Compassion fatigue in healthcare providers during the COVID-19 pandemic: a scoping review protocol.

INTRODUCTION: The COVID-19 pandemic has negatively impacted the psychological health and well-being of healthcare providers. An amplification in chronic stressors, workload and fatalities may have increased the risk of compassion fatigue and disrupted the quality of patient care. Although current studies have explored the general psychological status of healthcare providers during the COVID-19 pandemic, few have focused on compassion fatigue. The purpose of this review is to explore the impacts of the COVID-19 pandemic on compassion fatigue in healthcare providers and the repercussions of compassion fatigue on patient care. METHODS AND ANALYSIS: This scoping review will follow Joanna Briggs Institute and Arksey and O'Malley scoping review methodology. Comprehensive searches will be conducted in the following relevant databases: MEDLINE (Ovid), PsycINFO (Ovid), Embase (Ovid), CINAHL, Scopus, Web of Science. To expand the search, reference lists of included studies will be handsearched for additional relevant studies. Included studies must report on the impact of COVID-19 pandemic on compassion fatigue in healthcare providers and have been published in English since January 2020. ETHICS AND DISSEMINATION: This review does not require research ethics board approval. By examining the impacts of the COVID-19 pandemic on compassion fatigue in healthcare providers, this scoping review can offer important insight into the possible risks, protective factors and strategies to support healthcare providers' psychological health and patient care amidst persisting stressful conditions.

Exploring the Interprofessional Contributions of Spiritual Health Practitioners to Prevent Compassion Fatigue in Nurses.

BACKGROUND: Few studies in academic literature involve the application of a spiritual health intervention for the purpose of mitigating compassion fatigue in nurses. OBJECTIVES: The purpose of this qualitative study was to explore the perspectives of Canadian spiritual health practitioners (SHPs) in their support for nurses to prevent compassion fatigue. METHOD: Interpretive description was utilized for this research study. Sixty-minute interviews with 7 individual SHPs were conducted. Data were analyzed with NVivo 12 software (QSR International, Burlington, Massachusetts). Thematic analysis identified common themes that allowed data from interviews, a pilot project on psychological debriefing, and a literature search to be compared, contrasted, and compiled. RESULTS: The 3 main themes were found. The first theme highlighted the underlying issue of how spirituality is ranked or viewed within health care and the impact of leadership integrating spirituality in their practice. The second theme related to SHPs' perception of nurses' compassion fatigue and lack of connection to spirituality. The final theme explored the nature of SHP support to mitigate compassion fatigue before and during the COVID-19 pandemic. DISCUSSION: Spiritual health practitioners are positioned in a unique role to be facilitators of connectedness. They are professionally trained to provide a type of in situ nurturing for patients and health care staff through spiritual assessments, pastoral counseling, and psychotherapy. The COVID-19 pandemic has revealed an underlying desire for in situ nurturing and connectedness in nurses due to an increase in existential questioning, unusual patient circumstances, and social isolation leading to disconnectedness. Organizational spiritual values are recommended to be exemplified by those in leadership to create holistic, sustainable work environments.

Compassion Fatigue Education: What Is Available Online for Nurses? A Consumer Website Review.

BACKGROUND: Nurses have been identified as the most vulnerable health care profession to experience compassion fatigue. Currently, not much is known about the availability and credibility of online compassion fatigue resources for nurses. This systematic review of consumer websites explores the prevalence and quality of compassion fatigue educational resources available online to nurses. METHOD: A descriptive, cross-sectional, nonexperimental design was used. Findings were collected from the websites of the top 20 hospitals in the United States, all professional nursing organizations in the United States, and the top three most used social media platforms. Web-sites were evaluated for quality using the Journal of the American Medical Association (JAMA) benchmarks and Health on the Net Foundation certification. RESULTS: A total of 143 websites were evaluated. Of these, three websites were identified as having the most credible, comprehensive educational resources on compassion fatigue. CONCLUSION: There is a need for more hospitals, professional nursing organizations, and social media websites to provide high-quality compassion fatigue educational resources for nurses. [J Contin Educ Nurs. 2023;54(5):216-224.].

Compassion fatigue and COVID-19: A global view from nurses.

