Burnout, satisfação e fadiga por compaixão: relação com a qualidade assistencial e segurança do paciente / Burnout, satisfaction and compassion fatigue: relationship with quality of care and patient safety

Os enfermeiros que atuam na assistência hospitalar lidam com dor física, emocional, situações de alta complexidade, exposição ao sofrimento, medo, estresse e ansiedade, o que favorece o desenvolvimento da fadiga por compaixão, que é considerada uma forma de sofrimento decorrente da atividade laboral e pode comprometer a saúde e bem-estar do enfermeiro, bem como a segurança do paciente. Objetivou-se relacionar a fadiga por compaixão com aspectos da qualidade da assistência à saúde e segurança do paciente. Tratou-se de um estudo exploratório, quantitativo, correlacional, realizado entre maio e junho de 2021. A coleta de dados ocorreu por meio de questionário online após anuência do Comitê de Ética em Pesquisa e consentimento dos participantes. A amostra constituiu-se de 410 enfermeiros que atuavam em três hospitais privados de São Paulo; 319 (78%) eram do sexo feminino, 212 (51,71%) atuavam de 4 a 10 anos nos hospitais. Obteve-se correlações positivas entre índices elevados na dimensão de fadiga por compaixão e burnout do questionário ProQol-Br e aspectos relacionados à qualidade assistencial e segurança do paciente (p<0,001). Os enfermeiros concordaram que devido à sobrecarga de trabalho e exaustão mental deixaram de cumprir integralmente protocolos de qualidade e segurança do paciente, o que pode aumentar a ocorrência de eventos adversos. Evidenciou se a relevância de desenvolvimento de estratégias para melhorar a sobrecarga de trabalho, por meio da adequação dos recursos humanos, satisfação e reconhecimento profissional, a fim de minimizar à ocorrência de fadiga por compaixão e repercutir positivamente na qualidade assistêncial e segurança do paciente.

Nurses who work in hospital care deal with physical and emotional pain, highly complex situations, exposure to suffering, fear, stress and anxiety, which favors the development of compassion fatigue, which is considered a form of suffering resulting from work activity. and can compromise the health and well-being of nurses, as well as patient safety. The objective was to relate compassion fatigue with aspects of the quality of healthcare and patient safety. This was an exploratory, quantitative, correlational study, carried out between May and June 2021. Data collection took place through an online questionnaire after approval from the Research Ethics Committee and consent from the participants. The sample consisted of 410 nurses who worked in three private hospitals in São Paulo; 319 (78%) were female, 212 (51.71%) had worked in hospitals for 4 to 10 years. Positive correlations were obtained between high rates in the compassion fatigue and burnout dimension of the ProQol-Br questionnaire and aspects related to quality of care and patient safety (p<0.001). The nurses agreed that due to work overload and mental exhaustion, they failed to fully comply with quality and patient safety protocols, which could increase the occurrence of adverse events. The relevance of developing strategies to improve work overload was highlighted, through the adequacy of human resources, satisfaction and professional recognition, in order to minimize the occurrence of compassion fatigue and have a positive impact on the quality of care and patient safety.

Effectiveness of Resiliency and Recovery Program on Compassion Fatigue among Nursing Officers working in selected Hospitals in India / Efectividad del Programa de Resiliencia y Recuperación sobre la Fatiga por Compasión entre los profesionales de Enfermería que trabajan en Hospitales seleccionados de la India / Eficácia do Programa de Resiliência e Recuperação na Fadiga por Compaixão entre Profissionais de Enfermagem que Trabalham em Hospitais Selecionados na Índia

Objective. The study objective was to evaluate the effectiveness of Resiliency and Recovery Program on Compassion Fatigue level of Nursing Officer from selected hospitals of Pune City (India). Methods. The study used a quasi-experimental approach involving single group pre-test and post-test design. 100 nursing officers, working in selected hospitals of Pune city, who were willing to participate were selected using non probability convenience sampling. The data was collected using The Professional Quality of Life Scale: Compassion Satisfaction and Fatigue (ProQoL) Version 5 of Stamm. The study included pre-test, resiliency and recovery program and post-test. Resiliency and Recovery Program is an intervention aiming to develop five resiliency skills or antibodies including (a) self-regulation, (b) perceptual maturation, (c) intentionality, (d) self-care and (e) connection and support. Results. Statistically significant difference was revealed between the pre-test and post-test score means: Compassion Satisfaction (pre-test = 28.50 to post-test = 31.0; t-18.6671, p<0.001), Burn-out (pre-test = 35.2 to post-test = 31.7; t-15.00, p<0.001), and Secondary Traumatic Stress (pre-test = 37.4 to post-test = 33.07; t-14.8996, p<0.001). Conclusion. Resiliency and Recovery Program had a significant impact on Compassion Fatigue, leading to an increase in Compassion Satisfaction, and a reduction in Burnout and Secondary Traumatic Stress. Inculcating Resiliency skills in nursing officers can help them in reducing compassion fatigue and thus aids in health promotion.

Objetivo. El objetivo del estudio era evaluar la eficacia del Programa de Resiliencia y Recuperación en el nivel de Fatiga por Compasión de los profesionales de enfermería de los hospitales seleccionados de la ciudad de Pune (India). Métodos. El estudio cuasi-experimental con evaluación pre y post-intervención en un solo grupo. Se seleccionaron 100 profesionales de enfermería que trabajaban en hospitales seleccionados de la ciudad de Pune mediante un muestreo no probabilístico por conveniencia. Los datos se recogieron utilizando la Escala de calidad de vida profesional: Compassion Satisfaction and Fatigue ((ProQOL) Version 5 de Stamm. El estudio incluyó una prueba previa, un programa de resiliencia y recuperación y una prueba posterior. El Programa de Resiliencia y Recuperación es una intervención cuyo objetivo es desarrollar cinco habilidades o anticuerpos de resiliencia que incluyen (a) autorregulación, (b) maduración perceptiva, (c) intencionalidad, (d) autocuidado y (e) conexión y apoyo. Resultados. Se observaron diferencias estadísticamente significativas entre las puntuaciones promedio obtenidas antes y después de la intervención en la satisfacción con la compasión (antes = 28.5 a después = 31; t-18.6671, p<0.0001), el agotamiento (antes = 35.2 a después = a 31.7; t-15,00, p<0.001) y el estrés traumático secundario (antes = 37.4 a después 33.1; t-14.8996, p<0.001). Conclusiones. El Programa de Resiliencia y Recuperación tuvo un impacto significativo en la Fatiga por Compasión, lo que condujo a un aumento de la Satisfacción por Compasión y a una reducción del Burnout y del Estrés Traumático Secundario. Inculcar habilidades de resiliencia a los profesionales de enfermería puede ayudarles a reducir la fatiga por compasión y, por tanto, a promover la salud.

