Compassionate Care: A Qualitative Exploration of Nurses' Inner Resources in the Face of Burnout.

There is a universal shortage of nurses, with a current needs-based shortage of 5.9 million. This is not solely a recruitment issue but one of retention, triggered by high levels of work-induced stress, burnout, and reports of low job satisfaction resulting in poor care delivery. Some of the health repercussions on nurses include anxiety, insomnia, depression, migraines, irritability, absenteeism, and sometimes alcoholism and drug abuse. To tackle some of these costly issues, a qualitative exploration into how inner resources is used by nurses to cope with stress at different points of their careers is proposed. Through the lens of grounded theory, semi-structured interviews will be carried out with two distinct sets of participants: (1) Student nurses registered at the University of the Illes Baleares between 2022-2025. (2) Experienced nurses on the Balearic nursing register. Interviews will be coded and then analysed using Atlas.ti. Expected results will inform curriculum improvements that will benefit the well-being of (student) nurses, from the outset of their training, pre-empting potential psycho-social risks before they arise in the workplace. This is vital as it addresses nurses' mental health as well as chronic issues of retention and absenteeism.

Validation of the Spanish version of the five-item General Self-Efficacy (GSE) scale in a sample of nursing students: Evidence of validity, reliability, longitudinal invariance and changes in general self-efficacy and resilience in a two-wave cross-lagged panel model.

AIM: The aim of this study is to validate the Spanish version of the five-item General Self-Efficacy scale in a sample of nursing students, by: 1) offering evidence of validity and reliability; 2) studying the longitudinal measurement invariance of the scale; 3) providing evidence on the changes in the levels of self-efficacy that occur after one year of nursing education; and 4) offering longitudinal evidence on the relationship between nursing students' self-efficacy and resilience levels. BACKGROUND: Nurses' general self-efficacy has been related to both personal and organizational outcomes. In Spain, some competencies the students must acquire during the Degree in Nursing implicitly refer to self-efficacy. For the measurement of general self-efficacy, the General Self-Efficacy Scale is one of the most widely used in Europe. DESIGN: A longitudinal design was used. Research took place at the University of Valencia and the University of the Balearic Islands (Spain). Participants were 324 nursing students, in the first year of the Nursing Degree. METHODS: The five-item General Self-Efficacy scale and the Brief Resilience Coping Scale were used. Analyses included descriptive statistics, reliability estimates, confirmatory factor analysis, a longitudinal measurement invariance routine and several competing cross-lagged models. RESULTS: Evidence of reliability shown by the scale was adequate and a one-factor solution for the structure was found. Additionally, the five-item GSE showed evidence of invariance over time. A causal effect of self-efficacy on nursing students' levels of resilience was found. CONCLUSIONS: The Spanish version of the five-item General Self-Efficacy scale is a brief instrument that can contribute to the assessment of some of the basic competencies of the Degree in Nursing, which improve during their education and how these changes are related to other skills important for the nursing profession, such as resilience.

The role of social and intellectual activity participation in older adults' cognitive function.

THEORETICAL BACKGROUND: A challenge of the ageing of the population is cognitive performance, given its association to optimal ageing. Documented predictors of cognition have included socio-demographics, education or physical factors. However, the association of social and intellectual activity participation to cognition has been less studied. AIM: This study presents a predictive model of cognitive functioning including these alternative factors as well as more seminal ones to explain cognition in old age. MATERIALS AND METHODS: The sample was composed by 45475 older adult participants in the 8th Wave of the Survey of Health, Aging and Retirement in Europe, that took place between 2019 and 2020. A correlational design was specified to test the effects of age, gender, years of education, physical inactivity, number of chronic diseases, social activity participation and intellectual activity participation on temporal orientation, numeracy, verbal fluency and memory. A completely a priori Structural Equation Model with latent variables was tested. RESULTS: The sample had an average of 70 years of age, was well-educated and physically active and engaged in reading. There was a higher proportion of females. The model showed an optimal fit to the data, explaining 8.7%-36.0% of the different cognitive components' variance. Age, years of education and intellectual activity displayed the largest effects across the cognitive domains. CONCLUSIONS: Findings suggest that social and intellectual activity participation are of relative importance to predict cognition in old age, even when considering other well-documented factors affecting older adults' cognitive functioning.

