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Countering Compassion Fatigue: A Requisite Nursing Agenda

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  • Advanced Oncology Nursing Resources

Abstract

Nurses have a longstanding history of witnessing the tragedy experienced by patients and families; however, their own reactions to profound loss and premature death have not been systematically addressed. There is a paucity of research describing interventions to prevent or minimize the ramifications of repeated exposure to traumatic events in the clinical workplace. Compassion fatigue is a contemporary label affixed to the concept of personal vicarious exposure to trauma on a regular basis. Yet this phenomenon of compassion fatigue lacks clarity. In this article, the author begins by describing compassion fatigue and distinguishing compassion fatigue from burnout. Next she discusses risk factors for, and the assessment of compassion fatigue. The need to support nurses who witness tragedy and workplace interventions to confront compassion fatigue are described.
... This table leads to forgetfulness, attention deficit, fatigue, anger, and physical illnesses in nurses (20,21). It makes maintaining working difficult, decreases their motivation (22)(23)(24), and causes increased costs in care services (22,23). In other words, CF is a condition that negatively affects the health of nurses, patient safety, quality of care (22,23), and professional life (12). ...
... This table leads to forgetfulness, attention deficit, fatigue, anger, and physical illnesses in nurses (20,21). It makes maintaining working difficult, decreases their motivation (22)(23)(24), and causes increased costs in care services (22,23). In other words, CF is a condition that negatively affects the health of nurses, patient safety, quality of care (22,23), and professional life (12). ...
... It makes maintaining working difficult, decreases their motivation (22)(23)(24), and causes increased costs in care services (22,23). In other words, CF is a condition that negatively affects the health of nurses, patient safety, quality of care (22,23), and professional life (12). ...
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Background: Nurses may experience compassion fatigue due to the nature of the nursing profession, the pandemic period can increase this risk, and this can affect the nurse, the patient, and the health care system negatively. Objectives: The purpose of this study is to evaluate the compassion fatigue experienced by nurses during the pandemic process. Methods: This cross-sectional study was conducted with 280 nurses working in a hospital in Eskişehir. A structured questionnaire and the Compassion Fatigue -Short Scale were used as measurement tools. Results: The mean compassion fatigue score of the nurses was found as 68.36 (± 25.81). The compassion fatigue score of the nurses who were female, were graduates of health vocational high school, had 6-10 year of work experience, wanted to quit the job, worked for more than 48 hours a week during the pandemic, were anxious about being infected with the COVID-19 virus and spreading it to their family, and had family members diagnosed with COVID-19 was found to be significantly high. In addition, nurse's gender, weekly working hours, thoughts about the profession, feelings and experiences about the COVID-19 virus were determined to be risk factors for compassion fatigue. Conclusion: Considering the effect of compassion fatigue on nurses and the field of care, we recommend that nurses should be supported in this regard and that qualitative studies and prospective cohort studies with larger samples should ne planned. Key Words: Compassion Fatigue, COVID-19, Pandemic, Nursing.
... Compassion fatigue is a risk factor likely to be observed in about half of the health professionals who help individuals with traumatic experience (Wee & Myers, 2003) because the empathy ability, which constantly requires an effort to help the needy, causes the health professional to neglect his or her own needs. While compassion fatigue causes some members of the profession to develop reactions such as emotional detachment and collapse (Flarity, Gentry, & Mesnikoff, 2013), decreased empathy skills lead to problems such as the disappearance of objective perspective, and inability to perform tasks (Boyle, 2011). A caregiver's witnessing the physical pain suffered by the patient, making an intense effort during the treatment process, having an interrupted daily life, lacking social, psychological or economic support and having the feeling of being unsuccessful are among the reasons leading to compassion fatigue (Day & Anderson, 2011). ...
... Therefore, in the literature, empathy skill, which includes empathic concern and empathic response, is considered as one of the main factors that trigger compassion fatigue (Boyle, 2011). ...
