Empatitrötthet knackar på  Abstrakt Bakgrund: Begreppet empatitrötthet beskrivs som ett successivt och tilltagande slitage på vårdarens förmåga att engagera, känna med och bry sig om sina patienter. Ett biologiskt, psykologiskt och socialt tillstånd av utmattning och dysfunktion som kommer av långvarig exponering för andras lidande. Empatitrötthet kan skapa negativa känslor som skam, sorg, skuld, irritation, otålighet, otillräcklighet och ökad rädsla. Andra faktorer i privatlivet som sitt eget mående, hälsa eller missnöje kan också öka risken för empatitrötthet. Motiv: Empatitrötthet är ett problem i vården. Förhoppningen för studien är att det kan belysa kunskapsluckor i hur personalen upplever empatitrötthet och vad som kan förbättras för att minska risken. Syftet med studien var att utforska personals upplevelser av empatitrötthet, belyst från deras erfarenheter av att arbeta på en psykiatrisk slutenvårdsavdelning.  Metod: Studien genomfördes med semistrukturerade intervjuer och materialet analyserades med kvalitativ innehållsanalys. Samtliga deltagare i studien arbetar som vårdpersonal på en sluten psykiatrisk vårdavdelning. Tio individuella intervjuer genomfördes med fem sjuksköterskor samt fem undersköterskor. Resultat: Resultatet visade att Empatitrötthet skapar processer i arbetsgruppen, Patientmötet påverkas, Empatitrötthet går under radarn och Frustration leder till likgiltighet. Konklusion: Empatitrötthet finns inom den psykiatriska vården, det är något som de flesta upplever och som hämmar personalen i sitt dagliga liv. Det leder till frustration och irritation mot både kollegor och patienter. Med hjälp av varandra och insatser och strategier från arbetsledning kan det minskas eller hållas i schack. Genom att uppmärksamma hur viktig gruppdynamiken är i kampen mot empatitrötthet kan omvårdnaden och bemötandet förbättras. Denna studie kan bidra till en djupare förståelse för empatitrötthet och vad som anses viktigt av vårdpersonal när man hamnar i det. Eventuellt kan det även leda till att man pratar mer öppet och uppmärksammar det i arbetsgruppen. / Compassion fatigue comes knocking  Abstract Background: The term compassion fatigue as a successive and increasing wear on the staff’s ability to engage, feel and care with its patient. Biological, psychological and social condition of exhaustion and dysfunction that comes from a prolonged exposion of others suffering. Compassion fatigue can create negative feelings of guilt, shame, sorrow, irritation, impatience, inadequacy and increased fear. Other factors are problems in the private life and that health or dissatisfaction can increase compassion fatigue. Motive: Compassion fatigue is a problem in health care. Our hope is that the study can enlighten the knowledge gap on how the staff experience compassion fatigue. Aim: The aim of the study was to explore staff's experiences of compassion fatigue, highlighted from their experiences of working in a psychiatric inpatient ward. Methods: The study was conducted with interviews and the data vas analyzed with qualitative content analysis. All participants work as staff in an inpatient psychiatric ward. Ten individual semi-structured interviews were conducted with five registered nurses and five undergraduated nurses. Result: The result shows that Compassion fatigue creates processes in the work group, The patient meeting is affected, Compassion fatigue goes under the radar and Frustration leads to indifference. Conclusion: Compassion fatigue exists in the psychiatric care, and is hampering the staff’s social life. It leads to frustration and irritation towards booth patient and colleagues. With the help of each other and strategies from the work management, it can be reduced. By paying attention to how important group dynamics are in the fight against compassion fatigue, care and treatment can be improved. This study can contribute to a deeper understanding of compassion fatigue. It can also lead to talking more openly and paying attention to it in the work group.