Objetivo. O objetivo do estudo foi avaliar a eficácia do Programa de Resiliência e Recuperação no nível de Fadiga por Compaixão em profissionais de enfermagem em hospitais selecionados na cidade de Pune (Índia). Métodos. Foi realizado um estudo quase experimental com avaliação pré e pós-intervenção em grupo único. Foram selecionados 100 profissionais de enfermagem que trabalham em hospitais da cidade de Pune por meio de amostragem não probabilística de conveniência. Os dados foram coletados por meio da versão 5 da Escala de Qualidade de Vida Profissional: Compaixão, Satisfação e Fadiga (ProQoL) de Stamm. O estudo incluiu um pré-teste, um programa de resiliência e recuperação e um pós-teste. O Programa de Resiliência e Recuperação consistiu em uma intervenção cujo objetivo é desenvolver cinco habilidades de resiliência ou anticorpos que incluem (a) autorregulação, (b) maturação perceptual, (c) intencionalidade, (d) autocuidado e (e) conexão e suporte. Resultados. Foram observadas diferenças estatisticamente significativas entre as pontuações médias obtidas antes e depois da intervenção em satisfação por compaixão (antes = 28.5 a depois = 31; t-18.6671, p<0.0001), burnout (antes = 35.2 a depois = a 31.7; t-15.00), p<0.001) e estresse traumático secundário (antes = 37,4 a depois 33.1; t-14.8996, p<0.001). Conclusões. O Programa de Resiliência e Recuperação teve um impacto significativo na Fadiga por Compaixão, levando a um aumento na Satisfação por Compaixão e a uma redução no Burnout e no Estresse Traumático Secundário. Incutir competências de resiliência nos enfermeiros pode ajudá-los a reduzir a fadiga da compaixão e, portanto, promover a saúde.

Efeito da terapia floral na fadiga por compaixão em residentes de enfermagem: estudo piloto / Flower therapy effect on the quality of professional life in nursing residents: pilot study

Introdução: O residente de enfermagem está exposto a estresses e desgastes que impactam em sua qualidade de vida profissional. Nesse sentido, as práticas integrativas e complementares de saúde podem contribuir para promover o bem-estar físico, mental e espiritual. Objetivo: Verificar o efeito da terapia floral nos componentes da qualidade de vida profissional (fadiga por compaixão - Burnout e Estresse Traumático Secundário - e satisfação por compaixão) em residentes de enfermagem no contexto da pandemia de COVID-19. Metodologia: Estudo piloto quase-experimental do tipo antes e depois, com 16 enfermeiros residentes de hospitais de ensino, que responderam um questionário sociodemográfico e uma escala Professional Quality of Life Scale 4 (ProQOL-4), e utilizaram a fórmula emergencial associada ao Walnut dos Florais de Bach (FiveW) por três semanas com follow up após três semanas. Os dados foram analisados descritivamente e o efeito da intervenção pelo teste t-Student e pelo modelo de efeitos mistos, com nível de significância de 5%. Resultados: A terapia floral auxiliou na redução do escore da subescala Estresse Traumático Secundário do ProQOL-4 (p=0,017), com efeito residual após o follow up. Houve interação do ano da residência e especialidade do programa nas subescalas Satisfação por Compaixão e Burnout; e área de especialização da residência e adoecimento de pessoa próxima por COVID-19 no Estresse Traumático Secundário e Burnout (p<0,05). Conclusão: A fórmula floral FiveW mostrou redução dos escores do Estresse Traumático Secundário, evidenciando que a terapia floral pode contribuir como estratégia complementar para melhora da qualidade de vida profissional.

Introducción: La persona residente de enfermería está expuesta a situaciones estresantes que impactan en su calidad de vida profesional. En ese sentido, las prácticas de salud integradoras y complementarias pueden contribuir a promover el bienestar físico, mental y espiritual. Objetivo: Verificar el efecto de la terapia con esencias florales sobre los componentes de la calidad de vida profesional (fatiga por compasión -burnout y estrés traumático secundario- y satisfacción por compasión) en población residente de enfermería en el contexto de la pandemia por COVID-19. Metodología: Estudio piloto cuasiexperimental antes y después de un solo grupo, con 16 personas enfermeras residentes de hospitales universitarios, que respondieron un cuestionario sociodemográfico y la Escala de Calidad de Vida Profesional 4 (ProQOL-4). Además, utilizaron la fórmula de emergencia asociada al Walnut de los remedios florales de Bach (FiveW), durante tres semanas, con un seguimiento de tres semanas. Los datos fueron analizados descriptivamente y el efecto de la intervención por la prueba t-Student pareada y por el modelo de efectos mixtos, con un nivel de significación del 5 %. Resultados: La terapia floral ayudó a reducir la puntuación de la subescala de Estrés Traumático Secundario del ProQOL-4 (p=0.017) con un efecto residual después del seguimiento. Hubo interacción entre el año de residencia y la especialidad del programa en las subescalas Satisfacción por Compasión y Burnout, así como entre especialidad del programa y enfermedad por COVID-19 de una persona allegada en Estrés Traumático Secundario y Burnout (p<0.05). Conclusión: La fórmula floral FiveW mostró reducción en las puntuaciones de estrés traumático secundario, lo que demuestra que la terapia floral puede contribuir como un manejo complementario para mejorar la calidad de vida profesional.