Article
Compassion fatigue is the natural stress caused by the strong desire to help a valued person and alleviate the pain he/she suffers after he/she undergoes a traumatizing event. That caregiver who witnesses the physical suffering of the patient, who makes intense effort during the process deprived of the social, psychological, or economic support they need is among the reasons causing compassion fatigue. In this study, the aim was to test and describe the effects of compassion fatigue on informal caregivers of children with cancer. The study is phenomenological, a form of a qualitative study. The participants were the relatives of children with cancer. The data were obtained through in-depth interviews. The audio-recorded interviews were analyzed through the inductive thematic analysis to obtain answers to the questions. The findings were categorized under four headings which compassion fatigue was addressed: Empathy ability, compassion stress, problems experienced by the participants as components of compassion fatigue. The results of this study demonstrated that mothers were at risk of compassion fatigue. Those who give care to their relatives are faced with problems more than professionals. It is recommended that the implementation of multidisciplinary interventions that will improve caregivers' well-being, and preventive social work interventions, will prevent them from compassion fatigue.
... It can also be conceptualized as a combination of burnout, associated with a feeling of hopelessness and having to deal with work, and secondary traumatic stress linked to work-related secondary exposure to traumatic and stressful events [6]. The main difference between burnout and secondary traumatic stress is the causewhereas secondary traumatic stress is the result of repeated exposure to suffering, burnout is the result of long-term exposure to various workplace stressors [7]. ...
Article
Objectives Nurses are considered to be at risk of experiencing compassion fatigue, which can affect their personal and professional lives. The aim of this study was to investigate stressful factors contributing to the development of compassion fatigue in nurses, their experiences of compassion fatigue, and the coping strategies they used to cope with compassion fatigue. Methods The convenience sample of 86 nurses from Central Europe was recruited via social networking sites during the pandemic of COVID-19. Data collection was conducted via an online battery of questionnaires which included open-ended questions on the stressful factors, experiences, and coping strategies for compassion fatigue. The data were analysed using a theoretical thematic analysis based on Figley's descriptions of compassion fatigue. The initial data was read several times to identify recurring statements. Each statement was then categorized into the emerging domains, subdomains, categories, and subcategories. Results The results of our study show that stressful factors, experiences, and coping strategies for compassion fatigue in nurses in Central Europe could be related to cognitive, emotional, behavioural, somatic, personal relations, spiritual, and work-related symptoms of compassion fatigue as identified by Figley and that these may resemble experiences of nurses in North America, Japan, and Spain. Conclusion This study provides a detailed overview of the stressful factors, experiences, and coping strategies for compassion fatigue, which could be used to develop an early screening tool and interventions for alleviating compassion fatigue and for preventive adaptation of the health care system.
... Compassion fatigue is significantly dangerous in the clinical area, where nurses having a high level of compassion fatigue have higher practice errors, increased patient mortality, and higher infection rates, eventually reducing patient safety and quality of care (Boyle, 2011;Lombardo & Eyre, 2011). Organizations and managers should take responsibility for reducing the likelihood of compassion fatigue in the work environment by establishing an emotionally supportive, physically safe, and respectful work environment that will mitigate intrapersonal and interpersonal stress for the health care workers (Harr, 2013). ...
Article
This research study aimed to identify the level of Compassion Fatigue components, compassion satisfaction among ICU nurses, identify resilience levels and characteristics among ICU nurses. And to determine the association between resilience, Compassion Fatigue components, and compassion satisfaction. The results showed that nurses had a moderate\ average level of compassion satisfaction, a moderate\average level of burnout, and a moderate/average level of secondary traumatic stress. Also, a very low level of resilience, Self-reliance were the most characteristics of resilience. There was an association between the level of compassion satisfaction and income levels and the workplace. Also, there was an association between the level of burnout with income level and marital status. Resilience was associated with the level of resilience in the workplace. The study's results provided awareness about Compassion Fatigue and resilience in ICU nurses and provided practical implications for the need for education, assessment, prevention, and health promotion interventions addressing Compassion Fatigue and burnout among ICU nurses.
... Compassion fatigue impacts the ability of staff to provide compassionate care [20], as well as impacting service efficiency (through staff sickness or turnover) [30]. In addition, lower staff wellbeing is both a precursor to compassion fatigue, and a potential consequence, since compassion fatigue is associated with lower compassion satisfaction -the feeling of satisfaction from performing a caring role [31]. ...