Cross-Sectional Study of the Professional Quality of Life of Palliative Care Professionals during the COVID-19 Pandemic.

BACKGROUND: The display of compassionate care by palliative care professionals is of the utmost importance to the patients, their families, and even to their own professional well-being. Lately and, especially due to the emergence of the COVID-19 pandemic, palliative care professionals have been subjected to greater pressures stemming from their work environment, organizational standpoint, and emotional sense of view. Not only have these factors made it harder for professionals to deliver compassionate care to their patients, but they have also decreased their overall well-being. The aim is to study how sociodemographics, workplace characteristics, internal resources, and the COVID-19 pandemic-derived pressures have affected the professionals' capacity to perform compassionate care and their well-being while at the same time exploring the relationship between compassionate care and well-being. METHODS: This study used a cross-sectional design with data gathered from Spanish palliative care professionals. The final sample was formed by 241 participants. They were surveyed about compassion, professional quality of life, well-being, sociodemographic data, working conditions, self-care, and coping with death competence, and the impact of the COVID-19 pandemic. The analyses used were descriptive statistics, bivariate tests, and the construction of a structural equation model. RESULTS: Compassion was predicted by the ability to control their workload and the ability to cope with death. Burnout was predicted by age, workload, workload control, self-care, material resources, and changes in teamwork. Moreover, compassion, age, workload control, and changes in teamwork and self-care were shown to significantly predict compassion satisfaction. When it comes to compassion fatigue, different variables were shown to predict it, those being compassion, control over the workload, social self-care, and the ability to cope with death. CONCLUSIONS: Having a healthy lifestyle and an adequate social support system is key to maintaining professional well-being in the case of palliative care professionals. Inner resources such as the ability to perform self-care and the capacity to cope with death are of vital importance to taking care of these professionals. Thus, it would be beneficial to establish training programs focused on these aspects in the myriad of sanitary centers that perform these tasks, as these abilities are necessary to withstand the work-related pressures and, at the same time, be able to provide compassionate care for patients.

Using latent profile analysis to understand palliative care professionals' quality of life during the COVID-19 pandemic.

Healthcare workers' professional quality of life has been increasingly under the spotlight, even more so during the COVID-19 pandemic, which has posed a genuine challenge for them. This study aims to describe the professional quality of life profiles of a sample of Spanish palliative care professionals during the COVID-19 pandemic, encompassing aspects such as work satisfaction, burnout, compassion fatigue, and compassion satisfaction; while studying the relationships between these profiles and sociodemographic variables, clinical situations experienced during the pandemic, protectors of professional quality of life, the quality of care delivered, and the professionals' wellbeing. Data from a survey of Spanish palliative care professionals were used. The variables measured were professional quality of life, sociodemographic characteristics, COVID-19-related experiences, protectors of professional quality of life, wellbeing, and quality of care. Our research included latent profile analyses, along with chi-squared and t-tests. The results suggested two profiles of professional quality of life, namely low (32.78%) and high (67.22%). The following profile displayed a higher likelihood of having a low professional quality of life: younger professionals, registered nurses, with a decrease in their teamwork, without specific training in palliative care, in coping with death and stress or emotional training and with lower levels of self-care and self-compassion, whose patients were unable to die a dignified death. Similarly, a low professional quality of life profile was associated with reduced wellbeing and poorer quality of care offered. In conclusion, providing professionals with education and training to improve their ability to handle end-of-life care and stress, maintaining cohesive teams and promoting self-care and self-compassion are pivotal to maintaining the quality of life and wellbeing of palliative care professionals and the quality of care that they provide.

Wellbeing Training Based on Contemplative Practices in a Sample of Intensive Care and Homecare Professionals: A Pilot and Feasibility Non-Randomized Clinical Trial.

