Therapist self-compassion and compassion fatigue: the mediating role of resilience / Autocompasión del terapeuta y fatiga de la compasión: el papel mediador de la resiliencia

Las exigencias impuestas a los profesionales que trabajan con problemas psicológicos pueden resultar en un riesgo de agotamiento (Yang & Hayes, 2020). El objetivo de este estudio fue analizar el posible papel de la resiliencia como variable mediadora en la relación entre autocompasión y fatiga por compasión, burnout y satisfacción por compasión. Se utilizó un diseño de estudio descriptivo transversal. En el estudio participaron sesenta y cinco psicólogos clínicos (50 mujeres y 15 hombres) con edades comprendidas entre 23 y 71 años (M = 33.8, SD = 10.8). Los terapeutas completaron la Escala de Autocompasión, la Escala de Resiliencia de 14 ítems y la Escala de Calidad de Vida Profesional. Se probaron modelos de mediación simples separados para examinar en qué medida cada una de las variables de la escala de Resiliencia atenuó la relación entre Autocompasión y Calidad de Vida Profesional. Se realizaron modelos seriales de mediadores múltiples para explorar si las variables de resiliencia actuaban interactivamente como mediadores en la asociación entre la autocompasión y la calidad de vida profesional. Los análisis de mediación simples mostraron que la competencia personal fue un mediador parcial significativo en la relación entre la autocompasión y la satisfacción por la compasión y el agotamiento. La competencia personal y la aceptación de uno mismo y de la vida no fueron mediadores significativos de la relación entre la autocompasión y el estrés traumático secundario.(AU)

The demands placed on professionals working with psychologi-cal problems can result in a risk of burnout (Yang & Hayes, 2020). The ob-jective of this study was to analyze the possible role of resilience as a medi-ator variable in the relationship between self-compassion and compassion fatigue, burnout, and compassion satisfaction. A descriptive cross-sectional study design was used. Sixty-five clinical psychologists (50 women and 15 men) aged between 23 and 71 years (M= 33.8, SD= 10.8) participated in the study. The therapists completed the Self-Compassion Scale, the 14-Item Resilience Scale, and the Professional Quality of Life Scale. Separate simple mediation models were tested to examine the extent to which each of the Resilience scale variables attenuated the relationship between Self-compassion and Professional Quality of Life. Serial multiple mediator models were performed to explore whether Resilience variables acted in-teractively as mediators in the association between Self-compassion and Professional Quality of Life. Simple mediation analyses showed that Per-sonal Competence was a significant partial mediator in the relationship be-tween Self-Compassion and Compassion Satisfaction and Burnout. Per-sonal Competence and Acceptance of Self and Life were not significant mediators of the relationship between Self-Compassion and Secondary Traumatic Stress.(AU)

Compassion fatigue in palliative care: Exploring Its comprehensive impact on geriatric nursing well-being and care quality in end-of-life.

BACKGROUND: This study examines the experiences of geriatric nurses in palliative care. It aims to understand how these experiences influence their well-being and the quality of care. METHODS: Conducted in the Alahsa region of Saudi Arabia, the study employs qualitative methods, utilizing in-depth interviews with 12 geriatric nurses. The analysis employs a thematic approach, enriched by iterative reflections within a multidisciplinary research team. RESULTS: The analysis reveals main themes: 1) the deep emotional connections between nurses and their patients; 2) the challenges faced, including compassion fatigue, high patient mortality, and communication hurdles; 3) the impact of these challenges on the quality of care, highlighting issues like diminished empathy; 4) the coping strategies used by nurses, such as self-care practices and continuous education. CONCLUSIONS: The study concludes that coping strategies, including self-care and ongoing professional development, are vital for sustaining the nurses' well-being and ensuring the continued provision of high-quality care to Older Adults patients.

Psychometric properties of the Positive Thinking Skills Scale among undergraduate nursing students.

