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 and loneliness at work in nurses - the mediating role of resilience: a cross-sectional study.

Background: Heavy workload, job stress and lack of colleague support can lead to loneliness and burnout in nurses. Caring for a patient with constant pain can cause compassion fatigue. Loneliness at work and compassion fatigue also negatively affect the quality of patient care. Aim: This study aims to determine the effect of resilience on loneliness at work and compassion fatigue in nurses. Method: This is a descriptive cross-sectional study. The study was conducted with a total of 214 nurses. Results: A statistically significant negative relationship was found between the level of loneliness at work and resilience, and between resilience and compassion fatigue in nurses. The mediating role of resilience was found to be significant in the effect of loneliness at work on compassion fatigue in nurses. Conclusions: The results of this study suggest empowering nurses who have loneliness at work and compassion fatigue. Compassion fatigue is seen as occupational deformation. Nurses need to learn how to manage compassion fatigue, develop coping skills and receive support to ensure job satisfaction. In addition, nurse managers should create a reasonable workload for nurses. These efforts can increase the job satisfaction and patient care quality of nursing departments.

Effect of positive psychological capital on burnout in public hospital nurses: Mediating effect of compassion fatigue is greater than compassion satisfaction.

AIM: Although relationships among positive psychological capital (PsyCap), compassion fatigue, compassion satisfaction, and burnout have been reported, causal relationships among these variables have not been identified. This study examined the influence of positive PsyCap on burnout and confirmed the mediating effects of compassion fatigue and satisfaction among public hospital nurses. METHODS: This study adopted a correlational cross-sectional design. We recruited 237 nurses working at a public hospital, using convenience sampling. RESULTS: The fit of the hypothetical model was adequate. Positive PsyCap directly affected compassion fatigue and satisfaction, and burnout. It had an indirect effect on burnout. Compassion fatigue and satisfaction directly affect burnout. This finding indicates that compassion fatigue and satisfaction partially mediate between positive PsyCap and burnout. In addition, the mediating effect of compassion fatigue was greater than that of compassion satisfaction on the relationship between positive PsyCap and burnout. Finally, positive PsyCap, compassion fatigue, and compassion satisfaction explained 70.4% of the total variance in burnout scores. The effect size (f2) was 2.38 (large effect size). CONCLUSIONS: Burnout should be assessed with positive PsyCap, compassion fatigue, and compassion satisfaction among public hospital nurses. Given that the mediating effect of compassion fatigue was greater than that of compassion satisfaction, interventions for compassion fatigue may be a strategy to reduce burnout, especially among public hospital nurses with low levels of positive PsyCap.

Caring for the Caregivers: Supporting the Mental Health & Wellbeing of a Diverse Veterinary Team.

Veterinary medicine has embarked on a journey of understanding the factors impacting the psychological, emotional, physical, and social health of its people. Discussions of diversity, equity, inclusion, and belonging must address wellbeing; discussions of wellbeing must address diversity, equity, inclusion, and belonging. The profession and the world at large have failed to draw a direct correlation between the two. This article sheds light onto the inextricable link between the two so that no one is left behind as the health of the profession and its people advances.

Professional Quality of Life Among Mental Health Nurses: A Systematic Review and Meta-Analysis.

The professional quality of life (ProQOL) is increasingly applied to nurses and is a measure of the positive and negative aspects of their work. This systematic review and meta-analysis evaluated the level of compassion satisfaction, burnout and secondary traumatic stress (STS) in empirical studies. Electronic databases Scopus, PubMed and Web of Science were searched on 7th February 2024, and the review followed PRISMA guidelines. The pooled estimate of compassion satisfaction, burnout and secondary traumatic stress mean scores using a random-effects model for meta-analyses was undertaken. R statistical software and the dmetar program were used to execute the analysis. Heterogeneity was evaluated with the I2 statistics, while publication bias was evaluated using Egger's regression test. Twenty-four studies (sample size = 4274) were systematically reviewed and 18 studies (n = 3163) were incorporated into the meta-analysis. Burnout, secondary traumatic stress and compassion satisfaction are found to be at moderate levels in this research. The qualitative analysis informs that variables such as healthy lifestyle, work environment and psychological resilience contribute towards optimum ProQOL scores. The pooled mean estimate was 32.79 (95% CI = 29.57-36) for compassion satisfaction, 24.99 (95% CI = 23.75-26.23) for burnout and 21.99 (95% CI = 18.93-25.06) for secondary traumatic stress, respectively. Mental health nurse managers need to address the factors in the work environment and promote interventions to enhance coping with burnout and STS. Subgroup analyses of country-based economies & regions and years revealed significant results.

