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Jaramillo-Cartwright MJ, Mafla-Viscarra A, Izurieta N, Barnett DJ, Hsu EB, Grunauer M. Characterizing Mental Health in an LMIC Context: Measuring Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Health Care Providers in Ecuador During COVID-19 with the ProQOL V5 Questionnaire. Disaster Med Public Health Prep 2025; 19:e109. [PMID: 40313206 DOI: 10.1017/dmp.2025.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2025]
Abstract
OBJECTIVES This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm's Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn's test was then applied to determine whether groups differed from each other. RESULTS On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions. CONCLUSIONS Despite high compassion satisfaction, most surveyed health care providers from Ecuador's public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.
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Affiliation(s)
| | | | - Natalie Izurieta
- Universidad San Francisco de Quito, School of Medicine, Quito, Ecuador
| | - Daniel J Barnett
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Edbert B Hsu
- Johns Hopkins Center for Global Emergency Care, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michelle Grunauer
- Universidad San Francisco de Quito, School of Medicine, Quito, Ecuador
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Rao SR, Sherigar MN, Normen M, Joshi U. Teaching empathy and compassion to healthcare providers in palliative care: a scoping review. Ecancermedicalscience 2024; 18:1817. [PMID: 40171454 PMCID: PMC11959133 DOI: 10.3332/ecancer.2024.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Indexed: 04/03/2025] Open
Abstract
Empathy and compassion are core competencies that healthcare providers (HCPs) require when caring for patients and families with life-threatening illnesses like cancer. These constructs are often challenging to define and generalise and are often used interchangeably. Medical education has evolved from the traditional curriculum-based approach to a more eclectic competency-based approach. The purpose of this review is to explore the current evidence on teaching compassionate care for palliative care issues in cancer settings in lower-middle-income countries. A preliminary search of the Scopus database from 2,000 until now identified 1,502 records, of which 54 peer-reviewed articles were included in this review. Training in compassion and empathy was delivered in three formats: online, face-to-face and blended learning or hybrid. The training modalities were didactic, experiential and reflective, with many educational interventions using a multimodal approach. The educational interventions reported a positive outcome and improvement in empathetic and compassionate behaviours. However, they were limited due to inadequately defined constructs, use of self-reported outcome measures and difficulty in ascertaining if these skills were retained long-term and were translated into the clinical settings. Given that compassion and empathy are multidimensional constructs, it is imperative that educational interventions be multimodal and learner-centred, focusing on developing the knowledge, attitudes, skills and behaviours of the HCP in providing compassionate care while aiming for conceptual clarity regarding definition and more robust validated outcome measures.
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Affiliation(s)
- Seema Rajesh Rao
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- School of Medicine, Cardiff University, Cardiff’dCF14 4YS, UK
- https://orcid.org/0000-0001-8278-3640
| | - Mithili Narayan Sherigar
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
| | - Michelle Normen
- BHT-Karunashraya, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- https://orcid.org/0000-0001-9148-890X
| | - Udita Joshi
- BHT-Karunashraya Institute for Palliative Care Educ ation and Research, 40 Varthur Road, Marathahalli, Bengaluru 560037, Karnataka, India
- https://orcid.org/0000-0002-9039-7894
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Román-Calderón JP, Krikorian A, Ruiz E, Romero AM, Lemos M. Compassion and Self-Compassion: Counterfactors of Burnout in Medical Students and Physicians. Psychol Rep 2024; 127:1032-1049. [PMID: 36219581 DOI: 10.1177/00332941221132995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the relationship between self-compassion, compassion for others and Burnout in medical students and physicians. METHODS A cross-sectional study was conducted. Medicine students and general physicians from two Colombian cities participated (n = 359). The Compassion Scales and the Maslach Inventory were administered. An Exploratory Structural Equation approach was used for validating new measures and testing for relationships between latent variables. RESULTS Most participants were students (85.9%), mean age was 22 years (SD = 7), 55.2% were female, 62,6% dedicated more than 48 weekly hours to study or practice, while physicians had worked a mean of 10.34 years (SD = 8.67). Self-compassion and Compassion for others action subscales were validated, but engagement subscales of were not. Participant´s compassion actions for others and self-compassion actions are negatively related to depersonalization and emotional exhaustion, respectively. Additionally, compassion dimensions were positively associated with professional accomplishment. CONCLUSION Our findings indicate that compassion and self-compassion actions inversely relate to different components of Burnout and could constitute protective factors against the stress of healthcare. Compassion and self-compassion training programs for medical students and physicians might be an alternative to avoid Burnout, diminishing physicians' depersonalization and emotional exhaustion while enhancing their professional accomplishment.