Increasing the resilience of undergraduate nursing students is essential for the individual student's well-being and the healthcare system dealing with a looming nursing shortage. Undergraduate nursing students have reported that positive thinking and positive reframing are ways of coping with exposure to suffering, but measurement of these skills remains limited in this population. This is the first study to examine the psychometric properties of the Positive Thinking Skills Scale specifically in undergraduate nursing students and in a sample that includes students from both public and private universities. Internal consistency was demonstrated with a Cronbach's alpha of 0.824, convergent validity was demonstrated with correlations with measures of views of suffering and professional quality of life, and the one-factor structure was supported in a sample of 157 undergraduate nursing students. The Positive Thinking Skills Scale can be a useful tool to both assess and measure the development of positive thinking skills in undergraduate nursing students.

Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses.

OBJECTIVES: This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses. METHODS: A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses. RESULTS: So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition. CONCLUSION: the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care. IMPLICATIONS FOR NURSING PRACTICE: CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.

"COVID-19 and the New Hidden Curriculum of Moral Injury and Compassion Fatigue".

Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.

Depicting occupational trauma concepts impacting nurse well-being during the COVID-19 pandemic.

PURPOSE: The purpose of this concept delineation was to differentiate similar concepts impacting nurse well-being during the COVID-19 pandemic, including: compassion fatigue, burnout, moral injury, secondary traumatic stress, and second victim. METHODS: A total of 63 articles were reviewed for concept delineation. Morse's (1995) approach to concept delineation was utilized to analyse the articles. RESULTS: Concepts were described interchangeably but were found to present themselves in a sequence. A nurse may experience moral injury, leading to a second victim experience, synonymous with secondary traumatic stress, then compassion fatigue and/or burnout that can be acute or chronic in nature. An Occupational Trauma Conceptual Model was created to depict how these concepts interact based on concept delineation findings. CONCLUSION: Nurses are experiencing long-lasting occupational trauma and future intervention research should centre on optimizing nurse well-being to ensure the sustainability of nursing profession.

Work-related quality of life in professionals involved in pediatric palliative care: a repeated cross-sectional comparative effectiveness study.

Background: Working in pediatric palliative care (PPC) impacts healthcare and allied professionals' work-related quality of life (QoL). Professionals who lack specific PPC training but who regularly provide services to the affected children have articulated their need for support from specialized PPC (SPPC) teams. Objectives: This study had two objectives: (1) to evaluate whether the availability of a SPPC team impacted the work-related QoL of professionals not specialized in PPC; and (2) to explore the work-related QoL of professionals working in PPC without specialized training. Design: Repeated cross-sectional comparative effectiveness design. Methods: One hospital with an established SPPC program and affiliated institutions provided the intervention group (IG). Three hospitals and affiliated institutions where generalist PPC was offered provided the comparison group (CG). Data were collected by paper-pencil questionnaire in 2021 and 2022. The Professional Quality of Life (ProQOL 5) questionnaire was used to assess work-related QoL, yielding separate scores for burnout (BO), secondary traumatic stress (STS) and compassion satisfaction (CS). A descriptive statistical analysis was performed and general estimation equations were modelled. To increase the comparability of the IG and CG, participants were matched by propensity scores. Results: The 301 participating non-PPC-specialized professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. However, none of these scores (BO: p = 0.36; STS: p = 0.20; CS: p = 0.65) correlated significantly with support from an SPPC team. Compared to nurses, physicians showed higher levels of BO (1.70; p = 0.02) and STS (2.69; p ⩽ 0.001). Conclusion: Although the study sample's overall work-related QoL was satisfactory, it showed a considerable proportion of moderate BO and STS, as well as moderate CS. To provide tailored support to professionals working in PPC, evidence regarding key SPPC support elements and their effectiveness is needed. Trial registration: ClinicalTrials.gov ID, NCT04236180.

