Thesis (D. Min.)--Catholic Theological Union at Chicago, 2005. / Abstract and vita. Includes bibliographical references (leaves 180-189).

Background: Compassion Fatigue (CF) describes the emotional, spiritual, intellectual and physical exhaustion that results from untreated distress among nurses, stemming from exposure to traumatic events and work environment stressors. Comprised of Burnout (BO), Secondary Traumatic Stress (STS) and Compassion Satisfaction (CS), CF results when BO and STS outweigh CS. CF leads to physical and emotional problems including fatigue, hopelessness, anger, and an increased use of sick days. For hospitals, this means poor morale, increased medication errors and higher turnover. Objective: The purpose of this study was to determine the prevalence and severity of CF risk among the nursing staff at Maricopa Medical Center (MMC).Design: Descriptive study completed to determine: 1) What is the prevalence and severity of CF risk among nurses at MMC; and 2) compared to nurses with low CF risk, do nurses with high CF risk have differences in demographic and workplace characteristics? Setting: Maricopa Medical Center between April 14, 2015 and May 26, 2015 Participants: 315 full-time nurses at MMC in Phoenix. Measurements: Nurses were surveyed using the Professional Quality of Life Scale-5 (ProQOL-5) measuring the three components of CF: BO, STS and CS. Results: 46% of nurses reported moderate to high risk of CF. Nurses who worked in Labor and Delivery, Psychiatric Annex/Desert Vista, Emergency Departments, Intensive Care Units and Rapid Response units reported the highest risk. Risk increased significantly after their first year working at MMC. More frequent job changes outside of MMC correlated with lower risk profiles. Lower risk was seen in nurses with advanced degrees. Trends indicated that younger nurses, Clinical Resource Leaders, and nurses who had taken nine or more sick days in the previous six months were more at risk. Conclusion: Almost half of nurses were at moderate to high risk of CF. Unique findings were reported, including possible links between CF risk and job changes, and years working at a single facility. These links were previously unstudied. It was determined that the focus of interventions should be on nurses who work in the units most at risk and on new hire nurses, regardless of their years of nursing experience.

In the course of figuring out one’s identity, the proactive manner in which an individual defines one’s self or builds one’s character is an important aspect of the venture. Markus and Kitayama (1991) described and contrasted interdependent self-construal and independent self-construal, two forms of self-construction. This paper presents the theoretical link between interdependent self-construal and psychological resilience. Identity development is viewed through the interdependent self-construal perspective and it is explained how interdependence provides an individual with more and better opportunities for identity development. Through a conceptual tie to self-compassion, interdependent self-construal may be a key component to experiencing psychological resilience.

Bakgrund:Medkänsla och empati är en essentiell del i sjuksköterskeyrket. Compassion fatigue (CF) kan drabba sjuksköterskan när den emotionella utmaningen som yrket innebär blir för påfrestande och försämrar den egna hälsan. CF kan leda till en försämrad förmåga att ge en god och omsorgsfull vård till patienterna. Syfte:Att belysa compassion fatigue ur ett sjuksköterskeperspektiv. Metod:En litteraturöversikt med kvalitativ design. En induktiv ansats har tillämpats. CINAHL, PsycINFO och PubMed användes som databaser och genererade i 12 artiklar.  Resultat:Behålla balans mellan privatliv och arbetsliv, vikten av stödoch aspekter relaterade till vårdandetvar de tre huvudkategorier som kom fram. Sjuksköterskor löper en högre risk att drabbas av CF när arbetslivet påverkar privatlivet på ett negativt sätt. När sjuksköterskan inte kunde lindra patientens lidande eller när bristande stöd infann sig ökade också risken för CF. Adekvat stöd och det som ansågs givande med yrket kunde däremot motverka CF. Slutsats:CF påverkar sjuksköterskans eget välmående, vilket i sin tur kan leda till bristande vårdkvalitet. Att belysa begreppet och dess innebörd kan hjälpa att identifiera tecken på CF. En ökad kunskap kan leda till utveckling av personliga strategier och förbättringsarbete inom hälso- och sjukvården för att motverka CF. / Background:Compassion and empathy is an essential part of nursing. Compassion fatigue (CF) can happen to nurses when the emotional challenges in the profession is too much to handle which weakens their own health. CF can cause a compromised ability to provide a good and compassionate care.  Aim:To illuminate compassion fatigue from a nurse-perspective.  Method:A literature review with qualitative design. An inductive approach has been applied. CINAHL, PsycINFO and PubMed was used as databases and generated in 12 articles. Result:Three main categories appeared; keeping balance between work and personal life, importance of supportand aspects related to caring. Nurses run a higher risk of developing CF when the work affects their personal-life in a negative way. The risk for CF was also heightened when the nurse was not able to ease the patients suffering or if a lack of support occurred. On the contrary, adequate support and the rewarding parts of the profession could combat CF.  Conclusion:CF affect the nurses well-being which can lead to an inadequate care. Illuminating the phenomenon and its meaning can provide help to identify signs of CF. Increased knowledge can result in a development of personal strategies as well as an improvement in the healthcare system in order to prevent CF.