Introduction: The nursing resident is exposed to stressful situations that impact the quality of their professional life. Integrative and complementary health practices can contribute to promoting physical, mental, and spiritual well-being. Objective: To evaluate the effect of flower essence therapy on the aspects of the professional quality of life (compassion fatigue - burnout and secondary traumatic stress - and compassion satisfaction) of nursing residents in the context of the COVID-19 pandemic. Methods: Quasi-experimental pilot before and after study with 16 resident nurses from teaching hospitals, who answered a sociodemographic questionnaire and the Professional Quality of Life Scale 4 (ProQOL-4). The emergency formula associated with Walnut of the Bach Flower Remedies (FiveW) was used for three weeks with a three-week follow-up. Data were analyzed descriptively. The effect of the intervention was evaluated by the paired Student's t-test and by the mixed effects model, with a significance level of 5%. Results: Floral therapy reduced the score of the Secondary Traumatic Stress subscale of ProQOL-4 (p=0.017) with a residual effect after the follow-up. There was interaction between the year of residency and the program specialty in the Satisfaction for Compassion and Burnout subscales; and also between the program specialty and the COVID-19 infection of a close person in the Secondary Traumatic Stress and Burnout subscales (p<0.05). Conclusion: The FiveW floral formula showed a reduction in Secondary Traumatic Stress scores, evidencing that floral therapy can contribute as a complementary strategy to improve the quality of professional life.

Compassion Fatigue and Compassion Satisfaction among Staff Nurses Working in Critical Care Units

When compassion has been demonstrated for a long time, compassion fatigue could manifest as a negative outcome. Nurses who are affected by compassion fatigue have expressed feelings of depression, which may be related to the constant emotional trauma they experience by virtue of being employed in critical care areas. A cross-sectional descriptive study was conducted to assess compassion fatigue in terms of burnout and secondary traumatic stress and compassion satisfaction among nurses working in the critical care units of a tertiary care hospital in Punjab. A total of 100 staff nurses were selected by convenience sampling technique. Data was collected by socio-demographic profile, professional profile and Professional Quality of Life Scale (ProQOL) Version 5 (2009). The results revealed that 65 percent of the subjects had average level, 34 percent had low and only 1 percent had high level of burnout. It was found that 59 percent of the subjects had average level of secondary traumatic stress, 40 percent had low level and only 1 percent had high level of secondary traumatic stress. Majority (54%) had average level, 45 percent had high level and only 1 percent had low level of compassion satisfaction. Secondary traumatic stress was found to be significantly associated with socio-economic status, duration of work experience in critical care units and leave in past one week. Compassion satisfaction was significantly associated with age, habitat, professional qualification and extra duties performed. Majority of the subjects had average level of burnout and secondary traumatic stress. Secondary traumatic stress was higher in staff nurses who belonged to lower middle class (p=0.05) and who had not taken leave in the past one weak and among staff nurses who had 11-15 years of work experience in critical care units.

Fear and Coping with Death in Intensive Care Nurses: a Structural Model Predictor of Compassion Fatigue / Miedo y afrontamiento ante la muerte del usuario: un modelo estructural predictor de la fatiga por compasión en enfermeros de cuidados intensivos / Medo e enfrentamento da morte do usuário: um modelo estrutural preditivo da fadiga por compaixão em enfermeiros de terapia intensiva

Objective. To determine the effect of fear and coping with death on compassion fatigue in nurses working in the intensive care unit. Methods. Correlational-predictive design, applied in 245 nurses working in the intensive care unit through intentional sampling. The study applied a personal data card, the Collet-Lester Fear of Death Scale (α=0.72), the Bugen Fell of Death Scale (α=0.82), and the Empathy Exhaustion Scale (α=0.80). Descriptive and inferential statistics were performed, such as Spearman's test and a structural equation model. Results. The work had 255 nurses who participated, finding a relationship among fear and coping toward death and compassion fatigue (p<0.01), together with the equation model showing that fear and coping toward death have a positive effect in 43.6% on compassion fatigue. Conclusion. Fear and coping with death have an effect on compassion fatigue in nurses working in the intensive care unit, so that when working in a critical area it can cause health effects

Objetivo. Determinar el efecto del miedo y afrontamiento ante la muerte sobre la fatiga por compasión en enfermeros que laboran en la unidad cuidados intensivos. Método. Diseño correlacional-predictivo. A través de un muestreo intencional se seleccionaron 255 enfermeros que laboraban en Unidades de Cuidados Intensivos de Adultos de hospitales de la Península de Yucatán (México). Se aplicó una cédula de datos personales, la escala de miedo a la muerte de Collet-Lester (α=0.72), la escala de Bugen de afrontamiento de la muerte (α=0.82) y la escala de agotamiento por empatía (α=0.80). Se realizó estadística descriptiva e inferencial como prueba de Spearman y un modelo de ecuación estructural. Resultados. Se encontró relación del miedo y el afrontamiento hacia la muerte con la fatiga por compasión (p<0.01). Adicionalmente, el modelo de ecuaciones muestra que el miedo y el afrontamiento hacia la muerte predice en un 43.6% sobre la fatiga por compasión. Conclusión. El miedo y el afrontamiento hacia la muerte tienen efecto sobre la fatiga por compasión en los enfermeros que laboran en la unidad de cuidados intensivos, por lo que al estar laborando en esta área crítica puede provocar afectaciones en su estado de salud.

Objetivo. Determinar o efeito do medo e enfrentamento da morte na fadiga por compaixão em enfermeiros que atuam em Unidade de Terapia Intensiva (UTI). Métodos. Desenho preditivo correlacional. Por meio de amostragem intencional, foram selecionados 255 enfermeiros que trabalhavam em Unidades de Terapia Intensiva de Adultos de hospitais da Península de Yucatán (México). Foi aplicada uma ficha de dados pessoais, a escala de medo da morte de Collet -Lester (α=0.72), a escala de Bugen de enfrentamento da morte (α=0.82) e a escala de exaustão por empatia (α=0.80). Foram realizadas estatísticas descritivas e inferenciais como o teste de Spearman e um modelo de equação estrutural. Resultados. Encontrou-se relação entre medo e enfrentamento da morte e fadiga por compaixão (p<0.01). Além disso, o modelo de equação mostra que o medo e o enfrentamento da morte preveem 43.6% da fadiga por compaixão. Conclusão. O medo e o enfrentamento da morte afetam a fadiga por compaixão em enfermeiros que atuam em UTI, portanto, trabalhar nessa área crítica pode afetar seu estado de saúde.