Work-related quality of life in professionals involved in pediatric palliative care - Why was this study done? Caring for children suffering from life-limiting conditions and their families impacts professionals' work-related Quality of Life (QoL). Professionals without specific training often provide pediatric palliative care (PPC) to children and their families. - What did the researchers do? We aimed to determine whether the work-related the QoL of professionals without specialised PPC training would be positively influenced when they were supported by PPC specialists. We also wanted to explore what person-specific factors might correspond with higher or lower work-related QoL. Work-related QoL was analysed in relation to burnout (BO), secondary traumatic stress (STS), and compassion satisfaction (CS). These variables' levels were assessed with a questionnaire survey in 2021 and 2022. - What did the researchers find? The 301 participating professionals had overall low to moderate levels of BO and STS and moderate to high levels of CS. There was no substantial difference in work-related QoL in the professionals supported by PPC specialists compared to those who did not receive specialist support. Physicians showed higher levels of BO and STS than nurses. - What do the findings mean? Although the studied professionals' overall work-related QoL was satisfactory, there is a considerable proportion of moderate BO and STS scores in professionals working with children suffering from life-limiting conditions. Further research should explore the specific needs of professionals not specialised in PPC.

Quality of work life for health professions in Colombia's adult critical care: An integrative analysis.

BACKGROUND: Health professionals in Colombian and many parts of the world, in some cases, work in precarious conditions and intend to migrate to other countries in search of better living conditions for themselves and their families, which results in inadequate distribution worldwide and in the quality of care throughout the health system, which can ultimately influence the quality of life of patients in their health-disease processes. PURPOSE: Describe in depth what quality of life at work is like for the health workforce in adult critical care (ACC). METHODS: This is an investigation of convergent parallel mixed methods approach that are integrated by means of a matrix in terms of convergence, divergence, and complementarity. Two methods are used: a transversal analytical method in which three instruments were applied to 209 participants to study the relationship between Quality of Life at Work, exposure to psychosocial risks, compassion fatigue and the intention to rotate; other than from the experiences narrated by 10 Human Talent in Health explore organizational practices in critical care. RESULTS: The dimension of quality of work life with the greatest dissatisfied was the management of free time (77%), the most compromised psychosocial risk was the pace of work (84%). They have high compassion satisfaction (67%) and there is an intention to migrate to another country (66%). The narrative results in discrimination/harassment as normalized practices and faceless spirituality. The integration of mixed methods shows convergence between the use of the instrument that measures quality of life at work and the narratives of the participants, complementarity with the other instruments, and divergence regarding the intention to rotate to another health institution. CONCLUSION: The positive trend that converges with the two approaches is that of safety at work and well-being achieved through work, embodied in the constant updating of technology and care protocols, experience time, balance between salary and work effort, staffing and supplies, and disconnection with work.

Professional Quality of Life among Iranian Clinical Nurses at the Forefront of the Fight against COVID-19: A Multicenter Cross-Sectional Study.

Background: With the prolonged COVID-19 disease control time, concerns about the caring ability of clinically exposed nurses have increased. This study aimed to investigate Compassion Satisfaction (CS), Burnout (BO), and Secondary Traumatic Stress (STS) as elements of Professional Quality of Life among nurses in COVID-19 settings. Materials and Methods: In this descriptive online national survey, 427 clinical nurses who had worked in the COVID-19 wards from all Iran provinces answered the Persian version of the Professional Quality of Life Scale as the profile tool with three subscales, including CS, BO, and STS. Data were collected using email, Short Message Service (SMS), and social networks from December 2020 to February 2021. Results: The mean (SD) score of CS was 38.86 (9.00), the mean (SD) score of BO was 18.60 (4.08), and STS was 34.74 (7.02). STS was substantially more prevalent among married nurses whose Polymerase Chain Reaction (PCR) tests were positive for themselves or at least one family member (p < 0.05). Conclusions: Clinical nurses who respond to the COVID-19 crisis are at risk of STS and BO. In pandemic situations like COVID-19, it is necessary to consider supportive interventions to increase satisfaction and reduce burnout and secondary traumatic stress in nurses.

