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Silva E Silva V, Dupuis KL, Shoalts K, Dhanani S, Silva A. Exploring educational and training approaches for organ and tissue donation coordinators: A scoping review. NURSE EDUCATION TODAY 2025; 148:106630. [PMID: 39978221 DOI: 10.1016/j.nedt.2025.106630] [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: 06/03/2024] [Revised: 02/03/2025] [Accepted: 02/10/2025] [Indexed: 02/22/2025]
Abstract
INTRODUCTION Organ and tissue donation coordinators often have limited training leading to reduced service quality and increased work-related stress. Understanding the existing educational strategies and training methods is crucial for supporting their professional development. OBJECTIVES To synthesize existing literature on strategies used to educate healthcare professionals for the role of organ and tissue donation coordinators. DESIGN Scoping review guided by the Joanna Briggs Institute methodology. DATA SOURCES Searches were conducted in Medline, Embase, Cumulated Index in Nursing and Allied Health Literature, Web of Science, Cochrane Library, and Latin American and the Caribbean Literature on Health Sciences up to 2023. STUDY SELECTION Reports on education for healthcare providers working as organ and tissue donation coordinators were included. Reviewers independently screened documents for eligibility based on inclusion criteria. DATA EXTRACTION Data on study design, sample, educational strategies, and outcomes were extracted using a specially developed tool. The data were analyzed quantitatively (simple numeric count) and qualitatively (content analysis). RESULTS From 5420 articles, 33 met the inclusion criteria. The results were categorized into (1) Education Types and Engagement, (2) Education Strategy Development and Delivery, and (3) Education Evaluation Methods and Outcomes. CONCLUSION The findings highlight the diverse types, delivery methods, and evaluation approaches in organ and tissue donation coordinators' educational training. Ongoing education is vital to equip organ and tissue donation coordinators with essential skills for complex scenarios in organ donation and transplantation. Investing in comprehensive education programs is crucial for enhancing organ and tissue donation coordinators' work-related wellbeing, improving organ donation and transplantation outcomes, and promoting continued research and development tailored to their unique needs.
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Affiliation(s)
| | | | - Kerry Shoalts
- Department of Nursing, Brock University, St. Catharines, Canada
| | - Sonny Dhanani
- Research Institute, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Amina Silva
- Department of Nursing, Brock University, St. Catharines, Canada
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Silva E Silva V, Minervini A, Dupuis KL, Lotherington K, Dhanani S, Silva A. Understanding the work-related challenges of organ and tissue donation coordinators during the COVID-19 pandemic: a mixed-method study. BMJ Open 2025; 15:e088626. [PMID: 39800409 PMCID: PMC11752047 DOI: 10.1136/bmjopen-2024-088626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 12/04/2024] [Indexed: 01/24/2025] Open
Abstract
OBJECTIVES This study aimed to explore the perceptions of donation coordinators in Canada and understand how the COVID-19 pandemic impacted their work activities. DESIGN A sequential mixed-method design incorporating a cross-sectional survey investigating demographic data, substance use and abuse and perceived stress related to the pandemic and semistructured qualitative interviews to further investigate those. SETTING Organ donation organisations across Canada. PARTICIPANTS Canadian organ and tissue donation coordinators working within deceased donation programmes. Participants were recruited using a purposive sampling technique for the survey and qualitative interviews. Recruitment and data collection took place between January 2022 and March 2023. ANALYSIS The data were analysed using descriptive statistics for the quantitative findings and content analysis for the qualitative data. RESULTS Of the 175 available coordinators, 120 participated in the survey, and 39 participated in the qualitative interviews. The great majority were female (n=98; 81.7%), registered nurses (n=117; 97.5%) and on average 42 years old (SD=9.64). The survey result for perceived stress showed that, on average, coordinators did not experience high stress levels during the pandemic. We also identified an increase in the consumption of substances to manage workplace stress near the pandemic's beginning. The qualitative interviews yielded two main themes (Personal Life Changes and Workplace Adjustments) in which coordinators reported their views on challenges with uncertainties, effects on their personal lives, redeployment, stressors and among others. CONCLUSION Our study's results provide a comprehensive understanding of the perceptions and experiences of coordinators in Canada during the COVID-19 pandemic. Using a combination of methods, we identified various ways coordinators were affected by the pandemic in their personal and professional lives. These findings highlight the need to support the development of adaptive strategies and promote resilience during crises.