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Affiliation(s)
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Erika Ruiz
- Faculty of Psychology, Universidad Pontificia Bolivariana, Montería, Colombia
| | - Ana M Romero
- Faculty of Psychology, Universidad Pontificia Bolivariana, Montería, Colombia
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Drummond J. A visual ethnographic study on nurse lecturers' enactment of compassionate care within the adult pre-registration nursing curriculum. NURSE EDUCATION TODAY 2023; 130:105901. [PMID: 37549557 DOI: 10.1016/j.nedt.2023.105901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Nurse lecturers make a valuable contribution to developing the future nursing workforce. However, how this is nurtured within nurse education requires further exploration. There is limited research exploring the experiences of nurse lecturers providing compassionate care within the adult pre-registration nursing curriculum. OBJECTIVES This study explores how nurse lecturers enact compassionate care within the adult pre-registration nursing curriculum. To elicit shared patterns of behaviours and use creative methods to promote a critical dialogue. METHOD A visual ethnographic approach was used to explore nurse lecturers' experiences at a University in England. Using purposive sampling, nine auto-driven photo-elicitation interviews took place, and five participants attended a focus group to develop individual and collaborative concept maps. A thematic approach to data analysis was employed. FINDINGS Five themes were identified, illustrating compassionate care as the human condition involving appropriate behaviours and competent action. Compassionate care is threaded through the curriculum using different teaching and learning approaches, requiring a culture of shared human relationships. The combination of photographs, maps and descriptions provide a unique perspective of how nurse lecturers nurture and role model compassionate care to their students. CONCLUSION There are many ways compassionate care is experienced, enacted and enhanced by nurse lecturers within the adult pre-registration nurse curriculum. The five main themes act as a framework to guide nursing education and nursing practice. Future research should aim to understand better how compassionate care can be nurtured within different fields of nursing.
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Affiliation(s)
- Juliet Drummond
- Faculty of Health and Wellbeing, School of Nursing, University of Wolverhampton, Wulfruna Street, Wolverhampton, WV1 1LY, United Kingdom..
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Pades Jiménez A, García-Buades ME, Riquelme I. Development of emotional intelligence and assertiveness in physiotherapy students and effects of clinical placements. Physiother Theory Pract 2023; 39:72-79. [PMID: 34927528 DOI: 10.1080/09593985.2021.2005200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Emotional intelligence (EI) and assertiveness are key abilities for physiotherapists. Clinical placements seem to affect students' development of EI and assertiveness, and their construction of the professional role. PURPOSE This study aims to compare the EI of physiotherapy students with students from other health professions and explore the evolution of EI and assertiveness in physiotherapy students throughout their university education, focusing on the influence of clinical practice. METHOD Students (N = 753) completed a self-administered questionnaire to measure emotional intelligence (TMMS 24), assertiveness (CSES), and sociodemographic variables. RESULTS EI levels were adequate and very similar across the three disciplines. Regarding assertiveness, physiotherapy students in year 4 obtained significantly higher levels than students in years 1, 2, and 3. Significant correlations (rs (207) = 0.35, p < .001) were found between assertiveness and the number of modules of clinical practice. CONCLUSION This study contributes with further evidence on the improvement of assertiveness in physiotherapy students through their university education and, in particular, with clinical placements. Practical implications highlight the importance of training in EI and assertiveness during university, coupled with clinical placements, in order to prepare for an effective and satisfactory professional life.
