional and psychological effects of the frequent deaths encountered on the ward. Professional dissatisfaction was also brought about by the increased amount of patients who died on the ward, the gloomy nature of the care environment, and the feeling of incapacitation to help.

Conclusions

The findings indicate that nurses who care for cancer patients need to be supported to enhance their psychological and emotional well-being. The findings of this study could help nurse managers to understand the level of psychological pressure cancer care impose on nurses and the importance of improving the mental health of nurses in cancer care.

Compassion Fatigue, Compassion Satisfaction, and Burnout in Oncology Nurses: A Systematic Review and Meta-Analysis

Professionals working in cancer care are exposed to strong sources of stress. Due to the special characteristics of this unit, the appearance of burnout, compassion fatigue, and low compassion satisfaction is more likely. The principal aim was to analyze the levels and prevalence of burnout, compassion fatigue, and low compassion satisfaction in oncology nurses and interventions for its treatment. The search for the systematic review was done in Medline, ProQuest, Lilacs, CINAHL, Scopus, Scielo, and PsycINFO databases, with the search equation “burnout AND nurs* AND oncology AND compassion fatigue”. The results obtained from the 15 studies confirmed that there are levels of risk of suffering burnout and compassion fatigue among nursing professionals, affecting more women and nurses with more years of experience, with nurses from oncology units having one of the highest levels of burnout and compassion fatigue. The oncology nurse sample was n = 900. The meta-analytic estimations were 19% for low compassion satisfaction, 56% for medium and high burnout, BO, and 60% for medium and high compassion fatigue. The increase in cases of burnout and compassion fatigue in nursing staff can be prevented and minimized with a correct evaluation and development of intervention programs, considering that there are more women than men and that they seem to be more vulnerable.