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Affiliation(s)
| | | | | | | | - Sonny Dhanani
- Critical Care, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Amina Silva
- Nursing, Brock University, St. Catharines, Ontario, Canada
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Vincent BP, Randhawa G, Cook E. A qualitative study exploring barriers and facilitators in deceased organ donation process among transplant coordinators in India. Sci Rep 2024; 14:28773. [PMID: 39567632 PMCID: PMC11579380 DOI: 10.1038/s41598-024-80290-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 11/18/2024] [Indexed: 11/22/2024] Open
Abstract
Although India's organ donation rate is less than 1 per million population, significant disparities exist between the regions and centres within the country, leading to varying consent rates among different organ donation centres. Therefore, this study aimed to understand the experience of transplant coordinators and their barriers and facilitators in the deceased organ donation process across various organ donation centres in India. A phenomenological study using interviews was conducted among fourteen transplant coordinators purposefully recruited from public and private organ donation centres in India, with experience between six years and more than a decade. Audio recordings were transcribed and analysed using framework analysis. Five themes were identified namely: (1) supportive management policies, (2) infrastructure for the deceased organ donation process, (3) delays in the processing time, (4) active involvement in the identification process, and (5) explaining the concept of brain death. The study identifies that implementation priorities include strengthening teamwork, streamlining processes, optimising infrastructure for sensitive discussions, efficient donor identification, and empathetic handling of donor families' grief stages. Collaborating with law enforcement, applying successful medico-legal strategies, improving family communication, and clarifying brain death concepts ethically and legally can boost consent rates, fostering informed decisions and possibly achieving self-sufficiency in deceased organ donation.
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Affiliation(s)
- Britzer Paul Vincent
- Institute for Health Research, Faculty of Health and Social Sciences, University of Bedfordshire, Luton, UK
| | - Gurch Randhawa
- Department of Psychology, University of Bedfordshire, Luton, UK.
| | - Erica Cook
- Department of Psychology, University of Bedfordshire, Luton, UK
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Mollazadeh F, Habibzadeh H, Parizad N. "No One Seems to See Us, and They Look at Us as Worthless Colleagues": Challenges Experienced by Iranian Transplant Nurse Coordinators-A Qualitative Study. Pediatr Transplant 2024; 28:e14865. [PMID: 39343722 DOI: 10.1111/petr.14865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 09/02/2024] [Accepted: 09/13/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Transplant nurse coordinators have close and long-term interactions with organ donor families throughout the organ donation process. Due to the responsibilities and high sensitivity of organ transplant coordination, transplant nurse coordinators face several stressful challenges. This study aimed to explore the challenges faced by Iranian transplant nurse coordinators. METHODS This is a qualitative study conducted using qualitative content analysis. This study was conducted from February to September 2023. Semi-structured face-to-face interviews were conducted with a total of 14 transplant nurse coordinators. Data were analyzed using conventional qualitative content analysis proposed by Graneheim and Lundman. RESULTS "Challenges of living as a transplant nurse coordinator" was identified as the main category, the subcategories of which included "consent-obtaining obstacles," "exposure to violence," "compassion fatigue," "obsessive thoughts," "work-life imbalance," and "hardworking coordinators in the shadow." CONCLUSIONS The challenges experienced by transplant nurse coordinators can lead to several negative consequences, including job burnout and turnover, reduced quality of family and marital life, additional healthcare costs, and reduced organ donation rate. To address these challenges, cultivating a culture of organ donation in society could involve public awareness campaigns and educational initiatives. Improving the working conditions and occupational incentives could include reducing work hours, providing psychological support, and increasing salaries. Implementing psychological interventions could involve regular counseling sessions and stress management programs. These measures can effectively reduce the challenges transplant nurse coordinators face and improve their overall well-being and job satisfaction.