The COVID-19 pandemic, psychologists' professional quality of life and mental health.

Background: Psychologists are at known risk of work-related stress, secondary trauma, and burnout. The COVID-19 pandemic increased stress and anxiety for communities worldwide and corresponded with an increased demand for mental health services. Our study investigated the impact of COVID-19 on psychologists' professional quality of life, psychological symptoms, and work-related stress in Aotearoa, New Zealand (NZ). Method: Ninety-nine registered psychologists were recruited via NZ professional psychology organizations, representing 3% of the total workforce. Survey data collected included symptoms of compassion fatigue and satisfaction, psychological symptoms, COVID-19-related stress and resilience, and professional and personal circumstances during the third year of the pandemic, 2022. Results: Seventy percent reported that their work stress had increased, and 60% reported that their caseload intensity had increased during the COVID-19 pandemic. Psychologists reported receiving little to no additional personal or professional support, while 55% reported increased personal responsibilities during the pandemic (for example, closed childcare and schools during lockdowns). High rates of compassion fatigue (burnout and secondary traumatic stress) and low resilience were reported. We observed that psychological distress was higher than the community averages before the pandemic and comparable with frontline healthcare professionals. Compassion fatigue was associated with COVID-related stress, psychological distress, years in practice, and more frequent supervision, but not with working with at-risk clients, levels of personal support, or having children at home. Despite these difficulties, high Compassion Satisfaction scores were also reported, with over 90% indicating they had no intention of leaving the profession in the foreseeable future. Conclusion: Psychologists' compassion fatigue appears to have worsened during the COVID-19 pandemic, as have their symptoms of psychological distress. Increased workplace and clinical demands, telehealth difficulties, stress relating to the pandemic, inadequate support, and increased personal responsibilities were reported by psychologists. Mental health workforces are not immune to the personal and professional impacts of crises and are at risk of burnout and secondary traumatic stress. We hope that increased awareness and understanding of psychologists' own difficulties during COVID-19 can be used to better tackle future crises and support mental health professionals.

Factors affecting nurses' compassion fatigue: A path analysis study.

BACKGROUND: Nurses often experience compassion fatigue as a result of exposure to chronic work-related stress. It is thought that nurses' mindfulness levels and patience attitudes might be effective on compassion fatigue. AIM: Therefore, in this study, it is aimed to examine the relationship between nurses' compassion fatigue, mindfulness levels and patience levels. METHODS: The study was carried out in a descriptive and relation-seeking type and was completed with the participation of 469 nurses. Data Form of Demographic and Professional Characteristics, Compassion Fatigue-Short Scale, Mindful Attention Awareness Scale and The Patience Scale were used as data collection tools. FINDINGS: As a result of the research, it was determined that there was a relationship between the mindfulness and patience levels of nurses and compassion fatigue. As the mindfulness and patience levels of nurses increase, compassion fatigue decreases (p < 0.05). As the mindfulness levels of the nurses increase, their patience levels increase as well (p < 0.05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Accordingly, it is recommended to increase the level of patience and reduce compassion fatigue by applying interventions that will increase the mindfulness levels of nurses.

The Costs of Caring: Quantifying Compassion Fatigue and Compassion Satisfaction in Burn Therapists.

Recovery from a severe burn injury requires early and aggressive therapy, which is often painful and distressing to the patient. Burn therapists who guide these interventions may be prone to experiencing secondary trauma and compassion fatigue through repeated exposure to difficult situations. At the same time, therapists may gain a sense of purpose and altruism from their work, fostering compassion satisfaction. Despite being well documented in other health professions, compassion fatigue and compassion satisfaction have not been sufficiently explored among burn therapists. This study aimed to quantify and characterize burn therapists' compassion fatigue and satisfaction using the Professional Quality of Life scale and to answer the question of what job-related factors may impact these outcomes. A total of 143 burn therapists participated in this study. Results revealed compassion fatigue subsale scores of burnout and secondary traumatic stress in the low or moderate range and compassion satisfaction scores in the moderate or high ranges for all participants. This study presents new knowledge for the field of burn care in its quantification of professional quality of life in burn therapists. While burn therapists experienced moderate-to-high levels of compassion satisfaction in their work, burnout and stress also approached moderate levels. Years of practice was a significant predictor of compassion. Although the reasons for this are not clear, it may be related to increased competence or confidence in practice and may suggest a need for different support strategies for practitioners at each stage of their burn therapy career.

