Compassion fatigue in mental health nurses: A systematic review

Psychiatric Nurses' Compassion Fatigue, Moral Commitment, Workplace Civility, and Missed Nursing Care: The Mediating Role of Practice Environment

To the best of our knowledge, this study was the first to explore the moral commitment and workplace civility of psychiatric nurses working in a Middle Eastern country, as well as the mediating role of the practice environment in the associations between compassion fatigue, moral commitment, workplace civility, and missed nursing care. This cross-sectional and correlational study consecutively recruited psychiatric nurses (n = 207) from three government-owned mental health centers in Saudi Arabia. Five standardised scales were used to collect data from June to November 2024. Covariance-based structural equation modelling was used for data analyses. Psychiatric nurses' moral commitment had a direct, negative, and moderate influence on compassion fatigue (β = -0.24, p = 0.013), practice environment (β = -0.21, p = 0.007), and missed nursing care (β = -0.20, p = 0.008). Compassion fatigue had a direct, positive effect on the practice environment (β = 0.14, p = 0.033) but a negative, direct influence on missed nursing care (β = -0.28, p = 0.003). The practice environment directly and positively influenced missed nursing care (β = 0.16, p = 0.015). Path analyses indicated that moral commitment (β = -0.04, p = 0.027) and compassion fatigue (β = 0.02, p = 0.015) had statistically significant indirect effects on missed nursing care through the mediation of practice environment. Nurse leaders and healthcare institutions are responsible for creating an efficient practice environment for psychiatric nurses, strengthening their moral commitment while effectively managing their compassion fatigue and minimising missed nursing care.

How do emotional intelligence and professional identity affect humanistic care ability? A cross-sectional study among standardised training nurses in China

OBJECTIVES

To understand the current status of emotional intelligence, professional identity and humanistic care ability among standardised training nurses (STNs); to explore the mediating role of professional identity in the relationship between emotional intelligence and humanistic care ability; and to explore the potential mechanisms among these variables.

DESIGN

A cross-sectional study.

SETTING

A tertiary hospital in Chengdu, China.

PARTICIPANTS

A total of 134 STNs were recruited through convenience sampling.

METHODS

Using convenience sampling, 134 STNs were recruited. Participants completed the Nurse Professional Identity Scale (5-point Likert), the Humanistic Care Ability Scale (7-point Likert) and the Emotional Intelligence Scale (7-point Likert) to assess their levels of professional identity, humanistic care ability and emotional intelligence. Structural equation modelling was used to test the mediation model.

PRIMARY AND SECONDARY OUTCOME MEASURES

Participants completed the Nurses' Professional Identity Rating Scale, the Caring Ability Inventory and the Emotional Intelligence Scale. Pearson correlation and mediation analyses were performed using the PROCESS macro for SPSS.

RESULTS

STNs demonstrated low levels of humanistic care ability, moderate levels of professional identity and low levels of the ability to assess others' emotions. Emotional intelligence had a significant positive direct effect (0.798) on humanistic care ability and professional identity partially mediated (0.109) this relationship.

CONCLUSION

Emotional intelligence directly enhances humanistic care ability, and professional identity plays a partial mediating role. Integrating emotional intelligence and professional identity training into standardised nurse education may strengthen humanistic care competencies. Targeted emotional intelligence training for STNs may enhance empathy and professional identity, thereby improving humanistic care ability and contributing to better doctor-patient relationships.

Compassion fatigue among medical students and its relationship to medical career choice: a cross-sectional survey

BACKGROUND

Compassion fatigue can lead to various physical and mental health issues and reduce the work efficiency and motivation of medical professionals. This study explored the prevalence of compassion fatigue among medical students and its relationship to their decision to continue working in clinical medicine after graduation from medical school.

METHODS

A cross-sectional survey was conducted with clinical medicine students in several hospitals in Southwest China using convenience methods. The Chinese version of the Compassion Fatigue Scale was used to measure compassion fatigue. Additionally, the desire to have a career in clinical medicine after graduation was investigated to determine its relationship to compassion fatigue.

RESULTS

A total of 473 medical students participated in the survey. Among the participants, 46 experienced mild compassion fatigue, 205 experienced moderate compassion fatigue, and 210 experienced severe compassion fatigue. The regression analysis showed that a night shift frequency of 2-3 times/week (odds ratio (OR) = 5.33, 95% confidence interval (CI) [1.35, 21.0]), working 8-10 h per day (OR = 2.30, 95% CI [1.01, 5.22]), or working 10 h per day or more (OR = 8.64, 95% CI [1.99, 37.6]) were factors of severe compassion fatigue. Furthermore, 158 participants reported that they did not often or always want to pursue a career in clinical work after graduation. Regression analysis revealed that low empathy satisfaction was an independent risk factor for students not wanting to continue in clinical practice post-graduation (odds ratio = 2.30, 95% CI [1.00, 5.31]).

CONCLUSION

Compassion fatigue is common among medical students and may significantly influence their intention to pursue a medical career after graduation. Educational institutions, medical facilities, and relevant departments should prioritize addressing compassion fatigue in medical students and implementing effective preventive and interventional strategies.

The impact of an empathy education programme on empathy, communication skills and emotional competency in nursing students: A quasi-experimental study

AIMS

This study aimed to evaluate the impact of an empathy education programme on the empathy, communication skills and emotional competency of fourth-year undergraduate nursing students in Korea.

BACKGROUND

Empathy is crucial for building rapport with patients and supporting person-centred care. There is a need to integrate a sustainable empathy education programme into the nursing curriculum.

DESIGN

This quasi-experimental study assigned 50 fourth-year nursing students from two universities in Korea to experimental and control groups.

METHODS

The experimental group was exposed to an 8-week empathy programme, with 90-minute weekly sessions. The program included self-understanding, understanding others and therapeutic communication skills. Data were collected via questionnaires on empathy, communication skills and emotional competency at baseline, post-test and follow-up.

