Compassion fatigue and substance use among nurses

Nurses Lived Experiences, Burdens and Coping Strategies During COVID-19 Pandemic

This is a qualitative phenomenological study that was designed to navigate through nurses' lived experiences, burdens, and coping strategies while working with COVID-19 patients. The sample included 20 nurses who had worked with COVID-19 patients for more than or equal to 6 months. The interviews were conducted between October 1, 2021, and April 15, 2022. At that time, the third COVID wave had elapsed, and we were peaking on a fourth pandemic wave, so included participants had lived through a minimum of 2 to 3 peaks. Six themes emerged, which were: nurses coping with COVID-19 crisis, professional relationship burden, personal burden, environmental burden, physical symptom burden, and emotional burden of the crisis. Nurses' lived experiences during the pandemic were deep, intense, and moderately to highly affecting their ways of thinking, feeling, and behaving. That experience opened nurses' eyes on countless number of challenges that require special attention, care, and preparation on many levels. The minimal preparatory levels are personal, departmental, organizational, and strategic.

Workplace trauma and professional quality of Life in clinical and forensic psychiatry: the CRITIC study

Background

Frontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL).

Method

The Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling.

Discussion

The CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals.

Trial registration

The CRITIC study has been approved by the Medical Ethical Committee of the Erasmus Medical Centre, under trial registration number NL73417.078.20.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Nursing Staff at an Academic Medical Center: A Cross-Sectional Analysis

BACKGROUND

Although several studies have recently described compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in nurses, few to date have examined these issues across nursing specialties. Such examination is needed to inform future nursing-subspecialty tailored interventions.

AIMS

To examine (1) differences in CS, BO, and STS across nursing specialties and (2) differences associated with demographic, work-related, and behavioral factors among nurses.

METHOD

A secondary analysis of survey responses from nurses (N = 350) at an academic medical center. Demographic, behavioral, work-related, and professional quality of life variables were analyzed using hierarchical regression analyses.

RESULTS

CS, BO, and STS scores significantly varied across specialties with emergency nurses experiencing significantly elevated rates of BO and STS, and lowest rates of CS; scores were also differentially associated with demographic, work-related, behavioral, and workplace violence variables.

CONCLUSIONS

Key differences in CS, BO, and STS by nursing specialty suggests the importance of tailoring BO and STS mitigative interventions. BO and STS risk factors should be assessed in nurses (e.g., behavioral health problems and poor sleep quality) and specialty-specific interventions (e.g., reducing workplace violence exposure in emergency settings) may be considered to improve CS while reducing BO and STS among nurses.

Clinical nurses' compassion fatigue psychological experience process: a constructivist grounded theory study

BACKGROUND

Clinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses.

METHODS

Charmaz's Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes.

RESULTS

The data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period.

CONCLUSION

Clinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses' compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.

Prevalence of mental disorders and high rates of absenteeism from work among healthcare professionals in Slovenia: a retrospective study

OBJECTIVES

To investigate the prevalence of mental disorders and the higher rates of absenteeism from work among healthcare workers employed in Slovenia by analysing the prevalence of sick leave and medication prescriptions for treatment of mental health and behavioural disorders from 2015 to 2020.

DESIGN

Retrospective analysis of nationwide data on absenteeism and prescription of medications for treatment of mental health and behavioural disorders (anxiolytics, antipsychotics, antidepressants).

SETTING

National databases of the National Institute of Public Health in Slovenia.

PARTICIPANTS

All employed healthcare workers (35 008 in December 2020): dentists, midwives, nurses, nursing assistants, pharmacists and physicians in Slovenia from 2015 to 2020.

RESULTS

The most time spent on sick leave by male healthcare workers aged >50 was for 'neoplasms' (71.50 days on average), followed by 'mental health and behavioural disorders' (62.08 days on average). Female healthcare workers under 40 years old spent the most time on sick leave for 'pregnancy, childbirth, and the postpartum period (puerperium)', causing an average of 58.38 days of sick leave. From 2015 to 2020, the highest increase in prescribed medications for treatment of mental health and behavioural disorders was among nursing assistants (an increase of 38.42%), pharmacists (an increase of 29.36%) and nurses (an increase of 26.61%); since the COVID-19 pandemic, an increase of 12.36% was found among dentists, an increase of 11.51% among pharmacists and an increase of 11.36% among nurses.

