Compassion Fatigue and Compassion Satisfaction in Hospice Social Work

Understanding compassion fatigue among social workers: a scoping review

Exposure to significant sources of trauma and stress among social workers is increasingly identified as an important issue that can impact the quality of professional services, and the social worker's well-being. There is more and more literature focusing on this phenomenon and related concepts. However, to our knowledge, there has been no published systematic review of the literature on compassion fatigue (CF) among social workers. Therefore, we performed a systematic scoping review by searching five electronic databases for studies published from 2001 to 2021, with the aim of identifying relevant literature. A total of twenty-nine studies were selected in the review following the systematic search strategy. Five themes were identified through the use of a narrative approach to synthesizing the literature by a Five-step framework of scoping review, including the prevalence, factors related, attributes and characteristics, consequences and strategies or interventions to reduce compassion fatigue among social workers. Findings revealed that few studies had examined the consequences and tested the effectiveness of specific interventions. Furthermore, future research involving concept analysis and related theoretical model was required in the field of social work.

The Relationship Between Secondary Traumatic Stress and Compassion Satisfaction: A Systematic Literature Review

This systematic literature review examines the relationship between secondary traumatic stress (STS) and compassion satisfaction (CS) to identify the state of the science and directions for future research. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework was used to guide the identification and evaluation of studies. Eight academic databases were systematically searched between July and December of 2022 to identify articles and dissertations published in English or Hebrew between 2000 and 2022. Studies were considered for inclusion if they examined the relationship between STS and CS and met an established quality threshold. If studies used a mixed methods approach, only quantitative results were included in the review. The search strategy yielded 537 studies with 33 included in the final review. Findings of this review suggest experiences of high levels of STS can coexist with high levels of CS indicating that people can gain satisfaction from their work and experience STS. Most studies examined the relationship between STS and CS using bivariate analyses with variability found in the direction of the relationship. This variability was also found in multivariate studies included in this review. These findings suggest the need for interventions to address both STS and CS with attention paid to the potential negative impact of emotional contagion and the vulnerability of younger female practitioners. Future research should pay attention to the rigor of the analysis of STS and CS and the exploration of mediating or moderating mechanisms between these constructs.

'So being here is. . . I feel like I'm being a social worker again, at the hospice': Using interpretative phenomenological analysis to explore social workers' experiences of hospice work

BACKGROUND

Social workers have a significant role in hospices working with clients who are facing death but there is limited detailed understanding of the emotional impact of this work on social workers. Research has highlighted that those involved in hospice work find the work both a struggle (e.g. because of heightened emotions) and rewarding (noting that end-of-life care can feel like a privilege).

AIM

To explore UK hospice social workers' emotional experiences of work and how this influences their practice.

DESIGN

Semi-structured interviews were conducted with hospice social workers. Interviews were transcribed and transcripts were analysed using Interpretative Phenomenological Analysis.

SETTING/PARTICIPANTS

Eight social workers from different hospices in the UK.

RESULTS

Five overlapping superordinate themes emerged: making a difference to clients and families ('the difference made'), the emotional impact of working in hospices ('dealing with people's emotions, and death, and dying, it's serious stuff'), the relational context of this type of work ('awareness of affinity to connect'), the ways in which coping is facilitated in hospices ('seen it coming') and a foundation theme, connection and disconnection to values ('(dis)connection to values').

CONCLUSIONS

The results offer an exploration of social workers' experiences of their work in hospices; how adept they were at coping and how they prepared for and made sense of the often emotionally-laden experiences encountered. Their experience of the rewards and meaning derived from their work offers important findings for clinical practice. Further research is suggested to explore a multitude of healthcare professionals' perspectives across country settings using Interpretative Phenomenological Analysis.

"Without Compassion We Don't Have a Social Work Field": A Thematic Analysis Exploring Social Workers' Experiences with Compassion

PURPOSE

Evidence establishing the importance of compassion in the context of social work practice is emerging. Compassion, stemming from the Latin words com and pati, means to suffer with. Given the proximity social workers have to vast experiences of suffering, compassion may play a central role in providing meaningful care to individuals, communities, and systems. The purpose of this qualitative study was to explore social workers' definitions of and experiences with compassion.

METHOD

Participants included 12 social workers working across levels of practice in two Midwestern states in the United States. Data were collected via semi-structured interviews.

RESULTS

Thematic analysis demonstrated three themes present in the data. Consistent with previous conceptual scholarship, the findings illustrated that compassion is a central component of social work practice. Additionally, results from the study demonstrated that social workers find compassion to be an imperative component of ethical practice and suggested that both barriers to and facilitators of compassion are present across levels of social work practice.