Moral distress and compassion fatigue among nursing interns: a cross-sectional study on the mediating roles of moral resilience and professional identity.

BACKGROUND: Nursing interns often faced moral distress in clinical practice, similar to registered nurses, which can lead to compassion fatigue. The roles of moral resilience and professional identity in influencing the psychological well-being of nursing interns are recognized, but the interrelationships among moral distress, moral resilience, professional identity, and compassion fatigue in this group remain unclear. OBJECTIVES: This study aimed to investigate the impact of moral distress on compassion fatigue among nursing interns and to explore the mediating role of moral resilience and professional identity. METHODS: A quantitative cross-sectional study was conducted with 467 nursing interns. Data were collected using Compassion Fatigue Short Scale, Moral Distress Scale-revised, Rushton Moral Resilience Scale, and Professional Identity Scale. Data analyses were performed using SPSS 22.0 and Amos 21.0, adhering to the STROBE statement. RESULTS: The mean scores for compassion fatigue, moral distress, moral resilience, and professional identity were 35.876, 44.887, 2.578, and 37.610, respectively. Moral distress was positively correlated with compassion fatigue. Structural equation modeling showed that moral resilience and professional identity partially mediated the relationship between moral distress and compassion fatigue (ß = 0.448, P < 0.001). CONCLUSION: The findings suggest that moral distress directly influences compassion fatigue among nursing interns and also exerts an indirect effect through moral resilience and professional identity. Interventions aimed at enhancing moral resilience and fostering a strong professional identity may help mitigate the adverse effects of moral distress on compassion fatigue among nursing interns.

The culture of care to enhance laboratory animal personnel well-being: a scoping review.

There has been intense focus on improving the quality of animal research in recent times. An emerging concept of a 'culture of care' has been proposed as another important pillar to enhance scientific quality, with staff well-being being a critical aspect. Professionals working with research animals can face moral and psychological burdens and are at risk of experiencing work-related stress. However, data on the global prevalence of stress in this population is limited. Equally, it is not clear how these stresses manifest, and what impact they might have on an individual's workplace performance and research quality. The purpose of this review was to identify work-related stress, its prevalence, and map evidence on strategies to mitigate stresses. We also set out to identify studies assessing the association between work-related stress and research quality. A systematic search was conducted across four databases, in addition to hand searching relevant references. We included peer-reviewed publications describing work-related stress, culture of care and laboratory animal professionals. A total of 49 publications were included for data mapping. Compassion fatigue was the most frequently described work-related stress, and its prevalence across Europe and North America is likely to be widespread. Multiple strategies to mitigate compassion fatigue and work-related stress were put forward, however, limited empirical evidence was available to assess success. Moreover, no studies reported empirical data linking work-related stress with research quality, despite several publications stating the case. Further population-specific research and measured assessments are urgently needed to deliver culture of care programmes to improve human well-being, animal welfare and research quality.

South African speech-language therapists' and audiologists' professional quality of life.