BACKGROUND: Intensive care unit (ICU) and homecare unit professionals are susceptible to higher levels of stress and burnout than other healthcare professionals, which has an impact on their well-being, and in turn on their patients. In terms of data, there is not much research about the effects of psychological interventions on ICU and homecare professionals. The aim of this study was to investigate the effectiveness of Wellbeing Training based on Contemplative Practices (WTCP) for the increase of psychological functioning in a sample of ICU and homecare professionals. METHODS: A pilot and feasibility non-randomized clinical trial was conducted. Participants in the WTCP group (n = 19) attended an at-work 8-session/2 h group WTCP program aimed at directly training four basic skills: (a) sustained positive emotions, (b) recovery from negative emotions, (c) pro-social behavior and generosity, and (d) mind wandering, mindfulness, and "affective stickiness". Nineteen professionals were allocated in the control group. RESULTS: Results indicated that WTCP had a positive impact on self-compassion, personal accomplishment (burnout), and frequency of negative emotions. Moreover, a thematic analysis of participant interviews (n = 14) was conducted. CONCLUSIONS: These preliminary results are promising, though future research is needed to evaluate the effectiveness of WTCP using randomized controlled trial methodologies.

The Spanish Version of the State Self-Compassion Scale-Long Form (SSCS-L): A Study of Its Validity and Reliability in a Sample of Nursing Students.

BACKGROUND: In nurses, self-compassion mitigates the effects of stress, burnout and compassion fatigue, and enhances empathy, compassion and well-being and quality of life. The Self-Compassion Scale is the most-used instrument. The aim of this study is to validate the Spanish version of the new developed State Self-Compassion Scale-Long (SSCS-L). METHODS: Students of the first year of the Nursing Degree were surveyed online. Together with the SSCS-L, their levels of positive and negative affect was reported. Analyses included descriptive statistics, competitive confirmatory factor analysis, evidence on criterion-related validity and estimates of reliability. RESULTS: The best fitting model for the SSCS-L was the one hypothesizing six-correlated factors of self-compassion: self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification. Positive relations between the positive dimensions of self-compassion and positive affect were found, whereas there were negative relations between the positive poles of self-compassion and negative affect. Estimates of reliability were adequate, except for the dimension of over-identification. CONCLUSIONS: Self-compassion has become a key competency for nurses. The SSCS-L is an appropriate tool to allow an adequate assessment of self-compassion in experimental contexts.

Estudio descriptivo del impacto de la pandemia por COVID-19 sobre las condiciones de trabajo, el cuidado de los pacientes y la calidad de vida profesional de una muestra de profesionales de cuidados paliativos españoles / Descriptive study of the impact of the COVID-19 pandemic on the working conditions, patient care, and professional quality of life in a sample of spanish palliative care professionals

Antecedentes y objetivo: La pandemia por COVID-19 ha supuesto un importante reto para nuestros profesionales de cuidados paliativos. El objetivo del presente estudio es describir cómo ha afectado esta pandemia a las condiciones de trabajo, el cuidado de los pacientes y la calidad de vida profesional de una muestra de profesionales de cuidados paliativos.Materiales y métodos: Se llevó a cabo un estudio transversal en el que se contactó a 338 profesionales de cuidados paliativos. Se preguntó por datos sociodemográfi cos, condiciones de trabajo, cuidado de los pacientes, calidad de vida profesional y variables relacionadas.Resultados: Doscientos setenta y ocho profesionales contestaron la encuesta online. La edad media fue de 45,34 años. El 77,2 % fueron mujeres. Un 32,0 % informó no haber contado con los recursos materiales necesarios. Más de la mitad apuntaron que su carga de trabajo había aumentado considerablemente, siendo excesiva. La mayoría de quienes cuidaron a pacientes COVID-19 que fallecieron señalaron que el paciente no había sido acompañado por un familiar ni de forma adecuada por el propio profesional, no teniendo una muerte digna. Un 46,5 % sufría alto burnout y el 77,6 % alta fatiga por compasión, pero también alta satisfacción con la compasión (68,9 %). Muchos de ellos habían recibido formación previa y tenían altos niveles de compasión, autocompasión, autocuidado y competencia en afrontamiento de la muerte.(AU)