Bakgrund: En stor andel av personer som arbetar som sjuksköterskor riskerar att drabbas av empatitrötthet. Empatitrötthet kan resultera i negativa konsekvenser för sjuksköterskan, verksamheten och patienten. Syfte: Litteraturöversiktens syfte var att beskriva sjuksköterskors erfarenheter av empatitrötthet. Metod: Litteraturöversikt är baserad på elva kvalitativa studier. Databassökning genomfördes i PubMed och Cinahl. Analysprocessen verkställdes med hjälp av Fribergs modell i fem steg. Resultat: Ur analysen framkom fyra kategorier ’’Risken att utveckla empatitrötthet påverkas av höga krav, stress, brist på stöd och sjuksköterskans tidigare erfarenheter’’, ’’Empatitrötthet påverkar hälsan’’, ’’ Det finns olika sätt att hantera empatitrötthet’’ och ’’ Empatitrötthet påverkas av relationen mellan sjuksköterska patient och närstående’’. Konklusion: Empatitrötthet uppstår på grund av krav, stress och en brist på stöttning. Sjuksköterskor har olika sätt att hantera empatitrötthet, där vissa metoder anses bättre för att lösa problemet. Empatitrötthet har en inverkan på sjuksköterskan psykiskt, fysiskt, emotionellt och socialt, vilket påverkar sjuksköterskans privatliv och arbetsliv.

Bakgrund: God vård präglas av sjuksköterskor som bryr sig om sina patienter, ger dem av sin tid och gör det lilla extra. Vidare är medlidande en viktig egenskap för att uppnå en god vård och för att kunna visa andra medlidande behöver sjuksköterskor vara självmedkännande. Syfte: Att beskriva sjuksköterskors erfarenheter av att hitta kraft till att vårda. Metod: En allmän litteraturöversikt genomfördes där 12 artiklar valdes ut och analyserades. Resultat: Det framkom fyra teman i resultatet: Arbetsmiljö och stöd, Kunskap och utveckling, Vårdande egenskaper och Egenvård vid medkänslotrötthet. Resultatet visade att sjuksköterskors erfarenheter var att de behövde en stödjande arbetsmiljö och möjlighet att utvecklas i arbetet för att hitta kraft till att vårda. Vidare framkom det att egenvård och självmedkänsla var viktiga faktorer för att undvika medkänslotrötthet. Slutsats: Sjuksköterskor måste få tillåtelse att visa sig själva egenvård och självmedskänsla och stödjas av arbetsgivare och kollegor för att hitta kraft till att fortsätta vårda och inte drabbas av medkänslotrötthet. Arbetsgivare behöver lägga större vikt vid att stödja sjuksköterskor för att undvika en hög personalomsättning på grund av att de inte orkar fortsätta vårda. / Background: Good care consists of nurses who care about their patients, give them of their time and does more than just the necessary. Compassion is an important trait to achieve good care and nurses needs to be self-compassionate to be able to show compassion to others. Aim: To describe nurses experiences of finding strength to care. Method: A general literature review was performed where 12 articles were chosen and analyzed. Results: The result revealed four themes: Work environment and support, Knowledge and development, Caring behaviors and Self-care when dealing with compassion fatigue. The result showed that nurses experienced that they needed a work environment that supported them and gave them the opportunity to develop in their work to find strength to care for others. Furthermore, it emerged that self-care and self-compassion was important to avoid compassion fatigue. Conclusion: Nurses needed permission to be self-caring and self-compassionate and to be supported by employers and colleagues to find the strength to continue caring and avoid compassion fatigue. Employers need to focus more on supporting nurses to avoid high turnover because they cannot find the strength to continue caring.