RESULTS

The experimental group showed significant improvements in empathy, communication skills and emotional competency, with a sustained impact at the four-week follow-up.

CONCLUSION

The empathy education programme effectively enhanced empathy, communication and emotional competency in nursing students, serving as a valuable educational tool at the undergraduate level.

Analysis of Compassion Fatigue Among Psychiatric Nurses and Its Effect on Spiritual and Competent Care

BACKGROUND

Psychiatric nurses are exposed to patients experiencing severe emotional, psychological and behavioural challenges, which can lead to diminished empathy, compassion and overall well-being. Compassion fatigue, primarily work-related burnout, stems explicitly from the emotional strain of caregiving. The increasing prevalence of compassion fatigue among psychiatric nurses is a significant issue that threatens their ability to deliver competent and compassionate care.

AIM

This study seeks to explore the relationship between compassion fatigue, spiritual care and the competence of psychiatric nurses, emphasising the effect of compassion fatigue on spiritual and competent care.

METHOD

This study employed a cross-sectional and correlational design on 322 psychiatric nurses from four hospitals in Alexandria, Sohag, Portsaid and Cairo, selected using convenience sampling. Data were collected through anonymous self-administered questionnaires distributed from March to May 2024. The instruments used included the Compassion Fatigue Self-Test (CFST) scale, the Spirituality and Spiritual Care Rating Scale (SSCRS), the Self-Liking and Competence Scale-Revised Version (SLCS-R) and a demographic questionnaire.

FINDINGS

The study's findings revealed significant relationships between compassion fatigue, spirituality, spiritual care and competence among psychiatric nurses. Nurses reported a mean compassion fatigue score of 128.22, and the analyses showed that compassion fatigue negatively correlated with both spirituality and spiritual care (r = -0.411, p < 0.001) and competence (r = -0.196, p < 0.001). Additionally, spirituality and spiritual care were positively correlated with competence (r = 0.357, p < 0.001). Also, linear regression analyses indicated that compassion fatigue negatively impacted spirituality and spiritual care (β = -0.196, p < 0.001).

IMPLICATION

Enhancing nurses' spiritual care competence through training and support can foster a more compassionate and spiritually supportive environment for patients, which is crucial in psychiatric care settings where patients often face complex emotional and mental health challenges.

CONCLUSION

These findings suggest that psychiatric nurses can improve their ability to deliver spiritually and professionally competent care by mitigating compassion fatigue, thus improving patient outcomes and nurse well-being.

Anxiety and inhibitory control play a chain mediating role between compassion fatigue and Internet addiction disorder among nursing staff

Mental health problems among nurses are prevalent and harmful. Nurses worldwide have encountered serious mental health issues. Although fatigue has been proven to lead to substance abuse or addictive behaviors (such as internet addiction), there is a lack of sufficient data on whether there is a connection with compassion fatigue. Compassion fatigue is a common mental health problem in helping professions. Anxiety and inhibitory control have been demonstrated to be associated with internet addiction, but the mediating role between them in the state of compassion fatigue remains to be further explored. Therefore, this study aims to investigate the chain-mediating effect of anxiety and inhibitory control between compassion fatigue and internet addiction in the nurse population. From July to August 2024, a questionnaire survey was conducted using a convenience sampling method in 7 hospitals in Hunan Province, China. A total of 516 front-line clinical nurses were included, among whom 17 were male and 499 were female. Subjective data on compassion fatigue, internet addiction, anxiety, and inhibitory control were collected and analyzed. SPSS 26.0 and its PROCESS macro-plugin were used for data analysis. After controlling for age and gender, compassion fatigue was found to be a significant predictor of internet addiction (β = 0.40, P < 0.001). However, when anxiety and inhibitory control were added, the prediction of compassion fatigue on internet addiction in the nurse population remained significant (β = 0.18, P < 0.001). Eventually, the research results show that compassion fatigue can predict internet addiction through anxiety and inhibitory control. It is recommended that nursing managers provide appropriate emotional interventions for nurses with compassion fatigue or adjust the shift-scheduling and leave system to prevent the occurrence of internet addiction.

'I Was too Tired to Show Compassion': A Phenomenological Qualitative Study on the Lived Compassion Fatigue Experiences of Nurses Working in Acute Inpatient Psychiatric Units

INTRODUCTION

Psychiatric nurses are at risk of experiencing compassion fatigue. Despite the economic, emotional and physical effects of compassion fatigue, it has not been sufficiently investigated in the field of psychiatric nursing, and the lived experiences of compassion fatigue, in particular, require further investigation using qualitative methods.

AIM

The aim of this study was to examine the lived compassion fatigue experiences of nurses working in psychiatric clinics using a phenomenological approach.

METHOD

The study was conducted between December 2023 and February 2024 with 22 psychiatric nurses working in acute psychiatric clinics. Data were collected through individual, in-depth interviews, and analysed using Collaizi's seven-step descriptive analysis approach.

RESULTS

Data analysis revealed four main themes and eight subthemes: (1) being a psychiatric nurse (multifaceted role and benefits), (2) tiredness (from traumatic effects to depersonalisation and emotional isolation), (3) causes of compassion fatigue (patient derived, system and working environment derived) and (4) coping methods (individual and expectations).

DISCUSSION

Due to difficult patient profiles and adverse working conditions, psychiatric nurses experience compassion fatigue and may become desensitised to patient needs over time.

IMPLICATIONS FOR PRACTICE

Institutional support in the form of training for nurses on recognising and coping with compassion fatigue, as well as a safe and workload-balanced working environment, is essential.