Background and objective: The COVID-19 pandemic has been a major challenge for palliative care professionals. The objective of this study was to describe how this pandemic affected the working conditions, patient care, and professional quality of life in a national sample of palliative care professionals.Materials and methods: A cross-sectional study was carried out in which 338 palliative care professionals were contacted. Data on sociodemographics, working conditions, patient care, professional quality of life, and related variables were gathered.Results: Two hundred and seventy-eight professionals answered the online survey. Mean age was 45.34 years; 77.2 % were women; 32.0 % reported not having had the necessary material resources. More than half indicated that their workload had increased considerably, being excessive. Most of those who cared for COVID-19 patients who died indicated that these patients had not been accompanied by a family member or adequately by the professional him/herself, thus not having a dignified death. In all, 46.5 % suffered from high burnout and 77.6 % from high compassion fatigue, but also experienced high satisfaction with compassion (68.9 %). Many of them had received previous training and had high levels of compassion, self-compassion, selfcare and competence in coping with death. (AU)

The measurement of compassionate leadership: Adaptation and Spanish validation of the compassionate leadership self-reported scale.

BACKGROUND: A culture of shared leadership is widespread among palliative care teams based on a commitment to valuing and including all people equally. As compassion is a core value for end-of-life care work, compassionate leadership may be the best way to lead in palliative care. AIMS: The aims of this study were twofold: (1) to adapt and validate the Compassionate Leadership Self-reported Scale in a sample of palliative care professionals; and (2) to study the relation between compassionate leadership and associated concepts of self-compassion, awareness and self-care. METHODS: A cross-sectional survey of 296 Spanish end-of-life care professionals was conducted. Analyses included descriptive statistics, a confirmatory factor analysis (CFA) with four-correlated factors, reliability estimates and a structural model. RESULTS: Results suggested there were medium to high levels of compassionate leadership in the sample. The CFA showed an adequate overall fit: χ2 (98) = 277.595 (p < 0.001); CFI = 0.986; SRMR = 0.047; RMSEA = 0.088 [0.076, 0.100]. Reliability estimates for four subscales of compassionate leadership (attending, understanding, empathising and helping) were also adequate, ranging from 0.72 to 0.96. Finally, the structural model predicting compassionate leadership suggested that the dimensions of attending and understanding were most highly related to positive self-compassion and awareness; empathising, to self-care and awareness; and helping, to positive self-compassion and self-care. CONCLUSION: The Compassionate Leadership Scale has adequate psychometric properties when used to assess compassionate leadership in the context of end-of-life care. Our results indicate that self-compassion, awareness and self-care are important correlates of such compassionate leadership.

Psychometric Properties of the Self-Compassion Scale-Short Form: Study of Its Role as a Protector of Spanish Nurses Professional Quality of Life and Well-Being during the COVID-19 Pandemic.

Self-compassion is a multifaceted construct that represents compassion turned inward and involves approaching one's failure and inadequacy with kindness. To measure these self-compassionate behaviors, the Self-Compassion Scale-Short Form (SCS-SF) is one of the most widely used and has been recurrently employed in the healthcare arena. Specifically, self-compassion has been pointed out as essential for providing compassionate care and maintaining healthcare workers balance. AIM: The aim of this study is twofold: (1) to provide evidence of the psychometric properties of the SCS-SF in a sample of Spanish nurses and (2) to study of its role as a protector of Spanish nurses professional quality of life and well-being during the COVID-19 pandemic. METHODS: A sample of 115 Spanish nurses was studied. Mean age was 43.79 years old (SD = 10.99); 84.3% were women. The factorial structure of the SCS-SF was studied with competitive confirmatory factor analysis (CFA). Finally, a full structural equation model was tested, in which positive and negative self-compassion predicted professional quality of life, and professional quality of life, in turn, predicted well-being. RESULTS: Three a priori structures were compared: one-factor, two-factor, and six-factor model. The two-factor solution, positive and negative self-compassion, was retained as the best structure to represent the data. Regarding the predictive model, the two poles of self-compassion predicted professional quality of life prediction, and professional quality of life positively predicted well-being, showing a strong relationship. CONCLUSION: Self-compassion can be an important resource for nurses' balance, promoting adequate professional quality of life and their well-being.

The Impact of the COVID-19 Pandemic on Burnout, Compassion Fatigue, and Compassion Satisfaction in Healthcare Personnel: A Systematic Review of the Literature Published during the First Year of the Pandemic.