BACKGROUND:  Limited research is available regarding the professional quality of life experiences of South African speech-language therapists and audiologists, despite the implications this has for wellbeing, quality of patient care, productivity and attrition from the professions. OBJECTIVES:  This study explored levels of compassion satisfaction, burnout, and secondary traumatic stress, the relationships between these, differences on the basis of registration and years of experience and participants' perceptions of their professional quality of life. METHOD:  A sample of 92 South African speech-language therapists and audiologists completed an online survey that included the Professional Quality of Life (ProQOL) scale. The data were analysed using descriptive statistics, analysis of variation (ANOVA), correlations and thematic analysis. RESULTS:  The findings indicated that participants experienced slightly higher levels of secondary traumatic stress and burnout and slightly lower levels of compassion satisfaction than international samples. There were significant inter-relationships between the three elements of professional quality of life, and no significant differences for these on the basis of registration or years of experience. Participants identified a range of factors that contributed to their experiences of compassion satisfaction and fatigue, as well as suggestions for improvement. CONCLUSION:  Professional quality of life plays an important role in South African speech-language therapists and audiologists' professionalism, job performance and satisfaction and retention.Contribution: The data collected provide valuable insights into the professional quality of life experiences of South African speech-language therapists and audiologists, as well as those working in similar contexts. It also offers suggestions that may contribute to future research and interventions.

Beyond Burnout: Nurses' Perspectives on Chronic Suffering During and After the COVID-19 Pandemic.

Nurses around the globe have been impacted psychologically and emotionally during and after the COVID-19 pandemic. The purpose of this study was to describe nurses' perspectives on the concepts of compassion fatigue, second victimhood, burnout, and moral injury. Eight nurses were interviewed either individually or in groups of two. Data were analyzed using conventional content analysis. The following themes were identified: waves of compassion fatigue, traumatization within second victimhood, never the same after chronic burnout, moral injury: nurses couldn't do their best, and connections across concepts. Results showed nurses were most familiar with burnout and compassion fatigue, which remain chronic struggles. Second victimhood and moral injury were more distinct experiences related to traumatic or morally distressing events and likely contributed to experiencing burnout or compassion fatigue. Nurses' suffering heightened during the COVID-19 pandemic and remains prominent three years later. Future research and interventions are urgently needed globally to reduce workplace stressors and promote nurse well-being.

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.

Determining the Emotional Intelligence and Compassion Fatigue Among Postgraduate Dental Students Using the Emotional Intelligence Scale and the Quality of Life Scale: An Observational Study.

Introduction Compassion fatigue (CF) is a problem for professionals who work with traumatized individuals. CF manifests as reliving personal sorrow, nightmares, flashbacks, intrusive thoughts, numbing or avoiding memories of the experience, and elevated physiological arousal. CF makes professionals more likely to make bad choices, such as misplacing treatments or mistreating patients. Emotional intelligence (EI) is essential to comprehending human behavior, performance, and well-being. EI is a crucial component of professional competency in medical education, as postgraduate dental students are also at risk of having CF. They are professionals and have to work with traumatized patients, so the study was conducted to evaluate their CF and EI. This study aimed to evaluate EI and CF among postgraduate dental students at Sharad Pawar Dental College and Hospital, Wardha, India. Materials The observational study was conducted at Sharad Pawar Dental College and Hospital among postgraduate dental students. The data was collected from 80 postgraduate students who responded to the Professional Quality of Life Version 5 and the Emotional Intelligence Scale questionnaires. Result A total of 80 postgraduate dental students responded to the Professional Quality of Life Version 5 and the Emotional Intelligence Scale questionnaires, and all the responses were included in the study. Findings revealed that postgraduate dental students treating patients have high levels of CF and EI. Conclusion This study indicates that there is a high level of CF and EI in postgraduate dental students. As high CF is harmful and can affect physical and mental well-being, proper management should be done through psycho-education and self-care.

Tell Me More® As A Tool for Provider Connectedness With Hospitalized Patients: A Mixed-Methods Study.

Rates of burnout and compassion fatigue in healthcare professionals have remained high since the beginning of the pandemic with adverse implications for patient care. Tell Me More® (TMM) is a tool licensed by the Gold Foundation, which was created with the purpose of helping patients, caregivers, and hospital staff to connect with each other on a humanistic level. Research has shown the benefits of the TMM with students and anecdotally with patients. This mixed-method study, which consisted of surveys and semistructured interviews with healthcare professionals (n = 72), sought out to understand the impact of implementation of TMM on a hospital floor. Surveys were distributed before and after the occurrence of TMM with interviews only occurring afterward. Three out of 8 survey items were found to be significant. Content analysis from interviews generated 4 themes from participants which included "Connectedness to Patient," "Separation of Person and Illness," "Communication with Patient's Support Network," and "Connectedness with Non-Verbal Patients." TMM is a useful tool for strengthening provider-patient relationships in hospital settings and may therefore lessen compassion fatigue and burnout.