Optimising Scopes of Practice and Team-Based Collaborative Care Through Task-Shifting and Task-Sharing in Mental Health-A Collaborative Patient Care (CPC) Initiative

Team-based collaborative models utilise a broad range of healthcare clinicians that practise at the top of their licence, while proactively redistributing shared work through task-shifting, offering meaningful ways to contribute to patient care while ensuring high-quality outcomes. A mental health hospital in Canada embarked on a Collaborative Patient Care (CPC) initiative to optimise skill and skill mix of interdisciplinary inpatient teams. Implementation science, specifically the Exploration, Preparation, Implementation and Sustainment (EPIS) Framework, was utilised to guide the project. Following qualitative and quantitative syntheses, analyses and stakeholder engagement, CPC re-imagined team-based care by restructuring one clinical team of recreational therapy and introduced 26 new positions to infuse across the organisation, including new disciplines of rehabilitation assistant, geriatric physiotherapist, occupational therapists and bachelor of social work roles, while recruiting for more child and youth workers, recreational therapists, secretaries, psychologists, behavioural therapists and personal support workers. Scopes of work were defined to support differences (i.e., between Registered Nurses (RN) and Registered Practical Nurses (RPN)) while team responsibilities were designed to support shared practices. An educational upskilling plan was implemented to support unregulated and regulated clinicians to perform at the level of the new model. At the time of this paper, CPC is immersed in its Sustainment stage. CPC represents a comprehensive plan aimed at enhancing patient care through service efficiencies and optimising resource allocation. It is anticipated that the implementation of CPC will contribute to a shared vision for a better future where patients (and families) receive the right care at the right time by the right clinician.

Personality disorder functioning styles and empathy in trainee nurses: the mediating and moderating roles of death attitudes

BACKGROUND

There is abundant evidence that an individual's personality traits may influence their level of empathy. However, the role of death attitudes in the relationship between personality disorder functioning styles of nurses and their empathy remains to be elucidated.

METHODS

Personality disorder functioning styles, death attitudes, and empathy levels were assessed in 614 Chinese trainee nurses using the Parker Personality Measure (PERM), the Death Attitude Scale-Revised (DAP-R), and the Jefferson Scale of Empathy-Health Professionals (JSE-HP).

RESULTS

Among the trainee nurses, DAP-R Fear of Death, Death Avoidance, Escape Acceptance, Approach Acceptance, and Neutral Acceptance(-) partially mediated the negative correlations between all PERM styles except Obsessive-compulsive style and empathy. Furthermore, DAP-R Fear of Death, Escape Acceptance, and Approach Acceptance fully mediated that between Obsessive-compulsive style and empathy. Fear of Death and Death Avoidance attenuated empathy among those with higher Narcissistic and Dependent styles, respectively.

CONCLUSION

Death attitudes served as a mediator and moderator in the relationships between personality disorder functioning styles and empathy among trainee nurses, suggesting the need for targeted death education among early-career nurses with personality dysfunctions.

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.

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.

Exploring the relationship between compassion fatigue, stigma, and moral distress among psychiatric nurses: a structural equation modeling study

BACKGROUND

Psychiatric nurses experience unique emotional and ethical challenges, including moral distress, associative stigma, and compassion fatigue, that can negatively affect their mental health and clinical performance. The complex relationship among these variables has not been clearly defined. Thus, this study aimed to determine the levels of compassion fatigue, associative stigma, and moral distress and to investigate how these factors interact with an emphasis on the role of compassion fatigue in mediating the relationship between associative stigma and moral distress.

METHODS

A convenient sampling technique was used to recruit nurses from Erada Mental Health Complex in Riyadh. In addition to sociodemographic data, three validated tools were used to collect data: the Compassion Fatigue Scale, Clinician Associative Stigma Scale, and Moral Distress for Healthcare Professionals Scale. The structural equation modeling was used to examine the relationship among the three variables using the 'lavaan' package.

RESULTS

Mediation analysis revealed that compassion fatigue significantly mediates the relationship between associative stigma and moral distress, with 80% of the total effect mediated (β = 6.38, p < 0.001). Direct and indirect effects were confirmed, with associative stigma impacting moral distress both directly (β = 1.64, p < 0.001) and through compassion fatigue (84% of the effect). Structural equation modeling showed a satisfactory model fit (χ²/df = 2.84, CFI = 0.90, RMSEA = 0.075) and supported the central role of compassion fatigue in this relationship.

CONCLUSIONS

Our findings underscore the importance of addressing compassion fatigue and associative stigma to alleviate moral distress among psychiatric nurses. To ensure nurses' well-being and the delivery of high-quality mental health care, interventions such as peer support groups, resilience training, and organizational initiatives to decrease stigma and compassion fatigue should be considered for all nurses working in psychiatric mental health settings.

CLINICAL TRIAL NUMBER

Not applicable.

Mindful Self-Care and Compassion Fatigue in Nurses: The Chain Mediating Roles of Resilience and Professional Identity

Aim: To investigate the relationship between mindful self-care and compassion fatigue and the chain mediating effects of resilience and professional identity. Background: Compassion is a critical quality for nurses, but they often face the risk of compassion fatigue. Methods: From October 2023 to May 2024, a cross-sectional survey was conducted in six tertiary hospitals in Guangdong, Henan, and Jiangsu provinces by convenience sampling. A total of 1315 clinical nurses in the hospital were surveyed using the Social-demographic Characteristics Questionnaire, the Chinese Version of the Brief Mindful Self-Care Scale, the Chinese Version of the Connor-Davidson Resilience Scale, the Professional Identity Scale for Nurses, and the Chinese Version of the Compassion Fatigue Short Scale. The mediation model was analyzed using a bias-corrected bootstrapping method with PROCESS 4.1 implemented in SPSS 26.0. Results: Pearson correlation analysis showed that there was a positive correlation between nurses' mindful self-care, resilience, and professional identity. Mindful self-care, resilience, and professional identity were negatively correlated with compassion fatigue. Resilience played a partial mediating role between mindful self-care and compassion fatigue. Professional identity also played a partial mediating role between mindful self-care and compassion fatigue; mindful self-care affected compassion fatigue through resilience and professional identity. Conclusion: Nurses' mindful self-care can affect compassion fatigue through the mediating role of resilience and professional identity. In the future, attention should be paid to cultivating nurses' mindful self-care ability and resilience and improving nurses' professional identity, which may help to reduce nurses' compassion fatigue. Implications: Hospital leaders should actively pay attention to the mental health of nurses and take measures to improve their ability of mindful self-care, which may help to prevent compassion fatigue and improve nursing quality. Reporting Method: The study adheres to the STROBE reporting guidelines. Patient or Public Contribution: No patient or public contribution.