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Affiliation(s)
- Farzin Mollazadeh
- Patient Safety Research Center, Clinical Research Institute, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Hossein Habibzadeh
- Patient Safety Research Center, Clinical Research Institute, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Ali K, Zahra D, Bashir U, Daud A, Raja HZ, Witton R, Raja M. Beyond the Bite: Exploring Mental Health of Dental Faculty in Pakistan- a multi-institutional study. BDJ Open 2024; 10:80. [PMID: 39419982 PMCID: PMC11487246 DOI: 10.1038/s41405-024-00263-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Revised: 08/30/2024] [Accepted: 09/01/2024] [Indexed: 10/19/2024] Open
Abstract
INTRODUCTION Mental health issues are being reported increasingly amongst healthcare staff and students globally. The aim of this study was to investigate the frequency of common mental health issues amongst dental faculty members at multiple institutions in Pakistan. METHODS Following approval from the institutional ethics review board, dental faculty members at 14 dental institutions were invited to participate in an online survey based on globally validated scales for mental health problems including the Patient Health Questionnaire (PHQ-9), and the Depression, Anxiety, and Stress Scale (DASS-21). Two open-ended questions were included in the survey to identify perceived factors contributing to poor mental health and recommendations for improving institutional support. RESULTS A total of 200 faculty members out of provided their responses to the survey questionnaire but complete responses were provided by 183 participants which included 120 (65.57%) females, and 63 (34.43%) males. The total number of faculty members at the participating institutions was 426 and 183 responses translated into an overall response rate of 43%. Most participants were in the 31-40 years age-group (n = 81, 44.26%) followed by 25-30 year (n = 51, 22.87%) and 41-50 years (n = 40, 21.86%). The mean score on PHQ-9 was 6.51 (SD ± 5.4) while the mean DASS-21 score was 13.04 (SD ± 10.95). PHQ-9 Depression, and DASS-21 Depression, Anxiety, and Stress scores were all significantly positively correlated for the whole sample, and within each subgroup of each demographic factor. Job-related workload, lack of institutional support, financial limitations, and poor work life balance were identified as the main factors contributing adversely to the mental health of the participants. DISCUSSION This study provides useful insights into the scale of mental health status amongst dental faculty members at 14 institutions in Pakistan. Underlying factors affecting the mental health of faculty members adversely were identified and recommendations are provided to address these challenges.
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Affiliation(s)
- Kamran Ali
- Qatar University, QU Health College of Dental Medicine, Doha, 2713, Qatar.
