Coping strategies as moderating factors to compassion fatigue among critical care nurses

Measuring the prevalence, warning signs, and preventive measures of secondary traumatic stress among critical care nurses

Nurses are the front-liners for patients who need urgent care; therefore, they are exposed to several stressors. Indirect exposure to others' trauma is called secondary traumatic stress. This study examined the prevalence, warning signs, and preventive measures of secondary traumatic stress among critical care nurses in Jordan. A descriptive cross-sectional design was used. Data were collected through a questionnaire, both paper and electronic, from 317 nurses working in nine hospitals. Nurses in this study had moderate levels of secondary traumatic stress with a mean of 40.9 (SD = 11.29), and around half of them met the diagnostic criteria. Arousal was the most reported symptom followed by avoidance and lastly intrusion. The majority of nurses had a mild to moderate risk of developing secondary traumatic stress. Multiple traumatizing events had a positive relationship with STS prevalence. Nurses viewed the preventive measures as moderately to greatly effective. Efforts must be directed toward preventing, diagnosing, and treating secondary traumatic stress among critical care nurses.

Effects of compassion fatigue, structural empowerment, and psychological empowerment on the caring behaviours of intensive care unit nurses in China: A structural equation modelling analysis

BACKGROUND

Caring behaviours play a pivotal role in nursing. The negative correlation between caring behaviours and compassion fatigue in the intensive care unit (ICU) has been extensively researched. Nevertheless, considerable gaps persist in comprehending the associations of psychological empowerment and structural empowerment with outcomes, particularly in the highly stressful environment of the ICU.

OBJECTIVES

The aim of this study was to determine how compassion fatigue, structural empowerment, and psychological empowerment impact the caring behaviours of ICU nurses in China via a structural equation modelling analysis.

DESIGN

A cross-sectional study through convenience sampling was conducted in the ICU of 24 hospitals in China from February to June 2021.

METHODS

A self-designed demographic questionnaire, the Chinese version of the Caring Behaviors Inventory, the Chinese version of the Compassion Fatigue Short Scale, the Chinese version of the Conditions of Work Effectiveness Questionnaire-II, and the Chinese version of the Psychological Empowerment Questionnaire-12 were used to survey ICU nurses.

RESULTS

A total of 450 ICU nurses were recruited. The final model showed a good model fit. In the ICU nurse population, compassion fatigue (β = -0.582; 95% confidence interval: [-0.686, -0.455]) had a direct negative relationship with caring behaviours, whereas both structural empowerment (β = 0.448; 95% confidence interval: [0.372, 0.572]) and psychological empowerment (β = 0.438; 95% confidence interval: [0.333, 0.563]) had indirect positive associations with caring behaviours through compassion fatigue.

CONCLUSIONS

Our findings revealed a direct negative association between compassion fatigue and caring behaviours, whereas both structural empowerment and psychological empowerment are indirectly positively associated with caring behaviours through compassion fatigue amongst ICU nurses in China. Our research revealed that positive improvements in structural empowerment and psychological empowerment were associated with enhancements in compassion fatigue mitigation and the fostering of caring behaviours amongst ICU nurses in practice.

Strengths for Helping Professionals Exposed to Secondary Trauma: A Scoping Review

Helping professionals working with people who have experienced trauma are at risk of developing psychological distress. To date, most studies exploring psychological distress among helping professionals have focused on risk factors associated with the development of adverse reactions to secondary trauma, and few have identified strengths or protective factors, which may buffer and/or alleviate distress. Therefore, this scoping review uses the Resilience Portfolio Model (Grych et al., 2015) to synthesize literature on individual and environmental strengths, which may mitigate adverse reactions to secondary trauma in helping professionals. Utilizing the CINAHL, PsycArticles, PsycInfo, and MEDLINE databases, 43 articles published between 1990 and May 2023 from over 20 countries were identified. The findings suggest that professionals draw upon a portfolio of meaning-making, regulatory, interpersonal, and ecological strengths to increase their protective resources. Most studies identified were quantitative, and usually explored organizational factors, such as supervision. Further empirical investigations could help identify individual strengths that could be targeted within interventions to protect professionals against the impact of secondary traumatic stress. Additionally, more research is needed to investigate the interconnectedness of individual, organizational, and systemic factors that buffer helping professionals from the deleterious effects of trauma work.

The professional quality of life of flight nurses: a cross-sectional study

Background: The role of a Flight Nurse is specialised; they must have both education and experience to fulfil the requirements of the role. Mastering these skills takes time, thus long-term retention is essential. When nurses experience their work as more fulfilling, they are more inclined to remain within a role for an extended period. One of the ways to determine the lived experience of nurses is to measure their Professional Quality of Life. This is the first study to look at the Professional Quality of Life of Flight Nurses who work in public sector Aeromedical Retrieval Services in New Zealand.Aims: The aim of this study was to determine the Professional Quality of Life of Flight Nurses working in the public sector in New Zealand.Design: A survey based cross-sectional design was employed, using the Professional Quality of Life (ProQOL) V Health survey tool.Methods: Online survey data was collected from a convenience sample of 169 Flight Nurses working in public sector Aeromedical Retrieval services in New Zealand.Results: Of the 88 respondents, all reported either high or average levels of Compassion Satisfaction (High 48.86%, Average 51.13%) and Perceived support (High 44.31%, Average 55.68%). The majority reported Low to Average scores for Secondary Traumatic Stress (Low 30.68%, Average 67.04% and High 2.27%), Burnout (Low 4.54%, Average 89.77% and High 5.68%) and Moral Distress (Low 23.86% and Average 76.13%).Conclusion: This study highlights that Flight Nurses in New Zealand's public sector generally experience a positive Professional Quality of Life, but that there are also instances of Burnout and Secondary Traumatic stress.

Compassion fatigue and associated factors among nurses working in Jimma Zone public hospitals, southwest Ethiopia: A facility based cross-sectional study

BACKGROUND

Nurses are at risk of developing compassion fatigue, which has negative impacts on their well-being, quality care and leads to patient mortality and a financial burden on the healthcare system. However, data on compassion fatigue is scarce in Africa, particularly Ethiopia. Therefore, this study aimed to assess level compassion fatigue and associated factors among nurses in Jimma Zone public hospitals, Ethiopia.

METHOD

A facility-based cross-sectional study was employed from May 25 to June 25, 2023. A systematic sampling technique was employed to select among 422 respondents. Data were collected using pretested self-administered questionnaires. Professional Quality of Life Scale-5 was used for measuring compassion fatigues. Data were entered using Epi data version 4.6 and analyzed using SPSS version 25. Linear regression were done to identify factors associated with compassion fatigue. Statistically significant was declared at a p-value of ≤ 0.05 with 95% CI.