Improving Work-life Balance and Satisfaction to Improve Patient Care.

How to cite this article: Mitra LG, Sharma J, Walia HS. Improving Work-life Balance and Satisfaction to Improve Patient Care. Indian J Crit Care Med 2024;28(4):326-328.

Predictors of Quality of Work Life in Health Care Workers at Adult Critical Care Units: A Cross-sectional Study.

Aim and background: Satisfaction with the quality of work life reflects the inadequate distribution of the workforce in critical care units and is not enough; on many occasions, they work in precarious conditions and with high levels of physical, emotional, spiritual, and social demands, impacting the quality of care. Aim: To identify predictors of the quality of work life of healthcare workers in adult critical care units (ACCU). Materials and methods: Quantitative study, cross-sectional analytical design with stratified two-stage sampling; three instruments were applied to 209 healthcare professionals in adult critical care units in different sites in a region of Colombia, concerning Quality of Life at Work-GOHISALO, Copenhagen Psychosocial Questionnaire-COPSOQ and Professional Quality of Life-ProQoL V. Multiple ordinal logistic regression was performed with exposure variables from the COPSOQ and ProQoL domains; the outcome variables were the dimensions of the Quality of Work Life instrument. Ethical standards for research involving human subjects were ensured. Results: According to the results of the multiple logistic models, quality of work life is predicted by job integration and predictability (OR = 6.93; 95% CI = 3.6-13.9), leisure time management and double presence (OR = 4.5; 95% CI = 1.22-8.79). Both job satisfaction and job security are related to leadership quality (OR=3.82; 95% CI = 2.27-6.55 and OR = 3.18; 95% CI = 1.22-8.79), respectively. Conclusions: The quality of work life of healthcare workers in adult intensive care units is predicted by quantitative demands, double presence, emotional demands, work pace, predictability, vertical trust, and quality of leadership. How to cite this article: Quinones-Rozo LP, Canaval-Erazo GE, Sandoval-Moreno LM. Predictors of Quality of Work Life in Health Care Workers at Adult Critical Care Units: A Cross-sectional Study. Indian J Crit Care Med 2024;28(4):355-363.

What Can Laboratory Animal Facility Managers Do to Improve the Welfare of Laboratory Animals and Laboratory Animal Facility Staff? A German Perspective.

Laboratory animal facility managers must ensure that animal experiments can be carried out under optimal scientific conditions, that all legal requirements are met, and that animal welfare is maximized. Animal experimentation is stressful not only for the animals involved but also for the people who maintain these animals or carry out the experiments. Many of those involved find themselves in a constant conflict between scientific necessity, care, and harm. Under the term Culture of Care, procedures have been developed to reduce the burden of animal experimentation on the animals and the staff involved. The focus here is on what laboratory animal facility managers can do to improve the welfare of laboratory animals and the people working with them. Exemplary measures are the improvement of the housing conditions of laboratory animals, the introduction of uniform handling measures, clear and transparent structures via a quality management system, implementation of a no-blame culture of error (e.g., via Critical Incident Reporting System in Laboratory Animal Science [CIRS-LAS]), and open and respectful communication with all parties involved in animal experimentation, including the public and representatives of the authorities (public webpage, open house policy). The 6 Rs must be considered at all times: replacement, reduction, refinement, respect, responsibility, and reproducibility. We are writing this article from the perspective of laboratory animal facility managers in Germany.

Determination of Compassion and Compassion Fatigue in Intensive Care Nurses.

