Preventing and Protecting Healthcare Workers from the Prevalence of Compassion Fatigue
Kristine Ruche
Florida International University
MAN6974: HCMBA Abstract, Problem Statement, & Annotated Bibliography
Abstract
Compassion fatigue has been a popular topic amongst healthcare workers; however, many are not aware of the real-life effects of this fatigue and burnout. Research studies related to overcoming compassion fatigue in the University of Miami/Sylvester Comprehensive Cancer Center and protecting its healthcare workers from the prevalence of compassion fatigue. Studies from twenty research articles were conducted to investigate what study approaches were done to prevent compassion fatigue. The reviews of these research articles ultimately recommended further research to determine how to best protect the most vulnerable healthcare workers and how organizations can work towards trying to prevent compassion fatigue and other mental health outcomes they may be at risk for. Statistical analysis was done using different software which result in different results with different strategies. The interviews were related to studying their experience to evaluate or identify the strategies which can cope with and trigger what the nurses use to handle or manage compassion fatigue and burnout. Some research also highlights the policy recommendation based on the findings through research study so that the health care leaders along with the decision makers/stakeholders realize the value of the mental health situation of the nurses and health care department. The study reveals a lack of awareness of compassion fatigue because health professionals are unsure of how to deal with this situation and not having sufficient resources at the workplace to seek help or guidance. The evidence-based research assessment was designed to measure the symptoms of compassion fatigue. The findings also highlight that there is a need to overthink the clearer relationship between the vulnerability of fatigue and the sensitivity of the health care department and health care professionals. Health policy analysis should be done by reviewing these statistical data to prevent and overcome compassion fatigue.
Problem Statement
How can the University of Miami/Sylvester Comprehensive Cancer Center protect its healthcare workers from the prevalence of compassion fatigue?
Annotated Bibliography & Data Sources
Aslan, H., Erci, B., & Pekince, H. (2021). Relationship between compassion fatigue in nurses,
and work-related stress and the meaning of life.  Journal of Religion and Health,  61(3), 1848–1860. https://doi.org/10.1007/s10943-020-01142-0
This cross-sectional research study was conducted to investigate the work-life balance, the meaning of life outside of work, and work-related stress in association with compassion fatigue in nurses. The data were collected in face-to-face meetings where nurses filled out four separate forms in a 10–15-minute timeframe. The study found a positive correlation between work-related stress and compassion fatigue. Increased work-related stress also increased compassion fatigue which also negatively impacted their outlook on life outside of work. With the findings of this study, it was concluded that empathetic and compassionate nurses are necessary to carry out high-quality, compassionate care. Therefore, organizations need to provide support to protect the nurses from compassion fatigue, such as improving work conditions, nurse to patient ratios, and providing in-services and training programs on coping mechanisms to reduce work-related stress.
Cocker, F., & Joss, N. (2016). Compassion Fatigue among healthcare, emergency, and Community Service Workers: A systematic review.  International Journal of Environmental Research and Public Health,  13(6), 618. https://doi.org/10.3390/ijerph13060618
This study was comprised of thirteen relevant studies on a combination of nurses and community service workers. This review ultimately recommended further research to determine how to best protect the most vulnerable healthcare workers and how organizations can work towards trying to prevent compassion fatigue and other mental health outcomes they may be at risk.
Gustafsson, T., & Hemberg, J. (2022). Compassion fatigue as bruises in the soul: A qualitative study on nurses. Nursing ethics, 29(1), 157-170.
This was a qualitative study that aimed at exploring compassion fatigue that nurses experience and how it affects them in their personal and professional lives. The data consisted of transcripts from interviews with seven nurses in a variety of different settings. In conclusion, that compassion fatigue can leave scars, but like bruises, with time they will fade. However, it may leave scars and the nurses with a sense of caution which in turn, can negatively impact patient care and the ability to provide high-quality care.
Hewett, C. L. (2021). Compassion fatigue in critical care nurses: Putting the passion back in compassion (Doctoral dissertation, Bradley University).