RESULT

From a total of 422 respondents, 412(97.6%) of them gave complete responses. 47% of respondents, had a moderate level of compassion fatigue. Total experience [β = -0.04; 95%CI (-0.06, -0.01); p = 0.005], perceived social support [β = -0.13; 95% CI (-0.17, -0.08); p<0.001], self-compassion [β = -0.09; 95% CI (-0.14, -0.03); p = 0.003], support seeking [β = -0.23; 95% CI (-0.42, -0.04 p = 0.017], emergency ward [β = 0.36; 95% CI (0.2, 0.51); p <0.001], ICU [β = 0.38; 95% CI (0.21, 0.54); p<0.001], pediatric ward [β = 0.23; 95% CI (0.10, 0.36); p < 0.001] and average sleep hours per day [β = 0.46; 95% CI (0.35, 0.57); p<0.001] were statistically signifantly factors.

CONCLUSION AND RECOMMENDATION

The study revealed that one in four nurses had high level of compassion fatigue. The factors associated were work experience, perceived social support, self-compassion, coping strategies, work unit, and sleep hours. Therefore, stakeholders including hospital managers should implement targeted strategies to prevent compassion fatigue including training on coping strategy and, self-compassion and creating culture of team work among nurses.

Sensory processing sensitivity and compassion fatigue in intensive care unit nurses: A chain mediation model

BACKGROUND

Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue.

AIMS

This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue.

STUDY DESIGN

A cross-sectional descriptive study was conducted with 290 nurses from various hospitals in five cities in China.

METHOD

A self-designed demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Chinese version of the Highly Sensitive Person Scale, the Chinese version of the Perceived Social Support Scale, and the Chinese version of the Perceived Stress Scale were used to survey 290 ICU nurses. The mediating roles of perceived social support and perceived stress between sensory processing sensitivity and compassion fatigue were tested.

RESULTS

The research results indicate that the total effect of sensory processing sensitivity on compassion fatigue is significant (0.245 [0.093, 1.160]), whereas the direct effect of sensory processing sensitivity on compassion fatigue is not significant (-0.43 [-0.402, 0.247]). Perceived social support and perceived stress exhibit serial mediating effects between sensory processing sensitivity and compassion fatigue (-0.065 [-0.142, -0.013]).

CONCLUSION

Our results revealed, for the first time, the underlying mechanism between sensory processing sensitivity and compassion fatigue among ICU nurses. Providing necessary stress-relief condition and abundant social support are important measures for nursing managers to reduce compassion fatigue and improve the quality of critical care humanistic nursing services.

Psychological Distress and Quality of Life Among Military Trauma Patients

INTRODUCTION

Military trauma has a significant impact on soldiers, affecting many aspects of their lives, with the highest impact on their quality of life and psychological wellness. This study aimed to measure psychological distress and its relationship with the quality of life among Jordanian military trauma patients.

MATERIALS AND METHODS

A descriptive cross-sectional study was conducted in The Hashemite Protection Departments for military causalities in Amman, Irbid, and Al-Karuk. The authors used the WHO Quality of Life Scale-Brief and Trauma Symptoms Checklist-40 scales for assessing the quality of life and psychological distress among Jordanian military trauma patients. A total of 145 trauma survivors participated in the study and responded to all questionnaires out of 173 distributed. The study was approved by the institutional review board of Al-Zaytoonah University.

RESULTS

The result of this study revealed that military trauma survivors had high levels of psychological distress with a mean of 85.66 (SD = 19.418). The subscale of "Dissociation symptoms" had the highest rating (M = 19.92, SD = 5.096), while the "sleep disorders" subscale had the lowest rating (M = 10.000, SD = 3.501). On the quality of life scale, a moderate level of quality of life resulted among the participants with a mean of 61.620 (SD = 17.190). The "general health" subscale scored the highest among the other domains (M = 18.241, SD = 5.434), while the "physical health" domain scored the lowest (M = 4.910, SD = 2.078). Furthermore, a statistically significant negative relationship between psychological distress and quality of life was reported (r =-0.178, P < .05).

CONCLUSION

Jordanian injured military persons had a moderate quality of life level and high level of psychological distress. A structured follow-up program is required to be developed to improve those patients' health and quality of life. Furthermore, additional research is needed to investigate the impact of military trauma and services on soldiers in Jordan and the Middle East.

Workplace resilience and compassionate care among Jordanian private sector nurses

BACKGROUND

Compassionate care is a hallmark of the nursing profession. Yet, nursing is beset by perennial problems, not the least of which is nursing shortage and increased workload. As such, resilience becomes a critical ingredient that nurses must possess to overcome such challenges. However, there needs to be more evidence of the relationship between compassionate care and resilience within the Jordanian nursing context.

AIM

To explore the relationship between workplace resilience and compassionate care among Jordanian nurses working in the private sector.

METHODS

The study utilized a descriptive cross-sectional correlational design. Convenience sampling with inclusion-exclusion criteria was used to select participants from three private hospitals in Jordan. The Compassionate Care Questionnaire was used to measure levels of compassionate care, and the Resilience at Work Scale was used to measure workplace resilience. Ethical approval was obtained before data collection.

RESULTS

A total of 161 nurses participated in the study. Participants had high levels of compassionate care and workplace resilience. Male nurses and nurses with lower workloads had significantly higher levels of compassionate care. Likewise, older nurses, nurses with postgraduate degrees, and nurses with experience of less than 5 years in the current area had significantly higher levels of workplace resilience. Compassionate care had a mordantly solid and significant positive relationship with workplace resilience and all its seven dimensions (living authentically, finding one's calling, maintaining perspective, managing stress, interacting cooperatively, staying healthy, and building networks.

CONCLUSION

Developing workplace resilience can support nurses in implementing compassionate care. Nurse Managers and hospital administrators must consider the effects of compassionate care and workplace resilience on nurses and patients. Future research can include a longitudinal exploration of compassionate care and workplace resilience and an investigation of the levels of these variables outside a hospital setting.

Stress dimensions, patterns of coping, and psychopathological risk among nurses: a person-centred approach

BACKGROUND

Nurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive-Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns.

METHOD

This cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns.

RESULTS

Three stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) - followed by Passive/Disengaged group - in comparison with nurses belonging to Active/Solution-Oriented group.

CONCLUSION

Fostering nurses' awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses' health within/beyond the healthcare settings.