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Affiliation(s)
- Antonia Pades Jiménez
- Department of Nursing and Physiotherapy, Universitat de Les Illes Balears, Palma de Mallorca, Spain
| | | | - Inmaculada Riquelme
- Department of Nursing and Physiotherapy, Universitat de Les Illes Balears, Palma de Mallorca, Spain.,University Institute of Health Sciences Research (IUNICS-IDISBA), Universitat de les Illes Balears, Palma de Mallorca, Spain
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de-Diego-Cordero R, Martínez-del-Carmen C, Bonilla Sierra P, Vargas-Martínez AM. Impact of the COVID-19 Pandemic and Psychosocial Coping Strategies in Health Sciences Students at the University of Seville: A Pilot Study. Healthcare (Basel) 2021; 9:healthcare9121661. [PMID: 34946387 PMCID: PMC8702082 DOI: 10.3390/healthcare9121661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/16/2021] [Accepted: 11/27/2021] [Indexed: 12/02/2022] Open
Abstract
The new infection by coronavirus has supposed a challenge to all health systems worldwide, affecting our psychosocial health. Education as we knew it has changed, which is why university students, attending Health Sciences courses in this case, have been affected by the pandemic. This study aimed to analyze the impact of the preventative measures and restrictions associated with COVID-19 on multiple mental health and psychological well-being indicators in Health Sciences students at the University of Seville. A descriptive and cross-sectional pilot study in the University of Seville by means of an online questionnaire elaborated was conducted. Of the final sample (n = 68), more than 60% of the students acknowledged having received specific training by their university and/or health institution where they perform practices on COVID-19 measures; however, they negatively emphasized not having received psychosocial aid or support in most of the cases (94.12%). As the health situation imposed by COVID-19 is considered long-lasting, the proposal is to plan short- and long-term strategies for promotion and intervention in the mental health of students and future health care workers.
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Affiliation(s)
- Rocío de-Diego-Cordero
- Research Group PAIDI-CTS 969 Innovation in Health Care and Social Determinants of Health, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | | | | | - Ana-Magdalena Vargas-Martínez
- Research Group PAIDI-CTS 969 Innovation in Health Care and Social Determinants of Health, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
- Correspondence:
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Librada Flores S, Roa Trujillo SH, Torrejano Gonzálex N, García Buitrago MDP, Lucas Díaz MÁ. A Survey of Attitudes and Beliefs about Care, Compassion and Communities Networks in Palliative Care. A Preliminary Study for the Development of a Compassionate University. Healthcare (Basel) 2021; 9:healthcare9080946. [PMID: 34442083 PMCID: PMC8391360 DOI: 10.3390/healthcare9080946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to know the level of knowledge, sensitivities and training needs regarding care of people at the end of life in medicine, nursing and psychology students/academic and administration university personnel; and to identify skills to perceive and expressed values related to compassion it in their living environment. Method: a descriptive observational study was conducted among undergraduate medical, nursing and psychologist students, academic and administration personnel of the University of Bogotá in Colombia the survey was based on a web-based questionnaire (November 2019–April 2020). Levels of knowledge and sensitivities about care of people at the end of life, educational needs and compassion were assessed. Descriptive and comparative measures and statistical significance tests used, Student’s t and ANOVA (α = 0.05). Results: 465 people answered the survey; students (82.4%), academic (13.1%) and administration personnel (4.5%). 81.6% knew about palliative care concepts. 64.7% had not cared for other people with advanced or terminal illness. 44.7% talked about death without problems. The most evaluated training competences were humanity, dignity and compassion. Mean levels for compassion by Gilbert’s scale were 70.55 for self-compassion, 72.61 for compassion for others and 60.47 for compassion from others. Significant differences were found by age and gender in self-compassion values. Conclusions: the level of knowledge, sensitivities and training needs regarding care of people at the end of life in the University and the values related to compassion enables the development of Compassionate Universities.
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Affiliation(s)
| | - Sonia Herminia Roa Trujillo
- Welfare Department, Sanitas University Foundation, Bogota 111321, Colombia; (S.H.R.T.); (N.T.G.); (M.d.P.G.B.)
| | - Nurlian Torrejano Gonzálex
- Welfare Department, Sanitas University Foundation, Bogota 111321, Colombia; (S.H.R.T.); (N.T.G.); (M.d.P.G.B.)
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