Workplace violence and turnover intention among Chinese nurses: the mediating role of compassion fatigue and the moderating role of psychological resilience.

BACKGROUND: Workplace violence is a global public health issue and a major occupational hazard cross borders and environments. Nurses are the primary victims of workplace violence due to their frontline roles and continuous interactions. OBJECTIVE: The present study aimed to investigate the status of workplace violence, turnover intention, compassion fatigue, and psychological resilience among Chinese nurses, and explore the mediating role of compassion fatigue and the moderating role of psychological resilience on relationship between workplace violence and turnover intention among Chinese nurses. METHOD: A cross-sectional study was conducted among a convenience sample of clinical registered nurses from public hospitals in Changsha, Hunan, China. Data was collected through an online questionnaire, which included a demographic information form, the Workplace Violence Scale (WVS), the Turnover Intention Questionnaire (TIQ), the Compassion Fatigue Scale (CF-CN), and the Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics and correlation analysis were employed to examine the relationships among the main variables. A moderated mediation analysis was further conducted using the PROCESS macro for SPSS (Model 4 and Model 8) to examine the mediating role of compassion fatigue and the moderating role of psychological resilience. RESULT: The present survey recruited a convenience sample of 1,141 clinical registered nurses, who reported experiencing multiple types of workplace violence during the past year. Correlation analysis revealed significant positive correlations between workplace violence and turnover intention (r = 0.466, P < 0.01) as well as compassion fatigue (r = 0.452, P < 0.01), while negative correlation between workplace violence and psychological resilience (r=-0.414, P < 0.01). Moderated mediation analysis revealed that compassion fatigue mediated, while psychological resilience moderated, the positive relationship between workplace violence and turnover intention (all P < 0.05). CONCLUSION: This study underscores the mediating effect of compassion fatigue and the moderating role of psychological resilience in the relationship between workplace violence and turnover intention among Chinese nurses. Future efforts should be undertaken to develop effective preventive measures and intervention strategies at individual, organizational, and national levels to mitigate workplace violence and foster supportive work environment. CLINICAL TRIAL NUMBER: Not applicable.

Perceived social support and professional quality of life of health professionals during COVID-19 pandemic in Nepal: a cross-sectional study.

OBJECTIVE: To assess the perceived social support and professional quality of life (ProQOL) among healthcare professionals during COVID-19 pandemic in Nepal, encompassing both positive (compassion satisfaction) and negative (compassion fatigue) dimensions as well as the factors associated with them. DESIGN: A cross-sectional web-based study. SETTING: Nepal PARTICIPANTS: We carried out a convenience sampling technique to enrol 313 health professionals aged 18-60 years old. OUTCOME MEASURES: We employed the ProQOL V.5 questionnaire (comparing 30 self-report items) and the Multidimensional Scale of Perceived Social Support with 12 items to assess the ProQOL and social support, respectively. A χ2 test was performed to determine associated factors of different dimensions of ProQOL. RESULTS: The study included a total of 313 participants, mostly consisting of frontline health workers. More than one-third of the participants worked in places where precautionary measures were insufficient. However, the majority of them (73.8%) had high social support. Concerning the ProQOL, the percentage of health professionals that had moderate compassion satisfaction (CS), moderate Burnout (BO) and moderate secondary traumatic stress (STS) were 57.5%, 58.2% and 75.4%, respectively. Factors like sex, marital status, profession, work-shift, type of health institution and status of precautionary measures at the workplace were associated with the different dimensions of ProQOL at the significance level of 0.05. CONCLUSION: This study findings revealed a considerable proportion of BO and STS among health professionals during COVID-19 pandemic in Nepal. Implementation of appropriate interventions and support systems are needed to enhance CS, alleviate BO and mitigate STS among health professionals to combat future health emergencies.

Effects of COVID on Mandated Child Abuse Reporting Among Nurses: The Mediating Role of Compassion Fatigue.