Percepção da qualidade de vida profissional de uma equipe de reabilitação / Perception of the quality of professional life of a rehabilitation team

Na saúde, o conceito de Qualidade de Vida Profissional (QVP) é utilizado para avaliar a influência que o trabalho exerce sobre o indivíduo, através da compaixão. Abrange duas dimensões, Satisfação por Compaixão e Fadiga por Compaixão. Reconhece-se que profissionais que atuam diretamente com a dor e o sofrimento alheio podem sofrer impacto na qualidade de vida. Objetivo: Investigar a percepção da QVP no trabalho de uma equipe multiprofissional de um hospital de reabilitação. Método: Pesquisa transversal, analítica e exploratória. Amostra aleatória por conveniência, composta por 40 profissionais da saúde que atuavam no setor de enfermaria de reabilitação do hospital, elegidos conforme os critérios pré-estabelecidos. Os instrumentos utilizados foram o Questionário Sociodemográfico e a Professional Quality of Life Scale (ProQOL)-Escala-BR. A coleta de dados ocorreu de forma remota, através do aplicativo WhatsApp® e foi viabilizada pelo Google Forms®. Os dados foram analisados por meio de estatística descritiva e inferencial. Resultados: Constatou-se níveis adequados de QVP na equipe de reabilitação, 47,5% apresentaram alto nível de satisfação por compaixão, enquanto não foram observados altos níveis de fadiga por compaixão. Quando analisadas as influências sociodemográficas, foram observadas significâncias estatísticas entre as variáveis satisfação por compaixão e sexo (p=0,021) e alteração do apetite com estresse traumático secundário (p=0,006). Conclusão: Verificou-se a prevalência de percepções equilibradas de QVP para a equipe de reabilitação analisada. Esse resultado demonstra a necessidade de investigações posteriores sobre as influências da organização e das condições ergonômicas, considerando o setor de atuação

In health, the concept of Professional Quality of Life (QVP) is used to assess the influence that work has on the individual, through compassion. It encompasses two dimensions, Satisfaction by Compassion and Fatigue by Compassion. It is recognized that professionals who work directly with the pain and suffering of others can suffer an impact on quality of life. Objective: To investigate the perception of QVP in the work of a multidisciplinary rehabilitation team at a rehabilitation hospital. Method. Cross-sectional, analytical and exploratory research. Random sample for convenience, composed of 40 health professionals who worked in the rehabilitation ward of the hospital, chosen according to pre-established criteria. The instruments used were the Sociodemographic Questionnaire and the ProQOL-BR Scale. Data collection took place remotely, through the WhatsApp® application and was made possible by Google Forms®. Data were analyzed using descriptive and inferential statistics. Results: Adequate levels of QVP were found in the rehabilitation team, 47.5% had a high level of compassion satisfaction, while high levels of compassion fatigue were not observed. When sociodemographic influences were analyzed, statistical significance was observed between the variables satisfaction with compassion and sex (p=0.021) and change in appetite with secondary traumatic stress (p=0.006). Conclusions: There was a prevalence of balanced QVP perceptions for the analyzed rehabilitation team. This result demonstrates the need for further investigations into the influences of organization and ergonomic conditions, considering the sector in which they operate

Fadiga por compaixão e estratégias de enfrentamento diante da finitude / Compassion fatigue and coping strategies before death / Fatiga por compasión y estrategias de afrontamiento ante la finitud

Resumo A fadiga por compaixão é uma ameaça à saúde mental de profissionais de saúde diante da dificuldade em manejar a empatia. Assim, buscou-se verificar na literatura científica a correlação entre a fadiga por compaixão e a atuação de profissionais em unidades hospitalares que lidam constantemente com a morte, considerando estratégias adotadas para autocuidado. Realizou-se revisão integrativa da literatura, que identificou 11 artigos, nas bases de dados MEDLINE e PubMed, publicados entre 2011 e 2021. Constatou-se que a fadiga por compaixão ocorre com maior frequência em profissionais que lidam direta e recorrentemente com a morte, principalmente quando medidas distanásicas são adotadas. As principais estratégias de adaptação psicológica detectadas foram discussão de casos entre equipes, momentos de lazer e apoio de colegas, espiritualidade e meditação, além de uma liderança construtiva. Ressalta-se a necessidade de maior aprofundamento e novas pesquisas diante da escassez de estudos sobre o tema, principalmente no Brasil.

Abstract Compassion fatigue threatens healthcare professionals' mental health in face of difficulties in managing empathy. This integrative review sought to verify the correlation between compassion fatigue and health professionals' performance in hospital units that frequently deal with death, considering the self-care strategies adopted. Bibliographic search conducted on the MEDLINE and PubMed databases retrieved 11 articles published between 2011 and 2021. Results show that compassion fatigue occurs frequently in professionals who deal directly and recurrently with death, especially when dysthanasia measures are adopted. Case discussion between teams, leisure time and peer support, spirituality and meditation as well as constructive leadership were the main psychological adaptation strategies identified. Further and in-depth research is needed given the scarcity of study on the topic, especially in Brazil.

Resumen La fatiga por compasión es una amenaza para la salud mental de los profesionales de la salud ante la dificultad para gestionar la empatía. Se buscó en la literatura científica la correlación entre la fatiga por compasión y el trabajo de los profesionales en unidades hospitalarias que lidian constantemente con la muerte considerando las estrategias adoptadas para el autocuidado. La revisión integradora de la literatura realizada identificó 11 artículos en las bases de datos MEDLINE y PubMed, publicados entre 2011 y 2021. La fatiga por compasión se presenta más en los profesionales que lidian directa y recurrentemente con la muerte, especialmente durante la adopción de medidas de distanasia. Como principales estrategias de adaptación psicológica destacan la discusión de casos entre equipos, el tiempo libre y apoyo de los compañeros, la espiritualidad y meditación, y el liderazgo constructivo. Son necesarias más investigaciones a fondo dados los escasos estudios, especialmente en Brasil.