Mediating effect of moral sensitivity and professional identity between moral courage and compassion fatigue among nursing interns: a cross-sectional study.

BACKGROUND: Compassion fatigue in nursing interns contributes to career indecision and worsens the nursing shortage. While work environment and psychological factors are well-studied, the ethical dimension remains unexplored. Understanding these mechanisms, particularly the role of moral courage, is essential for designing interventions to combat compassion fatigue and address the workforce crisis. This study investigates the influence of moral courage on compassion fatigue among Chinese nursing interns, focusing on the mediating roles of moral sensitivity and professional identity. METHODS: A quantitative, cross-sectional study was conducted in accordance with the STROBE guidelines. We used the convenience sampling method to recruit 467 nursing interns from four public junior colleges in Hunan Province, China in February, 2024. Data were collected using Compassion Fatigue Short Scale, Moral Courage Scale, Revised Moral Sensitivity Questionnaire, and Professional Identity Scale. Data analyses were conducted using SPSS 22.0 and Amos 21.0. RESULTS: The modified model exhibited a good fit (χ2/df = 3.437, AGFI = 0.928, IFI = 0.984, TLI = 0.976, CFI = 0.984, NFI = 0.977, RMSEA = 0.072). Moral sensitivity positively influenced both moral courage and professional identity, while professional identity negatively impacted compassion fatigue. Importantly, the effect of moral courage on compassion fatigue was entirely mediated by moral sensitivity and professional identity (ß = -0.114, P = 0.001). CONCLUSION: This study suggests that moral courage in nursing interns mitigates compassion fatigue through the combined mediating effects of moral sensitivity and professional identity. Ethics education programs fostering moral courage, moral sensitivity, and professional values in nursing students could be crucial in alleviating compassion fatigue.

Experiences of compassion fatigue among Generation Z nurses in the emergency department: a qualitative study in Shanghai, China.

BACKGROUND: Due to the unique working environment and nature of work in emergency departments, nurses are prone to experiencing compassion fatigue (CF), leading to job burnout and attrition. As more Generation Z (Gen Z) nurses enter the emergency department with distinct personality traits compared to previous generations, studying their experiences with CF will inform future management strategies. METHODS: The qualitative phenomenological research method was utilised to investigate CF among Gen Z emergency nurses at a hospital in Shanghai, China. Data were collected through face-to-face semi-structured interviews and analyzed using Colaizzi's seven-step phenomenological analysis method. Study participants were purposively selected. RESULTS: Three main themes and nine sub-themes emerged from the study: secondary traumatic stress, including physiological symptoms, psychological symptoms, and behavioral changes; cumulative effects, including impaired empathy, interference with family life, and post-traumatic growth (PTG); coping strategies, including cognitive reconstruction, seeking support, and facilitating action. CONCLUSIONS: The aim of this study is to investigate the experience of CF among Gen Z emergency nurses, providing managers with a reference for future management strategies. The significance of multi-dimensional support for Gen Z emergency nurses is underscored by our findings. Additionally, interventions that enhance resilience and competency can facilitate their psychological transformation after experiencing CF and promote accelerated personal growth.

Sensory processing sensitivity and compassion fatigue in intensive care unit nurses: A chain mediation model.