Impact of Workplace Bullying on Quiet Quitting in Nurses: The Mediating Effect of Coping Strategies

Workplace bullying is common among nurses and negatively affects several work-related variables, such as job burnout and job satisfaction. However, no study until now has examined the impact of workplace bullying on quiet quitting among nurses. Thus, our aim was to examine the direct effect of workplace bullying on quiet quitting and to investigate the mediating effect of coping strategies on the relationship between workplace bullying and quiet quitting in nurses. We conducted a cross-sectional study with a convenience sample of 650 nurses in Greece. We collected our data in February 2024. We used the Negative Acts Questionnaire-Revised, the Quiet Quitting Scale, and the Brief COPE to measure workplace bullying, quiet quitting, and coping strategies, respectively. We found that workplace bullying and negative coping strategies were positive predictors of quiet quitting, while positive coping strategies were negative predictors of quiet quitting. Our mediation analysis showed that positive and negative coping strategies partially mediated the relationship between workplace bullying and quiet quitting. In particular, positive coping strategies caused competitive mediation, while negative coping strategies caused complimentary mediation. Nurses' managers and policy makers should improve working conditions by reducing workplace bullying and strengthening positive coping strategies among nurses.

Professional Quality of Life, Job Satisfaction, and Intention to Leave among Psychiatric Nurses: A Cross-Sectional Study

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered.

The relationship between received and perceived social support with ways of coping in nurses

BACKGROUND

Stress is inevitable in the nursing profession, and ways of coping are one of the solutions to reduce stress. Social support is one of the influencing factors on coping strategies, but there is probably a difference between the effects of received or perceived social support on coping strategies.

OBJECTIVE

The aim was to investigate the relationship between received and perceived social support with ways of coping in nurses.

METHODS

This is a cross-sectional descriptive-correlational study. The sample consisted of 292 nurses by simple random sampling. The data collection tool included Zimmet's multidimensional perceived social support scale, McCain and Marklin's perceived social support questionnaire, and Lazarus' ways of coping questionnaire. Data were analyzed using Pearson correlation and multiple regression tests in SPSS v.22.

RESULTS

The results showed that received social support (β= 0.20, p < 0.001) and perceived social support (β= 0.35, p < 0.001) are able to explain changes in the dimension of seeking social support. Received social support (β= 0.16, p = 0.005) and perceived social support (β= 0.22, p < 0.001) are able to explain changes after positive reappraisal, but only received social support could explain changes in accepting responsibility (β= 0.15, p = 0.01).

CONCLUSION

This study showed that received and perceived social support have a significant correlation with ways of coping, but only able to explain the changes in social support seeking dimensions, positive reappraisal, accepting responsibility. Both types of social support are necessary, but that received social support covered more adaptive coping strategies.

Predictors of compassion satisfaction among healthcare professionals working in intensive care units: A cross-sectional study

OBJECTIVE

To determine the prevalence of compassion satisfaction, related factors, and predictors among healthcare professionals in Thai intensive care units.

METHODS

A cross-sectional study was conducted in 12 intensive care units at a university hospital in Thailand from August to November 2022. All nurses and doctors were invited to complete an anonymous online survey which included: the Professional Quality of Life Scale version 5, Connor-Davidson Resilience Scale, Passion Scale, Flourishing Scale, and Acceptance and Action Questionnaire. Descriptive statistics, Pearson's correlation coefficients, and hierarchical multiple regressions were used for data analysis in SPSS 28.0.

RESULTS

A total of 178 nurses and doctors participated (92.13% nurses, 89.89% female, mean 32.10 years). Average compassion satisfaction (assessed using the Professional Quality of Life Scale) was moderate, with a mean score of 37.94 (SD = 5.58). The final regression model predicting compassion satisfaction was significant and explained 65% of the variance in compassion satisfaction, F (11, 154) = 26.00, p < 0.001. Four out of 11 predictor variables made unique statistically significant contributions to the final model: resilience (β = 0.48, p < 0.001), harmonious passion (β = 0.24, p < 0.001), being a nurse (not a doctor; β = 0.17, p < 0.05), and holding a postgraduate qualification (β = 0.10, p < 0.05).

CONCLUSION

Most healthcare professionals in critical care units have a moderate level of compassion satisfaction, which is correlated with resilience, flourishing, and harmonious passion. Resilience and harmonious passion predict compassion satisfaction. These factors are modifiable through intervention.

IMPLICATION FOR CLINICAL PRACTICE

Assessment of staff psychological well-being can identify those at risk for stress and impaired professional quality of life. Resilience and harmonious passion predict compassion satisfaction and can be modified through psychological interventions to promote psychological well-being and professional quality of life in healthcare workers in intensive care units.

Health professionals and family members during cardiopulmonary resuscitation: A qualitative study on the experience of witnessing resuscitation in Jordanian critical care units

BACKGROUND

The interaction between healthcare professionals (HCPs) and family members during cardiopulmonary resuscitation (CPR) in critical care units (CCUs) has received significant attention. In the Arabic region, family members are typically excluded from participating in critical care treatments, despite the cultural and religious significance of their presence. This highlights a lack of policies and research addressing the cultural factors related to family involvement in CPR within this context.

OBJECTIVES

The purpose of this study was to explore the nature of the relationship between HCPs and family member relations during CPR in Jordanian CCUs.

METHODS

This study employed a qualitative research design. Data were collected through semi-structured interviews with 45 participants, including 31 HCPs and 14 family members of patients who had undergone CPR in Jordan. Data was managed, organized, and thematically analyzed using NVivo.

RESULTS

The study revealed three main themes: Family-Witnessed Resuscitation (FWR) through the eyes of HCPs, FWR through the eyes of family members, and the relationship between HCPs and family members during CPR. The last theme has three subthemes: "Looking out for the Patient," "Looking out for Ourselves," and "Looking out for Each Other." These themes highlighted the complex and dynamic relationships between HCPs and family members during CPR in Jordan. Participants emphasized the importance of clear communication, mutual respect, and a collaborative approach to decision-making during CPR.

CONCLUSION

The resultant study model uniquely explains the relationship between Jordanian health professionals and family members during CPR, with important implications for clinical practice and healthcare policies regarding family involvement during resuscitation in Jordan. Further research is needed to explore the cultural and societal factors influencing family involvement in resuscitation in Jordan and other Arab countries.

Assessment of Psychological Consequences of Violence in Psychiatric Nurses

BACKGROUND

Workplace violence, particularly within psychiatric nursing environments, is an emerging concern globally and has been recognized as a significant occupational stressor with considerable psychological consequences, yet it remains underexplored, warranting an in-depth study.

AIM

This study aimed to assess the psychological consequences of violence on psychiatric nurses in Jeddah, Saudi Arabia.

METHOD

A descriptive, cross-sectional design was used. A convenience sampling technique was used to select 198 psychiatric nurses working in two hospitals with psychiatric departments in Jeddah. A self-administered questionnaire and the Impact of Event Scale - Revised (IES-R) were used for data collection. Data were analyzed using SPSS Statistics version 22 (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.).