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Background Compassion is vital in healthcare. Current understandings of the nature of compassionate care, its aids and barriers, are more theoretically developed than grounded in staff experience. This study explores staff perceptions of compassionate care in child and adolescent mental health wards. Methods Three focus groups were conducted with a total of 35 staff from adolescent mental health wards (10–12 people in each group), on the nature of compassionate care, aids and barriers. Transcripts were analysed using thematic analysis. A follow-up survey with 36 workers from other UK child and adolescent mental health wards was completed and means and standard deviations of responses were analysed to confirm wider resonance of themes. Results Elements of compassionate care fell into six themes relating to individual, team and organisational factors: emotional connection, sense of being valued, attention to the whole person, understanding, good communication, and practical help/resources. Aids and barriers mirrored each other, and showed that what staff think is key to the nature of compassionate care for patients is also what they feel they need to receive to be able to show compassionate care. Conclusions This study suggests that staff need the same elements of compassion as those which they seek to provide. A greater emphasis needs to be placed on providing staff with individual, team and organisational level resources which help them to feel compassionately held within the interconnected systems in which they work, in order to be able to continue to provide high level compassionate care. Staff need to be nourished, valued and compassionately cared for in order to be able to care compassionately for the patients they look after.
Article
Background and aim: The aim of this study was to examine the relationship between professional attitude and compassion among nurses. Material and methods: The sample of the crossectional study recruited 202 nurses who accepted participation and working in a state hospital. Data were collected between 20 June 2019 and 2 August 2019 with a questionnaire form, Inventory of Professional Attitude at Occupation (IPA) and Compassion Scale. Data were collected via face-to-face method. Form and scales were completed by the participants. The study was reported according to the STROBE. Results: The mean IPA was 134.57 ± 15.43. The mean score of the Compassion Scale was 73.89 ± 11.54. The mean scores of the Compassion Scale's sub-dimensions were 16.17 ± 3.22 for kindness, 8.62 ± 3.44 for indifference, 15.45 ± 3.17 for common humanity, 9.02 ± 3.46 for separation, 15.95 ± 3.00 for mindfulness, 8.67 ± 3.44 for disengagement. There were positive correlations between kindness (r = .356), common humanity (r = .214), mindfulness (r = .297) subscales and there were negative correlations between indifference (r = -.441), separation (r = -.411) and disengagement (r = -.415) subscales and the Inventory of IPA. There was a negative correlation between IPA and total Compassion Scale scores (r = -.140). IPA scores were significantly different according to sex, age, working duration, weekly working time, satisfied with colleague relationships. Compassion scores were significantly different for weekly working time, satisfaction with colleague relationships, suitability of the nursing profession and working in emergency and outpatient clinics (p < .05). Conclusion: As nurses' professional attitude scores increased, kindness, common humanity and mindfulness subscales scores increased, while indifference, separation and disengagement subscales scores of the compassion scale decreased. Relevance to clinical practice: Increasing the awareness about professional attitude and compassion in nursing should start with undergraduate education of nurses, and it is recommended to organise in-service training to develop professional attitudes and compassion in occupational life and to research patient perspectives about compassion.
Article
Introduction The misuse of and addiction to opioids are a national public health crisis. The complexity of delivering patient care in emergency departments exposes nurses to stressful work situations with complex patient loads and increasing levels of compassion fatigue. Emergency nurses were asked about their feelings of compassion fatigue while caring for patients with opioid use and/or substance use disorders. Methods Twenty-four focus groups with emergency nurses (N = 53) at a level I trauma center were conducted in late 2019 and early 2020 are used in this qualitative study using thematic analysis that identified 1 main theme of compassion fatigue with 3 subthemes (nurse frustration with addicted patients, emotional responses, and job satisfaction). Results Findings highlight that emergency nurses working with patients with opioid use and/or substance use disorders are dealing with a number of negative emotional stressors and frustrations, which in turn has increased their levels of compassion fatigue. These nurses repeatedly expressed feelings of increasing frustration with addicted patients, negative emotional responses, and decreasing levels of job satisfaction as components of their compassion fatigue. Discussion These emergency nurses identified 3 areas to improve their compassion: improved management support with encouragement across all work shifts, debriefing opportunities, and more education. Fostering a high level of self-awareness and understanding of how the work environment influences personal well-being are necessary strategies to avoid the frustrations and negative emotional responses associated with compassion fatigue.