BACKGROUND: Due to the rapid spread of COVID-19 variants, the number of people hospitalized for COVID-19 may create psychological burdens on nurses. Nurses with high levels of compassion fatigue (CF) are more likely to make work errors, deliver poor-quality care, and have greater intent to leave their position. OBJECTIVES: This study utilized the social-ecological model to examine factors associated with nurses' CF and compassion satisfaction (CS) during the COVID-19 pandemic. METHODS: Data were collected from the United States, Japan, and South Korea from July to December 2020. The Professional Quality of Life Scale was used to measure burnout (BO), secondary traumatic stress (STS), and CS. RESULTS: Data from 662 responses were used in the analysis. Mean scores were 25.04 (±6.44) for BO, 24.81 (±6.43) for STS, and 37.85 (±7.67) for CS. Multiple regression analyses indicated that resilience and intention to leave nursing were related to each study outcome (i.e., BO, STS, and CS). Greater resilience predicted lower BO and STS but greater CS, whereas intention to leave nursing indicated greater BO and STS, but lower CS. Furthermore, intrapersonal factors and organizational factors (i.e., nurses involved in developing policies to prepare for COVID-19 patients, organizational support, and personal protective equipment [PPE] provisions) were related to BO, STS, and CS. LINKING EVIDENCE TO PRACTICE: To promote nurses' psychological well-being, improvement of organizational factors such as support, PPE, and programs to enhance resilience is recommended to prepare for future emerging infectious disease crises.

Resilience of hospital staff facing COVID-19 pandemic: Lessons from Israel.

Introduction: The COVID-19 pandemic has placed additional burden on already strained healthcare systems worldwide, intensifying the responsibility and burden of healthcare workers. Although most hospital staff continued working during this stressful and challenging unprecedented pandemic, differences in the characteristics and attributes were noted between sectors and hospital departments. Israeli healthcare workers are trained and experienced in coping with national emergencies, but the pandemic has exposed variations in staff reactions. Understanding the intrinsic differences between sectors and departments is a key factor in staff and hospital preparedness for unexpected events, better resource utilization for timely interventions to mitigate risk and improve staff wellbeing. Objective: To identify and compare the level of resilience, secondary traumatization and burnout among hospital workers, between different sectors and hospital departments, during the COVID-19 pandemic. Methods: Cross-sectional research to assess the resiliency, secondary traumatization and burnout of healthcare workers at a large general public hospital in central Israel. The sample consisted of 655 participants across various hospital units exposed to COVID-19 patients. Results: Emergency department physicians had higher rates of resilience and lower rates of burnout and secondary traumatization than staff in other hospital departments. In contrast, staff from internal medicine departments demonstrated the highest levels of burnout (4.29). Overall, physicians demonstrated higher levels of resilience (7.26) and lower levels of burnout compared to other workers. Conclusion: Identifying resilience characteristics across hospital staff, sectors and departments can guide hospital management in education, preparation and training of healthcare workers for future large-scale health emergencies such as pandemics, natural disasters, and war.

Differences in the Long-term Impact of the COVID-19 Pandemic on the Mental Health and Professional Quality of Life of Resident and Specialist Physicians.

BACKGROUND: The COVID-19 pandemic created an extremely difficult situation for healthcare workers (HCWs) worldwide. We aimed to compare the mental health and professional quality of life of residents and specialist physicians in a cohort of Italian HCWs caring for patients with COVID-19 about two years after the start of the COVID-19 pandemic. METHODS: In November 2021, an online survey investigating the emotional states of depression, anxiety, stress, compassion satisfaction and compassion fatigue was administered to HCWs (N= 78) at the Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome. RESULTS: Our findings suggest that from 5 to 20% of our cohort of HCWs still showed the effects of the adverse psychological impact of the pandemic and more than half of them experienced medium levels of compassion fatigue as well as a medium level of compassion satisfaction. Our results also show that those with fewer years of clinical practice might be at greater risk of burnout (p= 0.021), anxiety and stress symptoms (both ps= 0.027) and might develop a lower level of compassion satisfaction (p=0.018). Moreover, the factors that potentially contribute to poor mental health, compassion fatigue and compassion satisfaction seem to differ between residents and specialist physicians. CONCLUSIONS: This overview presents one of the first pictures of the long-term effects of the pandemic on the mental health and professional quality of life of an Italian sample of HCWs. Moreover, it also helps identify professionals who are most in need of support and emphasises the importance of improving the psychological and professional wellbeing of these individuals especially during a pandemic-like crisis with long lasting effects.

Debriefing Among Hospice Professionals During a Pandemic.