BACKGROUND: Compassion among intensive care unit (ICU) nurses is an essential component of humanistic care in the ICU However, the enormous pressures of the job and the lack of social support have led to persistently severe compassion fatigue. Sensory processing sensitivity, as a personality trait for individuals to perceive external factors, has underlying significance for compassion fatigue. AIMS: This study aims to investigate the internal and external environmental factors and the underlying mechanisms that influence the impact of sensory processing sensitivity among ICU nurses on the development of compassion fatigue. STUDY DESIGN: A cross-sectional descriptive study was conducted with 290 nurses from various hospitals in five cities in China. METHOD: A self-designed demographic questionnaire, the Chinese version of the Professional Quality of Life Scale, the Chinese version of the Highly Sensitive Person Scale, the Chinese version of the Perceived Social Support Scale, and the Chinese version of the Perceived Stress Scale were used to survey 290 ICU nurses. The mediating roles of perceived social support and perceived stress between sensory processing sensitivity and compassion fatigue were tested. RESULTS: The research results indicate that the total effect of sensory processing sensitivity on compassion fatigue is significant (0.245 [0.093, 1.160]), whereas the direct effect of sensory processing sensitivity on compassion fatigue is not significant (-0.43 [-0.402, 0.247]). Perceived social support and perceived stress exhibit serial mediating effects between sensory processing sensitivity and compassion fatigue (-0.065 [-0.142, -0.013]). CONCLUSION: Our results revealed, for the first time, the underlying mechanism between sensory processing sensitivity and compassion fatigue among ICU nurses. Providing necessary stress-relief condition and abundant social support are important measures for nursing managers to reduce compassion fatigue and improve the quality of critical care humanistic nursing services.

Measurement of compassion fatigue in animal health care professionals: a systematic review of available instruments and their content validity.

Introduction: Compassion fatigue (CF) refers to emotional or physical exhaustion and emotional reactions resulting from prolonged exposure to traumatic events, commonly experienced by professionals in caregiving roles. CF is prevalent among healthcare professionals, including those in animal care. Several Patient-Reported Outcome Measures (PROMs) were developed to measure CF, but their psychometric validity was not reviewed systematically. This study aims to identify and review the content validity of CF PROMs used in animal health care professionals. Methods: Literature was searched in PubMed, PsycINFO, and EMBASE (1973-2023). We included studies conducted in animal health care professionals, using a PROM to measure CF, reporting at least one psychometric property of this PROM, and published as original research. For each identified PROM, additional literature search was conducted to identify PROM development and content validation studies. Three independent reviewers evaluated the content validity of each PROM using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and summarized the quality of evidence using a modified GRADE approach. The protocol was registered in PROSPERO (CRD42023433982) and results reported following PRISMA guidelines. Results: Initially, 1709 studies were identified. After a double screening, 17 eligible studies were included. CF was measured using six different PROMs or their modified versions. Only one PROM specifically targeted animal health care professionals: the ProQOL-5 Veterinary Medicine Version. This and three other original CF PROMs were reviewed. For all PROMs, the quality of content validity was rated as insufficient due to deficiencies in the concept and items elicitation, inadequate target population representation, and inadequate details on cognitive interview procedures. The overall evidence quality was rated as low due to a limited number of PROM validation studies, poor methodological and reporting quality, and indirect result. Discussion: There is a scarcity of studies examining CF within the target population, and the quality of evidence for content validity of the reviewed PROMs for CF measurement is currently low. CF definition and construct description in PROM development studies suffer from vagueness and seem inadequately reflected by the content of the reviewed PROMs. Further research with a robust methodology seems necessary to address the identified flows. Systematic review registration: Measurement of compassion fatigue in people working with animals: protocol for a systematic review. PROSPERO 2023 CRD42023433982. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023433982.

The relationships among factors affecting compassion fatigue, compassion satisfaction, and burnout in Japanese nurses: A cross-sectional study.

AIM: This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self-compassion, fears of compassion, and attachment styles. METHODS: This cross-sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web-based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self-compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors. RESULTS: Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R2 = .31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self-compassion, anxiety, and avoidance (R2 = .63). Compassion satisfaction was impacted by self-compassion, anxiety, and fears of compassion for self (R2 = .31). Additionally, self-compassion (R2 = .28) and fears of compassion for self (R2 = .55) were influenced by anxiety and avoidance. CONCLUSIONS: Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self-compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction.