| | - Daniel Zahra
- Plymouth University, School of Psychology, Plymouth, PL4 8AA, UK
| | - Ulfat Bashir
- Islamic International Dental College Riphah International University, Islamabad, Pakistan
| | - Alaa Daud
- Qatar University, QU Health College of Dental Medicine, Doha, 2713, Qatar
| | | | - Rob Witton
- Plymouth University, Peninsula Dental School, Plymouth, PL4 8AA, UK
| | - Mahwish Raja
- Qatar University, QU Health College of Dental Medicine, Doha, 2713, Qatar
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Wrześniewski K, Pałka T, Blecharz J. The influence of vibratory massage after physical exertion on selected psychological processes. Front Psychol 2024; 15:1380282. [PMID: 38765830 PMCID: PMC11099259 DOI: 10.3389/fpsyg.2024.1380282] [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: 02/01/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024] Open
Abstract
Good mental preparation of an athlete plays an important role in achieving optimal sports results. An athlete who enters a competition should not feel fatigue resulting from intense physical exercise. Therefore, new and effective methods are being sought that could help accelerate the process of both physical and mental regeneration. Vibrotherapy is one of them. The aim of the study was to determine the optimal frequency of vibration, its duration and the position in which the subjects were placed during the treatments, in relation to the reduction of subjectively perceived exertion muscle pain, mental discomfort, emotional states and the level of cognitive processes that were disturbed by intense physical activity. Sixteen healthy male volunteers were involved in this study. The participants were assessed for their aerobic and anaerobic capacity. Each of the subjects performed a set of intensive physical exercises and then underwent vibrotherapy treatment. In random order, each of the men tested the effectiveness of eight combinations of frequency, duration, and body position. Psychological tests were conducted for each combination: frequency, duration of treatment, and position during treatment, in four stages: (1) before the start of the experiment (baseline POMS measurements), (2) immediately after the exercise (VAS scale, scale examining psychological discomfort and STROOP test), (3) immediately after the vibration treatment (POMS measurements, VAS scale, scale examining psychological discomfort and STROOP test), (4) 24 h after the vibration treatment (VAS scale examining subjective assessment of perceived pain and psychological discomfort). Based on the results, it was concluded that all the studied variables improved significantly over time (after the vibration treatment and 24 h after training). In addition, a statistically significant interaction measurement × frequency was noted for vigor scale (52HZ favored greater improvement in this state), and a statistically significant interaction was found for measurement × time for the VAS scale (p < 0.05) - the lower pain value was indicated 24 h after the 10-min vibration treatment. The type of frequency used, position, and duration of the treatment did not play a statistically significant role in changing STROOP test results and severity of psychological discomfort (p > 0.05).
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Affiliation(s)
- Krzysztof Wrześniewski
- Department of Psychology, Institute of Social Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Tomasz Pałka
- Department of Physiology and Biochemistry, Institute of Biomedical Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
| | - Jan Blecharz
- Department of Psychology, Institute of Social Sciences, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland
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Silva AR, Rochon A, Hornby L, Lotherington K, James L, Webster R, Sucha E, Sarti A, Dhanani S, Silva E Silva V. Resilience among organ donation coordinators: a Canadian mixed-methods study. Front Public Health 2024; 12:1367546. [PMID: 38560430 PMCID: PMC10978649 DOI: 10.3389/fpubh.2024.1367546] [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] [Received: 01/08/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
Background Organ and Tissue Donation Coordinators (OTDCs) are key to the success of deceased organ donation processes. However, reduced resilience can leave them susceptible to the incidence of work-related issues and decrease the quality of the care provided. Therefore, this study aimed to examine the extent of resilience and influencing aspects among OTDCs in Canada. Methods Mixed-method (QUAN-qual) explanatory sequential design. Quantitative data was collected using an online cross-sectional survey approach with demographic data and the validated scales and analyzed using descriptive and inferential statistics. Qualitative data was collected using a descriptive approach with a semi-structured interview guide and analyzed using content analysis. Results One hundred twenty participants responded to the survey, and 39 participants were interviewed. Most participants from the survey were female (82%), registered nurses (97%) and on average 42 years old. The quantitative data revealed that OTDCs had a high level of perceived compassion satisfaction (ProQOL-CS = 36.3) but a resilience score (CD-RISC = 28.5) lower than other groups of healthcare professionals. OTDCs with over a year of experience in the role were more likely to have higher levels of resilience. The qualitative data identified that participants saw resilience as crucial for their work-related well-being. Although coping strategies were identified as a key factor that enhance resilience, many OTDCs reported difficulty in developing healthy coping strategies, and that the use of unhealthy mechanisms (e.g., alcohol and smoking) can result in negative physical consequences (e.g., weight gain) and reduced resilience levels. Conclusion Participants reported using a series of coping and protective strategies to help build resilience, but also difficulty in developing healthy mechanisms. The lack of healthy coping strategies were seen as contributing to negative work-related issues (e.g., burnout). Our findings are being used to develop tailored interventions to improve resilience and healthy coping strategies among organ donor coordinators in Canada.