RESULTS

Out of the 198 psychiatric nurses who participated in the study, 80.8% reported experiencing violence in their workplace, highlighting the need for effective interventions to prevent and manage violence in psychiatric settings. The majority of the participants had a diploma (68.2%), and 54.5% of the nurses had more than 10 years of experience. Among patient-related factors related to violence, drug abuse had the highest mean score of 4.07 (SD=0.89) and was ranked as the most significant factor, while among nursing-related factors, a lower level of experience in psychiatric care had the lowest mean score of 3.43 (SD=1.11) and was ranked as the least important factor. The nurses tended to avoid discussing the traumatic event, as indicated by the highest mean score of 2.10 (SD=1.18) for item 22, "I tried not to talk about it." The mean score for the avoidance subscale of the IES-R was 1.55 (SD=0.78), the highest mean score among the subscales and ranked first in terms of severity.

CONCLUSION

This study highlighted the significant psychological consequences of violence on psychiatric nurses in Jeddah, Saudi Arabia.

The impact of utilizing inclusive leadership among nurses during crises: A multisite comparative study

Nurses' psychological wellness and satisfaction are threatened by exposure to many stressors. Adopting a promising leadership style has beneficial impacts at different levels, especially during crises. This study aimed to examine the impact of inclusive leadership on nurses' satisfaction and psychological distress during crises, focusing on three Arabic countries. A cross-sectional descriptive design was utilized to meet the study goal. Data were collected electronically in the three countries using the Kessler Psychological Distress Scale (K-10), Minnesota Satisfaction Questionnaire, and Carmel's Inclusive Leadership Scale. Two hundred seventy-four participants fully responded: 90 from Egypt, 82 from Saudi Arabia, and 102 from Jordan. Descriptive statistics, Pearson R, Spearman Rho, Point biserial, and ANOVA tests were used to answer the research questions. There were statistically significant differences between countries in the mean scores of inclusive leadership and psychological distress. In addition, statistically significant relationships between inclusive leadership, psychological distress, and job satisfaction were found. The study focused on the importance of approaching inclusive leadership to increase employee satisfaction, reduce psychological distress, and achieve organizational goals.

The Relationship Between Compassion Fatigue and Nursing Care Quality in Intensive Care Units: A Correlational Study in Northeast of Iran

Intensive care unit (ICU) nurses are repetitively exposed to traumatic situations and stressful events, which can lead to compassion fatigue (CF). Compassion fatigue can negatively affect the nurses' emotional and physical health and job satisfaction. The aim of this study was to evaluate the relationship between CF and nursing care quality in ICU. This descriptive-correlational study was conducted on 46 ICU nurses and 138 ICU patients, in 2 referral hospitals in Gorgan, Northeast of Iran in 2020. Participants were selected using stratified random sampling. Data were collected using CF and nursing care quality questionnaires. The results of this study showed that most nurses were women (n = 31, 67.4%), with mean age of 28.58 ± 4.80 years. The mean patients' age was 49.22 ± 22.01 years and 87 (63%) of them were male. The severity of CF in most ICU nurses (54.3%) was moderate, with a mean score of 86.21 ± 16.78. Among of the subscales, psychosomatic score was higher than the rest of subscales (0.53 ± 0.26). Nursing care quality was at the optimal level (91.3%) with the mean score of 81.51 ± 9.93. The highest scores of nursing care were related to subscale of medications, intake, and output (0.92 ± 0.23). In this study, there was a weak and inverse relationship between CF and nursing care quality (r = -0.28; P = .058). The results of this study indicate a weak, nonsignificant inverse relationship between CF and nursing care quality in ICU.

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

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

Compassion Fatigue in Nurses: The Role of Spiritual Well-Being, Emotion Regulation and Time Perspective

Background

Nurses experience many psychological problems in the coronavirus disease 2019 (COVID-19) outbreak. This study aimed to investigate the prevalence of Compassion Fatigue (CF) in nurses and the role of Spiritual Well-being (SW), Emotion Regulation (ER), and Time Perspective (TP) in predicting it.

Materials and Methods

The research method was descriptive-correlational. The statistical samples of this study included 394 nurses in Iran who were selected by the census sampling method. The sub-scale of CF from the Professional Quality of Life Scale, SW questionnaire, ER, and the short form of TP questionnaires were used to collect data. Descriptive statistics and analysis of covariance tests were used to analyze the data.

Results

The prevalence of CF in nurses in the COVID-19 outbreak was 59.39%. CF in female nurses was higher than that in male nurses (F_3,392 = 15.23, p < 0.001); in married nurses, it was higher than that in single nurses (F_3,392 = 14.23, p < 0.001); and in nurses on fixed shifts, it was higher than that in nurses on rotating shifts (F_3,392 = 5.63, p < 0.001). Also, CF in the emergency nurses, intensive care unit nurses, and coronary care unit nurses working under COVID-19 pandemic was higher than that in the emergency nurses and nurses who worked in other wards (F_3,388 = 14.31, p < 0.001). The results of hierarchical regression showed that SW, ER, and positive past negatively and suppression, present-fatalistic, negative past, and negative future positively predicted the CF (p < 0.001).

Conclusions

Based on the results, programs and psychological trainings based on SW, ER, and TP are suggested to reduce CF in nurses in the COVID-19 outbreak.

Compassion Fatigue and Perceived Social Support among Polish Nurses

BACKGROUND

Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death from COVID-19. Many nurses are faced with increased pressure, stress, and other adverse effects on their mental health. The study aimed to measure the relationship between compassion fatigue and perceived social support in polish nurses.

METHODS

The study was conducted on 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). The professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann-Whitney U test, ANOVA Kruskal-Wallis test, and multiple comparisons (post-hoc). The relationships between variables were tested using Spearman's rho, Tau Kendall, and the chi-square test.

RESULTS

The research showed the presence of compassion satisfaction, compassion fatigue, and burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with lower compassion fatigue (r = -0.35; p < 0.001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p < 0.001). The study also found that a higher level of social support was associated with a lower risk of burnout (r = -0.41; p < 0.001).

CONCLUSIONS

Preventing compassion fatigue and burnout should be a priority for healthcare managers. Notably, an essential predictor of compassion fatigue is that Polish nurses often work overtime. It is necessary to pay more attention to the crucial role of social support in preventing compassion fatigue and burnout.

Investigation of psychological factors related to compassion fatigue, burnout, and compassion satisfaction among nurses

BACKGROUND

While compassion fatigue is evaluated positively in nurses, compassion fatigue and burnout are undesirable from the viewpoint of professionals, service providers, institutions and ultimately society. It is necessary to identify the factors that lead to undesirable results and to reduce their effects. This study aimed to investigate nurses' levels of compassion fatigue, compassion satisfaction, burnout, various psychopathological symptom levels, coping skills, and the relationship between them.