Although the hospice industry cannot afford to lose professionals to compassion fatigue and burnout, work challenges related to the COVID-19 pandemic potentially place hospice professionals at an increased risk. Reflective debriefing has been recommended to provide emotional support to battle job dissatisfaction, compassion fatigue, and burnout. The purpose of this study was to provide reflective debriefing sessions to hospice professionals and identify common themes reported about their professional and personal experiences during the COVID-19 pandemic. A qualitative descriptive design using focus groups set up as reflective debriefing sessions based on the Gibbs' Reflective Cycle was used. Debriefing sessions were recorded and transcribed for coding, followed by identification of themes. A total of 26 themes emerged from the data collected from the debriefing sessions. A postsurvey found that 96.0% of participants found the debriefing session helpful. Furthermore, 92.3% of participants answered they would like to regularly debrief at their workplace. During the pandemic, hospice professionals are at an increased risk of compassion fatigue and burnout from changes in the work, patient, and person environments caused by the pandemic. To address the unprecedented challenges hospice professionals are facing, it is imperative that employers provide them with emotional support.

Relationships between leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic.

AIM: To reveal the relationships between the leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic. DESIGN AND METHODS: This descriptive and cross-sectional study was performed with 353 nurse professionals participating from 32 cities across Turkey. The data were collected online between August and November 2020 by using the introductory information form, Minnesota Satisfaction Questionnaire, Leadership Behaviour Questionnaire and Compassion Fatigue subdimension of the Professional Quality of Life Scale. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed in the study. RESULTS: Nurses mostly stated their managers as employee-oriented and change-oriented leaders. Nurses' intrinsic and overall satisfaction was high, extrinsic satisfaction was low and their compassion fatigue was at a critical level during the pandemic. According to nurses' personal and professional characteristics, there were significant differences in job satisfaction, compassion fatigue and change-oriented leadership scores. When nurse managers exhibit employee-oriented leadership behaviour, nurses' compassion fatigue decreases and job satisfaction increases.

The Well-Being of Peer Supporters in a Pandemic: A Mixed-Methods Study.

BACKGROUND: Peer support is an effective, well-received approach to caring for health care professionals who face stress, challenges, and reduced well-being. Peer supporters may be at risk for emotional exhaustion and secondary traumatic stress due to their primary roles and involvement as peer supporters during the COVID-19 pandemic. METHODS: Peer supporters from five well-established peer support programs completed surveys (ProQOL and a five-item emotional exhaustion measure) to assess secondary traumatic stress, compassion satisfaction, and burnout during the pandemic. Analysis of variance models analyzed differences in these well-being outcomes by role, age, years in health care, and working in high-risk areas. Qualitative content analysis was performed for open-response questions about challenges, needs, and successful well-being strategies using Braun and Clarke's six-phase thematic analysis. RESULTS: A total of 375 peer supporters completed the survey between spring and summer 2021 for a response rate of about 38%. Most participants had low secondary traumatic stress and moderate to high compassion satisfaction; nearly 44% had concerning levels of emotional exhaustion. Compassion satisfaction was significantly lower (p = 0.003) and emotional exhaustion significantly higher (p < 0.001) among the youngest cohort, and both compassion satisfaction and emotional exhaustion differed across career stages (p = 0.003 and p = 0.04, respectively). Emotional exhaustion was significantly higher in peer supporters working in COVID units than in non-COVID units (p = 0.021). Peer supporters identified numerous protective and risk factors associated with serving as a peer supporter. CONCLUSION: Despite having moderate to high levels of compassion satisfaction, peer supporters report high levels of burnout and numerous challenges and needs to sustain their well-being. To maintain effective peer support programs during the ongoing pandemic, health care organizations must study and support the well-being of health care professional peer supporters.

Compassion and decision fatigue among healthcare workers during COVID-19 pandemic in a Colombian sample.

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals.

Clinician Perceptions of Incorporating Yoga into Therapeutic Practice.

Despite increased interest in mindfulness practices such as yoga as an adjunct for depression, anxiety, and other chronic health concerns, little research exists on the potential benefits of yoga in therapeutic settings. As a complementary therapy, yoga provides a value-added benefit to traditional clinical practices for (1) clinicians as a form of self-care in treating compassion fatigue caused by, for example, fallout from the COVID-19 pandemic, and (2) the patients they serve. The primary goal of the present study was to understand clinician perspectives of yoga as an intervention in the therapeutic setting for clinicians and clients. We conducted a qualitative study and surveyed therapists from a yoga teacher training program designed specifically for clinical therapists. Eight therapists completed a qualitative questionnaire designed to understand the effects of yoga on clinicians and patients in the therapeutic setting. Although the effects of COVID-19 had not been anticipated, survey results corroborate high rates of compassion fatigue for therapists and a decline in mental health for patients throughout the study. Yoga, specifically body awareness and breathwork, however, provided a baseline for navigating mental health for both patients and therapists amid the pandemic. Additionally, body awareness and breathwork were found to help therapists avoid burnout and compassion fatigue and facilitate a more positive therapy experience for patients and therapists. Yoga has the potential to be a positive adjunct in therapeutic settings and would benefit from further research into various applications.