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Affiliation(s)
- Amina R Silva
- Department of Nursing, Brock University, St. Catharines, ON, Canada
| | - Andrea Rochon
- Department of Nursing, St. Lawrence College, Kingston, ON, Canada
| | | | | | - Lee James
- Canadian Blood Services, Ottawa, ON, Canada
| | - Richard Webster
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ewa Sucha
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Aimee Sarti
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
| | - Sonny Dhanani
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
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Sun T, Huang XH, Zhang SE, Yin HY, Li QL, Gao L, Li Y, Li L, Cao B, Yang JH, Liu B. Fatigue as a Cause of Professional Dissatisfaction Among Chinese Nurses in Intensive Care Unit During COVID-19 Pandemic. Risk Manag Healthc Policy 2023; 16:817-831. [PMID: 37187922 PMCID: PMC10178901 DOI: 10.2147/rmhp.s391336] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
Aim To clarify the mediating role of burnout and the moderating role of turnover intention in the association between fatigue and job satisfaction among Chinese nurses in intensive care units (ICU) during the COVID-19 pandemic. Methods A cross-sectional survey of fifteen provinces in China was conducted, using an online questionnaire, from December 2020 to January 2021, during the COVID-19 pandemic. A total of 374 ICU nurses (effective response rate: 71.37%) provided sufficient responses. Sociodemographic factors, job demographic factors, fatigue, burnout, job satisfaction, and turnover intention were assessed using questionnaires. General linear modeling (GLM), hierarchical linear regression (HLR) analysis, and generalized additive modeling (GAM) were performed to examine all the considered research hypotheses. Results Fatigue was found to be negatively and significantly associated with job satisfaction. Moreover, burnout played a partial mediating role and turnover intention played a moderating role in the relationship between fatigue and job satisfaction. Conclusion Over time, a state of physical and mental exhaustion and work weariness among Chinese ICU nurses potentially results in job burnout and consequently promotes the level of job dissatisfaction. The results also found that turnover intention played a moderating role in the relationship between burnout and job satisfaction. Specific policies could be considered to eliminate nurses' fatigue and negative attitudes during times of public health emergencies.
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Affiliation(s)
- Tao Sun
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China
| | - Xian-Hong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, People’s Republic of China
| | - Shu-E Zhang
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Hong-Yan Yin
- Department of Humanities and Social Sciences, Harbin Medical University (Daqing), Daqing, 163319, People’s Republic of China
| | - Qing-Lin Li
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Lei Gao
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Ye Li
- Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China
| | - Li Li
- Department of Administration, School of Law, Zhejiang University City College, Hangzhou, 310015, People’s Republic of China
| | - Bing Cao
- Department of Oncology, Weifang People’s Hospital, Weifang, 261000, People’s Republic of China
| | - Jin-Hong Yang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, 400715, People’s Republic of China
| | - Bei Liu
- Global Center for Infectious Disease and Policy Research, Peking University, Beijing, 100191, People’s Republic of China
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Yeşil A, Polat Ş. Investigation of psychological factors related to compassion fatigue, burnout, and compassion satisfaction among nurses. BMC Nurs 2023; 22:12. [PMID: 36631763 PMCID: PMC9835325 DOI: 10.1186/s12912-023-01174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023] Open
Abstract
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.
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Affiliation(s)
- Aslı Yeşil
- grid.448598.c0000 0004 0454 8989Faculty of Humanities and Social Sciences, Department of Psychology, Bursa Technical University, Bursa, Türkiye
| | - Şehrinaz Polat
- grid.9601.e0000 0001 2166 6619Faculty of Nursing, Istanbul University, Istanbul, Türkiye
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