Because COVID triggered elevated rates of child abuse, but diminished rates of child abuse reporting, we explored predictors of nurses' attitudes toward reporting suspected child abuse during the COVID pandemic. In particular, we expected that compassion fatigue and compassion satisfaction would mediate the effects of COVID-related stressors (i.e., exposure to COVID patient death and suffering; COVID-related family income loss; frequent direct care of COVID patients; and parental burnout) on nurses' negative attitudes toward reporting suspected child abuse. Employing chain-referral sampling, we recruited a sample of 244 registered nurses (83% White; 87% women). Supporting hypotheses, compassion fatigue mediated the effects of job-related COVID stressors (exposure to COVID patient death and suffering; COVID-related family income loss; and frequent direct care of COVID patients) on nurses' negative attitudes toward reporting suspected child abuse. In addition, among nurses who were also parents, nurses' self-reported parental burnout mediated the relation between compassion fatigue and negative attitudes toward reporting suspected child abuse. In addition, compassion satisfaction mediated the effect of nurses' parental burnout on nurses' negative attitudes toward reporting suspected child abuse.

Prevalence and associated factors of secondary traumatic stress in emergency nurses: a systematic review and meta-analysis.

Background: Nurses in emergency departments are at a high risk of experiencing secondary traumatic stress because of their frequent exposure to trauma patients and high-stress environments.Objective: This systematic review and meta-analysis aimed to determine the overall prevalence of secondary traumatic stress among emergency nurses and to identify the contributing factors.Method: We conducted a systematic search for cross-sectional studies in databases such as PubMed, Web of Science, Embase, CINAHL, Wanfang Database, and China National Knowledge Internet up to October 21, 2023. The Joanna Briggs Institute's appraisal checklists for prevalence and analytical cross-sectional studies were used for quality assessment. Heterogeneity among studies was assessed using Cochrane's Q test and the I2 statistic. A random effects model was applied to estimate the pooled prevalence of secondary traumatic stress, and subgroup analyses were performed to explore sources of heterogeneity. Descriptive analysis summarized the associated factors.Results: Out of 345 articles retrieved, 14 met the inclusion criteria, with 11 reporting secondary traumatic stress prevalence. The pooled prevalence of secondary traumatic stress among emergency nurses was 65% (95% CI: 58%-73%). Subgroup analyses indicated the highest prevalence in Asia (74%, 95% CI: 72%-77%), followed by North America (59%, 95% CI: 49%-72%) and Europe (53%, 95% CI: 29%-95%). Nine studies identified associated factors, including personal, work-related, and social factors. In the subgroup of divided by recruitment period, emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%-78%).Conclusions: Secondary traumatic stress prevalence is notably high among emergency department nurses, with significant regional variations and period differences. The factors affecting secondary traumatic stress also varied across studies. Future research should focus on improving research designs and sample sizes to pinpoint risk factors and develop prevention strategies.Registration: PROSPERO CRD42022301167.

Secondary traumatic stress is considered an occupational hazard for nurses. Emergency department nurses, in particular, face a greater risk of secondary traumatic stress compared to other professions.While various studies have investigated the prevalence of secondary traumatic stress among these nurses, findings have been inconsistent.The pooled prevalence of secondary traumatic stress among emergency nurses is 65%. Subgroup analysis by region shows that Asia experiences the highest combined prevalence at 74%, with North America at 59% and Europe at 53%. Emergency department nurses in the COVID-19 outbreak period had a higher prevalence of secondary traumatic stress (70%, 95% CI: 62%­78%).

Assessing the professional quality of life in the context of pediatric care.

Background: This study examines the professional quality of life (ProQOL), including compassion satisfaction (CS) and compassion fatigue (CF), burnout (BO) and secondary traumatic stress (STS) among registered nurses in the context of pediatric care in Riyadh city in Saudi Arabia. Methods: This study utilised a random multistage sampling method and a survey to collect data from 250 participants on personal characteristics, work-related aspects, lifestyle, and professional quality of life. Results: The study participants were all female. Only 2.0% were under 25, with 27.2% aged between 25 and 30 years, 24.0% aged between 31 and 35, and 26.4% over 40 years old. The majority, 74%, were non-Saudis. The participants reported low compassion satisfaction (CS) and compassion fatigue (CF) levels. The CS, burnout (BO), and secondary traumatic stress (STS) scores were 3.23 ± 0.764, 2.75 ± 0.68, and 2.69 ± 0.54, respectively. The study found a significant difference in ProQOL level based on factors such as age, nationality, previous experience, department, shift length, overtime work, state of overtime (mandatory versus optional), and salary. Conclusions: Working with vulnerable groups poses unique challenges for pediatric nurses. The nationality, salary, and state of overtime were found to be significantly different when compared to CS scores. Additionally, age, department, previous experience, shift length, and overtime work were very different compared to CF scores. However, lifestyle factors did not affect CS and CF scores significantly. Implications: To improve their well-being and interest in activities, pediatric nurses should practice self-compassion and utilise available educational resources such as workshops. They should also strive to achieve a work-life balance and adopt healthy habits to reduce CF.