METHODS

This was a descriptive cross-sectional study. The participants were 356 nurses working in tertiary university hospitals in Istanbul (Türkiye). The Healthcare Professional Information Form, ProQOL-IV, Brief Symptom Inventory, and the Coping Orientations to Problems Experienced scale were used to collect data. Descriptive statistics, correlation analyses, and regression models were used to analyze the data.

RESULTS

According to the findings, low-level burnout, moderate-high compassion satisfaction, and low-moderate compassion fatigue symptoms were detected. Low-level anxiety, depression, somatization, hostility, and negative self-esteem were found. According to the results of regression analysis, mental disengagement and planning coping strategies positively affect the synergy of compassion fatigue (p < 0.05). Turning religion and restraint coping have a positive effect on compassion fatigue (p < 0.05). While depression has a positive effect on burnout, nurses' positive reinterpretation and growth strategy is effective in coping with burnout (p < 0.05). Positive reinterpretation and growth coping strategies are also effective in increasing job satisfaction (p < 0.05).

CONCLUSIONS

Nurses showing somatization symptoms are risk factors for compassion fatigue, and nurses showing depression symptoms are risk factors for burnout, so they should be closely monitored and should be given support. Mental disengagement and planning coping strategies can reduce compassion fatigue, and positive reinterpretation and growth methods can reduce burnout and increase compassion satisfaction. It may be useful to provide counseling and training for nurses to use the right coping methods.

Compassion fatigue and anxiety in critical care emergency nurses: In between efficiency and humanity

OBJECTIVES

To determine the emotional impact of permanent proximity to trauma and death in the Emergency and ICU's nurses establishing prevalence of Compassionate Fatigue (burnout and Secondary Traumatic Stress) and anxiety. Analyze its relationship with sociodemographic, training, workplace and psychological variables.

METHODS

Descriptive, cross-sectional and multicentre study. The validated ProQOL v. IV and STAI scales and an ad-hoc questionnaire with the variables of the second objective were used in 710 nurses from nine highly complex hospitals in Catalonia (Spain).

RESULTS

In both units, the prevalence of professionals affected with high scores of burnout was higher than 20%, on Secondary Traumatic Stress was 30% and, 12% on anxiety. Each subscale was significantly associated with the intention to leave units and the career. 97% of participants stated that they needed to be trained in emotional management.

CONCLUSION

The prevalence of burnout and Secondary Traumatic Stress were higher in our study than those offered in the reference literature in emergency and ICU nurses. The prevalence of each construct was individually related to the desire to leave work units and career. This fact, together with the participants' desire to be better trained in emotional management exposes the need to establish educational plans, as well as institutional measures to prevent and support nurses for Compassion Fatigue.

Evaluation of compassion fatigue and compassion satisfaction among emergency nurses in Jordan: A cross-sectional study

BACKGROUND

Nurses working in emergency departments are overworked and exposed to frequent stressors over time, leading to compassion fatigue, burnout, and secondary traumatic stress.

AIMS

This study aimed to assess the levels of compassion fatigue and compassion satisfaction, and examine the relationship of these two variables with specific demographic, health-related, and work-related factors among emergency nurses in Jordan.

METHODS

This is a cross-sectional study. The Professional Quality of Life Scale Version 5 was used to collect data.

RESULTS

A convenience sampling method was used to recruit 203 registered nurses from emergency departments in Jordan. The mean compassion fatigue and satisfaction scores were moderate. There was a significant but negligible correlation between compassion satisfaction and educational levels (r = 0.15, p < 0.05) and between secondary traumatic stress and comorbid diseases (r = -0.16, p < 0.05).

CONCLUSIONS

Although the levels of compassion fatigue and satisfaction were moderate, both may negatively affect nurses' care and patient outcomes. Conversely, compassion satisfaction should be improved in order to overcome the negative effects of compassion fatigue.

The Relationship Between Coping Strategies, Compassion Satisfaction, and Compassion Fatigue During the COVID-19 Pandemic

Introduction

The rapid spread of COVID-19 poses a significant threat to nurses' lives and health, resulting in varying degrees of mental distress. Nurses may experience compassion fatigue, and their professional quality of life and satisfaction may suffer as a result. Their coping mechanisms may vary as well, influencing their compassionate and safe care.

Objectives

The study's objectives are to explore levels of compassion satisfaction and fatigue among nurses and identify their coping strategies. Further, to investigate the relationship between coping strategies, compassion satisfaction, and compassion fatigue during the COVID-19 pandemic.

Methods

Using a descriptive correlational design, this study was conducted with a convenience sample of 443 nurses working in an Egyptian university hospital. Nurses completed the coping strategy indicator scale and the professional quality of life (compassion satisfaction and compassion fatigue) scale. The data were analyzed using descriptive statistics, Pearson correlation, and regression analysis.

Results

Nurses' professional quality of life was average in terms of compassion satisfaction (2.95 ± 0.92) and compassion fatigue (2.38 ± 0.35). Nurses have a moderate use of coping strategies (2.13 ± 0.35). Problem-solving was rated as the highest coping strategy, while avoidance was rated as the lowest. Coping strategies showed a positive correlation with compassion satisfaction (r = 0.503, p < .001) and a negative correlation with compassion fatigue (r = -0.352, p < .001). In addition, coping strategies could predict 25.4% and 12.4% of compassion satisfaction and compassion fatigue, respectively (p < .001).

Conclusion

Compassion satisfaction and fatigue are key determinants of nurses' quality of work life. Coping strategies, especially problem-solving and support systems, are vital to increase compassion satisfaction and mitigate burnout and secondary stress syndrome. Nurse managers should establish supportive work environments that promote nurses' well-being. Resilience-building programs and coping strategies' training are recommended to enhance the nurses' quality of work life and positive work attitudes.

The impact of stress associated with caring for patients with COVID-19 on career decisions, resilience, and perceived self-efficacy in newly hired nurses in Jordan: A cross-sectional study

Background and Aims

The decision to stay in nursing has been challenged by the recent coronavirus disease 2019 (COVID-19) pandemic. New nurses joined the workforce and provided care to patients with COVID-19 although they received limited training, which could have influenced their intention to stay in nursing. We aimed in this study to examine the impact of caring for patients with COVID-19 on career decisions, resilience, and perceived self-efficacy among newly hired nurses in Jordan. It also tested the predictors of intentions to stay among new nurses.

Methods

This cross-sectional quantitative study was conducted using an online electronic questionnaire form. The sample included newly hired nurses (n = 300) working in public hospitals and providing care to patients with COVID-19 in different levels of acuity units. The perceived stress scale and Connor-Davidson resilience scale 25 were used to measure stress and resilience among nurses.

Results

The majority chose nursing as their career, but they were not satisfied with the current work conditions or autonomy in decision-making. Many nurses reported having moderate to high work-related stress and low to moderate resilience. Among all variables in this study, financial income predicted mild intention to stay in nursing.

