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

Interventions to Reduce Compassion Fatigue in Nursing: A Systematic Review and Meta-Analysis of Controlled Studies

BACKGROUND

Compassion fatigue is the emotional response generated by continuous exposure to human suffering and is especially common among nursing professionals. This phenomenon can lead to decreased empathy and increased emotional exhaustion while affecting the quality of care.

AIM

To synthesize information from primary studies that have used and evaluated interventions aimed at managing compassion fatigue in nursing professionals.

DESIGN

A systematic review with meta-analysis of studies with randomized and nonrandomized control groups.

METHODS

Medline, CINAHL, Scopus, and Web of Science databases were searched for studies published between 2013 and 2023. The search was conducted in January 2024 to identify control group studies that provided quantitative pre-post data on both groups of compassion fatigue assessed with the Professional Quality of Life Scale (ProQol). Quality was assessed using the RoB2 and ROBINS-I scales. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024537935).

RESULTS

The search strategy yielded a total of 1006 records, of which 11 studies were selected; these provided a total of 763 participants. Most of the interventions consisted of providing knowledge and skills to increase resilience, emotional well-being, and stress coping. The interventions had an average duration of 6 weeks distributed in 9 sessions with an average of 90 minutes. After the intervention, a statistically significant increase in satisfaction was obtained and a statistically significant reduction in fatigue and burnout.

CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Interventions aimed at reducing compassion fatigue are effective among nursing professionals. In the future, further high-quality research with prospective follow-up designs is required.

Effects of compassion satisfaction, burnout, and secondary traumatic stress on current drug use among healthcare workers: Differences by occupational level

Work-related stress has been well-examined among physicians, but little is known about how it might affect drug use or healthcare workers in lower-wage occupations characterized by high job demands and low occupational autonomy (e.g., medical assistants, nursing assistants). We collected data from a diverse sample of healthcare workers (N = 200) and separately examined the cross-sectional relationships between several work-related experiences (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and measures of current drug use (i.e., non-medical use of prescription drugs [NMUPD], cannabis use, and illicit drug use). We then examined for differences in these relationships by occupational level (i.e., prescriber/administrator vs. other healthcare worker). In main effects models, greater burnout and secondary traumatic stress were both associated with higher odds of NMUPD, cannabis use, and illicit drug use (ps < 0.01). Greater compassion satisfaction was associated with lower odds of illicit drug use (p < 0.05), but not with NMUPD or cannabis use (ps > 0.05). There was a significant interaction between secondary traumatic stress and occupational level on NMUPD (p < 0.05) such that there was no relationship among prescribers/administrators, but the likelihood of NMUPD increased with greater secondary traumatic stress among other healthcare workers. Similar trend-level interactions were observed between secondary traumatic stress and occupational level on cannabis use (p < 0.10) and between burnout and occupational level on NMUPD. Burnout and secondary traumatic stress may contribute to drug use, and lower-wage healthcare workers may be especially vulnerable.

The impact of the nursing work environment on compassion fatigue: The mediating role of general self-efficacy

AIM

To explore the interplay between the perceived nursing work environment, general self-efficacy, and compassion fatigue among registered nurses in Chinese hospitals.

BACKGROUND

Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self-efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses.

METHODS

Employing a cross-sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self-efficacy, and different dimensions of compassion fatigue.

FINDING

More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10 ± 2.07), while general self-efficacy scored higher (27.54 ± 6.26). A positive relationship existed between the work environment and both general self-efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self-efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self-efficacy.

CONCLUSION

This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self-efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self-efficacy and overall well-being.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self-efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well-being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment.

The Mediation Impact of Compassion Competence on the Link Between Mindfulness and Job Burnout in Nurses: A Cross-Sectional Study

AIMS

This study explores the link between mindfulness, compassion competence and job burnout among nurses, and analyses the mediating role that compassion competence plays in this relationship.

BACKGROUND

Understanding nurses' mindfulness, compassion competence and job burnout is important, which could help devise interventions to relieve burnout in clinical nurses.

METHODS

This study adopts convenience sampling method and descriptive design quantitative research. A cross-sectional study of 513 nurses was conducted from June to October 2023 in mainland China. The Socio-demographic Questionnaire, Mindful Attention Awareness Scale, Maslach Burnout Inventory-Human Service Survey and Compassion Competence Scale for the Nurses were utilised to gather basic demographic information on nurses and to evaluate their level of mindfulness, compassion competence and job burnout. Descriptive statistics, Spearman's correlation analyses and structural equation model were used to analyse the data.

RESULTS

Five hundred and thirteen valid questionnaires were gathered. Spearman's correlation analysis revealed a strong negative link between mindfulness and job burnout, and between compassion competence and burnout, and a significant positive correlation between mindfulness and compassion competence. The results of the mediation analysis revealed that the relationship between mindfulness and job burnout was partially mediated by compassion competence, and the mediating effect accounted for 18.6% of the total effect.

CONCLUSION

Compassion competence performed as a partial mediator between mindfulness and job burnout among nurses. Nursing managers could enhance nurses' mindfulness level and compassion competence through Mindfulness interventions and Compassion training to reduce their burnout.

RELEVANCE TO CLINICAL PRACTICE

This study offers a fresh viewpoint on enhancing clinical nurses' compassion competence and reducing job burnout. Healthcare organisations and medical institutions can mitigate nurses' job burnout by improving their mindfulness levels and compassion competence.

REPORTING METHOD

The study used the STROBE checklist for reporting.

PATIENT OR PUBLIC CONTRIBUTION

All participants were nurses who completed an electronic questionnaire related to this study.

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.

Assessing the effectiveness of emotion-focused online intervention in mitigating compassion fatigue and enhancing compassion satisfaction among helping professionals

This study aimed to assess the effectiveness of a newly developed Emotion-Focused Training for Helping Professions in addressing levels of compassion fatigue, compassion satisfaction and self-criticism, both in the short and long term. A randomized controlled trial was conducted, with 667 participants recruited and randomly assigned to either the experimental active or control passive group ending up with 370 participants at follow-up measurement. The experimental group underwent a 14-day asynchronous online training program delivered via email, while the control group did not engage in any specific task except for the pre-, post- and follow-up assessments. The results from the linear mixed effects model analyses indicated significant group-by-time interactions for The Forms of Self-Criticizing/Attacking & Self-Reassuring Scale, and for The Compassion Satisfaction and Compassion Fatigue Scale. Specifically, participants in the Emotion-Focused Training for Helping Professions group exhibited a notable reduction in self-criticism and a notable increase in self-compassion and compassion satisfaction over time. The participants' scores of compassion fatigue decreased in both intervention as well as control groups; therefore, the group-by-time interaction was not significant. The findings suggest that the novel Emotion-Focused Training for Helping Professions intervention holds promise in effectively mitigating self-criticism while fostering greater compassion satisfaction and self-reassurance/self-compassion among helping professionals.

Managing Compassion Fatigue in Intensive Care Unit Nurses: A Systematic Review

BACKGROUND

Compassion fatigue is the accumulation of negative feelings from long-term exposure to human suffering, which leads to emotional, physical, and spiritual exhaustion. Intensive care unit nurses are especially prone to this due to the unique stressors of their work environment, such as high patient mortality and caring for medically unstable patients. There is currently a gap in literature appraising the effectiveness of interventions that help manage compassion fatigue in intensive care unit nurses.

OBJECTIVES

This systematic review evaluates the efficacy of compassion fatigue interventions for intensive care unit nurses.

METHODS

This systematic review was conducted following guidelines from the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Literature published between 2005 and 2024 was obtained from Cochrane Library, CINAHL, and PsycINFO databases. Studies were included if they met the following inclusion criteria: quantitative study design, involved an intervention to prevent or manage compassion fatigue, evaluation of compassion fatigue or one of its components (burnout and secondary traumatic stress), an intervention involving intensive care unit nurses, and articles published in the English language.These data were appraised by 2 independent reviewers using the Joanna Briggs Institute Critical Appraisal tool.

RESULTS

A total of 17 studies were included. This review found moderate and high strength of evidence for interventions to reduce compassion fatigue in intensive care unit nurses. The most effective interventions were mind-body interventions that were accessible, portable, brief, and adaptable to nurses' work settings.

DISCUSSION

This review has several limitations. Many studies included in this review had small sample sizes, were conducted at 1 hospital setting or unit, and used weak study designs. Several studies also used different interventions and measurement approaches, making it difficult to compare and synthesize findings and outcomes. Thus, the heterogeneity of studies limited our ability to draw strong conclusions about different types of interventions. Additional and more rigorous studies examining interventions to decrease and manage compassion fatigue in intensive care unit nurses are needed. There is also a need to foster better generalizability of research findings.

A neuroscience perspective on the plasticity of the social and relational brain

Over the past two decades, the fields of social and contemplative neurosciences have made significant strides. Initial research utilizing fMRI identified neuronal networks involved in empathy, mentalizing, and compassion, as well as complex interactions among these networks. Subsequent studies shifted to testing the plasticity of these social skills via different types of mindfulness- or compassion-based mental training programs, demonstrating brain plasticity, enhanced social capacities and motivation, as well as improved mental health and overall well-being. Next, researchers developed scalable evidence-based online mental training programs to address the growing levels of mental health problems and loneliness, both exacerbated by the COVID-19 pandemic. Innovative approaches, such as novel relational partner-based practices and online app-based dyadic training programs, offer scalable solutions to counteract ongoing societal and mental health deterioration. Current studies are now applying the above findings to support resilience building within diverse domains of society and professional populations-such as healthcare workers and teachers-at high risk of burn-out. Future research should explore the broader impact of such training-related individual changes on larger systems, potentially leading to the development of a translational social neuroscience approach that leverages insights from social brain plasticity research to support societal needs, thereby enhancing resilience, mental health, and social cohesion.