abstract: In a mere thirty years, hospice has grown from a purely ideological philosophy of care for terminally ill individuals and their families, to a large and well organized healthcare entity. And government statistics project that healthcare will generate more new jobs than any other industry in America until at least 2018. While most of the extant literature that has been published on healthcare workers has focused on negative organizational processes, such as stress and burnout, there has been a recent shift in scholarly ideology in which researchers have been challenged to consider the positive aspects of organizational life as well. Compassion, theorized as a three-part interrelated process, is one area that is garnering interest within organizational studies. Utilizing grounded theory, this study engaged literature from organizational studies on emotional labor, stress, and burnout, as well as literature on positive organizational communication. What emerged from the data is a richly detailed picture of the emotional highs and lows that hospice workers experience in their jobs. Research was conducted at two large hospices in the desert southwest, utilized qualitative methods of participant observation (161 hours), and informal and semi-structured interviews (29 interviews) as a means to understand hospice workers--nurses (32), nursing assistants (23), social workers (14), and spiritual care providers (4)--experiences of emotion. Through data analysis, compassion emerged as a salient concept in worker's daily experiences. Yet, my data suggested a reconceptualization of the way in which compassion has been theorized in the past--as noticing, feeling, and responding. Based on my findings, I argue that the three subprocesses could more accurately be described recognizing, relating, and responding. / Dissertation/Thesis / Ph.D. Communication 2010