Conclusions

Nurses expressed the presence of work-related stress and low to moderate levels of resilience. As new nurses, exposure to these stress levels might lead to burnout. Nursing managers should take necessary measures to promote better work conditions and improve resilience to avoid nurses leaving the profession at times when there is a shortage.

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

AIM

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

IMPLICATIONS FOR NURSING MANAGEMENT

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

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

INTRODUCTION

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

METHODS

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

RESULTS

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

DISCUSSION

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

Experiences of suffering among nursing professionals during the COVID-19 pandemic: A descriptive qualitative study

BACKGROUND AND AIM

Healthcare professionals have played a fundamental role in managing and controlling the COVID-19 health crisis. They are exposed to high levels of suffering, trauma, uncertainty, and powerlessness in the workplace. The objective of this study was to explore and understand experiences of suffering among primary care and hospital care nurses during the COVID-19 health crisis.

DESIGN

This is a descriptive qualitative study. Between March and April 2021, 19 in-depth interviews were carried out with nurses at health and social care facilities and hospitals in southern Spain. ATLAS.ti 9.0 software was used for discourse analysis.

RESULTS

Nurses reported that they had experienced suffering during their work in the pandemic. The main causes suggested were direct contact with patients' suffering and organisational difficulties. The repercussions are in emotional dimension and physical deterioration and social isolation.

CONCLUSION AND IMPLICATIONS

Given the circumstances, programmes to promote healthy, compassion-based behaviours and changes to the way in which professionals' suffering is handled must be implemented by healthcare facility managers. Nursing leaders should consider the management of suffering as a matter of the first order, both from the ethical point of view and the business profitability and make compassionate leadership.

Saudi Arabian nurses' workaholic tendencies and their predictive role in professional quality of life

PURPOSE

To determine whether nurses' workaholic tendencies and demographic variables predict their professional quality of life.

DESIGN

A cross-sectional design was utilized among 427 Saudi nurses which conveniently selected in four tertiary public hospitals in Saudi Arabia.

FINDINGS

Nurses' have higher workaholic tendencies level and moderate professional quality of life levels. Working more than 40 h per week correlates with one's risk of workaholism. Certain professional quality of life subscales is associated with gender, marital status, hospital experience, and work addiction tendencies.

PRACTICE IMPLICATIONS

The present study contributes to the development of new clinical practices by enlightening readers of the implications of workaholism for nurses' professional quality of life, so that this can be addressed and managed properly.

Exploring the psychological impact of working during COVID-19 on medical and nursing students: a qualitative study

OBJECTIVES

To identify the psychological impact of working during the COVID-19 pandemic on medical and nursing students' psychological well-being. To inform recommendations for the provision of future student well-being support.

DESIGN

An interpretative qualitative, semistructured interview study employing maximum variation sampling, snowball sampling and a thematic analysis.

SETTING

A large West Midlands (UK) university with medical and nursing undergraduate and postgraduate programmes. Study undertaken between January and May 2020.

PARTICIPANTS

A purposive sample of eight medical (six women and two men) and seven nursing (all women) students who worked >2 weeks in a healthcare setting during the COVID-19 pandemic (from 1 March 2020 onwards).

RESULTS

Four core themes with corresponding subthemes were identified: (1) COVID-19 sources of distress-working conditions, exposure to suffering, death and dying, relationships and teams, individual inexperience and student identity, (2) negative impact on mental health and well-being-psychological and emotional distress, delayed distress, exhaustion, mental ill health, (3) protective factors from distress-access to support, environment, preparation and induction, recognition and reward, time for breaks and rest and (4) positive experiences and meaningful outcomes.

CONCLUSIONS

Student pandemic deployment has had a significant negative impact on students' psychological well-being, as a result of demanding working conditions, unprecedented exposure to death and suffering and lack of preparation for new job roles. Universities and healthcare organisations must formally acknowledge this impact and provide well-being support for distressed students working in such challenging contexts. They must also establish more supportive and inclusive healthcare environments for medical and nursing students in future pandemic and postpandemic circumstances, through the implementation of support systems and adequate preparation.

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.

Research on the influencing factors of fatigue and professional identity among CDC workers in China: an online cross-sectional study

OBJECTIVE

This study aimed to investigate the status quo and the influencing factors of fatigue and professional identity among the Centers for Disease Control and Prevention (CDC) workers in China during the pandemic.

DESIGN

A cross-sectional design.

SETTING

CDC workers employed by the Liaoning CDC system were enrolled (administrative staffs were excluded).

PARTICIPANTS

1020 CDC workers.

PRIMARY OUTCOME MEASURES

Fatigue scores and professional identity scores.

SECONDARY OUTCOME MEASURES

Postcompetency scores, respect scores, occupational stress scores, resilience scores and self-efficacy scores.

RESULTS

The average scores of fatigue and professional identity were 8.23, 38.88, respectively. Factors including perceived public respect (β=-0.129, p<0.01), resilience (β=-0.104, p<0.05) and self-efficacy (β=-0.22, p<0.01) were negatively associated with fatigue. Educational background (bachelor vs junior college or below) (β=0.105, p<0.01), (master or above vs junior college or below) (β=0.092, p<0.05), workplace (county vs district) (β=0.067, p<0.05), (city vs district) (β=0.085, p<0.05), fighting the COVID-19 on the front line (β=0.059, p<0.05) and occupational stress (β=0.166, p<0.01) were positively correlated with fatigue. Educational background (bachelor vs junior college or below) (β=-0.097, p<0.01), (master or above vs junior college or below) (β=-0.114, p<0.01), workplace (city vs district) (β=-0.114, p<0.01), fighting the COVID-19 on the front line (β=-0.047, p<0.05) and occupational stress (β=-0.105, p<0.01) were negatively associated with professional identity. Factors including postcompetency (β=0.362, p<0.01), perceived public respect (general vs low) (β=0.219, p<0.01), (high vs low) (β=0.288, p<0.01), resilience (β=0.097, p<0.05) and self-efficacy (β=0.113, p<0.01) were positively connected with professional identity.

CONCLUSION

The fatigue among the CDC workers was at a higher level. The level of professional identity was high, and administrators should take measures to alleviate fatigue and maintain professional identity. In addition, methods aiming to attenuate occupational stress, and improve resilience and self-efficacy should be immediately put into action.

Compassion satisfaction, resilience and passion for work among nurses and physicians working in intensive care units: A mixed method systematic review

OBJECTIVE

To identify, appraise, and synthesise current evidence on prevalence, correlates, and interventions to enhance compassion satisfaction, resilience, and passion for work among nurses and physicians working in intensive care units.