The impact of support from emergency nurse organizations on compassion fatigue: the mediating role of psychological capital

Background

With ongoing healthcare system reforms in China and escalating demands for emergency services, emergency nurses frequently face high-pressure, complex work environments. This increases their psychological burden. Additionally, limited healthcare resources at the grassroots level and high workloads heighten their vulnerability to compassion fatigue. Current research into the interplay between psychological capital, perceived organizational support, and compassion fatigue among emergency nurses is limited, particularly regarding the mediating role of psychological capital.

Objective

This study aims to explore the relationship between organizational support, psychological capital, and compassion fatigue among emergency nurses. It specifically investigates the mediating role of psychological capital in the relationship between organizational support and compassion fatigue.

Methods

A total of 466 emergency nurses from medical institutions in the Chengdu-Chongqing area were selected through convenience sampling. Data were collected using the Psychological Capital Questionnaire, the Sense of Organizational Support Scale, and the Compassion Fatigue Scale. The correlations among these variables were analyzed using SPSS 26.0, and the mediating effects were tested using AMOS 26.0.

Results

There is a significant negative correlation between psychological capital and compassion fatigue among emergency nurses (r = -0.309, P < 0.01), as well as between organizational support and compassion fatigue (r = -0.449, P < 0.01). Psychological capital acts as a partial mediator in the relationship between organizational support and compassion fatigue, with a mediating effect value of -0.169, accounting for 27% of the total effect.

Conclusion

The findings indicate a significant association between psychological capital, perceived organizational support, and compassion fatigue among emergency nurses, with psychological capital playing a mediating role. Enhancing psychological capital and perceived organizational support for emergency nurses is an effective strategy for managing emotional stress at work. Healthcare institutions should implement targeted interventions to improve nursing service quality and promote the sustainable development of the nursing profession.

Cultivating compassion in care: evaluating a compassion-training intervention and exploring barriers to compassionate care in postgraduate medical education in Pakistan: a mixed-methods study

BACKGROUND

Compassionate patient care is essential for improving patient outcomes and enhancing healthcare experience. However, in lower-middle-income countries (LMICs) like Pakistan, systemic barriers and a lack of structured curricula hinder its consistent delivery. This study evaluates a targeted compassion-training intervention for residents in a tertiary care hospital and explores barriers to its implementation. Given shared challenges like resource constraints, high patient loads, and gaps in formal training, these findings have broader implications for integrating structured compassion-based education across LMICs.

METHODS

This quasi-experimental mixed-methods study was conducted with first-year residents over a one-year period (November 2023 - October 2024). A 4-hour compassion-training session was delivered to develop compassion as a clinical competency. Quantitative data on satisfaction and self-reported compassion competence were collected using the Sinclair Compassion Questionnaire-Healthcare Provider Competence Self-Assessment (SCQ-HCPCSA) and analyzed via paired t-tests. Qualitative data from focused group discussions (FGDs) exploring barriers and facilitators underwent thematic analysis.

RESULTS

204 residents participated. Baseline compassion competence was 4.03 ± 0.54, with no demographic variations (p > 0.05). Participants rated sessions highly for interest (4.54 ± 0.65), relevance (4.50 ± 0.82), and interactivity (4.68 ± 0.61). Post-training, compassion competence significantly improved to 4.58 ± 0.47 (p < 0.001), with all SCQ-HCPCSA items showing significant improvements (p < 0.001). Qualitative findings revealed key barriers to practicing compassionate care, including time constraints, high workloads, and compassion fatigue, particularly in high-pressure specialties like surgery and intensive care. Institutional factors like documentation inefficiencies, financial pressures, and hierarchical workplace culture also limit compassionate care delivery. Culturally specific challenges emerged, including language barriers, differences in patient expectations, and perceptions of compassion as a transactional service in a largely out-of-pocket healthcare system. Facilitators of compassionate care included interdisciplinary collaboration, supportive senior staff, and effective communication strategies.

CONCLUSIONS

Targeted compassion-training interventions can enhance compassionate care among physicians. To ensure long-term impact, postgraduate medical education programs should formally integrate structured curricula, alongside institutional policy reforms that reduce administrative burdens and promote interdisciplinary collaboration. Future studies should explore long-term retention of training effects and assess scalability of similar curricula across diverse healthcare settings, particularly in other lower-middle-income countries.

TRIAL REGISTRATION

Not applicable.

The Important Value of Nursing "Compassionate Care": A Phenomenological Study From the Perspective of Patients Living With a Cancer Diagnosis

BACKGROUND

Although the number of studies on the reflection of compassionate care practices in patient experiences has increased in recent years, the issue is still not sufficiently studied and clearly defined, and no study has been conducted with patients living with a cancer diagnosis in Türkiye.

OBJECTIVE

This study aimed to examine the perspectives of compassionate care and compassionate care experiences of cancer patients in-depth using qualitative methods.

METHODS

Between March and August 2024, 22 phenomenological semistructured interviews were conducted with cancer patients. The data were analyzed using Colaizzi's 7-step descriptive analysis approach.

RESULTS

Five themes emerged from the analysis: (1) compassionate care behaviors, (2) noncompassionate care behaviors, (3) the value of compassionate care for the patients, (4) perceptions of compassionate care barriers, and (5) suggestions to improve compassionate care.

CONCLUSIONS

Compassionate care from cancer patients' perspectives involves being friendly, respectful, and responsive to needs, whereas noncompassionate care behaviors mainly involve ineffective communication skills. Compassionate care has a positive effect on the outcomes of cancer patients with a long and challenging treatment journey. On the contrary, it may adversely affect communication, leading to an increase in unmet needs and a poor impact on cancer prognosis.

IMPLICATIONS FOR PRACTICE

Cancer nurses should be trained to gain awareness of compassionate care and practices to ensure compassionate care, and training should be repeated regularly. For institution managers, reducing the patient-nurse ratio, monitoring cancer nurses for compassion fatigue, implementing prevention and coping programs, and creating a corporate culture to provide compassionate care are recommended.

The Double-Edged Sword Effect of Empathic Concern on Mental Health and Behavioral Outcomes: The Mediating Role of Excessive Adaptation

This study examines the complex effects of empathic concern on mental health and behavioral manifestations and the potential indirect paths through excessive adaptation. A cross-sectional design with 1355 participants was employed. Empathic concern, excessive adaptation, prosocial behaviors, reactive aggression, depression, and positive mental health were assessed using established scales. Structural equation modeling and Bayesian linear regression were applied to analyze the paths. For direct paths, empathic concern positively predicted prosocial behaviors and positive mental health, whereas it was negatively related to depression and reactive aggression. For indirect paths, excessive adaptation was found to mediate the relationship between empathic concern and the outcome variables with the exception of positive mental health. By elucidating the mediating role of excessive adaptation, the results herein not only deepen our understanding of the dual effect of empathic concern on mental health and behavioral manifestations but also offer important insights for the medical and educational fields.

Association Between Nurses' Comfort and Confidence in Pain Management and Compassion Satisfaction and Fatigue

PURPOSE

A current challenge that may exacerbate symptoms of compassion fatigue and compromise the ability to experience compassion satisfaction among nurses is pain management. This study examined the associations between nurses' comfort with administering pain management, confidence in providers' prescribing patterns and reported compassion satisfaction and compassion fatigue (measured as burnout and secondary traumatic stress).

DESIGN

This exploratory study used a survey design to gather primary data from nurses via a convenience sampling method.

METHODS

A survey was created and disseminated electronically to registered nurses from September to November 2019. The survey asked about nurses' comfort administering pain medications, confidence in providers' prescribing patterns, and the Professional Quality of Life Scale (ProQOL).

RESULTS

While nurses reported comfort treating patients with pain and managing pain, they were less confident that providers opioid prescribing patterns. Confidence in provider prescribing was positively correlated with compassion satisfaction and negatively correlated with burnout.

CONCLUSIONS

Organizations should focus on continuing education of pain management, creating a culture of evidence-based pain management, and promoting effective communication.

Analysis of the Current Situation and Influencing Factors of Nurses' Voice Behavior in Neonatal Intensive Care Units of Grade A Tertiary Hospitals in Sichuan Province: A Multicenter Cross-Sectional Study

Aims: Voice behavior refers to nurses' proactive actions in offering constructive suggestions, providing feedback, or raising concerns in the workplace, which are crucial for enhancing care quality and improving the work environment. This study aims to investigate the current status and influencing factors of voice behavior among nurses in neonatal intensive care units (NICUs) in tertiary hospitals in Sichuan Province, providing empirical evidence for improved nursing management and hospital administration. Design: A multicenter, crosssectional survey. Methods: From January to June 2023, 422 neonatal nurses from tertiary hospitals in Sichuan Province were selected through stratified random sampling. Data were collected through self-reported questionnaires, including a general information questionnaire and a voice behavior scale. The voice behavior scale consists of 10 items, divided into promotive and prohibitive behavior dimensions, using a five-point Likert scale (1 = "never" and 5 = "always"). The scale has been widely used among Chinese nurses and demonstrates good internal consistency (Cronbach's α = 0.951). Data analysis was conducted using SPSS Version 26.0. Structural validity was assessed through exploratory factor analysis (KMO > 0.8, Bartlett's test p < 0.05), followed by confirmatory factor analysis using AMOS. For group comparisons, independent t-tests and analysis of variance (ANOVA) were used, with Welch's test for unequal variances. Post hoc multiple comparisons were performed using Tamhane's T2 for unequal variances and LSD for equal variances. A p-value < 0.05 was considered statistically significant. Results: Age, marital status, and number of children significantly influenced voice behavior. Voice behavior increased with age up to 50 years, unmarried individuals exhibited less voice behavior than married or divorced ones, and more children correlated with more voice behavior. Job title, position, and years of experience in the neonatal department also significantly impacted voice behavior. Higher positions and more than 15 years of experience were associated with increased voice behavior. Senior titles correlated with higher prohibitive voice behavior. Conclusion: The voice behavior of NICU nurses is influenced by various factors, including age, marital status, number of children, job title, position, and years of experience in the neonatal department. As age increases, the number of children grows, work experience accumulates, and nurses' voice behavior tends to intensify. In particular, for senior nurses, managers should pay attention to their prohibitive voice behavior and encourage their active involvement in decision-making processes to enhance the quality of care. Nursing managers should tailor management strategies based on these individual characteristics, providing customized support for nurses at different experience levels. At the same time, emphasis should be placed on creating a psychologically safe work environment to stimulate nurses' initiative and creativity, thereby improving team communication and collaboration. This approach will contribute to ensure the quality of care and patient safety in NICUs. Implications for the Profession: Understanding the factors influencing voice behavior helps nursing managers to enhance nurse participation and care quality. Nursing managers can implement the following strategies: (1) create a psychologically safe environment: encourage open communication by ensuring nurses feel their opinions are valued, with clear channels for feedback and action, (2) address senior nurses' prohibitive voice behavior: provide leadership training to senior nurses to transform negative feedback into constructive suggestions, promoting collaboration and work improvement, (3) tailor strategies based on experience: offer support and mentorship to new nurses, while encouraging experienced nurses to take leadership roles and contribute to decision-making, (4) incentivize contributions: develop reward systems to recognize nurses' involvement in improving patient care, such as acknowledging innovative ideas and active participation.