Psychiatric Wards Nurses' Experiences on Self-Compassion, Compassionate Care and Compassion Fatigue: A Qualitative Study

BACKGROUND

Compassion is an important component of providing quality nursing care, and the literature on compassionate care in psychiatric nursing is limited.

AIM

The aim of this qualitative descriptive study was to explore the experiences of psychiatric ward nurses regarding self-compassion, compassionate care and compassion fatigue.

METHODS

A qualitative descriptive study was conducted by thematic analysis with an inductive approach of semi-structured interviews with 16 psychiatric nurses across psychiatric ward in a state hospital, Kirkuk, Iraq, selected through purposeful sampling between 15 October and 15 November 2023.

RESULTS

The analysis of the data, two main themes emerged: 'freedom in difficulties' and 'togetherness of suffering'. These results indicate that psychiatric nurses need individual and organizational resources to provide compassionate care.

CONCLUSION

It is thought that developing programmes to improve the self-compassionate care of psychiatric nurses by institution managers and policy makers may be effective in reducing compassion fatigue and providing compassionate care. In the future research, how religion affects psychiatric nurses' ability to provide compassionate care and the role of belief in coping with compassion fatigue experienced by psychiatric nurses needs to be investigated.

The Impact of Clinical Supervision on the Mental Health Nursing Workforce: A Scoping Review

Clinical supervision is a psychologically safe practice that aims to provide support and training for workers within the healthcare industry, including mental health nurses. Over the years, clinical supervision has been cited as a practice to improve workforce outcomes for both individual mental health nurses and the organisations they work in. The aim of this scoping review is to examine the evidence exploring the relationship between clinical supervision and workforce outcomes for mental health nurses. Twenty-eight articles sourced from six databases were included in this study. The most frequently evaluated workforce outcomes were competence (n = 14), workplace culture (n = 13) and compassion (n = 7). Studies reported that the association between clinical supervision and workforce outcomes was predominantly positive, but there were mixed results for competence, workplace culture, job satisfaction and burnout. Details on the type of clinical supervision received by participants were limited, and most of the evidence included in this review included qualitative research and participants self-reporting their perceived benefits from clinical supervision, as opposed to using validated instruments in experimental and/or longitudinal study designs. Organisations should be hesitant to implement mandatory clinical supervision within workplaces, as this could have the opposite effect on workforce outcomes for mental health nurses who are already time-poor and overworked, as well as those who are indifferent or hostile to clinical supervision.

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.

Relationships Among Secondary Traumatic Stress, Mindfulness, Compassion Satisfaction, and Compassion Fatigue in Psychiatric Nurses

PURPOSE

To examine relationships among secondary traumatic stress, mindfulness, compassion satisfaction, and compassion fatigue in psychiatric nurses.

METHOD

Participants comprised 142 nurses working in two psychiatric hospitals in the same province of Turkey. Data were collected using a personal information form, the Secondary Traumatic Stress Scale, Mindful Attention Awareness Scale, and Compassion Fatigue and Compassion Satisfaction subscales of the Professional Quality of Life Scale.

RESULTS

A significant and negative correlation was found between secondary traumatic stress, mindfulness, and compassion satisfaction, and between mindfulness and compassion fatigue. A significant and positive correlation was found between secondary traumatic stress and compassion fatigue, as well as between mindfulness and compassion satisfaction (p < 0.05).

CONCLUSION

Findings demonstrate that mindfulness may be a protective factor in preventing secondary traumatic stress and compassion fatigue in psychiatric nurses. It is recommended that in-service training be organized periodically to increase levels of conscious awareness among psychiatric nurses. [Journal of Psychosocial Nursing and Mental Health Services, 63(1), 47-55.].

The mediating role of compassion fatigue between perceived organization support and caring behavior among outpatient nurses in China: a cross-sectional study

BACKGROUND

The caring behaviors of outpatient nurses play a crucial role in improving the quality of care in hospitals. Work resources and personal psychological resources have a significant impact on nurses' caring behavior. Previous research has shown that perceived organizational support and compassion fatigue are linked to nurses' caring behaviors. However, the specific relationship among these variables is less clear in the context of outpatient nurses working in high-stress environments.

METHODS

A convenience sampling method was utilized to recruit 413 outpatient nurses from six tertiary hospitals in Xi'an, China, as research subjects between November 2023 and January 2024. The questionnaires used in the study included a sociodemographic questionnaire, the Perceived Organizational Support Scale, the Chinese version of the Compassion Fatigue Brief Scale, and the Chinese version of the Caring Behavior Scale. Data analysis involved descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H rank-sum test, Spearman correlation analysis, and the PROCESS macro model 4.

RESULTS

A significant negative correlation was observed between the sense of organizational support and compassion fatigue (ρ=-0.547, P < 0.01). Conversely, a significant positive correlation was found between the sense of organizational support and caring behavior (ρ = 0.469, P < 0.01). Moreover, there was a significant negative correlation between compassion fatigue and caring behavior (ρ=-0.641, P < 0.01). Subsequent mediation analysis demonstrated that compassion fatigue partially mediated the relationship between perceived organizational support and caring behaviors. The overall impact of perceived organizational support on caring behavior (β = 0.363) encompasses both its direct influence (β = 0.131) and the indirect impact mediated by compassion fatigue (β = 0.232). The mediating effect accounts for 63.9% of the total effect.

CONCLUSION

Compassion fatigue acts as a partial mediator in the relationship between perceived organizational support and the caring behavior of outpatient nurses. It is essential for nursing managers to effectively manage both the work resources and personal psychological resources of outpatient nurses to improve their caring behaviors in high-stress settings. By improving nurses' organizational support resources, we can reduce the depletion of their personal psychological resources and alleviate negative emotions such as compassion fatigue. This, in turn, can improve nurses' caring behavior and ultimately enhance the overall quality of nursing services in the hospital.

