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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    • "Their experiences may promote positive professional development in the form of enhanced empathy, strengthened self-esteem, improvement of clinical skills, and development of expertise (Miranda et al. 2015; Runyon et al. 2010; Zahn et al. in review ). Their experiences may also result in negative outcomes such as burnout and compassion fatigue (e.g., Injeyan et al. 2011; Lee et al. 2014; Udipi et al. 2008). Zahm et al. (2015) examined professional development of 34 genetic counselors and found a commitment towards selfreflection about meaningful experiences in their personal lives led to deeper self-understanding, a stronger work-life balance, increased self-care, and enhanced boundaries. "
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    ABSTRACT: Genetic counselors routinely engage with patients and families who grapple with questions of meaning while making decisions about genetic risk. Research and theory demonstrate genetic counselors gain important personal insights through their work and develop professionally from self-reflective practice regarding their beliefs and values. Data are lacking, however, about the nature of the meaning genetic counselors bring to their profession and how they directly experience and/or navigate issues of meaning within clinical practice over time. Accordingly, a national sample (N = 298) of practicing genetic counselors completed a brief survey assessing their demographic characteristics and willingness to participate in a semi-structured telephone interview exploring their views on meaning as they relate to their clinical work and professional development. Sixty-eight individuals of varied experience levels were interviewed about: 1) how they define a meaningful life for themselves; 2) lifetime sources of influence on their sense of meaning; 3) how they experience meaning within both personal and professional contexts; 4) work-related contexts that reaffirm and challenge their sense of meaning; and 5) how their sense of meaning has changed over time. Twenty-five interviews were analyzed using Consensual Qualitative Research methods, at which point, data saturation was reached. Five themes, 32 domains, and 29 categories were extracted. Common findings include: importance of satisfying relationships; helping others; personal fulfillment; personal and patient experiences of illness and loss; religious and/or spiritual foundations; value conflicts; competing obligations; challenges to meaning; development of empathy; resiliency; and increased humility. Results suggest the importance of professional venues for discussions of meaning (e.g., genetic counseling program curricula, continuing education, and peer supervision/consultation). Additional findings, practice implications, and research recommendations are presented.
    Full-text · Article · Oct 2015 · Journal of Genetic Counseling
    • "The phrase " techniques and protocols " was replaced with " standards of care. " These modifications are consistent with those made in a prior study of genetic counselor compassion fatigue by Udipi et al. (2008). State-Trait Anxiety Inventory (STAI; Spielberger et al. 1983) The STAI is a widely used measure consisting of two scales (20 items each): state anxiety and trait anxiety. "
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    ABSTRACT: Compassion fatigue is a state of detachment and isolation experienced when healthcare providers repeatedly engage with patients in distress. Compassion fatigue can hinder empathy and cause extreme tension. Prior research suggests 73.8 % of genetic counselors are at moderate to high risk for compassion fatigue and approximately 1 in 4 have considered leaving the field as a result Injeyan et al. (Journal of Genetic Counseling, 20, 526-540, 2011). Empirical data to establish a reliable profile of genetic counselors at risk for compassion fatigue are limited. Thus the purpose of this study was to establish a profile by assessing relationships between state and trait anxiety, burnout, compassion satisfaction, selected demographics and compassion fatigue risk in practicing genetic counselors. Practicing genetic counselors (n = 402) completed an anonymous, online survey containing demographic questions, the State-Trait Anxiety Inventory, and the Professional Quality of Life scale. Multiple regression analysis yielded four significant predictors which increase compassion fatigue risk (accounting for 48 % of the variance): higher levels of trait anxiety, burnout, and compassion satisfaction, and ethnicity other than Caucasian. Additional findings, study limitations, practice implications, and research recommendations are provided.
    No preview · Article · May 2014 · Journal of Genetic Counseling
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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.
    Full-text · Article · Nov 2010 · Journal of Religion and Health
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