This literature review aimed to determine the level of burnout, compassion fatigue, and compassion satisfaction, as well as their associated risks and protective factors, in healthcare professionals during the first year of the COVID-19 pandemic. We reviewed 2858 records obtained from the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, and Web of Science databases, and finally included 76 in this review. The main results we found showed an increase in the rate of burnout, dimensions of emotional exhaustion, depersonalization, and compassion fatigue; a reduction in personal accomplishment; and levels of compassion satisfaction similar to those before the pandemic. The main risk factors associated with burnout were anxiety, depression, and insomnia, along with some sociodemographic variables such as being a woman or a nurse or working directly with COVID-19 patients. Comparable results were found for compassion fatigue, but information regarding compassion satisfaction was lacking. The main protective factors were resilience and social support.

Palliative Care Professionals' Inner Life: Exploring the Mediating Role of Self-Compassion in the Prediction of Compassion Satisfaction, Compassion Fatigue, Burnout and Wellbeing.

CONTEXT: Palliative care professionals are exposed to suffering on a daily basis. Working in such an environment frequently raises existential issues, psychological challenges, and emotional distress, that can detract from compassionate care. Identifying factors that help professionals cope with frequent exposure to issues related to mortality, such as compassion, could enhance palliative care providers' and patients' quality of life and wellbeing. OBJECTIVES: To improve our understanding of the factors associated with professionals' inner life studying the role of self-compassion as a mediating variable between self-care and awareness and professionals' quality of life, and quantifying the impact of compassionate care. METHODS: A cross-sectional online survey of palliative care professionals was conducted through the Spanish Society of Palliative Care. 296 professionals answered the survey. RESULTS: The model tested showed an adequate fit (χ2(212) = 476.688 (P < .001), CFI = .907, RMSEA = .066 [.058,.073], and SRMR = .068), and the hypotheses were supported. Self-care and awareness predicted coping with death and self-compassion, which in turn predicted professional quality of life. Self-compassion had the greatest predictive power. Professional quality of life showed a statistically significant and positive effect on personal wellbeing, explaining more than 50% of its variance (R2 = .574; P < .001). CONCLUSION: For palliative care professionals, the cultivation of self-compassion is equally needed as compassion for others. Professional quality of life and compassionate care are related to professionals' wellbeing: when professionals take care of themselves, this will lead in a more compassionate care, but also in healthier, happier professionals.

Interpretación de las puntuaciones obtenidas con la escala breve de calidad de vida profesional / Interpretation of the scores obtained with the short professional quality of life scale

Introducción: La Escala de Calidad de Vida Profesional, conocida por sus siglas en inglés (Pro- QOL), es una de las más utilizada en el contexto de los profesionales sanitarios para evaluar la calidad de vida profesional. Recientemente se ha presentado una versión breve de dicha escala, la Escala Breve de Calidad de Vida Profesional. El objetivo de este trabajo es ofrecer una guía para la interpretación de las puntuaciones obtenidas con la mencionada escala. Material y métodos: Se llevó a cabo un estudio transversal en el que participaron profesionales de cuidados paliativos españoles. Se evaluó calidad de vida profesional, mindfulness, autocom- pasión y bienestar personal. Se calcularon estadísticos descriptivos, incluyendo percentiles para la interpretación de la Escala Breve de Calidad de Vida Profesional, y análisis de varianza, para estudiar la bondad de los puntos de corte establecidos. Resultados: La satisfacción con la compasión puede considerarse baja con puntuaciones de 10 o menores, media con puntuaciones entre 11 y 13, y alta con puntuaciones de 14 o superiores. El burnout puede considerarse bajo con puntuaciones de 6 o menores, medio con puntuaciones en- tre 7 y 8, y alto con puntuaciones de 9 o superiores. La fatiga por compasión puede considerarse baja con puntuaciones de 4 o inferiores, media con puntuaciones de 5, y alta con puntuaciones de 6 o superiores. Así establecidas, las puntuaciones se relacionaron de la forma esperada con mindfulness, autocompasión y bienestar personal. Discusión: Los puntos de corte identificados para las puntuaciones de la Escala Breve de Calidad de Vida Profesional son útiles y coherentes para utilizar dicha escala. (AU)