'Throw me a life buoy, please': A systematic review and thematic synthesis of qualitative evidence regarding nurses' experiences of caring for inpatients with borderline personality disorder and/or non-suicidal self-injury

INTRODUCTION

Non-suicidal self-injury (NSSI) is prevalent in individuals diagnosed with borderline personality disorder (BPD), particularly in inpatient settings. This poses challenges, leading to frustration and powerlessness among healthcare professionals. This, in turn, puts mental health nurses at risk of compassion fatigue (CF), impacting treatment quality.

AIM

We conducted a systematic review and meta-synthesis to investigate the experiences of mental health nurses caring for people with BPD and/or NSSI in inpatient settings.

METHOD

Literature search was performed in MEDLINE, CINAHL, PsychINFO and Web of Science. The Critical Appraisal Skills Programme (CASP) was used to critically appraise each study. For synthesis of findings from original studies, Thomas and Harden's thematic synthesis was used.

RESULTS

In total 1492 studies were screened of which seven met the inclusion criteria. We identified four main analytical themes: 'Notions on nursing', 'Reality calls', 'Fall of ideals' and 'Throw me a lifebuoy, please', with each two subthemes included.

DISCUSSION

Despite nurses' strong motivations for positive change and assistance, unexpected demands lead to emotional exhaustion, affecting their care provision.

IMPLICATIONS FOR PRACTICE

The study underscores the necessity of addressing nurses' emotional strain through education and skill-oriented training, enhancing their resilience and reducing CF risk, ultimately securing adequate care, and improving patient outcomes.

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.

Psychosocial Care Delivery in Intensive Home Treatment During a Mental Health Crisis: A Qualitative Thematic Analysis

Community-based intensive home treatment (IHT) is delivered as an alternative to psychiatric hospital admission as part of crisis resolution services. People receiving IHT present with complex mental health issues and are acutely distressed. Home treatment options are often preferred and there is evidence of service fidelity, although less is known about psychosocial care in this setting. Underpinned by a critical realist epistemology, this study aimed to explore psychosocial care in the context of home treatment from the perspectives of staff, service users and family carers. Data were collected using individual interviews and focus groups in two NHS organisations in England. An inductive qualitative thematic analysis resulted in five themes focused on (1) the staffing model and effective care provision, (2) the organisation of work and effective care provision, (3) skills and training and service user need, (4) opportunities for involvement and personal choice, and (5) effective communication. Findings suggest that co-production may improve congruence between IHT service design, what service users and carers want and staff ideals about optimal care. Service designs that optimise continuity of care and effective communication were advocated. Staff training in therapeutic interventions was limited by not being tailored to the home treatment context. Evidence gaps remain regarding the most effective psychosocial care and related training and supervision required. There is also a lack of clarity about how carers and family members ought to be supported given their often-crucial role in supporting the person between staff visits.

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.

The Mediation Roles of Coping Modalities on the Relationship Between Stress and Quality of Life Among Jordanian Nurses

Nurses are at the frontline, dealing with people's most immense healthcare needs in stressful and demanding work environments. Consequently, it is essential to thoroughly examine how various coping mechanisms might affect the relationship between stress and quality of life (QOL). This study aimed to examine the mediation effect of both problem-focused coping (PFC) and emotion-focused coping (EFC) mechanisms on mitigating the effect of stress on the QOL among Jordanian nurses. A multisite cross-sectional descriptive correlational design was used in this study. An online survey was completed by 203 nurses using a convenience sampling technique between October 2023 and January 2024. The study included nurses working in different Jordanian healthcare sectors including governmental, private, and university-affiliated hospitals. Several measures were used to collect data, including questionnaires on sociodemographics, QOL, coping, and stress. Two models were hypothesized for this study. The two models were analyzed using Andrew Hayes Process Macro Model 4 for testing the mediation effects. Additionally, descriptive and correlational analyses were run prior to the main analysis. The results showed that coping significantly mediated the relationship between stress and QOL with variations between PFC and EFC. In conclusion, psychological distress symptoms were common among Jordanian nurses; psychological distress, coping, and QOL are correlating variables. Nurses' stress levels and coping modalities can predict QOL with a superior effect of PFC compared with EFC. Strategies should be put in place to improve effective coping to improve nurses' QOL. The results of this study have important implications for nursing education, practice, future research, and policy.

Moral distress and compassion fatigue among nursing interns: a cross-sectional study on the mediating roles of moral resilience and professional identity

BACKGROUND

Nursing interns often faced moral distress in clinical practice, similar to registered nurses, which can lead to compassion fatigue. The roles of moral resilience and professional identity in influencing the psychological well-being of nursing interns are recognized, but the interrelationships among moral distress, moral resilience, professional identity, and compassion fatigue in this group remain unclear.

OBJECTIVES

This study aimed to investigate the impact of moral distress on compassion fatigue among nursing interns and to explore the mediating role of moral resilience and professional identity.

METHODS

A quantitative cross-sectional study was conducted with 467 nursing interns. Data were collected using Compassion Fatigue Short Scale, Moral Distress Scale-revised, Rushton Moral Resilience Scale, and Professional Identity Scale. Data analyses were performed using SPSS 22.0 and Amos 21.0, adhering to the STROBE statement.

RESULTS

The mean scores for compassion fatigue, moral distress, moral resilience, and professional identity were 35.876, 44.887, 2.578, and 37.610, respectively. Moral distress was positively correlated with compassion fatigue. Structural equation modeling showed that moral resilience and professional identity partially mediated the relationship between moral distress and compassion fatigue (β = 0.448, P < 0.001).