Assessment of Compassion Fatigue and Empathy Levels in Nurses During the COVID-19 Outbreak: Turkey's Case.

This study was conducted to determine the compassion fatigue level of nurses and to review several variables believed to be associated with it; in addition, an assessment is made of empathy levels in the same group. This is a cross-sectional study conducted from December 2021 to May 2022 on nurses working at a city hospital linked to the Turkish Ministry of Health. The study group consisted of 616 nurses. A Personal Information Form, the Compassion Fatigue-Short Scale (CF-SS), and the Jefferson Scale of Empathy were used to collect data. Data were collected through face-to-face interviews. Student's t-test, One-Way Analysis of Variance, and Multiple Linear Regression Analysis were used for data analysis. The statistical significance value was accepted as p < 0.05. The study group consisted of 499 (81.0%) females and 117 (19.0%) males, and their ages ranged from 20 to 51, with a mean age of 29.2 ± 6.9 years. The scores obtained from the CF-SS ranged from 16 to 130, with a mean score of 70.96 ± 25.04. The level of compassion fatigue was found to be higher in participants with a low family income, those who work more than 40 h a week, those who chose their profession unwillingly, those who are not satisfied with their profession, and those with a history of contact with a COVID-19 patient (p < 0.05 for each group). There was a significant association between levels of compassion fatigue and empathy (r = 0.92; p = 0.220). The level of compassion fatigue was found to be moderate in the nurses observed. The factors affecting the level of compassion fatigue included gender, family income, reasons for choosing nursing as a profession, the number of patients given daily care by the nurses, satisfaction with their profession, and history of contact with a COVID-19 patient. More extensive studies focusing on the association between compassion fatigue and empathy in nurses are needed.

Compassion satisfaction, compassion fatigue, and vicarious trauma.

A descriptive study of the impact of the COVID-19 pandemic on non-direct care nurses.

Becoming an inner ally: the compassionate minds approach to self-compassion - an online programme.

A rapidly growing body of evidence indicates the enormous psychological burden of working in health care on nurses and other health professionals that is resulting in high levels of psychological problems. These will have profound effects on individuals and long-term ramifications for healthcare systems. Effective interventions that can counter the adverse psychological effects of caring during the COVID-19 pandemic and beyond are urgently required. With this in mind, the authors have created an online self-compassion programme to advance the health and wellbeing of the nursing workforce through developing proactive evidence-based preventive teaching and learning strategies to promote compassion satisfaction and prevent compassion fatigue by improving self-compassion. The online programme is underpinned by compassionate minds theories and research.

Prevalence of Compassion Fatigue and Its Association with Professional Identity in Junior College Nursing Interns: A Cross-Sectional Study.

Background: The issue of compassion fatigue among clinical nurses has received considerable attention, particularly during the COVID-19 pandemic. Yet, the current status of compassion fatigue among junior college nursing interns remains unclear. Additionally, professional identity can modulate the impact of compassion fatigue or burnout on psychological well-being; however, whether professional identity still works in this group is also unclear. This study aimed to reveal the current status of compassion fatigue among nursing interns in junior colleges and also investigate the association between compassion fatigue and professional identity. Methods: This cross-sectional survey evaluated the levels of participants' compassion fatigue (The Compassion Fatigue Short Scale) and professional identity (Professional Identity Scale) in 2256 nursing interns. Results: The mean score of compassion fatigue was 44.99, and 19.5% of the participants scored above The Compassion Fatigue Short Scale median scores for compassion fatigue. A moderate negative correlation was detected between compassion fatigue and professional identity. Conclusions: The level of compassion fatigue among nursing interns is low but nearly one in five nursing students is at risk of compassion fatigue. More attention should be paid to nursing interns with a high risk of compassion fatigue. Future studies are warranted to explore which pathways could mediate the relationship between professional identify and comparison fatigue.

Assessing the impact of the COVID-19 pandemic on nurse practitioners' professional quality of life.