Fadiga por compaixão em enfermeiros intensivistas: revisão integrativa / Compassion fatigue in intensive care nurses: integrative review / Fatiga por compasión en enfermeras de cuidados intensivos: revisión integradora

Introdução: A fadiga por compaixão é caracterizada pelo desenvolvimento de exaustão emocional, física e/ou espiritual como resultado do trabalho com indivíduos em estado crítico. Objetivos: analisar as evidências empíricas atuais relacionadas à prevalência, causas e resultados da fadiga por compaixão entre enfermeiros de cuidados intensivos. Método: Trata-se de uma revisão integrativa por meio de uma pesquisa avançada em bancos de dados: Pubmed, Scielo e Medline. A amostra foi composta por dez artigos que atenderam aos critérios de inclusão. A busca limitou-se a pesquisas realizadas de 2017 a 2022. Resultados: Os principais achados desta revisão integrativa foram que a prevalência de fadiga por compaixão entre os enfermeiros variou entre os diversos ambientes de cuidados intensivos. Em relação às causas e consequências da fadiga por compaixão, esta revisão descobriu que o ambiente de trabalho e a demografia dos enfermeiros, como idade e anos de experiência, foram preditores de fadiga por compaixão, e os fatores que atenuam os efeitos da fadiga por compaixão entre enfermeiros intensivista incluíram líder e suporte administrativo dentro do cenário clínico e as estratégias de enfrentamento empregadas pelos enfermeiros. Há evidências inconclusivas para identificar preditores explícitos de fadiga por compaixão entre enfermeiros intensivistas. Conclusão: É provável que o início da fadiga por compaixão entre os enfermeiros de cuidados intensivos possa ser reduzido com uma monitorização cuidadosa do bem-estar físico e emocional no ambiente de cuidados intensivos, bem como através da oferta de educação em saúde aos enfermeiros para ajudar no desenvolvimento de estratégias de enfrentamento para evitar fadiga da compaixão.

Introduction: Compassion fatigue is characterized by the development of emotional, physical, and/or spiritual exhaustion as a result of working with critically ill individuals. Aims: To analyze the current empirical evidence related to the prevalence, causes, and outcomes of compassion fatigue among critical care nurses. Method: This is an integrative review by means of an advanced search in databases: Pubmed, Scielo and Medline. The sample was composed of ten articles that met the inclusion criteria. The search was limited to research conducted from 2017 to 2022. Results: The main findings of this integrative review were that the prevalence of compassion fatigue among nurses varied across different acute care settings. Regarding the causes and consequences of compassion fatigue, this review found that work environment and nurse demographics, such as age and years of experience, were predictors of compassion fatigue, and factors that mitigate the effects of compassion fatigue among intensivist nurses included leader and administrative support within the clinical setting and the coping strategies employed by nurses. There is inconclusive evidence to identify explicit predictors of compassion fatigue among intensivist nurses. Conclusion: It is likely that the onset of compassion fatigue among intensive care nurses can be reduced with careful monitoring of physical and emotional well-being in the intensive care setting, as well as through the provision of health education to nurses to assist in the development of coping strategies to avoid compassion fatigue.

Introducción: La fatiga por compasión se caracteriza por el desarrollo de agotamiento emocional, físico y/o espiritual como resultado del trabajo con enfermos críticos. Objetivos: Analizar la evidencia empírica actual relacionada con la prevalencia, las causas y los resultados de la fatiga por compasión entre las enfermeras de cuidados intensivos. Método: Se trata de una revisión integradora a través de una búsqueda avanzada en las bases de datos: Pubmed, Scielo y Medline. La muestra se compuso de diez artículos que cumplían los criterios de inclusión. La búsqueda se limitó a investigaciones realizadas entre 2017 y 2022. Resultados: Los principales hallazgos de esta revisión integradora fueron que la prevalencia de la fatiga por compasión entre las enfermeras varió en los diferentes entornos de cuidados agudos. En relación con las causas y consecuencias de la fatiga por compasión, esta revisión encontró que el entorno de trabajo y los datos demográficos de las enfermeras, como la edad y los años de experiencia, fueron predictores de la fatiga por compasión, y los factores que mitigan los efectos de la fatiga por compasión entre las enfermeras de cuidados intensivos incluyeron el apoyo del líder y administrativo dentro del entorno clínico y las estrategias de afrontamiento empleadas por las enfermeras. No hay pruebas concluyentes para identificar predictores explícitos de la fatiga por compasión entre las enfermeras de cuidados intensivos. Conclusión: Es probable que la aparición de la fatiga por compasión entre las enfermeras de cuidados intensivos pueda reducirse con una cuidadosa monitorización del bienestar físico y emocional en el entorno de los cuidados intensivos, así como mediante la provisión de educación sanitaria a las enfermeras para ayudar en el desarrollo de estrategias de afrontamiento para evitar la fatiga por compasión.

Fadiga e satisfação por compaixão em profissionais oncológicos: revisão integrativa / Compassion fatigue and satisfaction in oncology professionals: an integrative review / Desgaste y satisfacción por empatía en los profesionales de oncología: una revisión integradora

Resumo Este artigo busca identificar fatores que podem promover ou prejudicar a qualidade de vida profissional dos profissionais oncológicos segundo critérios de fadiga e satisfação por compaixão. Utilizou-se estudo bibliográfico descritivo, tipo revisão integrativa, sem recorte temporal. Utilizaram-se as bases de dados CINAHL, Embase, Web of Science, PsycINFO, Scopus, MEDLINE e Biblioteca Virtual em Saúde para a pesquisa analisada por três revisores independentes. Incluíram-se estudos primários nos idiomas português, inglês e espanhol. Realizaram-se análise para alcançar os objetivos propostos neste estudo e síntese dos dados para a apresentação em tabelas e categorias temáticas. Como resultados, selecionaram-se 18 artigos para análise entre os 909 encontrados. Evidenciou-se que fatores sociodemográficos, internos e externos aos indivíduos podem alterar a qualidade de vida profissional. Concluiu-se que características intrínsecas e subjetivas, bem como aspectos do ambiente de trabalho, contribuíram para o desenvolvimento da fadiga por compaixão e da satisfação por compaixão.

Abstract This integrative review investigates the factors that may promote or harm the quality of life of oncology professionals, according to compassion fatigue and satisfaction criteria. Bibliographic research was conducted on the CINAHL, Embase, Web of Science, PsycINFO, Scopus, MEDLINE and Virtual Health Library databases. Primary studies published in Portuguese, Spanish and English were included. Of the 909 articles found, 18 were selected for analysis by three independent reviewers. Data were summarized in tables and thematic categories. Sociodemographic factors, internal and external to the individual, can alter professional quality of life. In conclusion, intrinsic and subjective characteristics, as well as work environment aspects, contribute to the development of compassion fatigue and satisfaction.

