Occupational well-being is how you use your skills and abilities to enrich your own life as well as the lives of those around you. Attitude is related to satisfaction regarding your work, whether it be paid or unpaid.
Compassion fatigue is a consequence of chronic work-related stress exposure among healthcare providers. Nursing is a high-risk, stressful profession which increases nurses’ vulnerability to compassion fatigue symptoms compared to other healthcare workers. Compassion fatigue has serious consequences for nursing staff, patients and healthcare organizations. Though several studies on the prevalence of compassion fatigue among nurses have been published, the reported data vary considerably across studies; and few meta-analysis have examined the prevalence of compassion satisfaction and compassion fatigue among nurses with large sample sizes.
Objectives: To systematically assess the prevalence of compassion satisfaction and compassion fatigue among nurses, and to evaluate the effect of different geographical regions, years and departments on the prevalence of compassion fatigue.
Design: Systematic review and meta-analysis DATA SOURCES: The Cochrane Library, PubMed, EMbase, Web of Science, CINAHL, PsyclNFO, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched in the systematic review. The time frame for the searches included all literature before January 31st, 2020.
Review methods: The reviewers independently completed study selection, quality assessments, data extraction and analysis of all included literature. The mean scores and standard deviations of the three subscales of the Professional Quality of Life (ProQOL) scale were pooled using random effects meta-analysis in Stata 16.0 software package. Finally, subgroup analyses were conducted to explore the sources of between-study heterogeneity.
Results: A total of 79 studies were included in the systematic review and meta-analysis, consisting of 28,509 nurses worldwide from 11 countries. In our studies, the pooled mean scores of compassion satisfaction, burnout and secondary traumatic stress were 33.12 (95% CI: 32.22-34.03), 26.64 (95% CI: 26.01-27.27) and 25.24 (95% CI: 24.69-25.79), respectively. In addition, the Asian region had the lowest levels of compassion satisfaction but the highest levels of compassion fatigue symptoms, while the Americas and Europe had the lowest levels of compassion fatigue but highest compassion satisfaction. Levels of compassionate fatigue in nurses increased gradually from 2010 to 2019, reaching the highest level in 2019; and nurses from ICU had the highest levels of compassion fatigue symptoms among all nurses.
Conclusion: The levels of compassion satisfaction and compassion fatigue among nurses are moderate. Nurses from the Asian region and in ICUs suffer from severe compassion fatigue symptoms, and the prevalence of compassion fatigue has increased over time. These findings may provide hospital administrators with the theoretical basis for the management and treatment of compassion fatigue.
Background: Compassion fatigue is a work-related professional hazard acquired when providing healthcare for patients. This hazard can lead to physical and mental health problems for nurses and may also affect the nursing care quality for patients. However, studies on Chinese nurses’ compassion fatigue are scarce, especially large sampled, multi-center empirical research.
Objectives: The goal of this study was to assess the prevalence of compassion fatigue among Chinese nurses, and to explore the factors associated with compassion satisfaction, burnout and second traumatic stress.
Design: A cross-sectional design with a convenience sample.
Settings: Participants were recruited from 11 tertiary hospitals in western (Chengdu, Chongqing), eastern (Hefei), southern (Shenzhen) and central China (Wuhan, Huangshi).
Participants: A total of 1044 registered nurses from different nursing departments were surveyed.
Methods: Demographic, work-related information, lifestyle questionnaire and the Professional Quality of Life Scale were used in this study. Descriptive statistics, t-tests, one-way analysis of variance, and Pearson or Spearman's correlation analyses were used to compare the differences and examine the relationships between participants’ demographic and work-related variables and compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression models were performed to identify salient variables associated with compassion satisfaction, burnout and secondary traumatic stress from among demographic and work-related factors.
Results: The mean scores for the dimensions of compassion satisfaction, burnout and secondary traumatic stress were 32.63±6.46, 27.36±5.29, and 26.88±5.13, respectively. The age of 36 or higher, being married, higher job satisfaction, good sleep quality and regular exercise were positively associated with compassion satisfaction, while smoking was a negative factor; these five factors explained 25.7% of the total variance. The average number of hours worked per day was a positive factor for burnout, while being married/member of an unmarried couple, job satisfaction, sleep hours per day and sleep quality were negative factors of burnout, explaining 38.8% of the total variance. In addition, we also found that four factors, poor sleep quality, low job satisfaction, more work hours, and second-hand smoke exposure were related to secondary traumatic stress, explaining 9% of the variance.