CONCLUSION

The prescription of medications for treatment of mental health and behavioural disorders was on the rise from 2015 to 2020. The importance of employee health to individuals and society necessitates the systematisation of effective prevention programmes as well as programmes to assist those in need, especially health workers, whose work contributes significantly to maintaining public health.

Compassion fatigue prevalence and risk factors among Saudi psychiatric nurses: A cross-sectional study

In recent times, compassion fatigue is increasingly being recognized as a damaging outcome associated with the stress experienced by psychiatric nurses. In addition to affecting their job performance work-related stress undermines nurses' physical and emotional well-being. However, there is a lack of research on compassion fatigue that specifically focuses on psychiatric nurses working in Saudi Arabia. This cross-sectional study investigated the prevalence and factors associated with compassion fatigue among Saudi psychiatric nurses. The study participants were asked to complete a demographic questionnaire and the Arabic form of the Professional Quality of Life Scale. Statistical analyses, including one-way ANOVA, t-tests, the Levene test, and multiple linear regression, were employed to assess variables related to compassion fatigue. The survey spanned 158 psychiatric nurses from the Mental Health Complex located in Riyadh City. The mean scores for compassion satisfaction, burnout, and secondary traumatic stress were 39.72 ± 6.881, 24.29 ± 5.386, and 26.94 ± 6.973, respectively. The analysis revealed that variables such as age range (36-55 years) and an associated degree or lower explained 5.2% of the variance in compassion satisfaction. Age range (18-25 years), exercise frequency, and years of nursing experience collectively accounted for 8.4% of the variables contributing to burnout. The age range (25 to 35 years) and working night shifts also explained 5% of the variance in secondary traumatic stress. The findings indicated that compassion satisfaction, burnout, and secondary traumatic stress among the population of psychiatric nurses working in Saudi Arabia were at a moderate level. A higher frequency of healthy lifestyle practices, such as regular exercise, and being in an older age range, were positively associated with compassion satisfaction and negatively associated with burnout and secondary traumatic stress.

Analysis of the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals

This article examines the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals. A longitudinal, before-and-after study was conducted with nursing professionals working in the frontline in the pre-pandemic and pandemic periods. Our study applied the Brazilian versions of the Professional Quality of Life Scale and the Utrecht Work Engagement Scale. High levels of compassion satisfaction (≥43.0), low levels of burnout (<23.0) and secondary traumatic stress (<23.0), as well as high levels of vigor (≥4.0 and ≤4.99), absorption (≥4.0 and ≤4.99), and overall score (≥4.0 and ≤4.99) were observed. Moderate, negative, and significant correlations of burnout with vigor (r: -0.505; p-value: <0.001), in the pre-pandemic period; and with overall score, in the pre-pandemic (r: -0.543; p-value: <0.001) and pandemic periods (r: -0.458; p-value: <0.001), were also observed. No changes in levels of work engagement were found. Professionals with compassion fatigue showed decreased vigor, absorption, and overall score, rated as medium in the pandemic period (≥2.0 and ≤3.99), and an increased dedication, which was low (≥1.0 and ≤1.99) in the pre-pandemic period. It was concluded that there is no harmful association between compassion fatigue and work engagement with COVID-19 in nursing professionals.

Investigating Correlates of Home Visitor Burnout, Compassion Fatigue, and Compassion Satisfaction in New York State: Implications for Home Visiting Workforce Development and Sustainability

INTRODUCTION

Home visitor well-being is integral to delivering effective home visiting services and a core component of successful home visiting program implementation. While burnout (BO), compassion fatigue (CF), and compassion satisfaction (CS) have been studied extensively in physicians, nurses, and other health providers, little is known about the correlates of these phenomena in home visitors.