Bakgrund:  Compassion fatigue hos sjuksköterskor beskrivs som en minskad förmåga att känna empati till följd av att ha levt sig in i andra människors trauman, samtidigt ses empati som en av kärnorna i omvårdnaden. Många sjuksköterskor saknar kunskap i ämnet men drabbade sjuksköterskor beskriver det som en överväldigande känsla av att något är fel. Detta kan leda till att många sjuksköterskor funderar på att lämna yrket. Syfte: Syftet var att kartlägga faktorer till uppkomsten av compassion fatigue hos sjuksköterskor. Metod: En litteraturöversikt enligt Fribergs metod som baserades på elva kvantitativa och en kvalitativ artikel. Resultat: Resultatet presenterades utifrån fyra teman: empati, skuldkänslor och moralisk stress, personliga och sociala faktorer, arbetsrelaterade och organisatoriska faktorer samt ålder, arbetslivserfarenhet och professionalism. Några faktorer som orsakar compassion fatigue var hög grad av empatisk förmåga och hanteringsstrategier. Diskussion: Watsons teori om mänsklig omsorg och Conti O´Hares theory of the nurse as a wounded healer användes som teoretiska referensramar. Watson beskriver empati som en av kärnorna i hennes teori. Samtidigt som litteraturöversiktens resultat visade att högre grad av empati hos sjuksköterskan ger större risk att drabbas av compassion fatigue. Detta kan ses som motsägelsefullt då empati är en förutsättning för god omsorg. Conti O´Hares teori och resultatet stämmer överens i det avseende att om trauman hanteras på ett negativt sätt leder det till ohälsa. / Background: Compassion fatigue among nurses is described as a reduced ability to feel empathy due to being exposed to other peoples trauma, at the same time empathy is seen as one of the core values in nursing. Many nurses lack knowledge about the subject but affected nurses describes it as an overwhelmingly feeling that something is wrong. This may lead to a lot of nurses thinking about leaving the profession. Aim: The purpose was to identify the factors that lead to compassion fatigue in nurses. Method: A literature review according to Friberg´s method that is based on eleven quantitative articles and one qualitative article. Results: The results were presented on the basis of four themes: empathy, feelings of guilt and morol distress, personal and social factors, work related and organizational factors and also age, work experience and professionalism. Some of the factors that cause compassion fatigue were degree of empathetic ability and personal coping strategies. Discussion: Watson´s theory of human caring and Conti O´Hare´s theory of the nurse as a wounded healer was used as theoretical frame of reference. Watson describes empathy as one of the core values in her theory of human caring, at the same time the results of the literature review showed that nurses with a higher degree of empathy were at higher risk to develop compassion fatigue. This can be seen as contradictory when empathy is a condition in caring. Conti O´Hare´s theory and the result agree in the regard that if trauma is not handled in a positive way it may lead to illness.

Bakgrund: Att jobba i den stressfulla och komplexa miljö som tillhör intensiv- och akutsjukvårdens vardag har visat sig medföra större risker för att utveckla arbetsrelaterad stress och negativa känslomässiga reaktioner. En sjuksköterskas förmåga att hantera sina egna känslor påverkar direkt omvårdnaden och relationen till patienter och deras familjer. För att bibehålla en god psykisk hälsa och välbefinnande är det viktigt för sjuksköterskor att utveckla och använda effektiva strategier för att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar. Syfte: Syftet var att beskriva specialistsjuksköterskors strategier för att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar. Metod: Designen för arbetet gjordes som en kvalitativ studie med induktiv ansats. Sjutton specialistsjuksköterskor inom intensivvård och anestesi intervjuades med individuella semistrukturerade intervjuer. Metoden för att analysera data var kritisk incidentteknik. Resultat: Analysen av data resulterade i fem slutkategorier. Specialistsjuksköterkors strategier för att hantera negativa känslomässiga reaktioner innefattade; Att prata om händelsen med andra, Att ta stöd i varandra och hjälpas åt, Att tillåta sig att visa känslor och känna med patienten, Att strukturera upp arbetet, fokusera på vad som ska göras och lita på sin kompetens samt, Att utöva egenvård och ta hand om sig själv Slutsats: Att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar har visat att det är avgörande för att upprätthålla en hög nivå av arbetsprestation och professionalism. Studien ger en djupare förståelse för hur olika strategier kan användas för att sjuksköterskan ska behålla en god hälsa och kunna ge en god omvårdnad. En nyckelfaktor var att prata om händelsen och en önskan om större stöd och uppmärksamhet inom ämnet från både verksamheten och sjuksköterskeutbildningens håll.