Compassion fatigue and the meaning in life as predictors of secondary traumatic stress in nurses during the COVID-19 pandemic.

AIM: This study aimed to investigate the relationship among secondary traumatic stress, compassion fatigue, and meaning in life in nurses during the COVID-19 pandemic. BACKGROUND: Changes in working conditions during the pandemic also changed the needs of nurses. In addition to physical health, the COVID-19 pandemic led to many psychosocial health problems such as sleep disturbances, depression, and traumatic stress. This makes nurses vulnerable to psychological side effects of the pandemic. DESIGN: A cross-sectional study was conducted. METHODS: This study was conducted with 166 nurses. Data were collected online at May-June 2021. A Personal Information Form, the Secondary Traumatic Stress Scale, Compassion Fatigue Scale, and Meaning in Life Scale were used. The STROBE reporting checklist was followed. RESULTS: As secondary traumatic stress levels increase, compassion fatigue increases, meaning in life decreases, and the search for meaning in life increases. CONCLUSION: Predictors of secondary traumatic stress were shown to be compassion fatigue, change in sleep habits, meaning in life, marital status, and having a chronic illness. This suggested that working during the pandemic posed significant risks in terms of manifesting negative consequences on mental health in the long term.

Trauma surgeons experience compassion fatigue: A major metropolitan area survey.

INTRODUCTION: Compassion fatigue (CF), the physical, emotional, and psychological impact of helping others, is composed of three domains: compassion satisfaction (CS), secondary traumatic stress (STS), and burnout (BO). Trauma surgeons (TSs) experience work-related stress resulting in high rates of CF, which can manifest as physical and psychological disorders. We hypothesized that TSs experience CF and there are potentially modifiable systemic factors to mitigate its symptoms. METHODS: All TSs in a major metropolitan area were eligible. Personal and professional demographic information was obtained. Each participant completed six validated surveys: (1) Professional Quality of Life scale, (2) Perceived Stress Scale, (3) Multidimensional Scale of Perceived Social Support, (4) Adverse Childhood Events Questionnaire, (5) Brief Coping Inventory, and (6) Toronto Empathy Questionnaire. Compassion fatigue subscale risk scores (low, <23; moderate, 23-41; high, >41) were recorded. Linear regression analysis assessed the demographic and environmental factors association with BO, STS, and CS. Variables significant on univariate analysis were included in multivariate models to determine the independent influence on BO, STS, and CS. Significance was p ≤ 0.05. RESULTS: There were 57 TSs (response rate, 75.4% [n = 43]; White, 65% [n = 28]; male, 67% [n = 29]). Trauma surgeons experienced CF (BO, 26 [interquartile range (IQR), 21-32]; STS, 23 [IQR, 19-32]; CS, 39 [IQR, 34-45]). The Perceived Stress Scale score was significantly associated with increased BO (coefficient [coef.], 0.52; 95% confidence interval [CI], 0.28-0.77) and STS (coef., 0.44; 95% CI, 0.15-0.73), and decreased CS (coef., -0.51; 95% CI, -0.80 to -0.23) ( p < 0.01). Night shifts were associated with higher BO (coef., 1.55; 95% CI, 0.07-3.03; p = 0.05); conversely, day shifts were associated with higher STS (coef., 1.94; 95% CI, 0.32-3.56; p = 0.03). Higher Toronto Empathy Questionnaire scores were associated with greater CS (coef., 0.33; 95% CI, 0.12-0.55; p < 0.01). CONCLUSION: Trauma surgeons experience moderate BO and STS associated with modifiable system- and work-related stressors. Efforts to reduce CF should focus on addressing sources of workplace stress and promoting empathic care. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level III.

Structural Factors Contributing to Compassion Fatigue, Burnout, and Secondary Traumatic Stress Among Hospital-Based Healthcare Professionals During the COVID-19 Pandemic.

High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative-quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values.

Professional quality of life and fear of COVID-19 among Spanish nurses: A longitudinal repeated cross-sectional study.

AIM AND OBJECTIVES: To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign. BACKGROUND: The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential. DESIGN: A repeated cross-sectional design was carried out with a time-lapse of 12 months. METHODS: A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies. RESULTS: The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = - .16, p = .001; r = - .22, p ≤ .001). RELEVANCE TO CLINICAL PRACTICE: Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care. PATIENT OR PUBLIC CONTRIBUTION: The nurses collaborated by participating in the present study anonymously and disinterestedly.