Care Aides Compassion Fatigue, Burnout, and Compassion Satisfaction Related to Long-Term Care (LTC) Working Environment

Severe staff shortages, sustained stress, low compassion satisfaction, high compassion fatigue, and serious levels of burnout among healthcare workers were frequently reported during COVID-19. In this cross-sectional study with 760 care aides working in 28 LTC homes in Alberta, Canada, we used a two-level multilevel regression model to examine how working environments were associated with compassion fatigue, burnout, and compassion satisfaction measured with the Professional Quality of Life (ProQOL-9) scale. Our findings showed that higher compassion satisfaction and lower burnout were observed when care aides perceived a more supportive working culture. Care aides reported higher compassion fatigue when there was a lack of structural or staffing resources. We also found that perceptions of not having enough staff or enough time to complete tasks were significantly associated with higher levels of burnout. These findings suggest which elements of the working environment may be promising targets for improvement efforts.

Resilience and Social Support Protect Nurses from Anxiety and Depressive Symptoms: Evidence from a Cross-Sectional Study in the Post-COVID-19 Era

Background: Nurses experience high levels of anxiety and depression since they work in a highly stressful environment. Thus, the identification of preventive factors against nurses' anxiety and depression is essential to improve their quality of life. In this context, our aim was to examine the impact of resilience and social support on nurses' anxiety and depressive symptoms. Methods: A cross-sectional online study was implemented in Greece in September 2024. We used the Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Patient Health Questionnaire-4 to measure resilience, social support, anxiety, and depressive symptoms, respectively. Results: Our sample included 677 nurses with a mean age of 37.73 years (standard deviation: 9.38). Our multivariable linear regression models identified a negative relationship between resilience and anxiety (adjusted standardized beta coefficient =-0.38; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.36; p < 0.001). Similarly, we found that significant others' support was associated with reduced anxiety (adjusted standardized beta coefficient = -0.27; p < 0.001) and depressive symptoms (adjusted standardized beta coefficient = -0.23; p < 0.001). The standardized beta coefficient indicated that resilience has a greater impact on anxiety and depressive symptoms than significant others' support. Conclusions: Our findings suggest resilience and social support have a protective function against nurses' anxiety and depressive symptoms. Managers and policymakers should adopt appropriate interventions to improve nurses' resilience and social support and, thus, to improve their mental health and quality of life.

Generalized anxiety disorder and major depressive disorder among healthcare professionals in Mbarara city, southwestern Uganda: the relationship with professional quality of life and resilience

BACKGROUND

Marking the lives of healthcare professionals (HCPs) are tensions arising from the conflict between fulfilling their duty of care and the demands of the healthcare setting, creating concern for HCPs' mental. In our study, we aim to determine the prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among HCPs in Southwestern Uganda and to establish how the disorders' prevalence affects professional quality of life and resilience.

METHOD

In total, 200 HCPs from two health facilities (one private and one public) in Southwestern Uganda enrolled in an analytical cross-sectional study. We used the Patient Health Questionnaire-9 (PHQ-9) to determine MDD, the Generalized Anxiety Disorder-7 (GAD-7) to determine GAD, the Professional Quality of Life Scale-5 (ProQOL-5) to determine professional quality of life and the Nicholson McBride Resilience Questionnaire (NMRQ) to determine resilience.

RESULTS

The prevalence of MDD was 11.0% and of GAD was 14.5%. High compassion fatigue increased the likelihood of MDD [aPR = 3.38, p value < 0.001]. However, high compassion satisfaction and exceptional resilience reduced the likelihood of GAD i.e., [aPR = 0.50, p value < 0.001] and [aPR = 0.50, p value < 0.001] respectively. Being male [aPR = 2.41, p value = 0.005] and being married [aPR = 1.79, p value = 0.017] increased the likelihood of having MDD. The likelihood of GAD among HCPs decreased with age, [aPR = 0.97, p value = 0.022].

CONCLUSION

There is a significant occurrence of MDD and GAD among healthcare professionals (HCPs) in Southwestern Uganda. Compassion fatigue is linked to an elevated prevalence of MDD, while compassion satisfaction and high resilience scores are associated with a reduced prevalence of GAD. We recommend creation and execution of extensive mental health initiatives designed for HCPs.

Construction and validation of a presenteeism prediction model for ICU nurses in China

Background

Presenteeism, also known as impaired health productivity, refers to the condition of impaired productivity of an individual due to physiological or mental health problems. ICU, as a place of intensive care for patients with acute and critical illnesses, nurses have long faced the nature of work with high loads, high pressures, and high intensities, which makes them a high prevalence group of presenteeism. Presenteeism not only affects the physical and mental health and work wellbeing of nurses but also reduces the quality of nursing services and affects the life safety of patients, such as increasing the risk of falls during hospitalization, increasing the risk of medication errors, and prolonging the hospitalization time of patients. Therefore, early identification and targeted interventions are crucial to reduce presenteeism among ICU nurses.

Objective

This study aimed to construct and validate a predictive model for presenteeism among ICU nurses.

Design

A cross-sectional study.

Methods

1,225 ICU nurses were convened from January to April 2023 from 25 tertiary and secondary hospitals in Sichuan Province, China. ICU nurses were randomly divided into a development set (n = 859) and a validation set (n = 366) according to a 7:3 ratio. Univariate and multifactorial logistic regression analyses were used to determine the influencing factors for presenteeism, and R software was used to construct a column-line graph prediction model. The differentiation and calibration of the predictive model were evaluated by the area under the curve of subjects' work characteristics (ROC) and the Hosmer-Leme-show test, and the clinical decision curve evaluated the clinical validity of the predictive model.

Results

The presenteeism rate of ICU nurses in the development set was 76.8%. Multifactorial logistic regression analysis showed that independent factors affecting ICU nurses' presenteeism included income per month, physical health status, job satisfaction, perceived work stress, perceived social support, transformational leadership, and occupational coping self-efficacy. In the development set and validation set, the area under the ROC curve was 0.821 and 0.786, respectively; the sensitivity and specificity were 80.6, 69.8 and 80.9%, 65.1%, respectively; the Hosmer-Lemeshow goodness-of-fit was χ 2 = 8.076 (p = 0.426) and χ 2 = 5.134 (p = 0.743), respectively, and the model had relatively good discrimination and consistency. The clinical decision curve showed that the model had good clinical validity.

Conclusion

The predictive model of presenteeism risk for ICU nurses constructed in this study has good predictive ability. The model can effectively identify ICU nurses with high presenteeism and provide a reference basis for developing targeted interventions to reduce presenteeism among ICU nurses.

Interventions for Compassion Fatigue, Burnout, and Secondary Traumatic Stress in Nurses: A Systematic Review and Network Meta-Analysis

This study uses network meta-analysis to evaluate the relative effectiveness of different interventions (behavioral, psychological, and comprehensive) in alleviating compassion fatigue, burnout, and secondary traumatic stress, as well as in improving compassion satisfaction among nurses, aiming to provide evidence-based insights for enhancing nurses' mental health and care quality. Compassion fatigue in nurses negatively affects their mental health, patient care quality, and healthcare efficiency. Various interventions (psychological, behavioral, and integrated) target this issue, but evidence on their effectiveness is inconclusive. Network meta-analysis. Randomized controlled trials on compassion fatigue interventions in nurses were reviewed, focusing on outcomes like compassion fatigue, satisfaction, burnout, and secondary traumatic stress. PRISMA guidelines were followed. Behavioral training significantly reduced compassion fatigue and improved compassion satisfaction. Comprehensive interventions were most effective in reducing burnout, while psychological interventions alleviated secondary trauma. Targeted, multifaceted interventions, especially behavioral and comprehensive strategies, effectively manage compassion fatigue, improving nurses' mental health, job satisfaction, and care quality.

The mediating role of nurses' spiritual well-being between moral resilience and compassion fatigue: A multicenter structural equation model study

AIMS

To investigate the mediating role of spiritual well-being in the association between compassion fatigue and moral resilience among nurses.

BACKGROUND

Nurses are inevitably placed in situations of compassion fatigue. Their moral resilience and spiritual well-being may play a crucial role in mitigating the impacts of compassion fatigue. Nonetheless, spiritual well-being, which mediates the influence between compassion fatigue and moral resilience, remains scarce among nurses.

DESIGN

Cross-sectional and correlational design.

METHODS

Nurses (n = 465) from four government-owned tertiary hospitals in Saudi Arabia were recruited and completed three self-report scales from July to December 2023. Descriptive statistics (e.g., mean, standard deviation, frequency, and proportions) and inferential statistics (Spearman rho and structural equation modeling) were used for data analysis.