METHODS

A mixed methods systematic review was conducted. The comprehensive search used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven databases (MEDLINE, EMBASE, CINAHL, JBI, ProQuest, PsycINFO, and Cochrane Library) were searched for literature published between January 2011 and June 2021. The Mixed Methods Appraisal Tool was used to assess methodological quality. Data from included studies were analysed using a convergent mixed methods design. The protocol was prospectively registered (PROSPERO 2021 CRD42021252051).

RESULTS

A total of 37 studies met the inclusion criteria. Most studies reported moderate levels of compassion satisfaction among intensive care health professionals, whereas levels of resilience varied. Compassion satisfaction and resilience were positively correlated, but relationships between compassion satisfaction and resilience and other correlates (personal factors, psychological factors, and work-related factors) were inconsistently reported. Only four interventions aimed to improve compassion satisfaction or resilience among intensive care health professionals. None of the included studies investigated passion for work.

CONCLUSION

Compassion satisfaction, resilience, and passion for work among staff in the intensive care unit are important in the current global COVID-19 pandemic. Health professionals report a moderate level of compassion satisfaction but findings in relation to resilience are mixed. No studies examined passion for work. Further research to determine ongoing psychological wellbeing and professional quality of life and evaluate tailored interventions to support intensive care staff well-being is recommended.

Compassion Fatigue and Satisfaction in Nurses and Midwives during the COVID-19 Pandemic in Turkey

Objective: To examine the levels of compassion fatigue and compassion satisfaction of nurses and midwives during the COVID-19 pandemic and the influencing factors. Methods: This descriptive study was carried out with the participation of Turkish midwives and nurses. In the study using the convenience sampling method, data were collected online using an online questionnaire. The questionnaire, created through the Google form, was shared between May and June 2021 in the midwife and nurse groups (Facebook, Instagram, WhatsApp) on electronic platforms. Compassion fatigue (CF) and compassion satisfaction (CS) consisting of the burnout (BO) and secondary traumatic stress (STS) subcomponents were assessed by the Professional Quality of Life scale. The study was completed with 402 nurses and midwives from various units. Descriptive statistics, and the Mann-Whitney U and Kruskal-Wallis tests were used in the analysis of the data. Results: Among the participants, the rate of dissatisfaction with the clinic worked was 24.6% and the turnover intention rate was 70.6%. During the pandemic period, 75.6% of the participants reported that they were exposed to verbal violence, 7.7% to physical violence, and 74.4% to mobbing behaviors. Low CS was found in 24.9% of the participants, a high level of BO in 27.1%, and high STS in 32.8%. Conclusion: Violence and mobbing against nurses and midwives should be prevented in order to increase the professional quality of life.

The association of mindfulness with professional quality of life and negative emotional states among critical care nurses during COVID-19 pandemic

BACKGROUND

The recent coronavirus disease 2019 (COVID-19) pandemic has imposed severe psychological pressure on nurses. Mindfulness has been shown to be effective in improving professional quality of life (ProQOL) and reducing psychological distress in a wide range of populations and contexts. However, its role in supporting critical care nurses during the outbreak of COVID-19 has yet to be established.

PURPOSE

This study explores the relationship of mindfulness with negative emotional states and ProQOL among nurses working in critical care units during COVID-19 pandemic.

METHODS

A cross-sectional descriptive correlational design was used. A sample of 156 critical care nurses completed self-reported measures of mindfulness, ProQOL, and negative emotional states. Multiple regressions were used to address the study purpose.

RESULTS

Overall, the participants had severe anxiety, moderate depression, moderate stress, moderate burnout, moderate secondary traumatic stress, and moderate compassion satisfaction. Mindfulness was significantly and negatively associated with stress (r = - 0.230, p = .004), depression (r = - 0.190, p = .018), burnout (r = - 0.218, p = .007), and secondary traumatic stress (r = - 0.168, p = .037). Mindfulness explained 3% of the variance in depression (B = -0.19, p = .018), 3.9% of variance in stress, (B = -0.201, p = .012), 4.2% of variance in BO (B = -0.206, p = .009), and 2.2% of the variance in secondary traumatic stress (B = -0.168, t = -2.104, p = .037), controlling for demographics.

CONCLUSIONS

The current study provides preliminary evidence that mindfulness can be helpful in reducing critical care nurses' psychological distress and promoting their ProQOL, and is worthy of further investigation in this population.

Emotional Intelligence and Perceived Health Related to Expressed Compassion Fatigue: A Study in Health Sector at Regional Level

Background: The work of health professionals often involves physical as well as psychological strain. They constantly deal with traumatic situations of pain and suffering, which destabilize the sense of well-being. Compassion fatigue is a feeling that appears in these cases and is related to other variables such as burnout or emotional drain.

Aims: The principal aim of this project was to deepen the analysis of compassion fatigue and how it could be explained through the relationship with other constructs such as emotional intelligence and perceived health.

Methods: This work followed the STROBE checklist for cross-sectional studies. In this study 1,521 nurses (M_age = 47.32; SD = 8.44) participated. The responses reported by the nurses were analyzed by classifying them as high or low compassion fatigue and the differences of both groups were analyzed for the variables of emotional intelligence, perceived health and quality of professional life.

Results: It was obtained significant differences for all factors except for emotional intelligence factor. A linear regression analysis showed both emotional intelligence and perceived health helped to explain (12%) compassion fatigue.

Conclusion: This study provides light on comprehending the conception of compassion fatigue. It highlights the importance of intervention programs that improve the quality of professional life.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19

Background: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses’ coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. Methods: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. Results: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. Conclusions: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Work Environment Characteristics and Emotional Intelligence as Correlates of Nurses' Compassion Satisfaction and Compassion Fatigue: A Cross-Sectional Survey Study

This cross-sectional survey study examined the relationship between Canadian nurses' work environment characteristics, emotional intelligence, compassion fatigue and compassion satisfaction (n = 1271). Psychological demands, decision latitude, supervisor and coworker support, and emotional intelligence (EI) were significantly correlated with nurses' compassion satisfaction and compassion fatigue, except for two EI subscales. Furthermore, these relationships were stronger for compassion satisfaction than compassion fatigue, suggesting that they are influenced by different factors. Our results highlight the importance of creating reasonable psychological demands, empowering nurses to make decisions in their jobs, supportive relationships at work, and fostering the development of nurses' EI.