Background: The Professional Quality of Life scale, known by its acronym in English, ProQOL, is one of the most widely used tools by health professionals to assess professional quality of life. Recently, a short version of this scale has been presented, the Short Professional Quality of Life scale. The aim of this work is to offer a guideline for the interpretation of the scores obtained with this scale. Materials and methods: A cross-sectional study was carried out in Spanish palliative care profes- sionals. Professional quality of life, mindfulness, self-compassion, and personal well-being were evaluated. Descriptive statistics were calculated, including percentiles for the interpretation of the Short Professional Quality of Life scale, and an analysis of variance was performed to study the validity of the established cut-off points. Results: Satisfaction with compassion can be considered low with scores of 10 or lower, medium with scores between 11 and 13, and high with scores of 14 or higher. Burnout can be considered low with scores of 6 or lower, medium with scores between 7 and 8, and high with scores of 9 or higher. Compassion fatigue can be considered low with scores of 4 or lower, medium with scores of 5, and high with scores of 6 or higher. The established cut-off point for these scores were correlated in the expected direction with mindfulness, self-compassion, and personal well-being. Discussion: The cut-off points identified for the Short Professional Quality of Life scale scores are useful and adequate for scale use. (AU)

Development and Validation of the Brief Nursing Stress Scale (BNSS) in a Sample of End-of-Life Care Nurses.

Nursing has been identified as a very stressful profession. Specifically in end-of-life care, nurses frequently experience stressful situations related to death and dying. This study aims to develop and validate a short scale of stress in nurses, the Brief Nursing Stress Scale. A cross-sectional survey of Spanish end-of-life care professionals was conducted; 129 nurses participated. Analyses included a confirmatory factor analysis of the Brief Nursing Stress Scale, estimation of reliability, relation with sex, age and working place, and the estimation of a structural equation model in which BNSS predicted burnout and work satisfaction The confirmatory factor analysis showed an adequate fit: χ2(9) = 20.241 (p = 0.017); CFI = 0.924; SRMR = 0.062; RMSEA = 0.098 [0.040,0.156]. Reliability was 0.712. Women and men showed no differences in stress. Younger nurses and those working in hospital compared to homecare showed higher levels of stress. A structural equation model showed nursing stress positively predicted burnout, which in turn negatively predicted work satisfaction. Nursing stress also had an indirect, negative effect on work satisfaction. The Brief Nursing Stress Scale showed adequate estimates of validity, reliability, and predictive power in a sample of end-of-life care nurses. This is a short, easy-to-use measure that could be employed in major batteries assessing quality of healthcare institutions.

Development and Psychometric Validation of the Brief Nurses' Practice Environment Scale and Its Relation to Burnout Syndrome and Job Satisfaction: A Study in Spanish Nurses.

Introduction: Nursing environment is a vast concept that traditionally has included a wide range of job characteristics and has been related to burnout and job satisfaction. For its measurement, the Practice Environment Scale of the Nursing Work Index (PESNWI) stands out. However, shorter instruments are needed. The purpose of the study is to develop and test the Brief Nurses' Practice Environment (BNPE) Scale. Methods: The BNPE Scale was developed and tested in a sample of 210 Spanish nurses (data collection 2018). Results: Cronbach's alpha was 0.702. The confirmatory factor analysis (CFA), with an excellent fit, offered evidence of internal validity. Regarding validity, the BNPE Scale predicted both burnout and job satisfaction. Finally, evidence pointed out a cutoff score of <12 for low levels of practice environment and a cutoff score of >15 for higher levels in practice environment. Conclusions: The BNPE Scale is a short, easy-to-use measure that could be employed in major batteries assessing the quality of healthcare institutions.

The Impact of the COVID-19 Pandemic on ICU Healthcare Professionals: A Mixed Methods Study.

The large numbers of patients admitted to intensive care units due to COVID-19 has had a major impact on healthcare professionals. The incidence of mental health disorders among these professionals has increased considerably and their professional quality of life has suffered during the pandemic. This study aims to explore the impact of the provision of COVID-19 patient care on ICU healthcare professionals. A mixed methods study with an exploratory concurrent design was conducted between June and November 2020 in the Balearic Islands, Spain. Data were collected using a self-report online survey (n = 122) based on three validated questionnaires, and individual semi-structured in-depth online interviews (n = 11). Respondents scored 2.5 out of 5 on the moral distress scale, moderate/high on the compassion satisfaction scale, and moderate on the burnout and compassion fatigue subscales. Age was significantly and negatively related to professional quality of life but was positively related to workload and unavailability of protective equipment. Three main groups of themes relating to the impact of the pandemic emerged from the in-depth interviews: (a) clinical, (b) professional, and (c) personal and family impacts in the two waves. ICU healthcare professionals should be viewed as second victims of the COVID-19 pandemic as they have suffered significant psychological, professional, and moral harm.