METHODS

This cross-sectional study examined demographic characteristics (age, race, gender), health and personal experiences (anxiety, physical health, and adverse childhood experiences), and job-related factors (caseload, role certainty, job satisfaction) as correlates of BO, CF and CS among a sample of 75 home visitors employed across six MIECHV-funded agencies in New York State. Descriptive statistics were used to characterize our sample; linear regressions were employed to investigate correlates with outcomes of interest.

RESULTS

Anxiety was significantly and positively associated with BO (β = 2.5, p < 0.01) and CF (β = 3.08, p < 0.01). Overall job satisfaction was significantly and inversely associated with BO only (β = -0.11, p < 0.001). Participants who identified as white were less likely to report higher levels of CS relative to non-white counterparts (β = -4.65, p = 0.014). Examinations of specific aspects of job satisfaction revealed significant associations between satisfaction with workplace operating conditions, nature of the work, and contingent rewards and select outcomes of interest.

DISCUSSION

Prioritizing preventive measures that target correlates of BO and CF, such as higher levels of anxiety and lower levels of job satisfaction - particularly operating conditions - may improve workforce well-being, continuity of service delivery, and ultimately quality of care provided to clients.

Resilience and stress as predictors of work engagement: the mediating role of self-efficacy in nurses

Background

Nurses face high levels of stress and work demands, which can affect their work engagement and psychological well-being. Resilience and self-efficacy have been identified as important resources to improve nurses' adaptation and work engagement.

Objective

This study aimed to evaluate the mediating role of self-efficacy in the relationship between resilience and stress on work engagement in Peruvian nurses.

Methods

A cross-sectional design was used, and data were collected from a sample of 459 nurses. Self-report questionnaires were administered to measure self-efficacy, resilience, stress, and work engagement. SEM analyses were performed to examine the relationship between these variables, and a mediation analysis was conducted to evaluate the role of self-efficacy as a mediator in the relationship between resilience, stress, and work engagement.

Results

The results indicated a positive relationship between resilience, self-efficacy, and work engagement, as well as a negative relationship between stress and work engagement. Additionally, self-efficacy mediated the relationship between resilience and work engagement, as well as the relationship between stress and work engagement in nurses.

Conclusion

Personal resources such as self-efficacy are a key factor in the relationship between resilience (work resources), stress (work demands), and work engagement of Peruvian nurses. Strengthening self-efficacy and resilience can improve work engagement and personal satisfaction of nurses. Hospital administrators and nursing managers should consider the importance of resilience, stress, work engagement, and self-efficacy in registered nurses and develop effective strategies to improve them. This can have a positive impact on the quality of care provided to patients and on the job satisfaction of nurses.

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

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

Which socio-demographic characteristics impact on the fatigue conditions in nurses: an Italian investigatory study

BACKGROUND AND AIM

Fatigue describes a wholeness feeling of tiredness or lack of energy. To assess which sampling nurses relating characteristics could influence the fatigue condition among nurses.

METHODS

From May 2020 to September 2021 a cross sectional, multicenter study was conducted among Italian nursing professional orders. An on-line ad hoc questionnaire was spread including sampling characteristics both on socio-demographic and nursing-relating work characteristics.

RESULTS

Significant associations were reported between item no.1 and gender (p<0.001) and BMI conditions (p=0.013), as most of the female participants (47%) affirmed to often feel themselves tired when they wake up, despite most of participants were at normal weight (32%). Item no.2 was significantly associated with gender (p=0.009), job role (p=0.039) and shift (p=0.030), as most of females never (31%) or often (31%) were not concentrated in their working tasks and, most of them were registered nurses (never: 41% and often: 35%), despite they were employed also during the night shift (never: 28%; often: 22%). Most of females (p=<0.001) were never slow in their reactions (42%), and they were young nurses (p=0.023). 44% of females declared to make an effort to express clearly themselves (p=0.031). Females reported significant high frequencies (p=0.016) in constant excitant substance assumption, such as caffeine (30%) and high significant percentage of females (p=0.047; 41%) reported the need to sleep during the day.

CONCLUSIONS

The fatigue will have a strong impact on the quality of life of nursing professionals, compromising their functional abilities, social relationships and their work and family roles.