Contribution The main contribution offered by my research is an increased understanding of medical students’ perceptions of empathy and the factors that influence this. By using an innovative method in medical education research, the study contributes to research methodology. Background Empathy is accepted as a fundamental part of the patient-doctor relationship and essential for effective clinical care. Current societal opinions are that some healthcare professionals lack empathy and that medical students become less empathetic during their training, although the reasons for this are not understood. If this perceived decline is to be addressed, medical educators need to understand students’ perspectives of the factors that influence their empathy. Aims of the research The study sought to gain a deeper understanding of the development of medical students’ empathy and the factors influencing this during their undergraduate training. It is hoped that this understanding may lead to improvements in medical education and patient care. Methods Ethical approval for the study was granted by the University. A phenomenological approach was adopted, which involved listening to the students’ views and experiences of their course. Serial, semi-structured, indepth, interviews were conducted with sixteen medical students. Each year the student completed an hour-long interview over three years. One group of eight students were followed during the preclinical years of the course (years 1-3) and the other group, during the clinical years (years 4-6). The interviews were audio-recorded, transcribed, coded using qualitative data analysis software (N Vivo), and analysed using an interpretative phenomenological approach. Findings The students in the preclinical years described empathy as a personal attribute, emphasising its emotional dimension. In the clinical years, students viewed empathy differently: as a complex relational process with the patient, which varied in depth and quality according to the clinical context. They described the tensions between connecting with and detachment from a patient. Students indicated influences which enhanced their empathy, including patient contact and positive role models. They also identified barriers to empathy, including: the medical school culture, a biomedical bias in the curriculum, a lack of patient contact, negative role models and teaching of professionalism as distancing from patients. The preclinical group of students reported gaining in self-confidence during their course. The clinical group described how their empathy with patients had increased but they detected a conflict between empathy and efficiency. Conclusions The use of an innovative longitudinal, phenomenological approach in medical education research generated new understanding of a complex interpersonal view of empathy and highlighted aspects of a ‘hidden curriculum’. The students maintained that their contact with patients was the most useful way of developing empathy. They expressed a desire to connect emotionally with patients but were uncertain how to balance this connection with professional detachment. They described a marked biomedical emphasis in their course and perceived that teaching on professionalism encouraged a distancing from patients. In contrast to the widely-reported opinion that there has been a decline in medical students’ empathy, this study suggested that students perceived that their empathy increased during their training. However, some students had learned distancing behaviours to hide their empathetic feelings. In the light of this research, it is hoped that medical educators will develop ways of supporting students to deal appropriately with their own emotions and those of patients.

The present study sought to investigate the effects of meditation practice on the neural mechanisms of attention and self-monitoring by comparing a group of experienced meditators to matched controls. Self-report measures of mindfulness and self-compassion were assessed to examine whether meditation-related improvements in attention and self-monitoring were linked to increases in these qualities. Thus, differences between groups (meditator versus control) on all variables and relationships among variables (attention, self-monitoring, self-compassion, and mindfulness) were explored. Results indicate that individuals with meditation experience showed enhancement in neural networks related to selective attention and attentional allocation, as evidenced by larger P1/N1 and P3b amplitudes, relative to controls. Meditators also showed improved self-monitoring of their errors, as indexed by enhanced Pe amplitudes, when compared to controls. Importantly, greater number of years of meditation experience was linked to larger Pe amplitudes, providing evidence that more practice with meditation was associated with greater error awareness. At the same time, meditators showed greater levels of mindfulness and self-compassion when compared to controls. Importantly, each of the neural indices was linked to greater levels of mindfulness and self-compassion. Specifically, self-kindness was correlated with each of these ERP components and to percentage of alpha power during meditation, and the mindfulness facet of observing fully mediated the relationship between meditation experience and P1 amplitudes. These findings suggest that the qualities that are enhanced with meditation are associated with enhancements in attentional control and awareness of errors. This study is an exciting step toward future intervention studies that combine multiple sources of information (self-report, neural measures, and behavior) to clarify the nature of the associations among these variables so that the mechanisms of mindfulness can be more fully understood.