The Personal Wellbeing Index in Spanish Palliative Care Professionals: A Cross-Sectional Study of Wellbeing.

Health professionals are especially exposed to stress, with consequences on professionals' health and wellbeing. However, palliative care professionals' wellbeing has been the subject of very little research. The aim of this work is to study the Personal Wellbeing Index (PWI) in a sample of Spanish palliative care professionals, as well as to study their levels of wellbeing and the relationships of wellbeing with variables such as gender, age, marital status, profession, and professional quality of life. A cross-sectional survey of Spanish palliative care professionals was conducted. The Spanish version of the PWI and the Short version of the Professional Quality of Life Scale were used. Here, 296 palliative care professionals attending patients at the end of life participated in the study. They showed medium to high levels of wellbeing. The PWI showed an adequate internal structure [χ 2 (20) = 116.130 (p < 0.001)]; Comparative Fit Index (CFI) = 0.970; standardized root mean square residual (SRMR) = 0.041; root mean square error of approximation (RMSEA) = 0.140 (0.116, 0.166)] and excellent estimates of reliability [α = 0.879 and Composite Reliability Index (CRI) = 0.923]. Wellbeing was higher for married compared to single and showed no relation with age, gender, and profession. Additionally, a structural equation model was estimated, in which a positive relation was found between wellbeing and compassion satisfaction and a negative one with burnout. The PWI is adequate to measure personal wellbeing in Spanish palliative care professionals.

Palliative Care Professionals' Inner Lives: Cross-Cultural Application of the Awareness Model of Self-Care.

Compassionate professional qualities traditionally have not received the most attention in either critical or end of life care. Constant exposure to death, time pressure and workload, inadequate coping with personal emotions, grieving, and depression urge the development of an inner curricula of competences to promote professional quality of life and compassionate care. The COVID-19 pandemic highlights the universality of these problems and the need to equip ourselves with rigorously validated measurement and monitoring approaches that allow for unbiased comparisons. The main objective of this study was to offer evidence on the generalizability of the awareness model of self-care across three care systems under particular idiosyncrasy. Regarding the sample, 817 palliative care professionals from Spain, Argentina, and Brazil participated in this cross-sectional study using a multigroup structural equation modeling strategy. The measures showed good reliability in the three countries. When testing the multigroup model against the configural and constrained models, the assumptions were fulfilled, and only two relationships of the model revealed differences among contexts. The hypotheses posited by the awareness model of self-care were supported and a similar predictive power on the professional quality of life dimensions was found. Self-care, awareness, and coping with death were competences that remained outstanding no matter the country, resulting in optimism about the possibility of acting with more integrative approaches and campaigns by international policy-makers with the consensus of world healthcare organizations.

The impact of a mindfulness-based intervention on the quality of life of Spanish national police officers.

PURPOSE: Police officers belong to a profession with a high risk of stress, burnout and compassion fatigue. Incorporating mindfulness practices into the health and occupational-risk prevention programs run by the national police forces in Spain could provide a new approach to reducing stress and enhancing the psychological and emotional balance of these officers. METHODS: A 7-week mindfulness-based intervention (MBI) was conducted in a group of 20 national police officers in Mallorca (Spain). Mindfulness, self-compassion, burnout, compassion fatigue, compassion satisfaction and perceived stress were measured and compared before and after the intervention. RESULTS: We identified significant differences in mindfulness (F(5, 14) = 7.441, p = 0.001, η2  = 0.727), compassion satisfaction (F(1, 19) = 5.929, p = 0.025, η2  = 0.238) and perceived stress levels (t(18) = 2.863, p = 0.010, d = 0.611) after the intervention; non-significant improvements were observed for the remaining variables assessed. CONCLUSIONS: MBIs could be an effective way of reducing stress levels among police officers in Spain.