Conclusions: Our findings reveal a serious phenomenon of the poor professional quality of life among Chinese nurses. The results may provide clues to help nursing managers identify nurses’ vulnerability to compassion fatigue and implement targeted strategies to reduce nurses’ burnout and secondary traumatic stress, while supporting compassion satisfaction.
Compassion satisfaction (CS) among healthcare professionals is a sense of gratification derived from caring for their suffering patients. In contrast, compassion fatigue, often a consequence of burnout (BO) and secondary traumatic stress (STS), is detrimental to healthcare professionals’ productivity and patient care. While several studies have examined CS, BO, and STS among healthcare professionals, the majority have assessed samples in specific disciplines. However, the comparative differences in these factors by discipline or work setting are not well known. The aims of this study were to examine the differences in CS, BO, and STS by discipline and work setting, and to assess demographic, work-related, and behavioural factors associated with these outcomes. An electronic survey was administered (N = 764) at a large academic medical centre in the southeast United States. Questions elicited demographic variables, work-related factors, behavioural/lifestyle factors, experience with workplace violence, and the Professional Quality of Life Scale. Findings of the study determined that the rates of CS, BO, and STS vary across healthcare disciplines and work settings. Demographic, work-related, behavioural, and work setting (i.e., experience of workplace violence) factors were differentially associated with experiences of CS, BO, and STS. The results of the study suggest two potential areas for research, specifically workplace violence and sleep quality as a means of further understanding reduced CS and increased BO and STS among healthcare workers. These findings have important implications for future research and policy interventions to enhance healthcare workers’ health and safety.
Background: The nurse workforce shortage, partially caused by high work turnover, is an essential factor influencing the quality of patient care. Because previous studies concerning Chinese nurse work turnover were predominantly quantitative, they lacked insight into the challenges nurses face as they transition from university to their careers. A successful transition can result in new nurses’ commitment to their careers. As such, this study sought to understand how new nurses commit to the career and focused on identifying facilitators and barriers to such commitment.
Methods: This was a qualitative study using a grounded theory design. Through purposive sampling, clinical nurses were recruited from hospitals in Western China to participate in semi-structured interviews. The data was analyzed through coding to develop categories and themes.
Results: Theoretical saturation was achieved after interviewing 25 participants. The data revealed the ‘zigzag journey’ of committing to the nursing career. The emerging core theme was “getting settled”, indicating that new nurses needed to acclimate to the work reality in the nursing career. By analyzing the data provided by the participants, the researchers concluded that the journey to getting settled in nursing compassed four stages:1) “sailing out with mixed feelings”, 2) “contemplating to leave”, 3) “struggling to stay”, and 4) “accepting the role”. For most participants, nursing was described as a way to earn a living for their family, not as a career they felt passionate about.
Conclusions: Committing to a nursing career is a complicated long-term process. There seems to be a lack of passion for nursing among the Chinese clinical nurses participating in this study. Thus, the nurses may need continued support at different career stages to enhance their ability to remain a nurse for more than economic reasons.
Aims: Among nursing professionals, our aims were to examine (a) self-reported traumatic experiences, (b) differences in post-traumatic growth (i.e. positive psychological growth after experiencing a traumatic event) by nursing professional level and (c) demographic, work-related, behavioural and traumatic experience covariates of post-traumatic growth.
Background: Trauma experience among nursing professionals is higher than observed in the general population. Due to the nature of their work environment, workplace trauma rates are particularly alarming. Understanding post-traumatic growth among nursing professionals may guide interventions to enhance well-being.
Method: A secondary analysis of cross-sectional survey data from nursing professionals (N = 299). Demographic, work-related, behavioural, trauma experience categories and post-traumatic growth variables were examined.