CONCLUSION

The findings suggest that moral distress directly influences compassion fatigue among nursing interns and also exerts an indirect effect through moral resilience and professional identity. Interventions aimed at enhancing moral resilience and fostering a strong professional identity may help mitigate the adverse effects of moral distress on compassion fatigue among nursing interns.

Psychological distress and attitudes toward seeking professional psychological help among Omani nurses: Strategies for nursing practice

BACKGROUND

This study investigated the psychological distress and attitudes toward seeking professional psychological help among Oman's nurses, highlighting the importance of changing negative attitudes toward mental health among healthcare professionals. Nurses face difficult circumstances and serve as role models. Creating supportive environments can improve treatment quality and public awareness and reduce social stigma, ultimately contributing to better care and quality of life.

MATERIALS AND METHODS

This study used a cross-sectional design with a convenience sampling approach. A sample of 205 nurses working in Oman completed the study questionnaires, including a sociodemographic questionnaire, the attitude toward seeking professional psychological distress scale, and the Kessler Psychological Distress Scale. The survey was distributed between May and June 2023.

RESULT

The study found that most participants had moderate psychological distress (43.22%, n = 67) and a low attitude toward seeking professional psychological help (66.67%, n = 48). There were significant differences in distress based on gender (P < 0.001), marital status (P < 0.001), and working department (F = 3.140, P = 0.004), while attitude had significant differences based on gender (P < 0.001) and marital status (P < 0.001). The study also found no significant correlation between psychological distress and attitudes toward seeking help among Oman's nurses (T (1, 204) = 0.019, P = 0.985), with a r2 of 0.005.

CONCLUSION

Nurses must be trained to handle stress and job strain from terminally ill patients, complex cases, and difficult situations. They should prioritize psychological assistance as a sign of strength and self-awareness as it demonstrates stability and self-awareness in nursing. This can be promoted by obtaining education, enhancing healthcare accessibility, and providing a support system.

Compassion Fatigue in a Cohort of South Italian Nurses and Hospital-Based Clinical Social Workers Following COVID-19: A Cross-Sectional Survey

Background/Objective: The COVID-19 pandemic has led to a significant increase in the workloads of healthcare workers (HCWs). The fear of contracting the new virus with the frequent medical consequences has affected their mental health. As a result, they are at high risk of compassion fatigue (CF). In this multicentric study, as a primary objective, we evaluate the incidence and/or prevalence of CF in a cohort of Italian nurses and HCWs (hospital-based clinical social workers of neurological patients) who have contracted SARS-CoV-2 infection. Our secondary aim is to evaluate the difference in experiencing CF between subjects with and without long-term COVID. Methods: In this study, 101 HCWs attending three different neurorehabilitation settings (the Neurorehabilitation Unit of the "Bonino Pulejo" Neurolesi Center of Messina, the Neurorehabilitation Department of Crotone, and the Psychiatric Unit of the University Hospital of Messina) were enrolled from May 2021 to May 2023. Data were collected through self-administered semi-structured interviews. Results: We observed high percentages of CF difficulties in both nurses and HCWs, related to mood alteration in 57.7%, headaches in 44.4%, and fatigue in 62%. Higher percentages were found in individuals with long-term COVID-19, including mood alteration in 93.9%, headache in 88.6%, and memory-related problems in 98.5%. Conclusions: The complexity of a patient's care pathway, especially in chronic disease situations, requires an enormous commitment that can lead to burnout and CF, which should be considered to initiate preventive interventions aimed at helping "those who help", for the well-being of patients, healthcare teams, and healthcare organizations.

'It's very values driven': A qualitative systematic review of the meaning of compassion according to healthcare professionals

AIMS AND OBJECTIVES

To explore the meaning ascribed to the concept of compassion by healthcare professionals.

BACKGROUND

Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear.

DESIGN

A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines.

METHOD

Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed.

FINDINGS

Seventeen papers met the inclusion criteria. An overarching theme, 'It's very values driven' underpins the four main themes identified: (1) 'It's about people and working with them': Compassion as being human, (2) 'There is this feeling': Compassion as being present, (3) 'If I don't understand them, I won't be able to help': Compassion as understanding, (4) 'Wanting to help in some way': Compassion as action.

CONCLUSIONS

Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners' experiences of compassion as part of their practice to inform health professions education, policy, and practice.

RELEVANCE TO CLINICAL PRACTICE

To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person's humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice.

NO PATIENT OR PUBLIC CONTRIBUTION

This systematic review had no patient or public contribution.

Ontological insecurity of inattentiveness: Conceptualizing how risk management practices impact on patient recovery when admitted to an acute psychiatric hospital

Risk management which assesses and mitigates risks such as suicide and violence is under scrutiny, particularly within psychiatric inpatient settings. Restrictive practices, which result from risk assessment, such as observations, physical restraint and ward seclusion can impact negatively on patient recovery, hindering abilities to develop a meaningful life that emphasizes purpose, hope and autonomy, despite experiencing mental distress. Yet, less is known about the impact from the patient's perspective when first admitted to hospital, a period which among other reasons may come with increasing risk management practices owing to the clinical uncertainties about patient risks. In this grounded theory study, we explore the impact on recovery, interviewing 15 adult participants with patient experiences of being in an acute hospital. The main theme of the study, termed a core category with a grounded theory, was identified as "ontological insecurity of inattentiveness". This highlighted a staff inattentiveness with involving patients with risk management and explaining the purposes of the practice, which raised insecurities about what was happening to the patients when admitted to hospital. Four subcategories support the core category; discounting the patients' experiences to gain a meaningful grasp of risk management, ambiguity about risk management rules, particularly the reasons around their use, forebodingness to the hospital environment and, management from afar, with patients feeling scrutinized from observations without a voice to offer different views. It is hoped these findings will add to the field of patient involvement in psychiatric inpatient settings, proposing attempts to raise understanding and inclusivity of risk management, starting when first admitted to hospital.