RESULTS

The emerging model afforded acceptable model fit parameters. Moral resilience had a negative effect on compassion fatigue (β = -0.05, p = 0.003) and a positive influence on spiritual well-being (β = 0.51, p = 0.003). Spiritual well-being negatively influenced compassion fatigue (β = -0.90, p = 0.003). Moral resilience had a moderate, negative, indirect effect on compassion fatigue through the mediation of spiritual well-being (β = -0.47, p = 0.002).

CONCLUSION

Our study offered a model that validated the mediating role of spiritual well-being in the association between moral resilience and compassion fatigue. Moral resilience directly and indirectly influences spiritual well-being and compassion fatigue, respectively.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

Healthcare institutions that employ nurses must continually assess compassion fatigue levels and provide necessary interventions. Nurses, nurse managers, and healthcare institutions may leverage moral resilience to improve nurses' spiritual well-being while averting the negative effects of compassion fatigue. Healthcare institutions may incorporate spiritual care into their mainstream support interventions to enhance their compassion, reduce fatigue, and enhance their mental well-being.

Interventions to promote well-being of nightshift nursing team members

PURPOSE

To measure the impact of a mindfulness or physical activity intervention and the combination of both on hospital nightshift nursing teams' professional quality of life, medication administration error, role meaning, and sleep quality.

DESIGN AND METHODS

In this two-site study using a cluster cross-over randomized trial design, 18 units were randomized to one of two interventions (mindfulness or physical activity) during the first 8-week period and to both interventions during the second 8-week period. Questionnaires completed at baseline (T0), Week 8 (T1), and Week 18 (T2) included the Professional Quality of Life (ProQOL-21) (Compassion Satisfaction, Compassion Fatigue), PROMIS Sleep Disturbance, PROMIS Sleep Impairment, Sleep Hygiene, and Role-Related Meaning Scale for Staff (RRMSS).

RESULTS

Participants (n = 82) completed questionnaires at T0, 33 at T1, and 23 at T2. Significant improvements in PROMIS Sleep Disturbance scores occurred within both study arms from T0 to T1 and T1 to T2 and within both arms in PROMIS Sleep Impairment scores from T0 to T1 and from T0 to T2. Across questionnaires, the largest improvement occurred between T0 and T2 and the least between T1 and T2. Compassion satisfaction had the largest improvement in the physical activity intervention and compassion fatigue had the largest improvement in the mindfulness intervention.

CONCLUSIONS

Mindfulness and physical activity interventions can reduce sleep disturbance, sleep impairment, and compassion fatigue and improve compassion satisfaction in nightshift nursing care teams.

PRACTICE IMPLICATIONS

Nursing care team members' sleep and professional quality of life could directly benefit from hospital-sponsored nightshift well-being interventions including mindfulness, physical activities and sleep hygiene information.

Establishment and validation of a prediction model for compassion fatigue in nursing students

BACKGROUND

Compassion fatigue is a common issue nursing students face during clinical internships. Prolonged exposure to patients' suffering and trauma can lead to emotional exhaustion and psychological stress. Compared to formal healthcare workers, nursing students have less professional experience and weaker emotional regulation abilities, making them more vulnerable to secondary trauma and other negative emotions, which exacerbates compassion fatigue. Early identification and intervention in compassion fatigue are crucial for improving the mental health of nursing students and the quality of care they provide.

OBJECTIVE

This study aims to develop a predictive model for compassion fatigue in nursing students using various statistical and machine learning methods, identify key influencing factors, and provide scientific evidence for nursing educators and administrators.

METHODS

A cross-sectional survey collected valid questionnaire data from 512 nursing students. LASSO regression was used to select critical variables, and models such as logistic regression, random forest, and XGBoost were applied for prediction. Model performance was evaluated, and SHAP values were used to interpret the importance of model features.

RESULTS

The logistic regression model performed best on the test set with an AUC value 0.77. Key predictive factors included psychological resilience, peer support, secondary trauma, and empathy satisfaction.

CONCLUSION

This study successfully developed a predictive model for compassion fatigue in nursing students, with the logistic regression model showing high accuracy. The critical factors identified provide theoretical support for early interventions, aiding in more targeted nursing management and enhancing the mental well-being of nursing students.

TRIAL REGISTRATION

Not applicable. This study is an observational study aimed at investigating compassion fatigue among students, without involving any interventions or treatment methods. Therefore, this study does not meet the definition of a clinical trial and does not require registration of a clinical trial number.

Protocol of the Nurses' Mental Health Study (NMHS): a nationwide hospital multicentre prospective cohort study

INTRODUCTION

Due to high workload, shift work and shortage of human resources, nurses are vulnerable to various mental health problems which are significantly related to their physical health, patient safety and healthcare quality. The long-term monitoring of nurses' mental health and identifying its risk factors are necessary. Accounting for more than one-fifth of global nurses, Chinese nurses have a demanding healthcare workload, especially in tertiary hospitals, yet there is no national cohort concerning their mental health and associated factors. This study (Nurses' Mental Health Study, NMHS) aims to investigate the mental health of Chinese nurses in tertiary hospitals and to identify the risk and protective factors.

METHODS AND ANALYSIS

NMHS is a multicentre prospective cohort study which plans to recruit at least 30 000 registered nurses from 62 tertiary hospitals using the cluster sampling method. Baseline data collection will be implemented through online questionnaires after obtaining informed consent from each participant. Variables including sociodemographic information, work-related factors, health status, lifestyle habits, objective experiences, family and social relations, current affairs opinions and overall evaluation will be collected. Annual follow-up will be conducted via a questionnaire link to monitor subsequent changes in nurses' mental health and related factors.

PATIENT AND PUBLIC INVOLVEMENT STATEMENT

No patient and public involvement in the study design.

ETHICS AND DISSEMINATION

This study was approved by the Institute Review Board from the ethical committee of The Second Xiangya Hospital of Central South University (E20230048) and NMHS will be performed in line with Helsinki Declarations. The results of NMHS will inform nursing research and practice by providing evidence to nurse managers, healthcare organisations and the government about the target mental health outcomes for early prevention and intervention.

TRIAL REGISTRATION NUMBER

This study has been registered at the Chinese Clinical Trail Registry (ID: ChiCTR2300072142, https://www.chictr.org.cn/showproj.html?proj=192676).

Toward a Comprehensive Understanding of Nurses' Compassion Fatigue: A Meta-Integrative Qualitative Synthesis

AIMS

The study aims to conduct a thematic synthesis approach of existing qualitative research to synthesise the real experiences of nurses dealing with compassion fatigue. This integration seeks to provide a comprehensive overview, identify common themes, and offer theoretical support for developing effective intervention strategies to mitigate compassion fatigue in healthcare settings.

DESIGN

A thematic synthesis approach was utilised, synthesising qualitative studies on nurses' experiences of compassion fatigue.

DATA SOURCES

Data were collected from major academic databases, including PubMed, CINAHL, Scopus, and Web of Science. A total of 15 studies met the inclusion criteria.

REVIEW METHODS

This study systematically reviewed 11 qualitative research articles from China, the United States, Japan, Spain, Iran and Finland, involving 1076 nurses, to analyse and integrate the phenomenon of compassion fatigue among nurses and extract common themes.

RESULTS

The analysis revealed that the leading causes of compassion fatigue include insufficient time and resources, psychosocial stressors, compassion overload and organisational and environmental factors. The manifestations of compassion fatigue primarily consist of work-related difficulties and impacts on family life, emotional and physical exhaustion and a mix of positive and negative emotions. Coping strategies focus on self-care and emotional regulation, symptom recognition and response strategies and organisational interventions and training.

CONCLUSION

This study's findings provide theoretical support for healthcare institutions to develop effective intervention strategies to alleviate compassion fatigue among nurses and improve the quality of care.

IMPACT

The study contributes to the body of knowledge by systematically synthesising qualitative evidence on compassion fatigue among nurses. The results have practical implications for nursing management and policy, emphasising the need for supportive measures to protect nurses from compassion fatigue and ensure sustainable care practices.

PATIENT OR PUBLIC CONTRIBUTION

This research does not directly involve patients or public participants but focuses on synthesising the experiences of nurses as reported in existing studies, thereby indirectly contributing to improving patient care by addressing the well-being of healthcare providers.

Evaluating the relationships between forgiveness, compassion and care behaviors of nurses: a structural equation modeling

Analyzing the levels of forgiveness and compassion, which may influence patient care and professional attitudes of the nurses, may provide data for nursing education and practices. The purpose of this study was to evaluate the relationship between compassion, forgiveness, and the caring behaviors of the nurses and reveal the role of compassion on forgiveness and nursing care behaviors. This cross-sectional study was conducted at a research and training hospital between July and December 2021 with 515 nurses. Sociodemographic form, Compassion Scale (CS), Caring Behaviors Inventory-24 (CBI-24), and Heartland Forgiveness Scale (HFS) were used for data collection. We found a positive and statistically significant relationship between the scores obtained from the CS and the CBI-24 (p < 0.05). Additionally, there was a positive and statistically significant relationship between kindness, indifference, common humanity, separation, mindfulness, and disengagement subscales of the CS and the scores obtained from the CBI-24 and its assurance, respectful, and connectedness subscales (p < 0.05). High-quality and humane nursing care require compassionate, merciful, and sympathetic nurses. Therefore, sources of stress in the workplace should be determined and reduced to help nurses to cope with compassion fatigue. Nurses' compassion finds its reflection in the caring behavior of the nurses.