Examining Relationships Among Nursing Students' Views of Suffering, Positive Thinking, and Professional Quality of Life.

BACKGROUND: Exposure to suffering can lead to compassion fatigue in undergraduate nursing students. OBJECTIVE: Guided by resilience theory, a cross-sectional, correlational design was used to investigate the potential moderating effect of positive thinking skills on the relationships between views of suffering, compassion fatigue, and compassion satisfaction. RESULTS: In 157 undergraduate nursing students, multiple regressions revealed that views of suffering and positive thinking explained 23.8% of the variance in compassion satisfaction (F11,145 = 4.121, P < .001), and 21.9% of the variance in burnout (F11,144 = 3.786, P < .001). The Suffering God view, which stresses the presence of a compassionate deity amid suffering, and positive thinking had significant main effects on compassion satisfaction (ß = 0.349, P = .025; and ß = 0.309, P < .001, respectively). Positive thinking, the Suffering God view, and the Random view, in which the occurrence of suffering is random and purposeless, had significant main effects on burnout (ß = -0.280, P < .001; ß = -0.392, P = .014; and ß = -0.206, P = .014, respectively). The Unorthodox view, in which a deity exists that allows suffering, had a significant main effect on secondary traumatic stress (ß = 0.232, P = .027). Positive thinking did not moderate any of the relationships between the views of suffering and the dependent variables. CONCLUSIONS: Knowledge of these relationships can aid in the assessment of nursing students at risk for poor outcomes and guide intervention development to promote professional quality of life.

Mediating effect of self-efficacy between social support and compassion fatigue among Geriatric Services and Management interns: A cross-sectional study.

OBJECTIVES: To explore the impact of social support on CF and further clarify the mediating role of self-efficacy among Geriatric Services and Management interns. METHODS: A cross-sectional survey study examined social support, self-efficacy and CF in 592 interns in Geriatric Services and Management from 46 institutions in China. RESULT: The level of CF among Geriatric Services and Management interns is low but about one-third of the respondents is at high risk of CF. Social support was positively correlated with self-efficacy (ß = 0.114, P < 0.01). Social support significantly reduced CF (ß = -0.322, P < 0.01). Similarly, self-efficacy had significant direct effects on CF (ß = -0.497, P < 0.01). Additionally, self-efficacy played a partial mediating role in the relationship between social support and CF. CONCLUSION: Social support can directly affect the CF of Geriatric Services and Management interns and indirectly through self-efficacy. Accordingly, It is necessary to strengthen social support and self-efficacy to relieve CF among Geriatric Services and Management interns.

Caring through crisis: The professional quality of pediatric nurses during the COVID-19 pandemic.

PURPOSE: This study described pediatric nurses' professional quality of life during COVID-19 and explored demographic/clinical practice factors independently associated with compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS). DESIGN AND METHODS: The Relational Caring Complexity Theory was used. This study employed a cross-sectional, descriptive, correlational design to describe professional quality of life of pediatric nurses (demographic questionnaire and ProQOL 5 measure) working during the COVID-19 pandemic. RESULTS: From 150 pediatric nurses, the mean scores were CS 40.8 (± 4.8), BO 22.6 (± 4.7), and STS 22.8 (± 5.8). Results of the multiple regression revealed that two variables, deployed to the same unit versus not deployed (ß = 2.424, p = .02) and currently practicing in perioperative/ambulation settings versus intensive care (ß = -0.272, p = .03), were independently associated with CS. Deployed to the same unit versus not deployed was found to be independently and significantly associated with BO (ß = -0.28, p = .005). The number of patients cared for with COVID-19 (ß = 0.196, p = .03) was significantly associated with STS. CONCLUSIONS: While the overall response was positive, these nurses were more likely to experience BO when deployed to the same area (likely a COVID-19 adult unit) and STS as they cared for more patients with COVID-19. PRACTICE IMPLICATIONS: Leaders should be aware of the impact of caring in times of crisis. Decentralized staffing may help meet emergent needs on a particular shift, but ensuring deployed nurses are well-supported is vital.