Another study is related to the “Professional quality of life†(ProQOL) survey. The purpose of this research work is to bring awareness about compassion fatigue to enhance nurse resilience and compassion satisfaction. A comparison of the ProQOL was measured with the help of a score in order to evaluate how the education interventions have affected and improved compassion satisfaction and also decrease compassion fatigue. The result of this study concluded that 19 nurses were the participants who has completed all the requirements and there is a significant increase in CS compassion satisfaction with p=0.03 and a significant decrease with p=0.01 in burnout which shows that these results suggested an educational intervention should be designed in order to reduce the fatigue compassion.
Zhang, B., Li, H., Jin, X., Peng, W., Wong, C. L., & Qiu, D. (2022). Prevalence and factors associated with compassion satisfaction and compassion fatigue among Chinese oncology healthcare professionals: A cross-sectional survey.  Asia-Pacific Journal of Oncology Nursing,  9(3), 153-160.
The study examined a cross-sectional survey to find the occurrence of compassion fatigue and satisfaction and the factors associated with it among cancer doctors. The methodology involves the sampling of 337 subjects from five general hospitals to fill up the survey related to the “Connor Davidson Resilience Scale: along with the professional quality of life scale. The result depicted a medium level of compassion satisfaction with a 78.34% rate. Furthermore, multiple regression analysis was also done which showed strength, with active coping, and positive refarming as a significant factors of compassion satisfaction with (p <0.001) with 48.6% of the total variance. Which permits the hospital’s management attention. Which is considered one of the strategies that can improve the professional life quality of the health care department.
Yoder, E. A. (2010). Compassion fatigue in nurses.  Applied nursing research,  23(4), 191-197.
Compassion fatigue, coping strategies, and the triggering of this kind of situation are common in the health care unit and among nurses. Qualitative and quantitative studies were conducted along with a questionnaire of 106 questions. Consisting of the primary part of the questionnaire was demographic information and the additional part of the questionnaire was about the professional quality of Life scale which (ProQOL) considered the latest version of the “compassion fatigue test†which includes three types of subscales to measure the compassion satisfaction, compassion fatigue along with secondary trauma CF and ST, and the burnout. The third part of the questionnaire is a qualitative study that includes a narrative response. Statistics was done using the Minitab version software. The score was analyzed by one-way analysis of the variance which depicted that the CF and ST are high for the nurses who worked for 8 hours. Further turkey’s method was conducted along with the post hoc in which compassion satisfaction is higher in ICU. The qualitative study was analyzed through narrative response. The responses were read with the themes and categories which concludes that nurses have able to cope with the situations. Personal coping is also utilized in this study.
Maytum, J. C., Heiman, M. B., & Garwick, A. W. (2004). Compassion fatigue and burnout in nurses who work with children with chronic conditions and their families.  Journal of pediatric health care,  18(4), 171-179.
A descriptive and qualitative pilot study in which twenty experienced nurses were interviewed who stayed with children having a chronic illness. The interview was related to studying their experience in order to evaluate or identify the strategies which can cope with and trigger what the nurse usage to handle compassion fatigue and burnout. The findings of this study present that the participants experienced a high range of emotional and physical symptoms of burnout and compassion fatigue.
Najjar, N., Davis, L. W., Beck-Coon, K., & Carney Doebbeling, C. (2009). Compassion fatigue: A review of the research to date and relevance to cancer-care providers.  Journal of health psychology,  14(2), 267-277.
In order to recognize compassion fatigue in the cancer unit, 57 studies were evaluated, assessed, and reviewed. The study then concluded that compassion fatigue has not adversely affected the cancer care unit and the care workers but also in the workplace. The findings also highlight that there is a need to overthink the clearer relationship between the vulnerability of fatigue and the sensitivity related to the health care department and healthcare professionals.
Pérezâ€GarcÃa, E., Ortegaâ€Galán, Ã. M., Ibáñezâ€Masero, O., Ramosâ€Pichardo, J. D., Fernándezâ€Leyva, A., & Ruizâ€Fernández, M. D. (2021). Qualitative study on the causes and consequences of compassion fatigue from the perspective of nurses.  International journal of mental health nursing,  30(2), 469-478.