BACKGROUND: The COVID-19 global pandemic has put health care professionals under immense pressure and hindered their ability to provide quality services. PURPOSE: This study aimed to examine the professional quality of life (ProQOL) among Georgia nurse practitioners during the COVID-19 global pandemic. METHODOLOGY: The ProQOL survey was distributed to nurse practitioners in Georgia by the professional organization's listserv. Multiple analysis of variance (ANOVA) analyses were performed to assess differences between employment settings, geographic location, and other relevant demographic qualifiers and levels of compassion satisfaction, burnout, and secondary traumatic stress. RESULTS: Hundred nurse practitioners (NPs) (n = 100) responded to the survey. Ninety-one percent were female and ages 25-35 years. Male NPs showed higher rates of compassion fatigue and secondary traumatic stress. CONCLUSIONS: A ProQOL survey demonstrated increased burnout and secondary traumatic stress among frontline practitioners in Georgia due to increased workloads, feelings of inadequacy, fear of being infected by the virus, and prolonged exposure to deaths. IMPLICATIONS: Ensuring effective communication, team collaboration, emotional, adequate staffing, and psychological support can help reduce compassion fatigue among NPs.

Compassion fatigue among frontline healthcare workers during the covid-19 pandemic in Tunisia.

BACKGROUND: Healthcare workers (HCWs) are highly vulnerable to compassion fatigue (CF), which not only leads to decreased mental and physical health, but also to deterioration in the safety of care delivered. Our study aims to measure compassion satisfaction (CS), CF levels and their predictors among Tunisian HCWs. METHODS: We conducted a cross-sectional study among HCWs caring for confirmed and suspected Covid-19 patients, staff at two university hospitals in Sousse, Tunisia during the 4thwave of coronavirus through a self-administrated Questionnaire, using the French version of the Professional Quality of Life scale ProQol, version 5. RESULTS: A total of 274 professionals were recruited with a mean age of 32.87±8.35 years. HCWs tend to have an overall moderate levels of compassion satisfaction, secondary traumatic stress and burnout with mean scores 35.09±7.08, 29.72±7.62, 28.54±5.44 respectively. Self-reported resilience (ß = 0.14, p = 10-3), work engagement (ß = 0.39, p = 10-3) and burnout (ß = -0.32, p = 10-3) were the predictors of compassion satisfaction in the linear regression analysis (adjusted r2 = 0.45). Similarly, limited work experience, compassion satisfaction and secondary traumatic sub-scores were the determinants of burnout (ß = -0.1, p = 0.04; ß = -0.54, p = 10-3; ß = 0.35, p = 10-3 respectively); (adjusted r2 = 0.48). Regarding STS, female professionals (ß = 0.20, p = 10-3), being married (ß = 0.19, p = 10-3), the fear of transmitting the infection (ß = 0.11, p = 0.03) and burnout (ß = 0.39, p = 10-3) were the predictors for the occurrence of secondary traumatic stress (adjusted r2 = 0.48). CONCLUSION: More resilience promoting interventions and more coping skills programs must be implemented to fulfill HCWs' psychological well-being needs.

Mindfulness-Based Intervention for the Reduction of Compassion Fatigue and Burnout in Nurse Caregivers of Institutionalized Older Persons with Dementia: A Randomized Controlled Trial.

The recent COVID-19 pandemic has severely impacted the mental health of nurses caring for institutionalized older people. Caring in this environment can be complex, with higher levels of burnout and compassion fatigue in staff. It is therefore important to find interventions to increase the well-being of staff. Mindfulness training is known to be effective in treating a variety of physical and mental health conditions. This study sought to conduct a direct evaluation of the effectiveness of a combined online training in two types of mindfulness-based therapies for the reduction of compassion fatigue and burnout in geriatric nurses caring for institutionalized elderly people with dementia. In a randomized controlled trial (n = 39 experimental group, n = 35 control group), we explored whether individuals with high levels of burnout and compassion fatigue would benefit more from an online mindfulness training program. The outcome variable was the ProQoL professional quality of life scale, which was collected at baseline, at six weeks, and at three months after completion of the intervention. Significant differences were found between both groups for the subscales Compassion Fatigue and Burnout (p < 0.05), with a significant improvement in the experimental group (significant effect size). These findings were maintained at three months after the end of the intervention for both compassion fatigue (F1,28 = 18.14, p = 0.003) and burnout (F1,28 = 7.25, p = 0.040). However, there were no differences between groups for the satisfaction subscale. The effect of time and the effects of comparing the two groups after controlling for time were statistically significant for all three subscales of the questionnaire (all p values < 0.001), with effect sizes ranging from small to large (R2 change 0.10-0.47). These data indicate that the experimental condition was more effective, explaining between 10 and 18% more of the variance. A short, online intervention based on mindfulness training appears to be effective for reducing compassion fatigue and burnout in geriatric nurses, with sustained effects over time.