Self-Compassion Intervention Programs for Nurses: A Scoping Review

Background: Nurses frequently face various sources of stress in the workplace, making self-compassion interventions crucial for promoting their mental well-being. This scoping review aims to: (a) identify self-compassion intervention programs implemented within the nursing population; and (b) analyze the content and outcome measures of these interventions. Methods: The study follows Arksey and O'Malley's scoping review framework and adheres to the PRISMA-ScR guidelines. Relevant literature on self-compassion interventions for nurses published between January 2010 and May 2024 was systematically reviewed. Databases searched included PubMed, Web of Science, Scopus, ProQuest, and the Cochrane Library, using MeSH terms and free-text keywords such as "self-compassion", "self-kindness", "self-appreciation", "self-worth", "self-forgiveness", "self-awareness", "nurses", and "nursing". Results: Fifteen studies met the inclusion criteria and were included in the review. Self-compassion interventions were categorized into two types: (1) mindfulness-focused programs, such as Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Care and Resiliency (MSCR), which treat self-compassion as a potential outcome; and (2) self-compassion-focused programs, including Mindful Self-Compassion (MSC), Compassion Focused Therapy (CFT), and Loving-Kindness Meditation (LKM). Conclusions: The mental health challenges faced by nurses have drawn growing attention, underscoring the importance of self-compassion interventions. This review examines empirical studies within the nursing population, contributing to the development of more targeted and effective strategies to enhance the mental health and well-being of nursing professionals.

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.

Moral distress, ethical climate, and compassion fatigue among oncology nurses: the mediating role of moral distress

BACKGROUND

Oncology nurses have a vital role in providing care for individuals with cancer. Ethical dilemmas arise for oncology nurses caring for these patients. Nurses experience moral distress when work conflicts with personal beliefs, leading to inappropriate responses or uncertainty about ethics. The ethical climate might influence nurses' response to moral distress. Moral distress in nurses can lead to work-related stressors like compassion fatigue.

RESEARCH OBJECTIVES

This study examined the relationship between moral distress, ethical climate, and compassion fatigue in oncology nursing. Moreover, the role of moral distress as a mediator in the link between ethical climate and compassion fatigue was examined.

METHOD

A descriptive correlational design was recruited. One hundred twenty-two participants were recruited using the convenience sampling method. The study data were collected using a demographic information form, Corley's Moral Distress Questionnaire, Revised Victor and Cullen's Ethical Climate Questionnaire, and the Professional Quality of Life questionnaire. The Ethics Research Center of Shahid Beheshti University of Medical Sciences approved the study.

FINDINGS

The overall moral distress, compassion fatigue, and ethical climate mean scores were 125.54 ± 37.50, 31.50 ± 9.23, and 49.03 ± 7.49, respectively. The analysis showed that among the dimensions of ethical climate (including egoism, benevolence and principled climate), egoism directly (p=0.03) and indirectly (p<0.001) and benevolence indirectly (p<0.001) (through moral distress) were significantly related to compassion fatigue. The principled ethical climate did not show any direct or indirect impact (p=0.72 and p=0.64, respectively).

CONCLUSIONS

Our findings showed moderate moral distress and low compassion fatigue among oncology nurses. In the examined oncology wards, the prevailing ethical climate was benevolent. Moral distress acts as a mediator between egoistic and benevolence ethical climate and compassion fatigue.

A Cross Section Study on the Relationship Between Nurse-Reported Missed Care, Emotional Labour, and Compassion Fatigue in Intensive Care Units

AIM(S)

To investigate the correlation between compassion Fatigue, emotional labour and missed nursing care among intensive care unit nurses.

DESIGN

A cross-sectional design.

METHODS

Data were collected from two hospitals in Shandong Province, China, from July to August 2024. A total of 226 intensive care unit nurses completed the questionnaires. The completion rate for the surveys was 98%. The Demographic Characteristic Questionnaire, Chinese version of Compassion Fatigue-Short Scale, Chinese version of Emotional Labor Scale and Chinese version of Missed Nursing Care Questionnaire were used for investigation. Descriptive statistics, Multiple-linear regression and Spearman correlation analyses were used for data analysis.

RESULTS

The mean (SD) scores of compassion fatigue, emotional labour and missed nursing care were 51.17 (24.64), 2.98 (0.51) and 37.71(14.11), respectively. Spearman correlation showed that compassion fatigue was positively associated with emotional labour (p < 0.05), and missed nursing care (p < 0.01). Furthermore, deep acting, a form of emotional labour, had a significant negative relationship with missed nursing care (p < 0.01).

CONCLUSION

The nursing care was rarely missed among intensive care unit nurses, while compassion fatigue and emotional labour were positively associated with missed nursing care. Therefore, focusing on developing interventions for alleviating compassion fatigue and emotional labour may contribute to decrease the incidence of missed nursing care.

IMPACT

The emotional state of intensive care unit nurses can have a significant impact on the quality of nursing care. It is recommended that nursing managers should promote relevant training in deep acting and instruct nurses to manage emotions during patient interactions, to decrease missed nursing care.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Nurses' role in spiritual care for patients and families in intensive care units: A scoping review

INTRODUCTION

Critically ill patients and their families benefit from spiritual care. There is limited evidence on how spiritual care is delivered in intensive care units (ICUs).

AIM

The objective of this review was to determine how nurses include spiritual care for patients and families in ICUs.

METHODOLOGY

A scoping review was conducted following the Joanna Briggs Institute methodology guidelines, with results reported using the PRISMA-ScR guidelines from March to April 2023. PubMed, Scopus by Elsevier, Web of Science (WOS), and the Ebsco search engine were consulted, including databases such as Medline Complete, Cinhal, and Academic Search Ultimate using the keywords: Nursing care, ICU, spirituality. Articles with qualitative and quantitative approaches of any design describing spirituality in nursing care for patients or families in ICUs were included, excluding editorials and letters to the editor. The time frame ranged from 2015 to 2023, with no language restrictions.

RESULTS

A total of 316 articles were retrieved, after removing duplicates and applying inclusion criteria with critical reading, 11 studies were included, 6 with a quantitative approach and 5 with a qualitative approach. Conditions for spiritual care are described highlighting the need for physical space and nurse-related conditions such as motivation and empathy. Personal, organizational, and team-related barriers to spiritual care exist. Facilitators for spiritual care are described such as preparation, communication, and the presence of chaplains.

CONCLUSIONS

Nurses in ICUs have various ways to provide spiritual care to patients and families. These must be developed considering barriers such as physical space, personal, organizational, and team-related challenges.

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.

Correlation of Mindfulness Practices, Resilience, and Compassion Satisfaction in Hospital-Based Healthcare Workers: A Randomized Controlled Trial

GOAL

A lack of healthcare worker well-being is a serious threat to patient care quality and safety, as well as to the overall operational performance of hospitals in the US healthcare delivery system. Extreme resilience depletion and compassion fatigue are known to negatively influence individual well-being and have contributed to the rise in turnover in the healthcare workforce. The primary aim of this research was to identify interventions that health system leaders can use to combat resilience depletion and exhaustion among healthcare workers.

METHODS

Researchers deployed a randomized controlled trial methodology to study the association between the use of regular mindfulness practices, resilience, and compassion satisfaction. After completing an initial screening questionnaire and preassessments, participants were randomized into one of two groups: (1) an experimental group with mindfulness practices as the intervention and (2) a control group. The experimental group participated in structured mindfulness practices during their regular workday on three different days per week for a minimum of 10 minutes per day. At the end of the six-week study period, both groups completed postassessment questionnaires. Results from the pre- and postassessments were analyzed to determine the correlation between mindfulness practices, resilience, and compassion satisfaction.

PRINCIPAL FINDINGS

Data analysis revealed that baseline resilience scores in the experimental group increased by 4 points, with a progressive 92% power. In addition, the experimental group demonstrated a statistically significant improvement in resilience (p mean difference pre-post = .147/.002) and compassion satisfaction (p mean difference pre-post = 3.99/.019).

PRACTICAL APPLICATIONS

Readily available, low-cost mindfulness practices may be introduced to hospital staff to build resilience and improve compassion satisfaction. In turn, this may help support hospital efforts to reduce turnover in the healthcare workforce.

Prevalence and related factors of compassion fatigue among registered nurses and nursing students during the internship: a systematic review and meta-analysis

BACKGROUND

Compassion fatigue impacts nurses' well-being and work efficiency. Extensive research has explored its prevalence, but evidence regarding related factors is broadly categorized and lacks descriptive data. There's also a lack of systematic reviews on compassion fatigue among nursing students during internships.

OBJECTIVES

To synthesize evidence on the levels and factors of compassion fatigue among nurses and nursing students during internships.

METHODS

This systematic review is registered with PROSPERO (ID CRD42023444173). Literature searches were conducted in five databases (Cochrane Library, PubMed, EMBASE, CNKI, and WanFang) up to November 30, 2022, with updates planned until January 17, 2024, if necessary. Inclusion criteria covered studies reporting data on the prevalence and related factors of compassion fatigue or its dimensions, burnout and secondary traumatic stress, among registered nurses or nursing students during internships. Independent study selection, quality assessment, and data extraction were performed. The Agency for Healthcare Research and Quality tool was used for critical appraisal of study quality. Random-effects model analyses were conducted using Stata 17.0 to pool data on prevalence rates and mean scores of compassion fatigue. When comprehensive data on compassion fatigue were unavailable, its dimensions were analyzed for both prevalence and mean scores.

RESULTS

Our review included 196 studies (73,034 nurses and 4,551 nursing students). For nurses, pooled mean scores for burnout and secondary traumatic stress were 26.81 (95% CI 26.28 to 27.35) and 25.88 (95% CI 25.39 to 26.37), respectively. For nursing students during internships, pooled mean scores were 29.16 (95% CI 26.95 to 31.37) and 25.64 (95% CI 20.95 to 30.34), respectively. Subgroup analyses revealed that post-COVID-19 pandemic, nurses exhibited higher compassion fatigue, especially in ICU or emergency departments. Evidence from 93 studies suggested that nurses' burnout and secondary traumatic stress are both influenced by work environment, social support, job satisfaction, workload, and psychological capital (moderate to low-certainty evidence). For nursing students, psychological capital plays a significant role (moderate to low-certainty evidence).