The study focused on compassion as a major element in the nursing care unit also the study focuses of understanding of the consequences and the cause of compassion fatigue from a different perception of the nursing care unit. A qualitative study was designed in which the phenomenology paradigm has been used. A session was conducted with the 43 nurses in five group sessions which result in two themes and six sub-themes. The result showed up showing that the main cause of compassion fatigue in nursing is the lack of resources and time provided to the nursing department. Furthermore, the consequences were also identified which involve difficulty in the workload, and adverse effects on private and personal life which led the nurse to quit the job. The motive of this study is to highlight the compassionate care for nurses to reduce compassion fatigue through the help of health care organizations.
Perry, B., Toffner, G., Merrick, T., & Dalton, J. (2011). An exploration of the experience of compassion fatigue in clinical oncology nurses.  Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie,  21(2), 91-97.
Reconnoitering the involvement of compassion fatigue in nurses is being studied in this research paper and considers the main objective. A qualitative study was conducted to assess the experience of the nurses and this research review has been followed with the help of JBI which is Joanna Briggs Institute which includes publications and databases from different research websites. The result depicts that 23 research papers were represented including the study of seven countries and more than 80 nurses as a participant which met the criteria for presence. The four syntheses were derived from the research study which has helped the management to reduce compassion fatigue.
Science Direct
Lotta, G., Nunes, J., Fernandez, M., & Correa, M. G. (2022). The impact of the COVID-19 pandemic in the frontline health workforce: perceptions of vulnerability of Brazil’s community health workers.  Health policy OPEN,  3, 100065.
The effect on the community health worker which are is at the frontline and how they impacted by the pandemic situation. The qualitative and quantitative data were collected in June and July of 2020 which consider the experience of community health worker and their perceptions. The author has focuses on the extent of the study where the pandemic has added vulnerabilities and the result conclude that Covid-19 has worsened the professional condition of the health worker.
Yu, H., Jiang, A., & Shen, J. (2016). Prevalence and predictors of compassion fatigue, burnout and compassion satisfaction among oncology nurses: A cross-sectional survey.  International journal of nursing studies,  57, 28-38.
Cancer has been considered the foremost cause of death, this paper describes the occurrence of the analysis of “professional quality of life†among cancer care nursing department with the help of two theoretical models. The study focuses on the cross-sectional survey which consists of 669 samples of nurses and all of these nurses work in the oncology care unit with one year of experience. The data was analyzed on the basis of demographic information and the professional quality of the scale for the nurses. The Chinese research conducted the “Jefferson Empathy†scale along with a questionnaire that involves a simplified coping method. Furthermore, a descriptive t-test, multiple linear aggression, and one-way variance analysis were conducted in order to determine predictors of fatigue. The result showed that there was high compassion fatigue was found along with burnout in the nurses who work in the cancer care unit. The strongest predictors were training and supportive programs, and cognitive sympathy with 23% variance.
Wiley Online Library
Ondrejková, N., & Halamová, J. (2022). Prevalence of compassion fatigue among helping professions and relationship to compassion for others, selfâ€compassion and selfâ€criticism.  Health & Social Care in the Community.
The main objective of this paper is to identify the pervasiveness and its difference in compassion fatigue in other health and helping professions and evaluate the relationship between self-criticism, self-compassion, compassion, and compassion fatigue. The study includes 607 participants who work in the helping career as a profession and the sample consist of 57 paramedic staff, 39 home nurses, 102 nurses, 103 psychologist,66 teachers, 39 priest, 76 social workers, and approximately 40 police officers. The data was collected through an online survey. The result showed a substantial difference in compassion fatigue. The participants with a high level related to compassion fatigue also scored high in self-criticism.
Springer Link
Paiva-Salisbury, M. L., & Schwanz, K. A. (2022). Building Compassion Fatigue Resilience: Awareness, Prevention, and Intervention for Pre-Professionals and Current Practitioners.  Journal of Health Service Psychology,  48(1), 39-46.