DISCUSSION AND CONCLUSION

This study adds to the growing body of social work scholarship exploring compassion and highlights implications for the social work discipline across levels of practice to more overtly center compassion in education, practice, and policy. Further research is needed to better understand multilevel barriers to compassion and develop strategies for overcoming them. Moreover, additional research is needed to holistically understand how to leverage and build upon the facilitators of compassion identified by participants in order to foster compassionate social workers, social work organizations, and systems.

A phenomenological study of compassion satisfaction among social work educators in higher education

Background

Compassion satisfaction (CS) is a phenomenon that has been studied among the helping professions, such as nursing and social work and has been linked to stress, burnout, compassion fatigue, and vicarious trauma. Social work educators may also experience these same issues, yet more research is needed on how they might counter the negative impacts associated with this type of work by utilizing their experiences of CS.

Objectives

A phenomenological study was carried out to explore and describe how social work educators in higher education experiences CS.

Methods

Eleven in-depth interviews with social work educators were conducted, and constructivist grounded theory techniques were utilized to analyze the data.

Results

Social work educators experienced CS within the education and personal realms, which encompassed four different elements: achievement, support, balance, and empathy.

Discussion

The four elements of CS were utilized by social work educators in this study as coping strategies to enhance their experience of CS, thus encountering threats to CS, such as institutional barriers, interaction with administrators and colleagues, and work overload.

Conclusion

Interventions fostering compassion satisfaction and reducing compassion fatigue, burnout, and stress should be considered, including interventions that increase the sense of accomplishment, promote holistic self-care, encourage administrative and collegial support, and improve work-life balance.

The Role of a Restorative Resource in the Academic Context in Improving Intrinsic and Extrinsic Motivation and Flow within the Job Demands-Resources Model

The perceived quality of the learning environment may influence both motivation and concentration. Little is known about how perceived characteristics of the learning environment, and specifically sub-dimensions of Perceived Restorativeness (being away, fascination, compatibility, and extent), can promote these positive effects in an academic context. We addressed, through a correlational study, the possibility that the characteristics of learning environments may promote concentration and involvement in activity (i.e., flow) via intrinsic and extrinsic motivation for academic study within the job demands-resources model. A total of 165 Italian university psychology classes in a 3-year degree course from two different universities context completed an online questionnaire made up of the construct considered in this study. Results in the hierarchical multivariate regression analyses confirm that the restorative quality of learning environments (i.e., being away, compatibility, extent) is positively correlated with flow. However, there is a non-significant relationship between extent and flow. Regression analyses show a significant indirect effect of compatibility, both through intrinsic and extrinsic student motivation. Furthermore, the results confirm a significant indirect effect of extent through intrinsic motivation and being away, and fascination through Extrinsic motivation. Furthermore, intrinsic motivation is a full mediator between the extent and flow relationship. The results underline the importance of considering the restorative quality of the environment for improving place design, concentration, and student learning motivation.

"We Are All Just Walking Each Other Home": Exploring the Lived Experiences of Rural Hospice Social Workers in "Companioning" the Dying

Social workers play a critical role on the hospice team including assessing risk and safety, advocacy, grief counseling, referral and connection to resources and providing guidance through advance care planning and advance directives. However, the voice of the rural hospice social worker is often absent from research. To address this gap in the literature, this study aimed to explore lived experiences of rural hospice social workers to better understand their role and challenges. Non-experimental qualitative research design was used for this study. Data was collected through in-depth qualitative interviews. A total of 19 rural hospice social workers participated in the study. We used a phenomenological approach focusing on the common lived experiences of rural hospice social workers and thus interviews were unstructured. Field notes and data were collected until data saturation was achieved. Five main themes were identified: (1) meaning of hospice social work, (2) role of hospice social workers, (3) vulnerability and realness, (4) self-care, and (5) rural culture. Based on these findings, we identified recommendations for hospice social work practice, research and policy, in general, as well as for rural hospice social work specifically. Future research could explore lived experiences of hospice professionals or of the dying and could also explore social worker experience of resource barriers.

Compassion and empathy in community social workers: A qualitative study in Spain

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term 'compassion' generates controversy among social workers, while the term 'empathy' seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers' experiences with empathy and compassion in the community setting. Between January and June 2019, nine in-depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress.