Stress coping strategies and their perceived effectiveness among HIV/AIDS healthcare providers in China: a qualitative study

Previous studies have suggested that many HIV/AIDS healthcare providers (HCPs), especially those in resource-poor settings, suffer from various work-related stress because of the complexity of HIV/AIDS patients' medical conditions, occupational exposure, HIV-related stigma, and challenges with patients' physical, mental, and social conditions. However, data are limited regarding how HIV/AIDS HCPs cope with the stress and their perceived effectiveness of these coping strategies. This qualitative study was designed to explore HCPs' coping strategies and their perceptions of effectiveness of these strategies. We conducted in-depth face-to-face interviews with 46 HIV/AIDS HCPs in Guangxi, China. The interviews were audio-recorded, transcribed and imported into NVivo V.11. Data were analyzed using a thematic approach. The analysis of the data revealed six general coping strategies: seeking social support, applying problem-solving strategies, adopting healthy lifestyle, developing self-compassion, using mindfulness-based stress reduction methods, and avoidance and escaping. It is imperative to increase institutional support and develop training programs to improve problem-solving skills, healthy lifestyle, and self-compassion among HIV/AIDS HCPs in China.

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.

Burnout, compassion fatigue and work-related stressors among organ donation and transplantation coordinators: A qualitative study

AIM

Organ and Tissue Donation Coordinators (OTDCs) are healthcare professionals who manage deceased organ donation cases. This study investigated the experiences and perceptions of OTDCs, pertaining to compassion fatigue, burnout, and resilience as it relates to their daily work.

METHODOLOGY

A qualitative descriptive study was undertaken using semi-structured interviews conducted with a convenience sample of OTDCs.

SETTING

A Canadian Organ Donation Organization.

FINDINGS

Seven out of the ten OTDCs contacted participated in this study. Coordinators all agreed that they work in a high-pressure and demanding environment and the constant exposure to work-related stress and grief has resulted in the majority of them experiencing signs and symptoms of burnout and compassion fatigue occurring throughout their career. Participants described that the emotional toll of work-related stressors and difficult cases led them to use a variety of defence strategies to protect and support their well-being. They also recognised that more strategies to help mitigate work-related stressors and to prevent burnout and compassion fatigue are needed and that management and institutions should lead the development of such interventions.

CONCLUSION

Our results describe how coordinators' mental health is affected by their daily work. Further research is needed to comprehensively examine these work-related stressors and to generate additional data to support the development of interventions to mitigate burnout and compassion fatigue among OTDCs.

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 relationships of both transition shock, empathy, resilience and coping strategies with professional quality of life in newly graduated nurses

Background

Data on professional quality of life in newly graduated nurses are scarce. This study aimed to describe the levels of professional quality of life, and to explore the relationships of transition shock, empathy, resilience and coping strategies with professional quality of life in newly graduated nurses.

Methods

This was a cross-sectional study, which used a two-stage sampling method to recruit 393 newly graduated nurses in Sichuan province of China. Multiple regression analysis was used to explore the effects of transition shock, empathy, resilience and coping strategies on professional quality of life. Data were collected using standardized scales.

Results

The prevalence of average levels of compassion satisfaction, burnout and secondary traumatic stress in newly graduated nurses were 80.2, 38.2 and 57.5%, respectively. Transition shock was a significant negative predictor, and empathy, resilience and adaptive coping were significant positive predictors for compassion satisfaction. Transition shock and passive coping were significant positive predictors, and empathy was a significant negative predictor for burnout and secondary traumatic stress. Resilience and adaptive coping contributed to burnout significantly and negatively.

Conclusion

Higher transition shock and lower empathy cause lower compassion satisfaction and higher compassion fatigue. More resilience and adaptive coping cause more compassion satisfaction and less burnout. More passive coping contributes to higher compassion fatigue. Strategies such as transition or preceptorship programmes, and empathy, resilience and coping training are effective methods to reduce transition shock, facilitate empathy, resilience and coping, and consequently, enhance professional quality of life in newly graduated nurses.

Where to Look for a Remedy? Burnout Syndrome and its Associations with Coping and Job Satisfaction in Critical Care Nurses-A Cross-Sectional Study

BACKGROUND

Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and a prolonged exposure to stress.

AIM

The aims of this study were to explore the associations between levels of burnout syndrome, coping mechanisms and job satisfaction in critical care nurses in multivariate modelling process. A specific aim was also to explore whether coping and job satisfaction in critical care nurses are gender related.

METHODS

A cross-sectional multicentre study was conducted in a convenience sample of 620 critical care nurses from five university hospitals in Croatia in 2017. The data were collected using the Maslach Burnout Inventory and the Ways of Coping and Job Satisfaction Scale together with the nurses' demographic profiles and were analysed using a multivariable model.

RESULTS

The results showed no significant association between gender, coping mechanisms and job satisfaction. However, significant negative associations between burnout and job satisfaction (OR = 0.01, 95%CI = 0.00-0.02, p < 0.001) and positive association between burnout and passive coping (OR = 9.93, 95%CI = 4.01-24.61, p < 0.001) were found.

CONCLUSION

The association between job satisfaction and burnout in nurses urges hospital management teams to consider actions focused on job satisfaction, probably modifications of the work environment. Given that passive coping may increase the incidence of burnout, it is recommendable for active coping to be implemented in nurses' training programmes as an essential element of capacity building aimed at reducing the incidence of burnout in 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.

When and how do hospital nurses cope with daily stressors? A multilevel study

BACKGROUND

During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses.

OBJECTIVES

To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses.

DESIGN

This study uses descriptive, correlational, two-level design with repeated measures.

SETTINGS

Wards of two University hospitals.

PARTICIPANTS

A random cohort of 113 nurses was studied.

METHODS

An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships.

RESULTS

Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task.

CONCLUSIONS

The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.

How the Lagged and Accumulated Effects of Stress, Coping, and Tasks Affect Mood and Fatigue during Nurses' Shifts

Nurses experience significant stress and emotional exhaustion, leading to burnout and fatigue. This study assessed how the nurses' mood and fatigue evolves during their shifts, and the temporal factors that influence these phenomena. Performing a two-level design with repeated measures with moments nested into a person level, a random sample of 96 nurses was recruited. The ecological momentary assessment of demand, control, effort, reward, coping, and nursing tasks were measured in order to predict mood and fatigue, studying their current, lagged, and accumulated effects. The results show that: (1) Mood appeared to be explained by effort, by the negative lagged effect of reward, and by the accumulated effort, each following a quadratic trend, and it was influenced by previously executing a direct care task. By contrast, fatigue was explained by the current and lagged effect of effort, by the lagged effect of reward, and by the accumulated effort, again following quadratic trends. (2) Mood was also explained by problem-focused and emotion-focused coping strategies, indicative of negative mood, and by support-seeking and refusal coping strategies. (3) Fatigue was also associated with direct care and the prior effect of documentation and communication tasks. We can conclude that mood and fatigue do not depend on a single factor, such as workload, but rather on the evolution and distribution of the nursing tasks, as well as on the stress during a shift and how it is handled. The evening and night shifts seem to provoke more fatigue than the other work shifts when approaching the last third of the shift. These data show the need to plan the tasks within a shift to avoid unfinished or delayed care during the shift, and to minimize accumulated negative effects.