Rural health care worker wellness during COVID-19: Compassion fatigue, compassion satisfaction & utilization of wellness resources.

OBJECTIVE: The goal of this study was to identify factors associated with compassion fatigue (CF) and compassion satisfaction (CS) among rural health care workers (HCWs) during the COVID-19 pandemic. The secondary purpose was to assess utilization of wellness resources and preferences for new resources. METHODS: A survey was distributed (October-December 2020) and completed by faculty, clinicians and staff (n = 406) at a rural university. Measures included a modified version of the Professional Quality of Life Scale (PROQOL-21), the Patient Health Questionnaire-4 and the Brief Resilience Coping Scale. Respondents reported their use of wellness resources and their preferences for new resources. RESULTS: The mean CF score was 21.1, the mean CS score was 26.8 and 42.0% screened positive for depression or anxiety. Few of the existing wellness resources were utilized and respondents' preferences for new wellness resources included time off (70.7%), onsite food trucks (43.0%) and support animals (36.5%). Younger age, depression and anxiety were associated with higher CF. Older age, better mental health and resilience were associated with higher CS. CONCLUSIONS: Rural HCWs have high CF, yet few utilize wellness resources. Rural health care organizations may foster wellness by providing time off for self-care, expanding mental health services and building resilience.

Compassion fatigue in healthcare providers: a scoping review.

The detrimental impacts of COVID-19 on healthcare providers' psychological health and well-being continue to affect their professional roles and activities, leading to compassion fatigue. The purpose of this review was to identify and summarize published literature on compassion fatigue among healthcare providers and its impact on patient care. Six databases were searched: MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science, for studies on compassion fatigue in healthcare providers, published in English from the peak of the pandemic in 2020 to 2023. To expand the search, reference lists of included studies were hand searched to locate additional relevant studies. The studies primarily focused on nurses, physicians, and other allied health professionals. This scoping review was registered on Open Science Framework (OSF), using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review. From 11,715 search results, 24 met the inclusion criteria. Findings are presented using four themes: prevalence of compassion fatigue; antecedents of compassion fatigue; consequences of compassion fatigue; and interventions to address compassion fatigue. The potential antecedents of compassion fatigue are grouped under individual-, organization-, and systems-level factors. Our findings suggest that healthcare providers differ in risk for developing compassion fatigue in a country-dependent manner. Interventions such as increasing available personnel helped to minimize the occurrence of compassion fatigue. This scoping review offers important insight on the common causes and potential risks for compassion fatigue among healthcare providers and identifies potential strategies to support healthcare providers' psychological health and well-being.

Compassion fatigue prevalence and risk factors among Saudi psychiatric nurses: A cross-sectional study.

In recent times, compassion fatigue is increasingly being recognized as a damaging outcome associated with the stress experienced by psychiatric nurses. In addition to affecting their job performance work-related stress undermines nurses' physical and emotional well-being. However, there is a lack of research on compassion fatigue that specifically focuses on psychiatric nurses working in Saudi Arabia. This cross-sectional study investigated the prevalence and factors associated with compassion fatigue among Saudi psychiatric nurses. The study participants were asked to complete a demographic questionnaire and the Arabic form of the Professional Quality of Life Scale. Statistical analyses, including one-way ANOVA, t-tests, the Levene test, and multiple linear regression, were employed to assess variables related to compassion fatigue. The survey spanned 158 psychiatric nurses from the Mental Health Complex located in Riyadh City. The mean scores for compassion satisfaction, burnout, and secondary traumatic stress were 39.72 ± 6.881, 24.29 ± 5.386, and 26.94 ± 6.973, respectively. The analysis revealed that variables such as age range (36-55 years) and an associated degree or lower explained 5.2% of the variance in compassion satisfaction. Age range (18-25 years), exercise frequency, and years of nursing experience collectively accounted for 8.4% of the variables contributing to burnout. The age range (25 to 35 years) and working night shifts also explained 5% of the variance in secondary traumatic stress. The findings indicated that compassion satisfaction, burnout, and secondary traumatic stress among the population of psychiatric nurses working in Saudi Arabia were at a moderate level. A higher frequency of healthy lifestyle practices, such as regular exercise, and being in an older age range, were positively associated with compassion satisfaction and negatively associated with burnout and secondary traumatic stress.