Introduction: Compassion is defined as the sadness felt by a living thing or a person due to a negative situation. Compassion fatigue describes emotional, physical, social and spiritual exhaustion or a decrease in these feelings. The concept of compassion, which is at the center of nursing, may be related to compassion fatigue in nurses. Objective: The aims of the study were to determine the level of compassion fatigue and compassion among intensive care nurses and to examine the relationship between them. Methods: This study was conducted through descriptive research and cross-sectional survey. The population of the research consisted of intensive care nurses from two hospitals in Turkey. Since the universe is accessible, the sample selection method was not used (n = 182). Demographic data form, Compassion Fatigue sub-dimension of the Professional Quality of Life Scale and Compassion Scale were used in the study. Results: The mean score of the nurses' compassion fatigue was 15.86 ± 7.22, and compassion was 72.21 ± 7.28. There was a moderate negative relationship between compassion and compassion fatigue (r = -.405). It was determined that the nurses' compassion was at a moderate level and their compassion fatigue was at a low level. Conclusion: It can be assumed that ICU nurses' compassion is at a medium level and their compassion fatigue is at a low level. It was established that as the compassion level of the nurses increased, the level of compassion fatigue decreased. Developing a sense of compassion in nurses working in intensive care units can reduce compassion fatigue.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Saudi Nurses at Medical City: A Cross-Sectional Study.

Compassion satisfaction, the pleasure gained from assisting others in their recovery from trauma, can help reduce the effects of burnout and secondary traumatic stress. As such, nurses' job satisfaction can be increased by increasing compassion satisfaction and decreasing compassion fatigue. This study examined the incidence of compassion fatigue and other influencing variables, such as compassion satisfaction, burnout, and secondary traumatic stress, among Saudi nurses. This was a cross-sectional study using convenience sampling. Participants comprised 177 registered nurses from various nursing departments. Data collection included the Professional Quality of Life Scale based on lifestyle, demographic details, and occupation-related questions. The averages of scores for the variables, compassion satisfaction, burnout, and secondary traumatic stress, were recorded (37.1 ± 7.4, 25.7 ± 7.5, and 26.7 ± 6.4). Participants aged 36 or older comprised a negative factor for compassion satisfaction, while years of nursing experience and higher job satisfaction were favorable predictors. Together, these three variables accounted for 30.3% of the overall variation. Low job satisfaction and poor sleep negatively affected burnout, accounting for 39.8% of the total variance. The results offer insights into identifying the risks of compassion fatigue in nurses and help design strategies to address burnout and secondary traumatic stress while enhancing their compassion satisfaction levels.

Investigating the relationship between compassion fatigue and moral injury in nurses.

Background: Compassion fatigue and professional quality of life are important in health and professional ethics. Aim: This study aimed to determine the relationship between compassion satisfaction, compassion fatigue, secondary traumatic stress, and moral injury in nurses. Research design: This research is a cross-sectional descriptive-analytical study. The research community of this research was all the nurses of the teaching hospitals of Ardabil city. Three questionnaires on demographic characteristics, the Professional Quality of Life Scale (ProQOL), and the Moral Injury Events Scale were used to collect data. SPSS (version 22) software was used for data analysis. Participants and research context: The study recruited 297 nurses randomly selected from five teaching hospitals in Ardabil city. Ethical considerations: Ethical approval was obtained from the Ardabil University of Medical Sciences ethics committee (with the code of ethics IR.ARUMS.REC.1401.198). Informed consent was obtained from the participants. Results: The results showed that the mean compassion satisfaction score of this study's participants was 37.61 ± 8.86, the mean compassion fatigue score of this study's participants was 28.73 ± 7.04, and the mean secondary traumatic stress score of this study's participants was 29.95 ± 7.84. The mean score of moral injury among nurses was 31.19 ± 8.54. The results showed a negative significant relationship between compassion satisfaction and moral injury (p < 0.001). Also, there is a positive significant relationship between compassion fatigue and secondary traumatic stress with moral injury (p < 0.001). Conclusion: The results of this study show a negative relationship between compassion satisfaction and moral injury. According to the results of the present study, nurse managers should implement educational interventions, create ethical processes, and clear ethical guidelines to reduce moral injury and increase compassion satisfaction.