Results: Advanced practice nurses and clinical nurses reported higher rates of workplace trauma, as compared to nursing assistants. Higher post-traumatic growth scores were associated with having a postgraduate degree, serving the paediatric population and lower frequency of alcohol use. Lower post-traumatic growth scores were associated with being married/widowed, being an advanced practice provider or clinical nurse, working in the intensive care unit and reporting workplace, family/personal stress and undisclosed trauma.
Conclusions: Nursing professionals have several demographic, work-related, behavioural and traumatic experience-related variables associated with and that explain variances in post-traumatic growth.
Implication for nursing management: Targeted screening and individualized treatment based on nursing professional level should be considered to support trauma recovery and post-traumatic growth.
Examining posttraumatic growth (PTG) can yield insight to constructively understand and approach trauma among nurses. Data was analyzed from 299 nursing staff on traumatic experiences and resulting PTG. Work-place trauma resulted in the lowest PTG scores among nurses should be explored.
Overwhelmed? BH WELL's very own Bassema Abu-Farsakh relates to feeling overwhelmed as a wife, parent, graduate student, and student worker. This video shares practical tips to help keep our boats steady as we cope with day-to-day stress.
Are you overwhelmed? I am at times. I wear MANY hats. I’m a wife, mom, graduate student, and student worker. It is easy to become overwhelmed. There have been days I felt like I was dragging pieces of myself from place to place, existing rather than thriving. I barely make it through classes. I arrive home only to realize I forgot what my kids’ faces look like! (Well, okay, almost forgot.) But wait, it’s time to manage dinner and homework, and say hello to my husband. No wonder my kids want my attention and no wonder I end up with short nerves. This day easily repeated, like Groundhog’s Day, simply because I could not fully manage or cope with my stress. I was stuck.
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Every person on earth has challenges in life but the good news is that there ARE ways to carry all these pieces and find balance. I love this saying, “Sometimes we cannot control the wind, but we can direct the sail.” However, when we are stressed, what we need at the moment may be just to keep our boat steady!
Here are some ways I have found help me deal with day-to-day stress. Feel free to pick one or two of your favorites to help your boat get back to steady!
No one in the world is perfect. So accept your strengths and weaknesses as they are and appreciate yourself.
FORGIVE yourself and LEARN from your mistakes.
STOP comparing yourself with other people. You are unique.
Always believe there is something GOOD in everyone as well as in YOU.
Celebrate your achievements, small or big! The sense of success becomes real when you do what you enjoy (watch a nice movie, dance, or hang out with a friend)
Do not spend time thinking about what other people think of you. Value yourself.
When possible, surround yourself with POSITIVE people and LIMIT TIME with negative people.
Find the POSITIVE side in any life event. Even if something horrible happens, we can always learn and grow through it.
Find positive ways to EXPRESS your emotion (writing, singing, or watching a movie).
Balance your day by keeping a TO DO list. Set time limits for work tasks. Include flexibility in your day along with time for loved ones.
Schedule a routine BREAK to refuel (exercise, play with your kids or pets, go for a walk, practice deep breathing, or take a day nap).
BE MINDFUL, just focus on the moment and press pause on the stresses of life.
SMILE! There is great power in smiling! It actually increases energy and eliminates stress.
FORGIVE others. I know it is not an easy task. However, the power of forgiveness can bring joy, harmony, and peace to you and your family.
Citations
Haun, V. C., Nübold, A., & Bauer, A. G. (2018). Being mindful at work and at home: Buffering effects in the stressor–detachment model. Journal of Occupational and Organizational Psychology, 91(2), 385-410.
Kraft, T. L., & Pressman, S. D. (2012). Grin and bear it: The influence of manipulated facial expression on the stress response. Psychological science, 23(11), 1372-1378.
Rasmussen, K. R., Stackhouse, M., Boon, S. D., Comstock, K., & Ross, R. (2019). Meta-analytic connections between forgiveness and health: the moderating effects of forgiveness-related distinctions. Psychology & health, 34(5), 515-534.
Bassema Abu-Farsakh is a registered nurse with expertise in psychiatric and medical-surgical nursing, a wife, a mom of two boys, a graduate nursing student, a graduate research assistant, and a real person who enjoys keeping her boat steady.