How Workplace Challenges Affect the Risk of Substance Use Disorders in a Health Care Environment

Health care environments have historically faced stressful situations that place those working in those environments at risk for substance use disorders. Over the past several years, the rates of burnout, workplace violence, diverse population stigmatization, and mental health concerns (including suicide) during the Covid-19 pandemic have increased, further challenging and contributing to development of negative coping skills, including use of substances to reduce the side effects and emotions from work. This article introduces the problem of substance use disorders, pathophysiology, and how the challenges contribute to the development of turning to substances to cope.

A Scoping Review of Compassion Fatigue Among Oncology Nurses Caring for Adult Patients

BACKGROUND

Oncology nurses have frequent contact with oncology patients during their cancer journey. This long-term, recurrent contact can impact the health and well-being of the nurse through the development of compassion fatigue (CF).

OBJECTIVES

To identify what contributes to CF and what individual, interpersonal, and organizational factors mitigate CF among oncology nurses caring for adult patients.

METHODS

A scoping review framework by Arksey and O'Malley guided this review. Electronic databases were searched for relevant studies. A blinded screening process was undertaken by the authors using the following inclusion criteria: English language published from January 2011 to December 2021, primary research peer-reviewed studies, and focusing on CF within oncology nurses caring for adult patients in any practice setting.

RESULTS

Nineteen studies (21 articles) were identified. The review found nurses' personal beliefs around nursing care being provided, and personality traits of psychological inflexibility, neuroticism, passive coping, and avoidance contributed to CF. Workplace conflict and lack of a healthy work-life balance also contributed to CF. However, nurses' personal resilience, ability to positively reflect upon their work, a supportive team environment, and continuing education were found to mitigate CF.

CONCLUSIONS

Levels of CF vary among oncology nurses caring for adult patients. Oncology nurses may benefit from personal and organizational resources aimed at improving oncology nurses' professional quality of life while decreasing CF.

IMPLICATIONS FOR PRACTICE

Consideration and future research of effective interventions are needed to sustain a future health workforce and mitigate CF among oncology nurses.

Compassion fatigue in nurses caring for chronic diseases

Objectives. The purpose of this study was to determine the level of compassion fatigue in nurses caring for chronic diseases and the factors that affect it. Nurses who provide continuous care for chronic diseases are under the risk of facing compassion fatigue. Methods. The descriptive and cross-sectional study took place during January-March 2019. The nurse identification form and the 'compassion fatigue' sub-dimension of the professional quality of life scale were used to determine compassion fatigue. Results. Nurses experience compassion fatigue at a moderate level. Female nurses, those who experience a decrease in their willingness to provide care and those who intend to leave work experience compassion fatigue more. Decrease in the willingness to provide care plays a determinant role on compassion fatigue. Nurses who experience compassion fatigue are unwilling to provide care to their patients. Conclusion. This study indicates the importance of the necessity for development of a compassion fatigue prevention program in the clinical area. Nurses should be trained on compassion fatigue within the scope of in-service training. This subject should be included in the school curriculum to increase the awareness of nursing students' about compassion fatigue.

Increased Substance Use among Nurses during the COVID-19 Pandemic

There is growing evidence that the COVID-19 pandemic has had a severe impact on the nursing profession worldwide. Occupational strain has disrupted nurses' emotional wellbeing and may have led to negative coping behaviors, such as increased substance use, which could impair cognitive functioning. The aim of this study was to examine whether increased substance use in a sample of U.S. nurses during the pandemic was related to greater workplace cognitive failure. An online questionnaire was administered in May 2020 to Michigan nurses statewide via three nursing organizations (n = 695 respondents). A path model was used to test the direct effects of reported increased substance use on workplace cognitive failure and via parallel psychological mediators. The model had excellent fit to the observed data, with statistically significant, unique mediating effects of greater symptoms of anxiety (b = 0.236, z = 2.22, p = 0.027), posttraumatic stress disorder (b = 0.507, z = 4.62, p < 0.001) and secondary trauma (b = 1.10, z = 2.82, p = 0.005). Importantly, the direct effect of increased substance use on workplace cognitive failure was not statistically significant independent of the mediators (b = 0.133, z = 0.56, p = 0.576; 95% confidence interval: -0.33, 0.60). These results point to the importance of further delineating the mechanistic pathways linking adverse stress to workplace cognitive failure. As we emerge from the pandemic, healthcare systems should focus resources on supporting cognitive health by addressing the psychological and emotional welfare of nurses, many of whom may be struggling with residual trauma and increased substance use.