Prevalence of burnout in healthcare professionals providing palliative care and the effect of interventions to reduce symptoms: A systematic literature review

BACKGROUND

In recent years there has been increasing attention for the prevalence and prevention of burnout among healthcare professionals. There is unclarity about prevalence of burnout in healthcare professionals providing palliative care and little is known about effective interventions in this area.

AIM

To investigate the prevalence of (symptoms of) burnout in healthcare professionals providing palliative care and what interventions may reduce symptoms of burnout in this population.

DESIGN

A systematic literature review based on criteria of the PRISMA statement was performed on prevalence of burnout in healthcare professionals providing palliative care and interventions aimed at preventing burnout.

DATA SOURCES

PubMed, PsycInfo and Cinahl were searched for studies published from 2008 to 2020. Quality of the studies was assessed using the method of Hawkers for systematically reviewing research.

RESULTS

In total 59 studies were included. Burnout among healthcare professionals providing palliative care ranged from 3% to 66%. No major differences in prevalence were found between nurses and physicians. Healthcare professionals providing palliative care in general settings experience more symptoms of burnout than those in specialised palliative care settings. Ten studies reported on the effects of interventions aimed at preventing burnout. Reduction of one or more symptoms of burnout after the intervention was reported in six studies which were aimed at learning meditation, improving communication skills, peer-coaching and art-therapy based supervision.

CONCLUSION

The range of burnout among healthcare professionals providing palliative care varies widely. Interventions based on meditation, communication training, peer-coaching and art-therapy based supervision have positive effects but long-term outcomes are not known yet.

Impact of COVID-19 Pandemic on Posttraumatic Stress, Grief, Burnout, and Secondary Trauma of Social Workers in the United St

The purpose of this study is to measure posttraumatic stress, grief, burnout, and secondary trauma experienced by employed social workers in the United States and to describe organizational support provided to social workers during the novel coronavirus disease 2019 (COVID-19) pandemic. This study used data from the first wave of the COVID-19 Pandemic and Emotional Well-Being Study, a prospective panel study examining the psychological impact of the COVID-19 pandemic, and includes a sample of 181 social workers. We conducted univariate analyses. Over a quarter (26.21%) of social workers met the diagnostic criteria for PTSD and 16.22% reported severe grief symptoms. While 99.19% of the sample reported average to high compassion satisfaction, 63.71% reported average burnout and 49.59% reported average secondary trauma. Findings indicate that social workers are reporting higher than national estimates of PTSD, indicating a greater need for more emotional support during the COVID-19 pandemic. Given the significance and severity of the pandemic, it is essential that organizations provide resources for both immediate and ongoing support for the emotional well-being of their employees.

Job Demands and Resources, Positive and Negative Affect, and Psychological Distress of Social Workers in China

Globally, human service professionals, like social workers, experience significant job demands (JD) which can lead to outcomes like psychological distress, burnout, and high turnover rates. This is especially true in China, where the social work profession has grown substantially in recent decades. Because social workers play a crucial role in supporting vulnerable communities, there is a need to understand how their work conditions affect outcomes like psychological distress. This study applies the job demands and resources (JD-R) model to study this relation, along with the mediational effects of positive affect (PA) and negative affect (NA), in social workers from Chengdu, China (n = 897). The results of structural equation modeling indicate that JD-R differentially affect psychological distress. PA and NA partially mediate these relations. Job resources (JR) reduced psychological distress by reducing NA and increasing PA. JD did not have any effect on PA but significantly increased NA, which was associated with higher psychological distress. The magnitudes of each estimate suggest that JR has a greater effect on PA and NA, relative to the effects of JD on PA and NA. Interventions that seek to promote PA and reduce NA may be able to work with existing JR to buffer against the effects of JD in social workers.

High Civic-Mindedness Reduces Compassion Fatigue in the First 3 Years of Professional Physical Therapist Practice: A Pilot Study

Introduction

Clinicians with compassion fatigue (CF) experience behavioral, cognitive, and emotional changes due to repeated exposure to second-hand trauma from the clients with whom they are working. A civic-minded professional possesses the core value of social responsibility. Physical therapy (PT) education programs must balance a focus on developing social responsibility and compassion against the risk of CF.

Objective

The objectives of this study were to (1) describe the prevalence of CF in a sample of physical therapists in the early years of practice and (2) to determine whether higher civic-mindedness leads to the development of CF in physical therapists.

Method

Three cohorts of recent graduates were administered the Professional Quality of Life (Pro-QOL) survey to measure CF. Thirty-five of 127 surveys sent (27.6% response rate) were completed.