Emotional experiences in palliative care and professional quality of life: a qualitative approach.

Objective: To explore the experiences that significantly impact the professional quality of life of people providing palliative care (PC) in Ecuador. Design: Observational cross-sectional qualitative research. Methods: In September 2022, 10 focus groups were carried out in four cities in Ecuador; each group lasted from 1 to 2 h, was audio recorded, and transcribed verbatim. Recruitment was conducted through convenience sampling, and a total of 71 individuals (15 students, 50 professionals, and 6 volunteers) linked to PC participated. Content analysis with a phenomenological and inductive approach was used to analyze the data. Results: People recognized their experiences in PC as having positive and negative impacts on their professional quality of life. Experiences were mapped as affecting them at individual, relational, and contextual levels. These experiences included personal growth, opportunity to provide care, teamwork, death-related issues, inability to deal with work-related stress, social acceptance of PC, and dealing with inefficient health systems, among others. Conclusion: Despite the positive emotions that arise with caring for others, individuals working and volunteering in PC experience situations that influence their professional quality of life. Addressing these factors to increase satisfaction and ease the burden of PC work is essential. Undergraduate education, continuous professional training, and PC teams should incorporate actions to address these factors at all levels, such as teaching coping skills, fostering social support, and increasing awareness of PC.

How experiences shape professional quality of life in palliative care This study explored how working in palliative care impacts the professional quality of life of people providing palliative care in Ecuador. The research team conducted 10 focus groups in four cities in Ecuador with 71 participants. The results show that people's experiences impact their professional quality of life in positive and negative ways. These experiences also affect people at individual, relational, and contextual levels. This study has identified common experiences that should be addressed to increase satisfaction and ease the burden of working in palliative care. These should be considered in undergraduate education, continuous professional training, and within palliative care teams.

Relationship between nurses' resilience and quality of professional life.

AIM: This study aimed to investigate the correlation between the resilience levels of nurses and qualit of their professional life. BACKGROUND: Nurses' resilience level can affect their professional qualityof life. A higher resilience level enables them to manage stress and overcome challanges more effectively leading to enhanced patient care and satisfaction. Coversly, lower resiliance can lead to burnout, negatievly impacting both the nurses' wellbeing and the quality of service delivered to patients. INTRODUCTION: It is crucial to understand the correlation between the professional life quality and resilience of nurses working in difficult conditions. METHODS: This correlational study was conducted between September 2021 and February 2022. A total of 276 nurses were included in the study. Data were collected using the Demographic Data Form consisting of sociodemographic characteristics, the Professional Quality-of-Life Scale, and the Resilience Scale for Adults. RESULTS: The resilience score was above average, and the professional quality of life was high. Compassion satisfaction and compassion fatigue, which are components of professional quality of life, were moderate, and the burnout level was low. A robust positive correlation was observed between resilience and the professional quality of life. The linear regression model showed that choosing the profession unwillingly, dissatisfaction with the unit in which one works, and the level of psychological resilience are independent factors of professional quality of life. CONCLUSION: According to the findings, high psychological resilience increases the quality of professional life. Resilience, choosing nursing willingly, and liking the unit in which one works are determinants of professional quality of life. IMPLICATIONS FOR NURSING POLICY: Enhancing the professional quality of life of nurses has important individual, institutional, and social consequences. Enhancing resilience has the potential to elevate the quality of professional life. Hence, it is important to develop national and international policies and models. Additionally, managers bear significant responsibilities in ensuring a positive work environment. Undoubtedly, having nurses work in units they like, feel happy in, and prefer will increase their professional quality of life and make positive contributions to patient care, the institution, and society.