The study reveals a lack of awareness of compassion fatigue because health professionals are unsure of how to deal with this situation. The evidence-based research assessment was designed to measure the symptoms of compassion fatigue. Ethical considerations can impact professional development. It is compulsory to make changes at the graduate level in form of training sessions. This paper depicts the awareness of compassion fatigue in the pre-professional health department.
APA Psyc Net
Rivera-Kloeppel, B., & Mendenhall, T. (2021). Examining the relationship between self-care and compassion fatigue in mental health professionals: A critical review.  Traumatology.
A critical review study was done to inspect the connection between compassion fatigue and self-care in the context of mental health. The major outcome of compassion fatigue is on the mental health of the health care department and especially nurses. In order to adapt the self-care practice, this paper examines the articles which were published from 2005 to 2019. The criteria of the selection consist of a peer review or empirical review, a sample of the studies which were related to mental health, and to focus on the association between compassion fatigue along with self-care. The result of the analysis depicted that there is a lack of limited sample, the cohesive theory was revealed with the urge to implement policy practice and clinical support.
Sinclair, S., Raffin-Bouchal, S., Venturato, L., Mijovic-Kondejewski, J., & Smith-MacDonald, L. (2017). Compassion fatigue: A meta-narrative review of the healthcare literature.  International journal of nursing studies,  69, 9-24.
A meta-narrative review was conducted in this paper which includes a research study through different research websites which include google scholar, PubMed, Medline, and manual research. The theoretical, seminal articles and empirical study and its literature review on compassion fatigue. 90 studies were conducted using the nursing literature.
Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority.  Frontiers in public health,  9, 679397.
Prioritizing the mental health o the worker is important because COVID-19 has a worse impact on the health care unit as well as on mental health. The article provides evidence-based research on mental health and its adverse impact during times of crisis. More auto has provided preventive and proactive measures and its intervention toward the systemic shift. The paper also deals with the health care stressor and the psychological need of the healthcare nurses who are working on the frontlines during pandemics. The paper also highlights the policy recommendation based on the findings through research study so that the health care leader along with the decision makers realize the value of the mental health situation of the nurses and health care department.
Journal of Compassionate Health Care
Upton, K. V. (2018). An investigation into compassion fatigue and self-compassion in Acute Medical Care Hospital Nurses: A mixed methods study. Journal of Compassionate Health Care, 5(1).
This was a mixed-method study along with quantitative data collection that was designed to examine the environmental and psychosocial influences that affect the prevalence of compassion fatigue in an acute care setting nursing staff and whether self-compassion can be used as a coping strategy. The study is related to survey methodology using work-related and demographic questionnaires to measure compassion fatigue CF. Statistics of ANOVA were conducted in order to evaluate the outcomes of these impacts on CF and self-compassion SC. This study concluded with findings that self-compassion has a moderate effect on CF.
Van Mol, M. M., Kompanje, E. J., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review.  PloS one,  10(8), e0136955.
A systematic literature study was conducted which include 1623 publications along with 14770 respondents. In which the two specific studies reported the prevalence of compassion fatigue at 7.3 percent and 40 percent. Furthermore, five types of research depicted the frequency of trauma related to stress which ranged from 0% to 38%, and the prevalence of burnout was recorded from 0 to 70%. The article also explores the intervention strategies in order to reduce stress in the ICU along with ten studies that have measured the impact of the intervention.
Xie, W., Chen, L., Feng, F., Okoli, C. T., Tang, P., Zeng, L., … & Wang, J. (2021). The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis.  International journal of nursing studies,  120, 103973.
The research paper systematically measures compassion fatigue and satisfaction in the nurses through reference to the department and the geographical unit. The study is related to the meta-analysis and the systematic review. The methodology consists of the study selection, data extraction, and the quality assessment of the literature review along with the analysis of standard deviation and three sub-scales of the (ProQOL) was used using the software STATA. The result found that on the bases of geographical region, the Asian region has lower compassion fatigue but has high compassion satisfaction. 28,000 nurses were selected from eleven countries using a pooled score mean of burnout, compassion satisfaction, and secondary trauma. These types of findings can help the health administration to work on a theoretical basis to manage compassion fatigue among health care workers.
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