Results

A Mann-Whitney U was run to determine differences in the Pro-QOL survey between those scoring high or low in civic-mindedness at graduation. Higher civic-mindedness scores exhibited significantly lower burnout and higher compassion satisfaction.

Conclusion

Higher levels of civic-mindedness appear to have a protective effect against developing CF.

Development and validation of the Short Professional Quality of Life Scale based on versions IV and V of the Professional Quality of Life Scale

Background

This research presents a short version of the Professional Quality of Life (ProQOL) scale, one of the most frequently used questionnaires in the arena of applied healthcare investigation. It measures burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS).

Methods

A 9-item version of the ProQOL was developed. In Study 1, this short version, which used items from version IV of the ProQOL, was administered to 817 palliative care professionals from Spain, Argentina, and Brazil. In Study 2, the same nine items, but this time from version V of the ProQOL, were administered to 296 Spanish palliative care professionals.

Results

Study 1: The Short ProQOL showed an adequate internal structure, and invariance across the countries studied (χ²(106) = 185.620 (p < 0.001), CFI = .929, RMSEA = 0.058 [0.044, 0.072], SRMR = 0.081). Argentinians showed higher levels of BO (mean difference = 0.172, p = 0.042, Cohen’s d = 0.168), whereas Brazilians showed higher levels of CF (Mean difference = 0.384, p = 0.002, Cohen’s d = 0.352). Study 2: the Short ProQOL again showed adequate internal structure and reliability (χ²(24) = 134.504 (p < 0.001); CFI = 0.953; RMSEA = 0.126 [0.106, 0.147]; SRMR = 0.063), and was related to coping with death, self-compassion, and self-care.

Conclusions

The Short ProQOL could help facilitate the application of harmonizing measurements and its use for cross-cultural comparisons and occupational health monitoring was satisfactory.

Oncology nurses' compassion fatigue, burn out and compassion satisfaction

BACKGROUND

For oncology nurses, compassion fatigue, burn out and compassion satisfactions are frequently experienced psychosocial consequences of the oncology work environment. Surveying such phenomena helps to understand how nurses feel and behave when cancer care is provided. Besides, tracking the evolving nature of those three concepts can lend a hand for the early detection of personal and professional suffering of nurses while offering some healing remedies to their struggling bodies and souls.

PURPOSE

The purpose of this study was to explore the level of compassion fatigue, burn out and compassion satisfaction among a group of specialized oncology nurses. Besides, this study aimed to detect some probable interesting inferences between compassion satisfaction and the concept of rest and leisure. Correlations between compassion fatigue, burn out and compassion satisfaction were investigated. Correlations between oncology nurses' scores on the three subscales and a group of demographic, organizational and leisure-related variables were examined.

METHODS

This study adopted a descriptive correlation design to survey compassion fatigue, burn out and compassion satisfaction among a convenient sample of 100 oncology nurses who work in a specialized cancer care centre. Participants completed compassion fatigue self-test developed by Figely (Compassion fatigue, New York: Brunner/Mazel. B. HudnallStamm, Traumatic Stress Research Group; 1995-1998. http://www.dartmouth.edu/~bhstamm/index.htm, 1995) and a literature-based demographic survey. Analysis of data included descriptive statistics and Pearson correlation co-efficient.

RESULTS

Nurses reported a low level of compassion satisfaction, moderate risk for burn out and an extremely high risk for compassion fatigue. Results revealed significant negative relationships among compassion satisfaction and the number of dependents per nurse. Additionally the correlation between compassion satisfaction and the nurses' number of hours slept was positive. Only two components of the concept rest and leisure yielded statistical significance when correlated to the concept of compassion satisfaction. A significant negative relationship was observed between compassion satisfaction and compassion fatigue while a strong positive relationship was observed between compassion fatigue and burn out.

CONCLUSIONS

The studied oncology nurses sample had evidently low level of compassion satisfaction when contrasted to the significantly increased risks of burn out and compassion fatigue. Thus, health authorities and management are advised to care, in a holistic approach, for nurses who work in oncology departments. Staff-oriented services that offer comfort, reward, leisure, screening, consultation and support are urgently recommended.