Resumen Este artículo identificó los factores que pueden promover o dificultar la calidad de vida profesional de los profesionales de oncología según criterios de desgaste y satisfacción por empatía. Se utilizó un estudio bibliográfico descriptivo, del tipo revisión integradora, sin corte temporal. El análisis de los datos recopilados en CINAHL, Embase, Web of Science, PsycINFO, Scopus, MEDLINE y Biblioteca Virtual en Salud fue realizado por tres evaluadores independientes. Se incluyeron estudios primarios en portugués, inglés y español. Se realizaron un análisis de los datos, para lograr los objetivos propuestos, y una síntesis para presentarse en tablas y categorías temáticas. Entre los 909 artículos encontrados, se seleccionaron 18 artículos para el análisis. Los factores sociodemográficos, internos y externos a los individuos, pueden alterar la calidad de vida profesional. Se concluye que las características intrínsecas y subjetivas, así como los aspectos del ambiente laboral contribuyeron al desgaste y la satisfacción por empatía.

An intervention to manage compassion fatigue in oncology nurses in Durban, South Africa

Background: Oncology nurses are involved through the often protracted and potentially traumatic continuum of diagnosis and treatment of their patients, which places them at high risk of developing compassion fatigue. Aim: The aim of the study was to develop and implement an in-facility intervention to manage compassion fatigue among oncology nurses in Durban, South Africa. Setting: The study was conducted with oncology nurses at state, private (private health insurance) and non-governmental oncology facilities (Hospice). Methods: The Self-Care Intervention for Oncology Nurses was developed and implemented using action research with a mixed methods sequential explanatory design. It involved an integrative review, Professional Quality of Life (ProQOL) v 5 questionnaires (n = 83) and indepth individual interviews (n = 8). Results: Developed from the findings of the integrative review, quantitative and qualitative data, the Self-Care Intervention for Oncology Nurses comprised three components, namely psycho-education on risks (booklet), practices of remembrance (remembrance tree) and support structures (support group and follow-up family call). Overall, the participants enjoyed reading the booklet and engaging in the support group. There were varied responses to the remembrance tree and hesitancy to partaking in the follow-up phone call. Conclusion: The developed intervention could encourage awareness of compassion fatigue amongst oncology nurses' engagement in self-care practices such as symbolic remembrance of patients and recognition of the value of support structures. Contribution: The intervention may assist oncology nurses in the provision of compassionate caring for their patients and potentially minimise compassion fatigue

The relationship between compassion fatigue and workplace psychological violence, alexithymia, and empathy among clinical nurses / 中国职业医学

Objective: To study the relationship between compassion fatigue and workplace psychological violence, alexithymia, and empathy in clinical nurses. Methods: A total of 1 159 clinical nurses from 10 cities in Henan and Fujian Provinces were enrolled using the method of grabbing random balls. Questionnaires including Workplace Psychologically Violent Behaviors Instrument, the Toronto Alexithymia Scale, Jefferson Scale of Empathy Health Professionals, Professional Quality of Life Scale were used to investigate the status of workplace psychological violence, alexithymia, empathy, and compassion fatigue in participants. Bootstrap analysis was used to analyze the relationship between workplace psychological violence, alexithymia, empathy, and compassion fatigue scores. Results: The average score for workplace psychological violence among clinical nurses was (26.2±6.5), with 405 nurses (34.9%) having experienced workplace psychological violence. The scores for alexithymia, empathy and compassion fatigue were (58.3±12.3), (104.3±18.6) and (48.5±6.7) respectively. Mild compassion fatigue was detected in 34.9% of participants, while moderate to severe compassion fatigue accounted for 48.8%. Bootstrap test result showed that workplace psychological violence had a positive impact on compassion fatigue ［standardized effect value (β)=0.40, 95% confidence interval(CI)： 0.35-0.44］. Workplace psychological violence had separate mediating effects through alexithymia (β=0.15, 95%CI： 0.10-0.19), empathy (β=0.16, 95%CI： 0.10-0.21) , and a chain mediating effect through alexithymia and empathy on compassion fatigue (β=0.06, 95%CI： 0.03-0.09). Conclusion: Compassion fatigue symptoms are relatively common among clinical nurses. Experiencing workplace psychological violence directly affects compassion fatigue and can indirectly affect it through the mediating effects of alexithymia and empathy.

Influence of compassion fatigue, psychological stress and positive psychological capital on overall happiness of firefighters / 中国职业医学

Objective: To study the relationship between compassion fatigue and overall happiness among firefighters, and the mediating role of psychological stress and positive psychological capital. Methods: A total of 894 firefighters in Shandong Province were selected as the research subjects using purposive sampling method. Questionnaires including the Professional Quality of Life Scale, the Military Psychological Stress Self-Assessment Scale, the Positive Psychological Capital Scale, and the Overall Happiness Scale were used for data collection. Results: The scores of compassion fatigue, psychological stress, positive psychological capital and overall happiness among firefighters were (40.1±13.5), (13.9±3.9), (133.0±26.4) and (84.9±15.2), respectively. There were correlations between compassion fatigue, psychological stress, positive psychological capital and overall happiness (all P<0.01). Psychological stress partially mediated the relationship between compassion fatigue and overall happiness, and the mediating effect accounted for 27.0% of the total effect. Positive psychological capital moderated the front half path and the direct path between compassion fatigue and overall happiness (all P<0.01). Conclusion: Compassion fatigue can directly or indirectly affect the firefighters' overall happiness. Psychological stress plays a partial mediating role and positive psychological capital plays a moderating role between compassion fatigue and overall happiness.

Comparison in the rise of Compassion Fatigue and Stress Levels for Male and Female COVID Caregivers

The COVID-19 pandemic has had a significant impact on everyone’s health, particularly the vulnerable populations. One such group is that of informal caregivers. The onset of the pandemic has led to many individuals assuming COVID caregiving responsibilities within their homes. They often already suffer from psychological and physical distress which has risen immensely during the pandemic. The research seeks to examine the rise in the level of Compassion Fatigue and Stress for these COVID caregivers and if their gender has had an impact on the same. In the context of this study, compassion fatigue refers to the condition of emotional and physical exhaustion experienced as a result of helping or wanting to help individuals experiencing trauma (in the case of the pandemic, people suffering from COVID-19). Constant exposure to such trauma can lead to a severely diminished ability to empathize and feel compassion. Eight COVID caregivers, including four males and four female, were interviewed and their responses have been analyzed within this paper. These caregivers are either salaried employees or self-employed professionals.