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

BACKGROUND

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

AIMS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The Relationship between Compassion Satisfaction and Fatigue with Shift Nurses' Patient Safety-Related Activities

Background

We examined the relationships of compassion satisfaction and fatigue among shift nurses on nursing engagement activities related to patient safety with the aim of improving shift nurses' physical and psychological aspects in order to use the findings as a basis to enhance nurses' engagement in activities related to patient safety.

Methods

The data collection period for this cross-sectional study was from Nov 21, 2019, to Jan 3, 2020. A convenience sample of 280 shift nurses who were working for more than six months at three tertiary hospitals in Korea was used. Collected data comprised general and job-related characteristics of subjects, compassion satisfaction, compassion fatigue, and patient safety nursing activities. SPSS was used for statistical analysis, and multiple regression analysis was used to examine the relationship between shift nurses' compassion satisfaction, compassion fatigue, and patient safety nursing activities.

Results

Compassion satisfaction had the greatest impact on engagement in nursing activities related to patient safety (β= .32, P<.001), followed by compassion fatigue. Higher compassion satisfaction and lower compassion fatigue indicates a higher engagement in patient safety-related nursing activities (β= -.15, P<.008).

Conclusion

In order to maximize compassion satisfaction and reduce compassion fatigue among shift nurses, it is important for health policymakers to improve their welfare system and create a supportive environment where negative emotions can be expressed freely and accepted positively.

Compassion Fatigue and Coping Mechanisms of Laboratory Animal Professionals from Europe, China, and Japan

Laboratory animal professionals (LAP) may experience situations that contribute to compassion fatigue (CF). The goal of this research was to better understand CF in LAP in and across employment categories. Surveys were distributed through LAP organizational listservs in the European Union (EU), China, and Japan, and results were analyzed to identify CF prevalence, personal and work-related factors, coping mechanisms, and beneficial work-support programs. Independent χ²-tests compared personal and work-related factors and feelings of CF. Feelings of CF and coping mechanisms were compared with personality scores using independent sample t tests. There were 302 respondents from the EU, 39 from China, and 77 from Japan. Over half of respondents from the EU (52%) and China (56%) reported experiencing CF (52%), with fewer (32%) reporting CF in Japan. No major differences were found based on employer type. Personality scores were significantly related to feelings of CF and preferred coping mechanisms. Work-related factors that contributed to feelings of CF in over half of respondents included staffing levels, workplace relationships, and availability of programs geared to address CF. Across regions, talking to someone, physical activity, getting away from work, and self-care were effective coping mechanisms in over 50% of respondents. Fewer than 30% of respondents indicated that their place of employment had CF support programs, and even fewer (8% to 28%) indicated that these programs were helpful. The study results suggest that to be effective, employer CF programs for LAP should consider providing quiet places at work and programs for self-care, promoting physical and mental health and social support systems, and establishing opportunities to memorialize animals.

Distress Tolerance and Emotion Regulation as Potential Mediators Between Secondary Traumatic Stress and Maladaptive Coping

The extant literature has illustrated that protective service workers experience negative repercussions associated with their job (including the development of secondary traumatic stress; STS) and may utilize maladaptive coping mechanisms. Developing an improved understanding of factors that might explain the relationship between STS and the utilization of maladaptive coping mechanisms is warranted. This study sought to examine emotion regulation and distress tolerance as potential mediators between STS and the utilization of maladaptive coping mechanisms. Participants were 152 elder protective service workers and 105 child protective service workers who completed an online survey of self-report measures of emotion regulation, distress tolerance, STS, and coping behaviors. A parallel multiple mediator model was analyzed using structural equation modeling (SEM) to examine the hypothesis that distress tolerance and emotion regulation would mediate the relationship between STS and the utilization of maladaptive coping. Our hypothesis was partially supported as the effect of STS on maladaptive coping was mediated by emotion regulation but not by distress tolerance. The results from this study have both prevention and intervention implications. From a prevention perspective, efforts could be directed at teaching emotion regulation skills to those at risk for developing STS as a mechanism for decreasing the probability of denial, substance use, behavioral disengagement, and self-blame that may occur as a consequence of STS. From an intervention perspective, some of the negative sequelae of exposure to STS may be averted by teaching EPS and CPS workers who present with STS symptoms, emotion regulation skills.