CONCLUSIONS

Both registered nurses and nursing students experience moderate compassion fatigue. Work environment, social support, job satisfaction, workload, and psychological capital are key factors associated with burnout and secondary traumatic stress in registered nurses. For nursing students, psychological capital plays a similarly significant role. Given that this is the first systematic review to explore these factors among nursing students, further research is essential to deepen understanding and develop effective interventions.

Development and validation of a machine learning-based predictive model for compassion fatigue in Chinese nursing interns: a cross-sectional study utilizing latent profile analysis

BACKGROUND

Compassion fatigue is a significant issue in nursing, affecting both registered nurses and nursing students, potentially leading to burnout and reduced quality of care. During internships, compassion fatigue can shape nursing students' career trajectories and intent to stay in the profession. Identifying those at high risk is crucial for timely interventions, yet existing tools often fail to account for within-group variability, limiting their ability to accurately predict compassion fatigue risk.

OBJECTIVES

This study aimed to develop and validate a predictive model for detecting the risk of compassion fatigue among nursing students during their placement.

DESIGN

A cross-sectional study was used to capture the prevalence and associations of compassion fatigue among nursing interns, as it allows for timely assessment of key influencing factors without requiring long-term follow-up.

METHODS

A convenience sampling strategy was used to recruit 2256 nursing students from all ten public junior colleges in Hunan province in China between December 2021 and June 2022. Participants completed questionnaires assessing compassion fatigue, professional identity, self-efficacy, social support, psychological resilience, coping styles, and demographic characteristics. Predictors were selected based on prior literature and theoretical frameworks related to compassion fatigue in nursing. Latent profile analysis was used to classify compassion fatigue levels, and potential predictors were identified through univariate analysis and least absolute shrinkage and selection operator (LASSO) regression. Eight machine learning algorithms were applied to predict compassion fatigue, with performance assessed through cross-validation, calibration, and discrimination metrics. The best-performing model was further validated to ensure robustness.

RESULTS

A three-profile model best fits the data, identifying low (55.73%), moderate (32.17%), and severe (12.10%) profiles for compassion fatigue. Generally, an area under the curve (AUC) above 0.700 is acceptable, and above 0.800 indicates good predictive performance. The AUC values for the eight machine learning models ranged from 0.644 to 0.826 for the training set and 0.651 to 0.757 for the test set, indicating moderate to good discriminatory ability. The eXtreme Gradient Boosting (XGBoost) performed best, with AUC values of 0.840, 0.768, and 0.731 in the training, validation, and test sets, respectively. Shapley Additive Explanation (SHAP) analysis interpreted the model by quantifying the contribution of each variable to the prediction, revealing that psychological resilience, professional identity, and social support were the key contributors to the risk of compassion fatigue. A user-friendly, web-based prediction tool for calculating the risk of compassion fatigue was developed.

CONCLUSIONS

The XGBoosting classifier demonstrates excellent performance, and implementing the online tool can help nursing administrators manage compassion fatigue effectively. It holds practical value for nursing education and practice by supporting early detection and intervention. Future research should validate its use across settings, and longitudinal studies could assess its long-term impact.

Impact of COVID-19 on nurse outcomes in the private sector of South Africa: a cross-sectional study

BACKGROUND

This study explored and described the impact of the COVID-19 pandemic on nurse outcomes in the private sector of South Africa. National research shows that nurses had poor nurse outcomes prior to the pandemic, amidst these issues the COVID-19 pandemic occurred, with nurses having to play a key role in the public health response. International studies have shown that although nurses were willing to serve in this manner, they experienced moderate to high burnout, anxiety, depression, fear and exhaustion. However, this topic has received comparatively little attention in African countries.

METHODS

A cross-sectional survey design was conducted. Multistage sampling was applied in selection of provinces, hospital groups, hospitals, units, and nursing personnel. Valid and reliable tools were used to measure nurse outcomes. Data was collected from April 2021 until January 2022.

RESULTS

Nurses described having high levels of compassion satisfaction, moderate levels of compassion fatigue, and high levels of burnout. Nurses appeared satisfied with their job and career. Almost a quarter of nurses reported the intention to leave their job, and of those about a fifth indicated that they intended to leave the profession. The nurses who routinely cared for COVID-19 patients had a small statistically significant increase in compassion fatigue, compassion satisfaction, emotional exhaustion and, job turnover intention, and a small statistically significant decrease in job satisfaction. Increased exposure to death and dying showed small correlations with emotional exhaustion and career turnover intentions.

CONCLUSION

The results of this study show that nurses were impacted by COVID-19 and death and dying during the pandemic, and that follow-up studies are needed post-pandemic.

IMPLICATIONS OF STUDY

It is important that burnout and compassion fatigue be addressed on an organizational level, as nurse outcomes were already negative prior to the pandemic, and all global evidence points to the worsening of these outcomes post-pandemic. There were many psychological support interventions with proven effectiveness that should be explored and applied for the South African context.

The relationship between organizational trust and voice behavior among neonatal intensive care unit nurses in tertiary A hospitals in Sichuan Province: the mediating role of career resilience

Background

Neonatal intensive care unit (NICU) nurses face immense pressure, yet research on their voice behavior and the motivational mechanisms behind it is limited. Specifically, the impact of organizational trust and career resilience on this behavior has not been thoroughly explored.

Aim

This study aims to examine the relationship between organizational trust and voice behavior in NICU nurses, with career resilience acting as a mediating factor, providing empirical evidence for nursing management.

Methods

A multicenter cross-sectional survey was conducted from January to June 2023, involving 422 neonatal nurses from tertiary hospitals in Sichuan Province, China. Data were collected using a self-designed questionnaire, a voice behavior scale, an organizational trust scale, and a career resilience scale. Hierarchical regression and structural equation modeling (SEM) were employed to analyze the relationships among the variables.

Results

Hierarchical regression analysis revealed that organizational trust (β = 0.28, p < 0.001) and career resilience (β = 0.45, p < 0.001) significantly predicted voice behavior. Mediation analysis using structural equation modeling confirmed that career resilience mediated the relationship between organizational trust and voice behavior, with a mediation effect of 0.340, accounting for 44.8% of the total effect. The structural model demonstrated good fit indices (CFI = 0.962, RMSEA = 0.045), indicating the robustness of the proposed model.

Conclusion

Organizational trust significantly influences NICU nurses' voice behavior, with career resilience playing a critical mediating role. Enhancing organizational trust and fostering career resilience among NICU nurses can improve their willingness to engage in voice behavior, ultimately leading to better healthcare outcomes.

Implications for nursing management

Nursing managers should foster a trusting and supportive work environment to improve nurses' job satisfaction and organizational commitment. This can be achieved by enhancing psychological empowerment and promoting positive interactions between nurses, the organization, and leadership. Such an environment helps reduce burnout and strengthens career resilience. Increased resilience enables nurses to better manage clinical pressures and challenges, elevating their career expectations and enhancing their willingness to engage in work. This, in turn, promotes innovation, active participation, and improved voice behavior, ultimately contributing to organizational success.

Factors influencing sleep quality among nurses in tertiary hospitals in Kelantan, Malaysia: a cross-sectional study

BACKGROUND

Poor sleep quality among nurses can negatively impact their performance, leading to increased risks of errors in nursing practice, which directly affect patient safety. However, there is limited research on the factors influencing sleep quality and its subsequent consequences on patient safety, particularly in tertiary hospitals in Kelantan, Malaysia. This study aimed to determine the factors influencing sleep quality and the prevalence of poor sleep quality among nurses at tertiary hospitals in Kelantan.

METHODOLOGY

A cross-sectional study was conducted in two tertiary care hospitals in Kelantan between December 2023 and February 2024. A proportionate stratified random sampling method was employed to recruit a sample of 470 registered nurses. Data were collected using a validated self-administered questionnaire comprising 19 items across seven component scores.

RESULTS

The prevalence of poor sleep quality among nurses was found to be 69.8%. The study identified several significant factors associated with poor sleep quality, including sleep duration (aOR 0.291; 95% CI: 0.215-0.393; p < 0.001), years of work experience (aOR 0.953; 95% CI: 0.924-0.984; p = 0.003), history of involvement in medication errors (aOR 2.669; 95% CI: 1.413-5.041; p = 0.002), and experiences of commuting injury (aOR 1.869; 95% CI: 1.119-3.121; p = 0.017).

CONCLUSION

The high prevalence of poor sleep quality among nurses highlights the need for targeted interventions to address this issue. In addition to ongoing education, implementing sleep hygiene programs, offering stress management workshops, and introducing flexible work schedules could significantly improve sleep quality. Creating a supportive work environment that prioritizes nurse well-being is crucial for enhancing patient safety and overall healthcare outcomes.

Intention to stay of pediatric nurses: Does pediatric nurse-parent partnership and perceived stress matter?

AIMS

To explore intentions to stay of pediatric nurses and to determine how pediatric nurse-parent partnership and perceived stress differ among the subgroups.

BACKGROUND AND INTRODUCTION

The shortage of nurses, particularly pediatric nurses, has become a global problem. Intention to stay has been an established predictor of nurse retention. Less is known about the heterogeneity of intention to stay and the specific characteristics, which may restrict the effectiveness of prevention and interventions for pediatric nurse retention.

METHODS

This was a cross-sectional online survey. A total of 603 pediatric nurses were surveyed on their pediatric nurse-parent partnership, perceived stress, and intention to stay. Latent class analysis, multinomial logistic regression, and univariate analysis were used to analyze the related factors. We followed the STROBE checklist.

RESULTS

Three latent classes of intention to stay were identified: low level, moderate level, and high level. Aged between 31 and 35, higher perceived stress, contract nurse, and no spouse were associated with the low level of intention to stay. Good sensitivity in the pediatric nurse-parent partnership was associated with high level of intention to stay. Having a spouse was associated with moderate level compared with low level of intention to stay.