Burnout, Moral Distress, and Compassion Fatigue as Correlates of Posttraumatic Stress Symptoms in Clinical and Nonclinical Healthcare Workers.

GOAL: Research has highlighted psychological distress resulting from the COVID-19 pandemic on healthcare workers (HCWs), including the development of posttraumatic stress symptoms (PTSS). However, the degree to which these conditions have endured beyond the pandemic and the extent to which they affect the entire healthcare team, including both clinical and nonclinical workers, remain unknown. This study aims to identify correlates of PTSS in the entire healthcare workforce with the goal of providing evidence to support the development of trauma-informed leadership strategies. METHODS: Data were collected from June to July 2022 using a cross-sectional anonymous survey in a large academic medical center setting. A total of 6,466 clinical and nonclinical employees completed the survey (27.3% response rate). Cases with at least one missing variable were omitted, for a total sample size of 4,806, the evaluation of which enabled us to understand individual, organizational, and work-related and nonwork-related stressors associated with PTSS. Data were analyzed using ordinal logistic regression and dominance analyses to identify predictors of PTSS specific to clinical and nonclinical workers. PRINCIPAL FINDINGS: While previous studies have shown that HCWs in different job roles experience unique stressors, our data indicate that the top correlates of PTSS among both clinical and nonclinical HCWs are the same: burnout, moral distress, and compassion fatigue. These three factors alone explained 45% and 44.4% of the variance in PTSS in clinical and nonclinical workers, respectively. PTSS was also associated with a lower sense of recognition and feeling mistreated by other employees at work in the clinical workforce. Concerningly, women and sexual minorities in the clinical sample exhibited a higher incidence of PTSS. In nonclinical workers, social isolation or loneliness and lower trust and confidence in senior leadership were associated with PTSS. Nonwork-related factors, such as exhaustion from caregiving responsibilities and financial strain, were also significantly associated with PTSS. Even after controlling for discrimination at and outside of work in both samples, we found that non-White populations were more likely to experience PTSS, highlighting a deeply concerning issue in the healthcare workforce. PRACTICAL APPLICATIONS: The primary objective of this article is to help healthcare leaders understand the correlates of PTSS across the entire healthcare team as organizations recover from the COVID-19 pandemic. Understanding which factors are associated with PTSS will help healthcare leaders develop best practices that aim to reduce HCW distress and strategies to circumvent trauma derived from future crises. Our data indicate that leaders must address the correlates of PTSS in the workforce, focusing attention on both those who work on the frontlines and those who work behind the scenes. We urge leaders to adopt a trauma-informed leadership approach to ensure that the entire healthcare workforce is recognized, supported, and cared for as each HCW plays a unique role in the care of patients.

Compassion fatigue and compassion satisfaction in pediatric and neonatal care nurses during the COVID-19 pandemic in Sweden.

PURPOSE: Quality of care and the mental and physical health of nurses are interlinked. The COVID-19 pandemic has imposed an extremely high burden on health care. This study aimed to: 1) describe professional quality of life of registered nurses (RN) working in the pediatric and neonatal care units during the COVID-19 pandemic in Sweden, 2) compare professional quality of life between RNs with and without a Master's degree in specialist nursing pediatric care (MSc), and 3) compare differences in professional quality of life associated with the nursing experience (years). DESIGN AND METHODS: This study adopted a cross-sectional survey design. The PROQoL®-5-questionnaire was administered as a web survey to 160 RNs at four pediatric wards and two neonatal units of two hospitals in Sweden. RESULTS: Seventy-one RNs responded to the survey. Overall, they reported a sufficient professional quality of life. RNs with an MSc suffered significantly lower secondary traumatic stress levels. Experienced RNs reported significantly higher compassion satisfaction and lower occupational burnout. CONCLUSION: Higher education and longer experience are beneficial for nurses' professional quality of life when working in pediatric care units. PRACTICAL IMPLICATIONS: Results from this study highlights the importance of offering RN education in pediatric care at master level and supporting novice nurses, to prevent negative professional well-being outcomes in pediatric care, because the health of nurses is of utterly importance when crisis such as a pandemic hits the world. The findings also suggest that the conditions for professional quality of life could improve through activities such as self-care, time for reflection, better working hours, competence-adjusted salary, and educational opportunities.