Compassion fatigue and compassion satisfaction among Chinese palliative care nurses: A province-wide cross-sectional survey

AIMS

We aim to explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses.

BACKGROUND

Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients.

METHODS

A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression.

RESULTS

Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all p < .001).

CONCLUSIONS

The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.

Dealing with Emotional Vulnerability and Anxiety in Nurses from High-Risk Units-A Multicenter Study

Compassion fatigue and anxiety derived from continued exposure to trauma and death greatly impact nurses’ quality of care and quality of life, increasing their desire to leave work. The aim of the study is to assess compassion fatigue and anxiety prevalence and their association with secondary variables. A multicenter, cross-sectional study in nurses from four high-risk units, Emergency, Intensive Care, Oncology, and Pediatrics, was carried out in 14 hospitals in Catalonia (Spain) between 2015 and 2016. The primary endpoints were compassion satisfaction and compassion fatigue (burnout and secondary traumatic stress), which were assessed by Professional Quality of Life (ProQOL), and anxiety, assessed with the State-Trait Anxiety Inventory (STAI). Multivariable logistic regression analyzed the association of sociodemographic, training, working, and psychological factors. Of a total of 1302 nurses, 18.6% presented low compassion satisfaction; 19.7%, high burnout; and 36.4%, high secondary traumatic stress. Trait anxiety scored high in 7.2%. Although compassion satisfaction was present, it did not protect sufficiently against the high level of compassion fatigue or anxiety present in nurses in all centers. The working conditions in the units and variables showed a strong association with nurses’ desire to leave. This corroborates the global challenge of healthcare professionals’ shortage. Participants expressed the need for better training in emotional management.

The effect of resilience and self-efficacy on nurses' compassion fatigue: A cross-sectional study

AIM

To measure the prevalence of compassion fatigue among Chinese clinical nurses and to examine the effects of resilience and self-efficacy on compassion fatigue.

DESIGN

A cross-sectional descriptive survey was conducted in accordance with the STROBE guidelines.

METHODS

Participants were recruited from three tertiary hospitals in central China from October 3 to December 15, 2019, using convenience sampling. Clinical nurses (n = 992) from different nursing departments completed the General Information Questionnaire, Professional Quality of Life Scale, Connor-Davidson Resilience Scale, and General Perceived Self-Efficacy Scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson or Spearman's correlation analyses, and multiple linear regression models were used.

RESULTS

Nurses experienced moderate levels of compassion fatigue (burnout and secondary traumatic stress). Resilience and self-efficacy were significantly negatively correlated with burnout but not with secondary traumatic stress. Linear regression analysis showed that resilience, self-efficacy, exercise, and physical conditions were the main predictors of burnout. Only physical conditions and marital status significantly predicted secondary traumatic stress.

CONCLUSION

Nurses are vulnerable to compassion fatigue in China. Resilience and self-efficacy significantly negatively predicted nurses' compassion fatigue. Physical conditions, healthy lifestyles, and social support are also important factors for compassion fatigue.

IMPACT

Our findings can be used to generate targeted intervention and coping strategies for nurses to improve their resilience and self-efficacy to alleviate compassion fatigue.

Investigating the relationship between workplace stressors and caring behaviours of nursing staff in inpatient wards: A cross-sectional study

AIM

The present study aimed to investigate the effects of various job stressors on caring behaviours of nursing staff.

DESIGN

A cross-sectional nationwide study.

METHODS

This cross-sectional, descriptive-correlational study was conducted on 260 nurses employed in the inpatient wards of seven teaching hospitals in Tehran, Iran during December 2019-February 2020. The participants were selected via convenience sampling. Data were collected using a demographic questionnaire, the nursing stress scale and the caring behaviours inventory. Data analysis was performed in SPSS version 20 using descriptive statistics and linear regression analysis.