Impact of clinical supervision on the mental health nursing workforce: a scoping review protocol

INTRODUCTION

Mental health nurses work in potentially unpredictable, stressful and complex environments that can lead to burn-out and high staff turnover. Clinical supervision is a formal and professional agreement between two or more people that aims to strengthen individuals' competencies and organisational strengths. Effective clinical supervision has been noted as a method of reducing workplace issues within mental health nursing, but there is not currently a synthesis of evidence in this area. The key objective of this scoping review is to identify, map and analyse the available evidence reporting on the impact of clinical supervision on workforce outcomes for mental health nurses.

METHODS

A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension method will be conducted exploring clinical supervision for mental health nurses. A search for academic literature from Medline, CINAHL, Embase and PsycINFO will be combined with grey literature sourced through Google to identify potentially relevant studies. Studies identified by the search strategy will be managed using Covidence, and two authors will screen all identified articles. Reference lists of included studies will be handsearched to identify any potentially relevant studies missed by the search strategy.

ANALYSIS

A summary tool including predefined categories (such as author, date published, workforce outcome measured) will be used to summarise the included studies in this scoping review. Additionally, a narrative synthesis approach will be used to report the outcomes of included studies and provide further analysis.

ETHICS AND DISSEMINATION

This scoping review protocol described research that will use secondary analysis of publicly available information, and therefore, does not require ethics approval. The findings of this research will be disseminated through publication in a peer-reviewed academic journal and relevant conference presentations.

Navigating whiteness: affective relational intensities of non-clinical psychosocial support by and for culturally and linguistically diverse people

Mental health is political, with intersecting economic, cultural, racialized, and affective dimensions making up the care assemblage, signalling how care is conceptualised and who is deserving of care. In this article, we examine emotions circulating in a non-clinical psychosocial support program for culturally and linguistically diverse people experiencing mental ill-health, foregrounding the relations between culture, race, economy, and assumptions underpinning understandings of care. The mental health program under study offers psychosocial support for culturally and linguistically diverse people to manage life challenges and mental ill-health exacerbated by navigating the complexities of Australia's health and social care systems. We draw on interviews with clients, staff, and providers of intersecting services, employing Ahmed's concept of affective economies and Savreemootoo's concept of navigating whiteness to examine the care assemblage within interview transcripts. We provide insight into affective intensities such as hate, anger, and indifference embedded in white Anglo-centric services, positioning culturally and linguistically diverse people on the margins of care. Non-clinical psychosocial support programs can counter such affective intensities by training and employing multicultural peer support workers-people with lived experience-prioritising relational and place-based approaches to care and supporting and providing clients with relevant skills to navigate an Anglo-centric care system. However, this support is filled with affective tensions: (com)passion, frustration and fatigue circulate and clash due to the scarcity of resources, further signalling what type of care (and with/for whom) is prioritised within Australian relations of care.

The nurse bombarded, consumed and vulnerable: An interpretative phenomenological analysis of mental health nurses' self-care at work

INTRODUCTION

Self-care is essential for nurses' wellbeing, with stress posing a major barrier. Research into self-care is often absorbed into studies of burnout or resilience. Understanding lived experiences of influences on nurses' self-care practices is essential. There is currently a paucity of literature on this topic.

AIM

To explore mental health nurses' views about what influences their ability to self-care in relation to workplace stress and the impact on their practice and work environment.

METHODS

An Interpretative Phenomenological Analysis approach was utilized. In-depth interviews explored how nurses perceived the influence of environment and relationships on self-care practices in the workplace.

RESULTS

Participants' perceptions and experiences are embodied by the theme: the nurse bombarded, comprising two subordinate themes-the nurse consumed by the intensity of work and therapeutic relationships; and feeling vulnerable from colleague relationships and feeling undervalued. Participants described conflict between workload demands and expectations and the desire to provide optimal care.

CONCLUSIONS

Stressful working environments pose major barriers to effective self-care. Feeling bombarded and vulnerable, impacts nurses' lives personally and professionally.

IMPLICATIONS FOR PRACTICE

Mental health nurses' self-care is crucial for quality practice. Strategies to address relational, personal and environmental barriers to self-care are therefore necessary.

Interventions for Compassion Fatigue in Healthcare Providers-A Systematic Review of Randomised Controlled Trials

BACKGROUND

Compassion fatigue is a significant issue considering its consequences including negative feelings, impaired cognition, and increased risk of long-term morbidities. We aimed to assess current evidence on the effects of interventions for compassion fatigue in healthcare providers (HCP).

METHODS

We used the Cochrane methodology for Systematic Reviews and Meta-Analyses (PRISMA) for conducting and reporting this review.

RESULTS

Fifteen RCTs (n = 1740) were included. The sample size of individual studies was small ranging from 23 to 605. There was significant heterogeneity in participant, intervention, control, and outcome characteristics. The tools for assessing intervention effects on compassion fatigue included ProQOL, compassion fatigue scale, and nurses compassion fatigue inventory. Thirteen out of the fifteen included RCTs had overall high risk of bias (ROB). Meta-analysis could not be performed given the significant heterogeneity.

CONCLUSIONS

Current evidence on interventions for reducing compassion fatigue in HCPs is inadequate. Given the benefits reported in some of the included studies, well-designed and adequately powered RCTs are urgently needed.

The relationship between psychological resilience and professional quality of life among mental health nurses: a cross-sectional study

BACKGROUND

Mental health nursing is a demanding and stressful profession that impacts nurses' professional quality of life. Psychological resilience can be a protective factor. However, the relationship has not been extensively studied. This study aims to examine the relationship between psychological resilience and professional quality of life and identify potential predictors of ProQOL subscales among mental health nurses.

METHODS

The study employed a cross-sectional design to collect data from 179 mental health nurses. Data was collected using two standardized questionnaires: the Connor-Davidson resilience scale and the professional quality of life scale. Participants were recruited through convenient sampling during a 3-month period from April to June 2022, and the data were collected using an online survey tool called QuestionPro.