Chain mediations of perceived social support and emotional regulation efficacy between role stress and compassion fatigue: insights from the COVID-19 pandemic.

Background: Nurses at the frontline faced high risks of the COVID-19 infection, undertook heavy workloads of patient care, and experienced tremendous stress that often led to compassion fatigue. Aim: This study was to explore the role of positive psychosocial resources (i.e., perceived social support and emotional regulation efficacy) in the relationship between role stress and compassion fatigue. Methods: A cross-sectional design was conducted in Hubei Province, China between May and September 2021. The Role Stress Questionnaire, the Perceived Social Support Scale, the Emotional Regulation Efficacy Scale, and the Professional Quality of Life Scale were used to measure key variables of interest. Nurse socio-demographic data were also collected. Structural equation modeling was used to explore the relationships, including potential mediating effect, among role stress, perceived social support, emotional regulation efficacy, and compassion fatigue. Results: A total of 542 nurses participated in this investigation, and 500 were eventually enrolled in the analysis. The incidence of compassion fatigue among nurses was 94.2%, including 65.8% of nurses reporting at least moderate compassion fatigue. Univariate analysis showed that educational level, marital status, hospital rank, sleep time were the factors affecting compassion fatigue of the nurses. The structural equation modeling revealed that: Role stress had a direct positive effect on compassion fatigue; Perceived social support and emotional regulation efficacy partially mediated the link between role stress and compassion fatigue respectively; And there was a chain mediating role of perceived social support and emotional regulation efficacy between role stress and compassion fatigue. Conclusion: The incidence of compassion fatigue was high during the COVID-19 pandemic among bedside nurses in China. Improving social support and enhancing the efficacy of emotion regulation may help alleviate compassion fatigue directly and/or via buffering the impact of role stress.

Analysis of the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals. / Análise da associação entre níveis de fadiga por compaixão e engajamento no trabalho com a COVID-19 em profissionais de enfermagem.

This article examines the association between levels of compassion fatigue and work engagement with COVID-19 in nursing professionals. A longitudinal, before-and-after study was conducted with nursing professionals working in the frontline in the pre-pandemic and pandemic periods. Our study applied the Brazilian versions of the Professional Quality of Life Scale and the Utrecht Work Engagement Scale. High levels of compassion satisfaction (≥43.0), low levels of burnout (<23.0) and secondary traumatic stress (<23.0), as well as high levels of vigor (≥4.0 and ≤4.99), absorption (≥4.0 and ≤4.99), and overall score (≥4.0 and ≤4.99) were observed. Moderate, negative, and significant correlations of burnout with vigor (r: -0.505; p-value: <0.001), in the pre-pandemic period; and with overall score, in the pre-pandemic (r: -0.543; p-value: <0.001) and pandemic periods (r: -0.458; p-value: <0.001), were also observed. No changes in levels of work engagement were found. Professionals with compassion fatigue showed decreased vigor, absorption, and overall score, rated as medium in the pandemic period (≥2.0 and ≤3.99), and an increased dedication, which was low (≥1.0 and ≤1.99) in the pre-pandemic period. It was concluded that there is no harmful association between compassion fatigue and work engagement with COVID-19 in nursing professionals.

O artigo analisa a associação entre níveis de fadiga por compaixão e engajamento no trabalho com a COVID-19 em profissionais de enfermagem. Estudo longitudinal, tipo antes e depois, realizado com profissionais de enfermagem da linha de frente, nos períodos pré-pandêmico e pandêmico. Utilizou-se as versões brasileiras da Professional Quality of Life Scale e da Utrecht Work Engagement Scale. Observou-se altos níveis de satisfação por compaixão (≥43,0), baixos níveis de burnout (<23,0) e estresse traumático secundário (<23,0); e níveis altos de vigor (≥4,0 e ≤4,99), absorção (≥4,0 e ≤4,99) e escore geral (≥4,0 e ≤4,99). Houve correlação moderada, negativa e significativa do burnout com vigor (r: -0,505; p-valor: <0,001), no pré-pandemia; e com o escore geral, no pré-pandemia (r: -0,543; p-valor: <0,001) e período pandêmico (r: -0,458; p-valor: <0,001). Não houve alterações nos níveis de engajamento no trabalho. Profissionais com fadiga por compaixão tiveram redução do vigor, absorção e escore geral, classificados como médios no período pandêmico (≥2,0 e ≤3,99); e aumento da dedicação, que era baixa (≥1,0 e ≤1,99) no pré-pandemia. Concluiu-se não haver associação danosa entre fadiga por compaixão e engajamento no trabalho com a COVID-19 nos profissionais de enfermagem.

Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study.

BACKGROUND: Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization. OBJECTIVES: Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses. DESIGN: A cross-sectional study. DATA SOURCES: The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022. METHODS: Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve. RESULTS: The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. CONCLUSIONS: A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.

Stress Work and Hopelessness in Mental Health Workers/Caregivers: an Observational Study in Pandemic and Post COVID-19 Pandemic.

BACKGROUND: WHO has decreed an end to the pandemic crisis from COVID-19. However, the consequences of stress, compassion fatigue, and healthcare workers' expectations are still evident. Also, the hope of ending the problems associated with the pandemic is still present, although the awareness of maintaining a high level of attention is current in the HCWs. METHOD: In our observational study, 102 (65 females, 37 males) mental healthcare workers were evaluated during and post-COVID-19 pandemic. They were divided into different categories of workers: nurses, physicians, psychologists, social assistants, social educators, social health workers, and psychiatric rehabilitation technicians. We used the ProQoL for compassion fatigue, compassion satisfaction, and burnout; BHS for hopelessness. RESULTS: ProQoL data showed a significant increase in compassion satisfaction in post-pandemic (p=0.002) in all professional workers. The same results in burnout and secondary stress subscales (respectively, p=0.018, p=0.000) are evident. The BHS total score indicated that the difference between T0 vs. T1 was not statistically significant (p=0.109). CONCLUSIONS: The collected data during and post-COVID-19 pandemic showed reduced burnout and compassion fatigue in the helping professions. However, in the periods analyzed, no changes in hope are observed.

The Emotional Impact on Mental Health Workers in the Care of Patients with Mental Disorders in the Pandemic and Post COVID-19 Pandemic: a Measure of "Burnout" and "Compassion Fatigue".

BACKGROUND: Emotional pressure, fear, and uncertainties affected healthcare workers (HCWs) who played a significant role during the COVID-19 pandemic. After the pandemic crisis, the consequences on the health of mental HealhCare Workers are still significant. Our work aimed to evaluate burnout and compassion fatigue in HCWs. METHOD: In our observational study, 102 (65 females, 37 males) mental HCWs were evaluated during and post-COVID-19 pandemic. We used the Compassion Fatigue-Short Scale, Balanced Emotional Empathy Scale, and Beck Depression Inventory. RESULTS: Subscale Secondary Trauma Stress of CF-SS demonstrated an increase in the rate in the post-pandemic phase (24.51% in all HCWs). The percentage reached in males was high (37.84%). Instead, the levels of Job Burnout remained constant in the two periods analyzed (during and post-COVID-19). Depressive symptoms remained constant with a prevalence in females of the post-COVID period. CONCLUSION: The results confirm increased stress secondary to the traumatic event, while the levels of job burnout are high. Closely associated with compassion fatigue are levels of empathy that were found to be unchanged.

The mediating role of job satisfaction in the relationship between social support and the consequences of secondary exposure to trauma among medical providers working with trauma victims.

OBJECTIVES: Medical providers working with trauma survivors are exposed to the negative and positive effects of secondary trauma, both of which are affected by social support and job satisfaction. The aim of this study was to determine the mediating role of job satisfaction in the relationship between social support and the negative and positive effects of secondary exposure to trauma among medical personnel. The negative indicator of such exposure was secondary traumatic stress (STS), while the positive indicator was secondary posttraumatic growth (SPTG). MATERIAL AND METHODS: The analyses included 419 medical providers working with trauma victims (201 paramedics and 218 nurses). Data was collected with the Secondary Traumatic Stress Inventory, Secondary Posttraumatic Growth Inventory, Social Support Scale, Work Satisfaction Scale, and survey. Mediation analyses were applied to assess relationships between variables. RESULTS: The mediation analyses indicated that job satisfaction mediates (mainly partly) the relationship between social support and STS and SPTG. This may indicate that both social support and job satisfaction act as significant predictors of the negative and positive effects of secondary exposure to trauma. CONCLUSIONS: As a friendly and mutually-supportive environment can increase job satisfaction, reducing the risk of secondary traumatic stress and promoting positive posttraumatic changes, it is important to increase social support and job satisfaction among medical providers exposed to secondary trauma. Int J Occup Med Environ Health. 2023;36(4):505-16.