RESULTS

The results of regression analysis indicated that job stress is correlated with nurses' caring behaviours (β = -.36; p = .001). Factors such as workload (β = -.27; p = .001), uncertainty about patient treatment (β = -.26; p = .017) and lack of emotional preparation (β = -.20; p = .017) were the important stressors associated with nurses' caring behaviours.

CONCLUSIONS

According to the results, high levels of perceived job stress due to workload, uncertainty about patient treatment and lack of emotional preparation are associated with lower levels of nurses' caring behaviours.

IMPACTS

The findings of this study showed that to provide patients with optimal caring behaviours, hospital and nursing managers should design interventions to reduce nurses' job stressors, especially in terms of their interactions with their colleagues and physicians.

Compassion fatigue, burnout and compassion satisfaction among emergency nurses: A path analysis

AIMS

To verify a hypothesized model of the relationships between compassion fatigue, burnout and compassion satisfaction, as well as their influencing factors and consequences, among emergency nurses.

DESIGN

A descriptive, cross-sectional design.

METHODS

A hypothesized model was proposed on the basis of the current literature. A convenience sample was conducted of nurses working in the emergency departments of six hospitals in Shanghai, China, from July to September 2020. A total of 445 valid data points were collected using various self-designed and well-validated instruments. Descriptive statistics and correlations were computed, and a path analysis was used to assess model fitness and to investigate direct and indirect effects.

RESULTS

The final model reported a desirable fit with significant paths. Compassion satisfaction and compassion fatigue directly and inversely affected burnout, and compassion satisfaction positively influenced compassion fatigue. Perceived social support directly improved compassion satisfaction and protected against compassion fatigue. Compassion satisfaction and compassion fatigue directly affected mental health, and burnout directly influenced physical health. Compassion fatigue, burnout and compassion satisfaction had complicated effects on turnover intention.

CONCLUSION

Emergency nurses' compassion satisfaction and compassion fatigue may be two coexisting constructs, and both affect burnout. Perceived social support acts as a protector of the three dimensions, and their effects on health status and turnover intention can be significant and complicated.

IMPACT

Emergency nurses may experience high levels of compassion satisfaction and compassion fatigue simultaneously, which can help to explain why compassion fatigue did not directly increase emergency nurses' turnover intention. The direct effects of compassion fatigue and burnout on emergency nurses' health status and working engagement were significantly different. Support from significant others, professional psychological intervention and emergency nursing system reforms are required to tackle emergency nurses' compassion fatigue and burnout and improve their compassion satisfaction.

The Effects of Mindfulness Meditation on Stress and Burnout in Nurses

Background: Occupational burnout related to stress in the workplace is experienced by nurses who are regularly confronted with trauma, suffering, and high workloads. Burnout can negatively impact patient care and have detrimental effects on nurses' physical and mental health. Mindfulness-based stress reduction programs have been researched as a potential holistic intervention for reducing stress and burnout in nurses through cultivating present awareness, emotional regulation, and positive thinking. Purpose: This critical review of the literature explores current knowledge on the effectiveness of mindfulness meditation on stress and burnout in nurses, examines gaps in the current literature, and provides recommendations for future research on this topic. Methods: Search terms included mindfulness, meditation, mindfulness-based stress reduction , occupational stress, stress, burnout, and nurs*. Peer-reviewed research directly related to the impact of mindfulness-based stress reduction on nurses experiencing stress and/or burnout was reviewed. Findings: Findings reveal evidence that mindfulness meditation is effective in decreasing stress and burnout in nurses. Mindfulness-based interventions have been shown to significantly decrease stress, improve all aspects of burnout, and increase self-compassion and compassion satisfaction in practicing nurses. Conclusions: Mindfulness meditation has the potential to decrease stress and burnout in nurses by decreasing self-judgment and overidentification with experience, and by increasing resiliency, compassion, and emotional regulation.

Nurses' stressors and their quality of life: A study on nurses caring for older patients

Aim

To determine the sources of occupational stress and the level of quality of life among nurses caring for older people in Lebanon and examine the underlying factors to predict nurses' quality of life.