RESULTS

The study found a strong positive correlation between psychological resilience and compassion satisfaction (r = 0.632, P < 0.001). However, there was a negative significant correlation between resilience with burnout (r = -0.470, P < 0.001) and secondary traumatic stress (r = -0.210, P = 0.005). The study also found that higher resilience levels were associated with higher levels of compassion satisfaction and lower levels of secondary traumatic stress. Additionally, higher burnout scores were associated with higher levels of secondary traumatic stress. The study also identified that age and the number of children had weak associations with compassion satisfaction, while workplace was a significant predictor of burnout and secondary traumatic stress.

CONCLUSION

The study emphasizes the importance of resilience, burnout, and secondary traumatic stress in the well-being of healthcare professionals, especially nurses. The findings suggest that assessing nurses' resilience and professional quality of life can raise psychological resilience awareness and help managers create the necessary working conditions to improve nurses' professional quality of life.

Resilience and mental health nursing: An integrative review of updated evidence

Mental health nursing work is challenging, and workplace stress can have negative impacts on nurses' well-being and practice. Resilience is a dynamic process of positive adaptation and recovery from adversity. The aims of this integrative review were to examine and update understandings and perspectives on resilience in mental health nursing research, and to explore and synthesize the state of empirical knowledge on mental health nurse resilience. This is an update of evidence from a previous review published in 2019. Using integrative review methodology, 15 articles were identified from a systematic search (July 2018-June 2022). Data were extracted, analysed with constant comparison method, synthesized narratively and then compared with the findings from the original review. As an update of evidence, mental health nurse resilience was moderate to high across studies, was positively associated with psychological well-being, post-traumatic growth, compassion satisfaction and negatively associated with burnout, mental distress and emotional labour. Lack of support and resources from organizations could negatively impact nurses' ability to maintain resilience and manage workplace challenges through internal self-regulatory processes. A resilience programme improved mental health nurses' awareness of personal resilience levels, self-confidence, capacity to develop coping skills and professional relationships. Some studies continue to lack contemporary conceptualizations of resilience, and methodological quality varied from high to low. Further qualitative and interventional research is needed to investigate the role of resilience in mental health nursing practice, personal well-being, workforce sustainability and the ongoing impacts of the COVID-19 pandemic.

Effect of compassion fatigue on the caring ability of young psychiatric nurses: A dominance analysis and chain mediation model

AIMS

The aim of this study is to explore the mechanism by which three factors of compassion fatigue affect caring ability in young psychiatric nurses.

METHODS

We used the Professional Quality of Life Scale and Caring Ability Inventory to investigate 309 young nurses in three psychiatric hospitals in Heilongjiang. Dominance analysis and chain mediation model were performed to explore the effects of three factors of compassion fatigue on caring ability.

RESULTS

(1) The three factors of compassion fatigue affected the caring ability of young in the order compassion satisfaction > burnout>secondary traumatic stress by dominance analysis; (2) burnout played a partially mediating effect between compassion satisfaction and caring ability; and (3) secondary traumatic stress and burnout had a chain mediating effect between compassion satisfaction and caring ability.

CONCLUSIONS

Higher levels of compassion satisfaction had the strongest impact on the caring ability of young psychiatric nurses which could be mediated via burnout and secondary traumatic stress. No patient or public contribution.

Associations between compassion fatigue, burnout and secondary traumatic stress with lifestyle factors in mental health nurses: A multicenter study from Uganda

PURPOSE

This cross-sectional study aimed (a) to explore levels of compassion satisfaction, secondary traumatic stress, and symptoms of burnout among Ugandan mental health nurses working in regional referral hospitals in Uganda during the Covid-19 pandemic, and (b) to investigate associations between compassion satisfaction, secondary traumatic stress, and symptoms of burnout and sedentary levels, physical activity (PA) levels, sleep quality, and harmful drinking.

MATERIAL AND METHODS

In total 108 mental health nurses from 8 regional referral hospitals across Uganda (age = 34.8 ± 10.0 years; 55.6 % female) completed the Professional Quality of Life Scale-5, (PQoLS-5), the Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Vital Sign (PAVS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorder Identification Test - Concise (AUDIT-C). Spearman Rho correlations and Mann-Whitney U tests were applied.

RESULTS

ProQOL-5 compassion satisfaction correlated significantly with SIMPAQ walking, PSQI and AUDIT-C, ProQOL-5 burnout with SIMPAQ exercise and PSQI and ProQOL-5 traumatic with SIMPAQ walking and PSQI. Mental health nurses meeting PA guidelines reported higher ProQOL-5 compassion satisfaction and lower ProQOL-5 burnout and traumatic stress than those who did not. Those who reported a poor sleep quality reported significantly less ProQOL-5 compassion satisfaction and higher ProQOL-5 burnout than those who did not. Those who reported harmful drinking patterns reported a significantly lower compassion satisfaction versus those who did not.

DISCUSSION

In mental health nurses, a lower professional quality of life is associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience and self-care programs for mental health nurses focusing on unhealthy lifestyle patterns should be explored.

Bibliometric Analysis of the Scientific Production on Compassion Fatigue

Background: Compassion fatigue is a common phenomenon among healthcare professionals and includes several concepts that share a direct relationship with quality of life, with consequences on both physical and emotional well-being but also at the economic and organizational levels. Objectives: To analyze the profile of scientific publications on compassion fatigue, dissecting trends, and highlighting research opportunities. Method: Bibliometric analysis based on Donthu’s guidelines, data collection from Web of Science (Clarivate Analytics), and analytic techniques (performance analysis and science mapping) with VOSviewer^® and CiteSpace^®. Results: We obtained 1364 articles and found that the concept emerged in 1995 and is frequently associated with areas of general health. Through analysis, we identified the following research frontiers: “vicarious traumatization”, “working”, “survivor”, “mental health”, and “impact”. Conclusion: There has been a growing interest in this subject among researchers, with an increase in scientific production related to areas of health such as nursing, providing a solid starting point for further investigation. Registration number from the Open Science Framework: osf.io/b3du8.