Relação entre satisfação por compaixão, burnout e estresse traumático com a segurança do paciente / Relación entre satisfacción por compasión, burnout y estrés traumático con la seguridad del paciente / Relationship among compassion satisfaction, burnout and traumatic stress with the patient safety

Objective: to analyze the relationship among compassion satisfaction, burnout, and secondary traumatic stress with the patient safety culture. Method: cross-sectional study with nurses (n = 201) from hospitals in Portugal. The Professional quality scale and the three sections of Hospital survey on patient safety culture were used to data collection. Correlation and regressions tests were implemented. Results: compassion satisfaction was positively related to four of the five patient safety culture dimensions and with the patient safety grade, while burnout had a negative relationship with all the dimensions and with the patient safety grade and secondary traumatic stress had a negative relationship with three patient safety culture dimensions. Conclusions: measures aimed at increasing compassion satisfaction and decreasing burnout and secondary traumatic stress should be implemented to improve the quality of professional life and patient safety.(AU)

Objetivo: analizar la relación entre satisfacción por compasión, burnout y estrés traumático secundario con la cultura de seguridad del paciente. Método: estudio transversal con enfermeras (n = 201) de hospitales de Portugal. Para la recopilación de datos se utilizaron la Professional quality scale y tres secciones de la Hospital survey on patient safety culture. Se implementaron pruebas de correlación y regresión. Resultados: la satisfacción por compasión se relacionó positivamente con cuatro de las cinco dimensiones de cultura de seguridad del paciente y con el grado de seguridad, mientras que burnout tuvo una relación negativa con todas las dimensiones y con el grado de seguridad y estrés traumático secundario tuvo una relación negativa con tres dimensiones. Conclusiones: se deben implementar medidas destinadas a aumentar la satisfacción por compasión y disminuir el burnout y el estrés traumático secundario para mejorar la calidad de vida profesional y la seguridad del paciente.(AU)

Objetivo: analisar a relação entre satisfação por compaixão, burnout e estresse traumático secundário com a cultura de segurança do paciente. Método: estudo transversal com enfermeiros (n = 201) de hospitais de Portugal. Para a coleta de dados, utilizou-se a Professional quality scale e três seções do Hospital survey on patient safety culture. Testes de correlação e de regressão foram implementados. Resultados: a satisfação por compaixão foi positivamente relacionada com quatro das cinco dimensões da cultura de segurança do paciente e com o grau de segurança do paciente, enquanto o burnout teve relação negativa com todas as dimensões e com o grau de segurança do paciente e o estresse traumático secundário teve relação negativa com três dimensões. Conclusões: medidas que visem aumentar a satisfação por compaixão e diminuir o burnout e o estresse traumático secundário devem ser implementadas visando melhorar a qualidade de vida profissional e a segurança do paciente.(AU)

A CASE STUDY ON COMPASSION FATIGUE AMONG TEACHERS HANDLING STUDENT WITH DISRUPTIVE BEHAVIOURS IN INCLUSIVE CLASSROOM

The case study highlights on examining the compassion fatigue among teachers handling student with disruptive behaviours in inclusive classroom. If a child has a diagnosis of disruptive behavior disorder, it may be decided to place him in a special classroom set up for more intensive behavior management. Compassion fatigue occurs when the person handling with the child with a disorder becomes so preoccupied with the disability of the child that it in turn makes the therapist or the helper stressful. Disruptive behavior disorders can seriously impact a child's daily life. Children with disruptive behavior disorders show ongoing patterns of uncooperative and defiant behaviors. Treatment procedures involve therapy for such children to reduce the behavioral issues and provide positive reinforcement to improve self-control. The present study adopted a qualitative approach, a semi-structured interview was conducted among six teachers to assess the compassion fatigue while handling student with disruptive behavior in three different inclusive schools. The teachers were interviewed individually on two occasions to gather information on the impact of this phenomenon. The interview data were coded and categorized using thematic analysis. Through this analysis, three criteria were generated, that is, preparation and adaptation of learning materials, instructional process, and interpersonal relationships. The results revealed that the six teachers go through different emotional problems due to disruptive behaviours exhibited by their students and had health-related issues. It also showed that teachers' were mostly concerned with the loss of their instructional time. As a result of this, these teachers were unable to deliver the curriculum within the allocated time. The teachers' reported that the impact is not only the disruptively behaved child but the learning of the rest of the students were also hindered due to the disruptive behavioural issues. The implications of the findings for teachers and further research are discussed

The correlation between the professional quality of life and job satisfaction of physicians and nurses currently working in COVID-19 areas of tertiary hospitals in Metro Manila and CALABARZON (Region IV-A) / The Health Sciences Journal

INTRODUCTION@#The COVID-19 pandemic put the healthcare worker’s professional quality of life (ProQoL) and job satisfaction (JS) at risk. This study determined the correlation between ProQoL, and the nine facets of and overall JS of physicians and nurses working in COVID-19 areas in Metro Manila and CALABARZON tertiary hospitals. It also determined their demographics, and measured the ProQoL, and overall JS and its nine facets.@*METHODS@#Physicians and nurses working in COVID-19 areas of tertiary hospitals in Metro Manila and CALABARZON were recruited and asked to answer the Professional Quality of Life Scale Version 5 and Job Satisfaction Survey. Correlation between ProQoL and JS was determined through Spearman’s correlation coefficient.@*RESULTS@#High overall JS among 90 physician and nurse respondents correlated with high compassion satisfaction (ρ = 0.310), low burnout (ρ = -0.480) and secondary traumatic stress (ρ = -0.240). Correlations were found between ProQoL, and overall JS and pay, supervision, contingent rewards, coworkers, nature of work, and communication. A strong negative correlation between pay and burnout was observed (ρ = -0.500).@*CONCLUSION@#The overall JS of physicians and nurses has a moderate positive correlation with compassion satisfaction, moderate negative correlation with burnout, and low negative correlation with secondary traumatic stress. Pay and burnout have a strong negative relationship.