Design

A descriptive correlational design.

Methods

Data were collected from 119 nurses using Nursing Stress Scale and WHO‐Quality of Life Brief.

Results

Nurses reported the highest frequency of stressful events related to their workload (mean = 16.42, SD 1.03), followed by “death and dying” (mean = 14.61, SD 1.02). Nurses reported the highest level of quality of life domains was physical health (mean = 15.74, SD = 2.63), while the lowest level was environmental domain (mean = 11.15, SD = 1.86). After controlling for demographic and work‐related variables, occupational stress explained a large variance in the physical (R² change = .43), psychological (R² change = .44) and social relationship (R² change = .35) domains of quality of life.

A comprehensive review of compassion fatigue in pre-licensure health students: antecedents, attributes, and consequences

Compassion fatigue has been documented in the nursing and allied health literature as an emerging issue for health professionals. Little is known regarding the experience of compassion fatigue in undergraduate, pre-licensure students entering health care professions. This study used Walker and Avant’s concept analysis methodology to explain antecedents, attributes, and consequences of compassion fatigue in undergraduate, pre-licensure students. Exploration of the published literature from January 1992–April 2020 occurred using systematic review criteria based on the Joanna Briggs Institute. Findings revealed three antecedents that included: Coping Ability; Self-Efficacy; and Clinical and Occupational Hazards. Three defining attributes of compassion fatigue included: Psychological Stress; Witnessing Negative Experiences of Others; and Depression. Consequences included: Decreased Well-Being; and Program Withdrawal and Intention-to-Leave. The results offer new perspectives and opportunities for research in pre-licensure health studies undergraduate students expected to uphold the values of their professional program prior to entry into the workforce.

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.

Effect of Workplace Violence and Psychological Stress Responses on Medical-Surgical Nurses' Medication Intake

BACKGROUND

Workplace violence is a prevalent phenomenon in the health-care sector globally, but few studies have examined its impact on nurses' use of prescribed and/or over-the-counter medications to manage signs and symptoms.

PURPOSE

The purpose of this study was to examine the direct and indirect effect of workplace violence, through the pathway of psychological stress responses, on nurses' frequencies of medication intake. An occupational stress and health outcomes model was tested in this study.

METHODS

A secondary analysis of cross-sectional survey data from 551 medical-surgical nurses in British Columbia was conducted. Both emotional and physical workplace violence were examined. Emotional exhaustion and posttraumatic stress disorder were psychological stress responses to workplace violence.

RESULTS

Emotional and physical violence from patients and/or families were the most prevalent sources of workplace violence. Physical violence and psychological stress responses increased the frequency of medication intake after controlling for nurse characteristics. Emotional violence was not related to medication intake over and above the effect of psychological stress responses. Physical and emotional violence elicited psychological stress responses resulting in increased medication use.

CONCLUSION

Workplace violence triggers psychological stress responses with adverse outcomes on nurses' health and well-being.

Compassion fatigue among nurses working on an adult emergency and urgent care unit

OBJECTIVE

to assess compassion fatigue levels among nurses and its variation according socio-demographic and professional characteristics.

METHOD

quantitative, descriptive and cross-sectional study, with 87 nurses from an emergency and urgent care unit for adults from a university hospital. A socio-demographic and professional questionnaire, along with the Professional Quality of Life Scale 5 were used. Data analysis was performed using descriptive and inferential statistics.

RESULTS

compassion satisfaction presents the highest means, followed by burnout and secondary traumatic stress. Among the participants, 51% presented a high level of compassion satisfaction, 54% a high level of burnout, and 59% a high level of secondary traumatic stress. Older participants presented higher score of compassion satisfaction, and younger nurses, women, nurses having less job experience and nurses without leisure activities showed higher means of secondary traumatic stress.

CONCLUSION

we found compassion fatigue, expressed in the large percentage of nurses with high levels of burnout and secondary traumatic stress. Fatigue is related to individual factors such as age, gender, job experience and leisure activities. Doing research and understanding this phenomenon allow the development of health promotion strategies at work.