Article
Background: Emergency and intensive care health care professionals are experiencing exhaustion and helplessness, which may cause compassion fatigue. Unaddressed compassion fatigue impacts staff morale and patient safety. Structured debriefing sessions may reduce compassion fatigue by providing social support and increasing job satisfaction. Objective: To investigate the feasibility of a 12-week pilot of structured debriefing sessions and its impact on compassion fatigue experienced by emergency and intensive care health care professionals after patient death. Methods: In this 12-week pilot study (March 2021 to May 2021), we used a preintervention/postintervention design to determine the feasibility of structured debriefing among trauma health care professionals experiencing patient death in an urban, academic, 300-bed, Midwest, Level II trauma center. Compassion fatigue was measured using the Professional Quality of Life Measure survey. Univariate descriptive statistics, independent unpaired t tests, and χ2 tests examined the intervention impact. Results: Fifty-six health care professionals participated in 20 debriefing sessions during the 12-week intervention: 37 (80%) registered nurses, 10 (5.6%) respiratory therapists, and 5 (11.2%) nursing assistants or emergency medical technicians. The debriefings covered nearly half of all patient deaths (38%). No significant differences were seen in burnout (M = 25.5, SD = 5.4, p = .47), secondary traumatic stress (M = 23.9, SD = 5.6, p = .99), or compassion satisfaction (M = 36.8, SD = 6.4, p = .61). Conclusions: Structured debriefings to address compassion fatigue among trauma health care professionals are feasible, but further research on effectiveness is needed. Administration-provided emotional support strategies may assist health care professionals in processing work-related stress.
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z Bu araştırmada Merhamet Yorgunluğu-Kısa Ölçek (MY-KÖ)'in Türkçe'ye uyarlanarak geçerlilik ve güvenirli-liğinin incelenmesi amaçlanmıştır. Araştırmanın verileri bir üniversite hastanesinde çalışan 128 hemşireden elde edilmiştir. Ölçeğin faktör yapısını belirlemek için açıklayıcı ve doğrulayıcı faktör analizi, ölçüt geçerliliği için Spearman's korelasyon katsayısı ve güvenirlilik için Cronbach α katsayısı, madde toplam korelasyonu kullanıldı. Açıklayıcı ve doğrulayıcı faktör analizi sonuçları doğrultusunda ölçeğin iki boyutlu bir yapı gösterdiği ortaya konulmuştur. Ölçeğe ait bütün maddelerin faktör yüklerinin 0.40'ın üzerinde olduğu bulunmuştur ve ölçekten hiçbir madde çıkarmadan orjinal ölçekle benzer şekilde iki alt boyutlu yapı kabul edilmiştir (x2=106.72; df=61; RMSEA=0.007; p=0.0001). MY-KÖ Cronbach α katsayısı 0.876; ikincil travma alt boyutu için 0.748 ve mesleki tükenmişlik alt boyutu için 0.852 olarak belirlenmiştir. Bu çalışma sonucun-da Merhamet Yorgunluğu-Kısa Ölçeğinin merhamet yorgunluğunun değerlendirilmesinde geçerli ve güvenilir bir değerlendirme aracı olduğu saptanmıştır. Abstract The aim of this study was to examine the reliability and validity of the Compassion Fatigue-Short Scale (CF-SC) in Turkish. The data of the study were obtained from 128 nurses working in a university hospital. In order to determine the factor structure of the scale, explanatory and confirmatory factor analysis, Spear-man's correlation coefficient and Cronbach α coefficient, item-total correlation were used for criterion validity. In light of the results of the explanatory and confirmatory factor analysis, the scale showed a two-dimensional structure. The factor loadings of all items of the scale were found to be over 0.40, and without subtracting any item from the scale, two sub-dimensional structures were accepted similar to the original scale (x2 = 106.72; df = 61; RMSEA = 0.007; p = 0.0001). CF-SC Cronbach α coefficient is 0.876; for secondary trauma sub-dimension of 0.748 and for job burnout sub-dimension of 0.852. As a result of this study, Compassion Fatigue-Short Scale has been found to be a valid and reliable assessment tool in evaluating compassion fatigue.
Article
Oncology nurses are at risk for compassion fatigue, which is often assessed using the Professional Quality of Life Scale (ProQOL). Nursing researchers and leaders use the ProQOL to determine risk for compassion fatigue or effectiveness of interventions to reduce compassion fatigue. However, the ProQOL was designed for social workers, and research has shown it to be less suitable to assess the work of nurses. This article synthesizes a realist review of the literature about instruments measuring nurses' professional quality of life (QOL). The following three themes emerged: (a) a robust body of literature aimed at defining professional QOL, (b) a limited historical context of the ProQOL instrument, and (c) newer instruments. Findings suggest that the ProQOL-21 and the Risk Factors for Compassion Fatigue Inventory are more specific to nursing and better suited to measure nurses' perceived professional QOL.
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