DISCUSSION AND CONCLUSION

Our study was one of the first to show three different classes of intention to stay of pediatric nurses, and the specific sociodemographic information, perceived stress, and pediatric nurse-patient partnership associated with different classes of intention to stay were reported.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Our results informed the development of pediatric nurse support strategies. Nurse managers could consider the specific factors affecting the intention to stay and make great efforts in developing strategies and projects for different classes of intention to stay that can maximize nurse intention to stay.

Nurses Supporting Nurses: A Model for Providing Mental Health Services During War

Nurses routinely face psychological challenges as part of their work, acutely so during times of crises when nurses may treat many severely injured and dying patients. While the need for such support is well documented in the literature, mental health support programmes aimed at healthcare workers, even when available, are often underutilised, especially by nurses. To gain insights about needed mental health supports for nurses and programme implementation, this study examines a programme launched following a surprise attack on Israel on 7 October, 2023, resulting in thousands of deaths and injuries and precipitating a war. The programme deployed 30 volunteer nurses trained in cognitive behavioural therapy, trauma support and mental health first aid to offer up to three, anonymous, 30-min online therapy sessions to nurses around Israel in December 2023. Using a qualitative descriptive design, we engaged 22 of these volunteers in one of the three focus groups lasting 60-90 min each. Our findings highlight a range of mental health issues-among both the volunteers and therapy recipients-as well as barriers to providing mental health support to nurses. The importance of normalising the pursuit of mental health support in nursing education and ensuring the availability of support in healthcare organisations was emphasised.

Professional Quality of Life Among Mental Health Nurses: A Systematic Review and Meta-Analysis

The professional quality of life (ProQOL) is increasingly applied to nurses and is a measure of the positive and negative aspects of their work. This systematic review and meta-analysis evaluated the level of compassion satisfaction, burnout and secondary traumatic stress (STS) in empirical studies. Electronic databases Scopus, PubMed and Web of Science were searched on 7th February 2024, and the review followed PRISMA guidelines. The pooled estimate of compassion satisfaction, burnout and secondary traumatic stress mean scores using a random-effects model for meta-analyses was undertaken. R statistical software and the dmetar program were used to execute the analysis. Heterogeneity was evaluated with the I2 statistics, while publication bias was evaluated using Egger's regression test. Twenty-four studies (sample size = 4274) were systematically reviewed and 18 studies (n = 3163) were incorporated into the meta-analysis. Burnout, secondary traumatic stress and compassion satisfaction are found to be at moderate levels in this research. The qualitative analysis informs that variables such as healthy lifestyle, work environment and psychological resilience contribute towards optimum ProQOL scores. The pooled mean estimate was 32.79 (95% CI = 29.57-36) for compassion satisfaction, 24.99 (95% CI = 23.75-26.23) for burnout and 21.99 (95% CI = 18.93-25.06) for secondary traumatic stress, respectively. Mental health nurse managers need to address the factors in the work environment and promote interventions to enhance coping with burnout and STS. Subgroup analyses of country-based economies & regions and years revealed significant results.

Does the presence of calling relate to career success? The role of strengths use and deficit correction among nurses

BACKGROUND

The presence of calling has been associated with beneficial outcomes for nurses, yet our understanding of these effects remains limited. Additionally, the mechanisms linking the presence of calling to these outcomes have not been well established in the nursing literature.

AIM

This study aimed to investigate the relationship between the presence of calling and nurses' career success, mediated by the parallel effects of strengths use and deficit correction.

DESIGN

A cross-sectional design was used.

METHODS

Data were collected from December 2022 to April 2023, involving 237 nurses working in six hospitals in Port Said, Egypt. The study utilized the Demographic Information Form, the Presence of Calling Scale, the Strengths Use Scale, the Deficit Correction Scale, and the Career Success Scale. Study hypotheses were evaluated using structural equation modeling.

RESULTS

Presence of calling positively related to nurses' career success. Furthermore, nurses' strengths use and deficit correction played a mediating role in the relationship between the presence of calling and career success.

CONCLUSION

Nurses who view their work as a calling are more inclined to utilize their strengths and address their deficits, resulting in a heightened sense of career success.

IMPLICATION FOR NURSING POLICYMAKING

Emphasising that nursing is a calling should commence during the undergraduate education of nurses, and this concept should be continually cultivated by hospital administrators throughout their professional careers. This approach empowers nurses to leverage their strengths, address their deficits, and ultimately enhance their sense of success in their nursing careers.

Determination of Compassion Satisfaction and Compassion Fatigue Among Surgical Nurses

PURPOSE

The purpose of the study was to examine the level of compassion satisfaction and compassion fatigue in surgical nurses.

DESIGN

A descriptive and relationship-seeking study.

METHODS

The study sample consisted of 200 surgical nurses working in surgical units. Data were collected using the "Nurse Introduction Form," "Compassion Scale," and "Professional Quality of Life Scale." The data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp).

FINDINGS

According to this study, surgical nurses had a high level of compassion satisfaction and a moderate level of compassion fatigue. There is a statistically significant correlation between compassion satisfaction and compassion fatigue (P = .002, r = 0.220).

CONCLUSIONS

Among surgical nurses, the moderating variables that influenced levels of compassion satisfaction were gender, educational level, professional experience, and overall job satisfaction. Concurrently, age and professional experience were identified as significant factors affecting compassion fatigue.

The dual roles of empathy in mediating structural empowerment and compassion fatigue among Chinese nurses

BACKGROUND

Nurses in dynamic healthcare environments face escalating challenges that impact their efficacy and well-being. These challenges arise from both the increasing complexity of medical procedures and the intense emotional demands of caregiving, often leading to compassion fatigue. A global prevalence of burnout at 30.0% was observed over the past decade. This study examines the relationship between structural empowerment, empathy (cognitive and affective), and compassion fatigue among Chinese nurses. Understanding these relationships is crucial for developing strategies to mitigate compassion fatigue. It also contributes to enhancing nurses' well-being.

METHODS

Conducted at a public hospital in Shanghai, this cross-sectional study surveyed 305 nurses, with 277 valid responses. Structural empowerment was measured using the Conditions for Work Effectiveness Questionnaire-II, empathy with the Kiersma-Chen Empathy Scale, and compassion fatigue with the Compassion Fatigue Short Scale. We performed correlation and mediation analyses to explore the direct and indirect effects of structural empowerment on compassion fatigue through empathy.

RESULTS

A significant negative direct effect of structural empowerment on compassion fatigue was evidenced by a coefficient of -0.165 (confidence interval: [-0.311, -0.013]). Further analysis revealed a negative indirect effect through cognitive empathy, indicated by an effect of -0.103 (confidence interval: [-0.220, -0.008]). Increased structural empowerment was linked to higher levels of cognitive empathy, which correlated with decreased compassion fatigue. Conversely, the mediation through affective empathy showed a positive indirect effect, indicated by an effect of 0.126 (confidence interval: [0.047, 0.229]). This suggests that higher structural empowerment was associated with increased affective empathy, leading to higher levels of compassion fatigue.

CONCLUSION

The study illuminates the dual role of empathy within the framework of structural empowerment and its impact on compassion fatigue. Cognitive empathy serves as a protective factor, reducing susceptibility to compassion fatigue, while affective empathy appears to heighten vulnerability. These findings provide direct evidence supporting the dual processing pathways of empathy. It is recommended that healthcare policies integrate organizational support with targeted empathy training, such as cognitive reappraisal, emotion regulation, and peer support, to effectively counteract compassion fatigue among nurses. However, due to the cross-sectional nature and the single-hospital setting, the findings should be interpreted cautiously.

Moral sensitivity, spiritual care perception, and compassion fatigue of nurses caring for earthquake victims

BACKGROUND

Two major earthquakes occurred within 10 hours in Kahramanmaraş on February 6, 2023, which resulted in thousands of deaths and injured people within Turkey.

AIM

To determine the relationship between moral sensitivity, spiritual care perception, and compassion fatigue among nurses caring for earthquake victims.

METHODS

The study population consisted of 483 nurses working in public, private, and university hospitals in earthquake-affected areas in Turkey. The sociodemographic characteristics form, moral sensitivity questionnaire, spirituality and spiritual care rating scale, and compassion fatigue short scale were used for data collection.

RESULTS

There was a statistically significant negative relationship between nurses' moral sensitivity and compassion fatigue; in other words, as compassion fatigue increases, nurses' moral sensitivity decreases. A statistically significant negative relationship was found between nurses' perception of spiritual care and their compassion fatigue; in other words, as compassion fatigue increases, nurses' perception of spirituality and spiritual care decreases.

CONCLUSION

This study provides valuable insights into moral sensitivity, perceptions of spiritual care, and compassion fatigue among nurses caring for earthquake victims.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Minimizing nurses' compassion fatigue improves quality patient care, increases patient and employee satisfaction, and maintains commitment to the profession. To achieve this goal, it is essential to offer in-service training, conferences, or seminar programs to nurses focused on fostering a sense of compassion. Nurses should be provided with environments that will improve their self-care, and institutional policies and strategies should be developed to cope effectively with this situation.

The effect of perceived organizational support and ego-resilience on the relationship between occupational stressors and compassion fatigue in COVID-19 frontline nurses: a cross-sectional study in Sichuan, China

AIM

To investigate the level of compassion fatigue among frontline nurses during the COVID-19 pandemic and to explore the relationship between occupational stressors and compassion fatigue among frontline nurses based on structural equation modelling.

BACKGROUND

Three years into the COVID-19 pandemic, nurses on the frontlines of the battle were overwhelmed by affective and emotional inputs while caring for patients, and they generally experienced varying degrees of psychological problems. High levels of compassion fatigue can affect nursing quality and patient safety and therefore should be taken seriously by nursing managers.

