The Psychic Costs of Empathic Engagement: Personal and Demographic Predictors of Genetic Counselor Compassion Fatigue

Journal of Genetic Counseling (Impact Factor: 2.24). 01/2008; 17(5):459-471. DOI: 10.1007/s10897-008-9162-3


Empathic connection with one’s patients is essential to genetic counselor clinical practice. However, repeatedly engaging
with distressed patients may cause compassion fatigue, a phenomenon characterized as feeling overwhelmed by experiencing patients’
suffering. In order to extend findings of an initial qualitative study, we surveyed 222 genetic counselors about their compassion
fatigue and factors that predict its occurrence. Multiple regression analysis identified seven significant predictors accounting
for 53.7% of the variance in compassion fatigue. Respondents at higher risk of compassion fatigue were more likely to report
being burned out, using self-criticism and giving up to manage stress, experiencing a greater variety of distressing clinical
events, having larger patient caseloads, relying on religion as a coping strategy, having no children, and seeking support
to manage stress. Respondents also provided critical incidents regarding their compassion fatigue and themes in these incidents
are described. Practice and research recommendations are provided.

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    • "The author of the scale even recommended the use of selected sub-scales when researchers have very focused interests or need to restrict participant response burden to a minimum. This flexibility is no doubt the reason for the popularity of the instrument, which has been used in a wide range of populations, including people suffering from migraine (Radat et al. 2009), parents of children with end-stage renal disease (Zelikovsky et al. 2007), emergency workers (Cicognani et al. 2009), genetic counselors (Udipi et al. 2008), and international university students (Miyazaki et al. 2008). For the initial development of the Brief COPE, Carver (1997) conducted a principal component analysis on data collected from a community sample of hurricane survivors and reported that the two items from the sub-scale turning to religion loaded onto a unique factor. "
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    ABSTRACT: Results from empirical studies on the role of religiosity and spirituality in dealing with stress are frequently at odds, and the present study investigated whether level of religiosity and spirituality is related to the way in which religious coping is used relative to other coping strategies. A sample of 616 university undergraduate students completed the Brief COPE (Carver in Int J Behav Med 4:92-100, 1997) questionnaire and was classified into groups of participants with lower and higher levels of religiosity and spirituality, as measured by the WHOQOL-SRPB (WHOQOL-SRPB Group in Soc Sci Med 62:1486-1497, 2006) instrument. For participants with lower levels, religious coping tended to be associated with maladaptive or avoidant coping strategies, compared to participants with higher levels, where religious coping was more closely related to problem-focused coping, which was also supported by multigroup confirmatory factor analysis. The results of the present study thus illustrate that investigating the role of religious coping requires more complex approaches than attempting to assign it to one higher order factor, such as problem- or emotion-focused coping, and that the variability of findings reported by previous studies on the function of religious coping may partly be due to variability in religiosity and spirituality across samples.
    Journal of Religion and Health 11/2010; 51(4). DOI:10.1007/s10943-010-9416-x · 1.02 Impact Factor
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    • "The largest predictor of compassion fatigue was delivering bad news (Udipi, et al., 2008) and a turning point for this counselor was the realization that she could stay within the field of genetic counseling while avoiding involvement with giving patients bad news. "
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    ABSTRACT: To determine the nature, sources, prevalence, and consequences of distress and burnout among genetics professionals. Mailed survey of randomly selected clinical geneticists (MDs), genetic counselors, and genetic nurses. Two hundred and fourteen providers completed the survey (55% response rate). Eight discrete sources of distress were identified forming a valid 28-item scale (alpha = 0.89). The greatest sources of distress were compassion stress, the burden of professional responsibility, negative patient regard, and concerns about informational bias. Genetic counselors were significantly more likely to experience personal values conflicts, burden of professional responsibility, and concerns about informational bias than MDs or nurses. Burnout scores were lower among those practicing more than 20 years and nurses. Distress scores were positively correlated with burnout and professional dissatisfaction (P < 0.0001). Eighteen percent of respondents think about leaving patient care, and burnout was the most significant predictor. Predictors of burnout included greater distress, fewer years in practice, working in university-based settings, being a genetic counselor or an MD, and deriving less meaning from patient care. Genetic service providers experience various types of distress that may be risk factors for burnout and professional dissatisfaction. Interventions to reduce distress and burnout are needed for both trainees and practitioners.
    Genetics in medicine: official journal of the American College of Medical Genetics 06/2009; 11(7):527-35. DOI:10.1097/GIM.0b013e3181a6a1c2 · 7.33 Impact Factor
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