Bakgrund: Empatisk utmattning (eng: compassion fatigue) berör den utmattning sjuksköterskor kan uppleva genom att ha tagit del av patienters fysiska eller psykiska lidande. Denna empatiska utmattning bidrar till en känsla av kronisk trötthet och oförmåga att uppleva empati för sina patienter. Problem: För att ge en god patientvård förväntas att sjuksköterskorna lever sig in i patienternas situation. Eftersom sjuksköterskorna ofta befinner sig i stressfyllda situationer med korta återhämtningsperioder och samtidigt måste leva sig in i patienternas lidande kan vissa av dem få problem med att ta väl hand om sig själva, vilket gör att deras förmåga att känna empati för sina patienter avtar. Sammantaget bidrar det till en försämrad patientvård. Syfte: Syftet var därför att belysa sjuksköterskornas erfarenheter av empatisk utmattning i vården. Metod: Sjuksköterskornas erfarenheter av empatisk utmattning jämfördes genom en beskrivande analys av 10 kvalitativa artiklar. Resultat: Sjuksköterskorna med empatisk utmattning erfor sina arbetsmiljöer som påfrestande och stressiga. De upplevde bristfälligt stöd från kollegor, familj, vänner, arbetsledning och otillräcklig utbildning i hur de kan motverka riskerna med att drabbas av empatisk utmattning. Ofta hade de upplevt upprepade traumatiska händelser i vården, vilka framkallat känslor av maktlöshet, frustration och sorg. Resultatet visade även att de sjuksköterskor som drabbades av empatisk utmattning var mer benägna att lägga stora krav på sig själva, ha svårt för att dra en skiljelinje mellan privatliv och yrkesliv, samt vara känsliga för stora intryck från omvärlden. Vissa sjuksköterskor hade lättare för att ta hand om sig själva och kunde därmed ge bättre patientvård. Snarare än att bli utmattade tenderade dessa sjuksköterskor att inspireras av sin vårdsituation och drivas till att fortsätta uttrycka empati och inlevelse i kontakterna med patienterna. Det bidrog till empatisk tillfredsställelse snarare än empatisk utmattning, samt till goda ömsesidiga upplevelser mellan sjuksköterskor och patienter.

abstract: Mindfulness is a concept derived from the Buddhist discourses of the Satipattana. Interventions that draw on mindfulness have been shown to reduce psychologically distressing symptoms in clinical settings. It has become widely used as a therapeutic technique in counseling, so it is important to develop an instrument measuring mindfulness-related constructs. This study presents a new instrument measuring the importance of mindfulness-related constructs. Results from an exploratory factor analysis revealed a clear two-factor structure, with the factors named "Present Moment Awareness", and "Compassion and Ethical Behavior." These items were positively correlated with each other and, as expected, negatively correlated with depression. Finally, hours of meditation moderated this association such that the association was stronger among participants who reported higher levels of meditation practice. / Dissertation/Thesis / Masters Thesis Counselor Education 2014

Sjuksköterskans arbete, förhållningssätt och arbetsmiljö regleras i etiska koder, lagar och förordningar. Hen visar omsorg om patienten genom omvårdnad i dennes hela kontext. Trenden är att sjuksköterskan skall vårda personcentrerat och inte bara utföra uppgifter av teknologisk karaktär, det förstnämnda ställer krav på empati. En god omsorg och ett personcentrerat arbetssätt kan ses som en utmaning att hantera i sjuksköterskans arbetsmiljö. När sjuksköterskan inte klarar detta kan hen utveckla samvetsstress. Litteraturöversikten syftade till att beskriva upplevelsen av samvetsstress. Artikelsökning i databaser på termen compassion fatigue genomfördes och en blandning av kvalitativa och kvantitativa studier från Nordamerika, Kina och Portugal granskades. Totalt 12 artiklar samt en avhandling inkluderades i översikten. Resultatet delades in i tre huvudkategorier och totalt 14 subkategorier. Kategorierna besvarar frågeställningarna: faktorer som påverkar samvetsstress, symtom på samvetsstress och hur sjuksköterskor hanterar samvetsstress. Påverkansfaktorer var erfarenhet, förmåga till gränssättning, organisatoriska faktorer och svåra etiska frågeställningar. Symtomen var avskärmning, minskad tolerans, upplevelse av inkompetens och fysisk utmattning. Sjuksköterskan hanterar samvetsstress genom att prioritera sitt sociala liv, söka ledighet, byta patient, utbilda sig och byta arbete. I studier inom området råder en viss begreppsförvirring och olika forskare studerar och tolkar begreppen olika. Sjuksköterskor och organisationer har en begränsad kunskap om fenomenet. Bredden i funna studier bidrar med kunskapsunderlag om fenomenet samvetsstress. Utbildningsinsatser om fenomenet samvetsstress både inom utbildningsväsendet, för organisationen och sjuksköterskor i klinisk verksamhet är indicerat för att arbeta preventivt mot utveckling av samvetsstress.