METHODS

A cross-sectional survey of 1432 frontline nurses in Sichuan Province, China, was conducted from January to March 2023 via convenience sampling methods. The General Information Questionnaire, the Nurses' Occupational Stressors Scale, the Ego-Resilience Scale, the Chinese version of the Compassion Fatigue Brief Scale, and the Perceived Organizational Support Scale were used to collect the data. Hypotheses were tested using structural equation models and bootstrapping methods.

RESULTS

Nurse occupational stressors had a significant direct effect on compassion fatigue (B = 2.429, p < 0.001). Perceived organizational support exerted a mediating effect of 11.36% between occupational stressors and compassion fatigue. In addition, ego-resilience had a moderating role in the relationship between nurses' occupational stressors and compassion fatigue, between nurses' occupational stressors and perceived organizational support, and between perceived organizational support and compassion fatigue. Multiple linear regression analysis revealed that the most influential dimension of occupational stressors on compassion fatigue was work-family conflict (β = 0.253, p < 0.001), followed by organizational issues (β = 0.153, p < 0.001), work demands (β = 0.103, p < 0.001) and difficulty taking leave (β = 0.102, p < 0.001).

CONCLUSION

Nurse occupational stressors are positively associated with compassion fatigue and influence nurse compassion fatigue through the mediating effect of perceived organizational support and the moderating mechanism of ego-resilience. Managers can reduce nurses' compassion fatigue levels by reducing occupational stressors, promoting nurses' perceived organizational support, and fostering ego-resilience.

IMPLICATIONS FOR NURSING MANAGEMENT

This study further integrated the external and internal factors affecting compassion fatigue and constructed a structural equation model of the mechanism of compassion fatigue in frontline nurses, which has implications for the early identification and intervention of compassion fatigue in nurses.

Empathy fatigue among physicians and its influencing factors: a cross-sectional survey from Southwest China

BACKGROUND

Empathy fatigue refers to the excessive empathy required of medical staff in the process of helping patients, which can produce traumatic experiences and emotional exhaustion. Severe empathy fatigue can even lead to medical disputes and errors, exacerbating increasingly tense doctor-patient relationships. Most studies on empathy fatigue focus on nurses, with few studies on physicians.

METHODS

A cross-sectional questionnaire was used to assess empathy fatigue among physicians in public tertiary general hospitals in southwest China using convenience sampling.

RESULTS

A total of 562 physicians participated in the survey; average empathy satisfaction scores were 32.1 ± 6.85, 28.2 ± 5.30, and 26.2 ± 6.04 for empathy satisfaction disorder, job burnout, and secondary traumatic stress domains, respectively. We identified 291 (51.8%) physicians with severe empathy fatigue. Working two or three night shifts per week was associated with severe empathy fatigue. In total, 424 (75.4%) physicians had thoughts of resigning. Weekly rest time, empathic satisfaction disorder, job burnout, and secondary traumatic stress disorder influenced thoughts of resigning.

CONCLUSIONS

The majority of hospital physicians experience empathy fatigue and have considered resigning; this study provides reference data that demonstrate the extent of this issue. Efforts are urgently needed to address empathy fatigue in physicians and, therefore, increase physician retention.

[Impact of care for victims of gender violence on the health professionals]

Professionals who work with women victims of gender violence face difficult emotional situations, and it is important to be aware of the emotions and feelings that the attitudes and behaviour of victims and aggressors generate in them. These emotions can become barriers to communication and seriously affect the professional's relationship with victims. Furthermore, they can generate situations of sustained stress, lead to emotional exhaustion, and affect their health, life, and work performance. We describe the consequences, risk factors and warning signs, as well as protective or resilience factors, that are important to know, and we list the current challenges and some recommendations for professionals and management in order to help prevent such effects and improve professional performance without health risks.

Academic and Employment Preferences of Nursing Students at the University of Las Palmas of Gran Canaria: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

It is well known that there are differences in the academic and employment preferences of nursing students once they have completed their undergraduate studies in nursing. These preferences are largely influenced by students' affinity for certain thematic areas over others. Therefore, the objective of this study was to identify the employment and academic preferences of third- and fourth-year Nursing Degree students at the University of Las Palmas de Gran Canaria (ULPGC).

METHODS

A cross-sectional, descriptive observational study was conducted among nursing students across three campuses of the ULPGC (Canary Islands, Spain). An online questionnaire was used to collect various sociodemographic and academic variables, as well as preferences across ten thematic areas. Descriptive and bivariate inferential analyses were performed, along with a correlation analysis among the areas.

RESULTS

The areas of highest preference were "Emergency Nursing", "General Nursing", and "Family and Community Nursing". The areas of lowest preference were "Other Areas (teaching, management, research)", "Mental Health and Psychiatric Nursing", and "Geriatric Nursing". Three clusters of closely correlated areas were identified: cluster 1 (Intensive and Critical Care Nursing, Emergency and Emergency Nursing and Operating Theatre and Anaesthesia Nursing), cluster 2 (Obstetric-Gynaecological Nursing-Midwifery, Paediatric Nursing and Mental Health and Psychiatric Nursing) and cluster 3 (remaining areas). A significant proportion of students expressed intentions to pursue postgraduate studies.

CONCLUSIONS

Strategies should be implemented to enhance students' preferences in the areas of "Mental Health and Psychiatric Nursing" and "Geriatric Nursing", which are areas where there is a high demand for nurses. It is also necessary to increase their interest in research, management, and teaching. This study was not registered.

Professional quality of life profiles and its associations with turnover intention and life satisfaction among nurses: a prospective longitudinal study

BACKGROUND

Nursing shortage is a global issue. Turnover intention and life satisfaction are significant predictors of turnover. The specific nature of nursing and stressful work schedules lead to impaired professional quality of life (ProQOL), and existing studies have confirmed the effect of a dimension of ProQOL (such as secondary trauma stress, burnout and compassion satisfaction) on turnover intention and life satisfaction. Yet the heterogeneity of ProQOL across individuals is not known. A lack of research on the relationship between potential ProQOL subgroups and turnover intention and life satisfaction, and the mechanisms underlying this relationship remain understudied. The study aimed to determine different ProQOL profiles, and their cross-sectional and longitudinal effects on turnover intention and life satisfaction, while exploring the mediating roles of job satisfaction and work engagement within the relationship.

METHODS

Data were collected at a tertiary hospital in a northeastern province of China. An online questionnaire was administered twice over the course of six months. 1832 and 900 participates provided cross-sectional and longitudinal data respectively. We used latent profile analysis (LPA) and K-means clustering to identify ProQOL profiles, and used the PROCESS macro program to conduct mediation analysis.

RESULTS

The LPA results supported a 4-profile solution, including balanced protection, good quality, traumatic satisfaction and burnout problem. ProQOL profiles directly predicted nurses' current and subsequent turnover intention and life satisfaction. In addition, job satisfaction and work engagement mediated the effects of ProQOL profiles on turnover intention and life satisfaction in cross-sectional sample, and mediated the effects of ProQOL profiles on turnover intention in longitudinal sample.

CONCLUSION

The findings suggest that nurses' ProQOL has distinct categorical characteristics and is strongly associated with turnover intention and life satisfaction. Hospital administrators should implement individualized, join management and interventions according to each profile. Furthermore, more attentions should focus on improving nurses' job satisfaction and work engagement levels to promote good work and life outcomes.

The prevalence and related factors of compassion fatigue among nursing interns: a cross-sectional study

BACKGROUND

Compassion fatigue is common among nurses and can lead to decreased motivation, impaired physical and mental health, and turnover. Nursing interns often face environments the same as professional nurses, yet their compassion fatigue has received less attention. Therefore, this study aims to assess the prevalence and related factors of compassion fatigue among nursing interns.

METHODS

This was a cross-sectional study involving 221 nursing interns in 2 tertiary-level hospitals in Shanghai, China. A general information questionnaire was formulated to investigate the demographic characteristics and internship-related factors of nursing interns. Compassion fatigue was assessed using the Professional Quality of Life Scale [compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS)]. Psychological resilience, empathy, and perceived stress were evaluated by the Connor-Davidson Resilience Scale, Jefferson Scales of Empathy, and Perceived Stress Scale, respectively. Personality traits were assessed using the extroversion/introversion subscale of the Eysenck Personality Inventory. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson's correlation analysis, and multiple linear regressions were used to determine the predictors of the main research variables.

RESULTS

The prevalence of mild, moderate, and severe compassion fatigue in 221 nursing interns (mean age 21 years, 202 [91.4%] females) was 10.4%, 46.6%, and 43.0%, respectively, and their mean scores for CS, BO, and STS were 29.75 ± 6.39, 28.72 ± 4.78, and 28.51 ± 7.51, respectively. Psychological resilience and empathy were the strongest protective factors for CS and BO, respectively (p < 0.001), and the number of night shifts monthly was the most significant positive independent predictor of STS (p = 0.001). Additionally, male gender negatively predicted CS (p = 0.009). Younger age and extended daily working hours were associated with elevated levels of both BO and STS (p < 0.05). Clinical nursing teachers with intermediate or senior titles, as well as departments of pediatrics and obstetrics had a positive effect on STS (p < 0.05), while internship time had a negative effect on STS (p = 0.005). Furthermore, the variables of perceived stress, personality traits, and choice of nursing profession did not exhibit statistical significance in the multivariate analysis. Related factors predicted 14.2%, 26.2%, and 23.9% of the variance in the model of CS, BO and STS, respectively (all P < 0.001).

CONCLUSION

The compassion fatigue of nursing interns was more serious, especially for nursing interns who were male and younger, and who had shorter internship time, departments of pediatrics and obstetrics, and clinical nursing teachers with intermediate or senior titles. Nursing educators can improve the psychological resilience and empathy of nursing interns by offering relevant psychological courses according to the different stages of internship, as well as rationalizing their daily working hours and the frequency of night shifts to improve the compassion fatigue of nursing interns.

REGISTRATION NUMBER

ChiCTR2400081968.