The effectiveness of psychological intervention on nursing staff' compassion fatigue: a meta-analysis / 中华劳动卫生职业病杂志

Objective: To systematically evaluate the impact of psychological intervention on nursing staff' compassion fatigue. Methods: From March to May 2020, PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, Wanfang and other databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of psychological intervention on nursing staff' compassion fatigue with the main search terms including compassion fatigue, nurs*, psychological intervention, mental intervention, RCT and so on from inception to March 31, 2020. Screened literature, extracted data and assessed the risk of bias of included studies. The Stata 16.0 software was used to calculate the pooled effectiveness of psychological intervention on nursing staff' compassion fatigue. Results: All 13 RCTs were enrolled, including 940 nursing staff. Meta-analysis results demonstrated that the psychological intervention group was superior to the control group in the improvement of the compassion fatigue score (SMD=-0.96, 95%CI: -1.17-0.74, P=0.001) , compassion satisfaction score (SMD=0.61, 95%CI: 0.45-0.77, P=0.002) , burnout score (SMD=-0.46, 95%CI: -0.62-0.29, P=0.006) , secondary trauma score (SMD=-0.40, 95%CI: -0.68-0.12, P=0.020) , and the difference was statistically significant. Subgroup analysis found that the psychological intervention group was more effective than the control group in improving compassion satisfaction score, reducing burnout score and secondary trauma score, and the differences were statistically significant (P<0.05) in different intervention time (<8 weeks and ≥8 weeks) and intervention methods. Conclusion: The psychological intervention can improve the level of compassion satisfaction, and reduce the compassion fatigue among nursing staff, and have a certain preventive effect on compassion fatigue.

Professional quality of life of nurses in critical care units: Influence of demographic characteristics

Background. Professional quality of life, measured as compassion satisfaction, is a prerequisite for nurses working in intensive care units where patients rely on their care. Nurses who experience compassion satisfaction, or good professional quality of life, engage enthusiastically with all work activities and render quality patient care. In contrast, compassion fatigue eventually leads to disengagement from work activities and unsatisfactory patient outcomes. In this study, we described the demographic factors influencing professional quality of life of intensive care nurses working in public hospitals in Gauteng, South Africa (SA), during the first wave of the COVID-19 pandemic. Objective. To describe the demographic factors associated with professional quality of life of critical care nurses working in Gauteng, SA. Methods. In this cross-sectional study, we used total population sampling and invited all nurses who had worked for at least 1 year in one of the critical care units of three selected public hospitals in Gauteng to participate. One-hundred and fifty-four nurses responded and completed the ProQol-5 tool during the first wave of the COVID-19 pandemic. Data were analysed using descriptive and inferential statistics. Results. The nurses' average age was 45 years, and 59.1% (n=91) had an additional qualification in critical care nursing. Most of the nurses had a diploma (51.3%; n=79), with a mean work experience of 12.56 years. The main demographic variables that influenced professional quality of life were years of work experience (p=0.047), nurses' education with specific reference to a bachelor's degree (p=0.006) and nurse-patient ratio (p<0.001). Conclusions. Nurses working in critical care units in public hospitals in Gauteng experienced low to moderate compassion satisfaction, moderate to high burnout and secondary traumatic stress, suggesting compassion fatigue. The high workload, which may have been associated with the COVID-19 pandemic, influenced nurses' professional quality of life.

Phenomenological study of the effects of traumatic birth events on compassion fatigue among midwives / 中国实用护理杂志

Objective:To provide theoretical reference for the construction of effective prevention and control strategies. The study deeply investigates the impact of traumatic birth events on compassion fatigue and inner feelings of midwives.Methods:Fifteen midwives from five tertiary hospitals in Guangzhou were interviewed in depth by semi-structured interview method from April to June 2021. Colaizzi analysis and Nvivo12 plus software were used to analyze and integrate the data and extract themes.Results:Three main themes were extracted, including the characteristics of traumatic birth events (high incidence, sudden and dangerous, preventable and controllable); exacerbating compassion fatigue (reducing compassion satisfaction levels; exacerbating burnout; and aggravating traumatic stress responses); and exploring effective coping strategies (time required for adjustment, seeking stress release).Conclusions:As a strong stressor, traumatic birth events aggravate the symptoms of compassion fatigue in midwives. Managers should pay attention to the occupational exposure of traumatic childbirth events, actively guide midwives to make psychological adjustments. In addition, managers can increase social support and strengthen the ideological and political education of midwives, so that they have good stress tolerance and excellent professional psychological quality.

Family supportive supervisor behavior and compassion fatigue of operating room nurses: the chain mediating effect of bidirectional work-family conflict / 中国实用护理杂志

Objective:To explore the relationship between family supportive supervisor behavior and compassion fatigue of operating room nurses and the mediating role of bidirectional work-family conflict, that is, work interference with family and family interference with work.Methods:In November 2021, a total of 350 operating room nurses in Qilu Hospital of Shandong University, the Second Hospital of Shandong University, and the First Affiliated Hospital of Shandong First Medical University were surveyed by convenience sampling method with questionnaires of self-made general information questionnaire, Work-Family Conflict Scale, Family Supportive Supervisor Behavior Short-Form, and Professional Quality of Life Scale.Results:Family supportive supervisor behavior was negatively correlated with work interference with family and compassion fatigue ( r= -0.211, -0.245, both P<0.01). Work interference with family was positively correlated with compassion fatigue and family interference with work ( r=0.383, 0.274, both P<0.01). Family interference with work was positively correlated with compassion fatigue ( r=0.249, P<0.01). There was no correlation between family supportive supervisor behavior and family interference with work ( r=0.040, P>0.05). The structural equation model showed that bidirectional work-family conflict had multiple chain mediating effects between family supportive supervisor behavior and compassion fatigue ( P<0.05), and the mediating effects were -0.082, accounting for 21.6% of the total effect. Conclusions:Family supportive supervisor behavior can directly or indirectly affect compassion fatigue through work-family conflict. Managers can adopt supportive human resource management policies by implementing family supportive supervisor behavior, to help operating room nurses flexibly balance work-family relationships and reduce role conflict, so as to alleviate the compassion fatigue of operating room nurses.