Impact of Crisis Line Volunteering on Mental Wellbeing and the Associated Factors: A Systematic Review

Crisis line services, operated by volunteers, have been proven to be effective in decreasing psychological pain and preventing suicidality. Although working at the crisis line may be rewarding, for some the confrontation with highly complex topics (i.e., suicidality, abuse, and loneliness) in combination with inappropriate calls (i.e., sexually abusive calls), may lead to distress or vicarious trauma. The aim of this paper is to systematically review the studies that have examined mental wellbeing of crisis line volunteers and the factors associated with it. Thirteen published empirical studies on the topic were found. These showed that crisis line volunteers are at increased risk of declined mental wellbeing. However, a wide range of operationalizations were used and most studies did not use validated instruments. On the other hand, studies showed that many volunteers experience satisfaction and gratification from their work. This review gives insight into some of the work-related, organization-related, and volunteer-related factors that may be associated with the decrease of mental wellbeing. More high quality, comprehensive, and quantitative research using validated instruments is urgently needed to assess the impact of the work on mental wellbeing and the relative impact of influencing factors.

Productive Aging in the Social Work Profession: A Comparison of Licensed Workers 60 Years and Older with Their Younger Counterparts

This article reports the findings of an online survey in 13 U.S. states that compared the self-described demographics, wellness factors (mental health, physical health, and substance misuse), practice factors (fields of practice and work environment issues), and feelings about being a social worker (compassion satisfaction, workplace stress, being glad one chose social work and feeling valued as a professional in society) of 870 employed licensed social workers age 60 and older to 4076 licensed social workers under age 60. The results indicate that the older social workers were more likely to be male and white, less likely to report mental health problems, and more likely to work exclusively in private practice. Although older workers reported more serious physical health problems, they rated their physical health more favorably than their younger counterparts. In both bivariate and multivariate analyses, the older social workers scored significantly higher in compassion satisfaction, being glad they chose social work as a career, and feeling valued as a professional in society. The older social workers scored lower in workplace stress at levels that were statistically significant in a bivariate analysis, but not in a multivariate analysis.

Personal characteristics, coping strategies, and resilience impact on compassion fatigue in critical care nurses: A cross-sectional study

Compassion fatigue is known to impact the well-being of nurses and patient safety outcomes. Currently, there is limited academic understanding of the role of demographic factors in contributing to compassion fatigue in critical care nurses. The aim of this study was to examine the relationship between nurse demographic characteristics and the development of compassion fatigue, as indicated by level of burnout and compassion satisfaction in critical care nurses in Saudi Arabia. The cross-sectional study design included administering three surveys to critical care nurses (n = 321) in four Saudi public hospitals to examine the nurse demographic variables in relation to compassion fatigue, the compassion fatigue coping strategies of nurses, and nurse resilience. The results show both demographic and workplace structural elements, such as length of work shift, education level, and nationality, were all significant factors in resilience to compassion fatigue among Saudi critical care nurses, whereas factors of age and sex were not significant. This study concludes that the demographic characteristics of critical care nurses enable the identification of levels of compassion fatigue and compassion satisfaction, and their resilience to the effects of compassion fatigue.

Improving Retention Among Certified Nursing Assistants Through Compassion Fatigue Awareness and Self-Care Skills Education

Background: Retention of certified nursing assistants (CNAs) is an ongoing challenge for nursing homes. Purpose: To combat the effects of providing complex care needs to residents, this quality improvement project explored a 90-minute evidence-based education program on compassion fatigue awareness and multiple self-care skill strategies for CNA retention. Design: A single-group pre- and posttest design, mixed-methods approach. Method: A preintervention demographic survey, a postexperience survey, and the ProQOL (Professional Quality of Life; Version 5) tool measured the CNAs' level of compassion satisfaction, burnout, and secondary traumatic stress at three time points: preintervention, 1 month postintervention, and 3 months postintervention. Results: Forty-five CNAs participated. After 1 month, CNA retention increased by 43%, and at the end of the fourth month, the facility's retention rate was 100%. Forty-four percent of the full-time supplemental agency CNAs became full-time facility employees. The use of supplemental agency staff decreased to less than 5% of the total CNA hours worked. CNAs improved their compassion satisfaction, burnout, and secondary traumatic stress scores. Conclusion: This education program proved to be an effective, low-cost intervention. The quality improvement project highlighted the need for additional study on holistic interventions such as workplace education programs addressing compassion fatigue awareness and self-care skill strategies in this understudied group of formal caregivers.

Self-care behaviours and their relationship with Satisfaction and Compassion Fatigue levels among social workers

Compassion fatigue is a syndrome resulting from an empathic listening to the client's distress. Social workers, by the relational nature of their task, can be at risk and may suffer from adverse health effects. This quantitative research (N = 270) aimed to assess the efficiency of social workers' self-care practices. The conclusion is that personal and professional self-care practices reduce compassion fatigue levels as well as increase satisfaction levels. Promoting self-care practices will bring benefits for the professional and, therefore, in the client and the institution.