Doctor of Philosophy / Department of Family Studies and Human Services / Farrell J. Webb / This study examined the relationships between and among the factors of compassion fatigue, burnout, compassion satisfaction and spiritual resiliency in association with the care work of United States Army chaplains who minister to soldiers, families, and Department of the Army (DA) civilians in the military. This investigation breaks new ground in understanding the factors that affect chaplain care work. Data were collected from 408 active duty Army chaplains who responded to and completed the online survey. Information about rank, years of service, battle fatigue/stress and number of deployments was collected. These data along with specific scales were combined into the Chaplain Care Work Model—the tool used in this investigation. Scores from three measurement instruments: Professional Quality of Life Scale R-IV, Spiritual Well-Being Scale, and the Resilience Scale were used to test the hypotheses for this study. Of particular interest, the measurement scales of Spiritual Well-Being and Resiliency were combined to develop a new measurement construct labeled Spiritual Resiliency. The model of Chaplain Care Work was tested using path analysis and structural equation modeling techniques to illustrate the relationships of the predictors (constructed from latent variables—Chaplaincy Status, Deployment Status, and Self Care) to the outcome measure of Care Work (also a latent variable). Overall 85% of the variance in care work can be attributed to the model’s predictors, adding to the value of examining care work among those who provide direct service to others. Findings indicated that spiritual resiliency ebbed and flowed as a function of the different levels of compassion fatigue, burnout, and compassion satisfaction experienced by the chaplains because of their care work. Furthermore, number of deployments and experience (years of chaplain service) had significant relationships with compassion fatigue and burnout. Results from the findings were underpinned by explicit narrative comments provided by chaplains. These comments provided rich material in support of the significant relationships discovered in this study, and offered insights into how care work is both meaningful and necessary for maintaining a healthier chaplaincy.

Studiens syfte var att undersöka vilka erfarenheter kuratorer inom somatisk hälso- och sjukvård har av sympatistress samt undersöka hur kuratorerna upplever arbetssituationen utifrån KASAM. Syftet var också att förstå kuratorernas erfarenheter av sympatistress i relation till kuratorernas arbetssituation utifrån KASAM. Metoden som använts i studien var en kvalitativ intervju där sex kuratorer inom somatisk hälso- och sjukvård har intervjuats enskilt. Studien visade att kuratorerna har erfarenheter av sympatistress. Studien visade också flera indikationer på att det fanns arbetssituationer där kuratorerna hade vissa svårigheter att känna hanterbarhet, begriplighet och meningsfullhet. Det framkom även flera indikationer på att det fanns arbetssituationer där kuratorerna kände hanterbarhet, begriplighet och meningsfullhet. Studiens slutsats var att kuratorerna är utsatta för situationer i arbetet som kan leda till att de utvecklar symptom för sympatistress. / The purpose of this study was to investigate hospital social workers experiences of compassion fatigue as well as examine how they feel and think about their work situation based on KASAM. The purpose was also to understand the hospital social workers experiences of compassion fatigue in relation to the hospital social workers feelings and thoughts about their work situation based on KASAM. The method that was used is a qualitative interview in which six hospital social workers were separately interviewed. The study showed that several hospital social workers have experiences of compassion fatigue. The study also showed several indications that there were work situations where hospital social workers had some difficulties in feeling manageability, comprehensibility and meaningfulness. It also showed several indications that there were work situations where hospital social workers felt manageability, comprehensibility and meaningfulness. The study concluded that the hospital social workers are exposed to situations in their work that can lead to the development of symptoms for compassion fatigue.

Introdução: Esta pesquisa é um recorte do projeto de pesquisa INVESTIGAÇÃO DAS DIFICULDADES HUMANAS DE PROFISSIONAIS DE SAÚDE NAS PRÁTICAS DE CONTROLE DE INFECÇÃO RELACIONADA À ASSISTÊNCIA À SAÚDE. Parte da hipótese de que o sofrimento decorrente da condição que um profissional de assistência à saúde (PAS) tem de se envolver emocionalmente e afetivamente ao sofrimento e às dores dos pacientes a quem prestam assistência possa ser a principal causa da não adesão às práticas de controle de infecções relacionadas à assistência à saúde (IRAS) e a responsável por fazer com que eles se descuidem, colocando a vida do paciente e a deles própria em risco de morte uma vez que o sofrimento decorrente dessa condição interfere em seus trabalhos, aumentando a possibilidade de erros e de não adesão, colaborando, assim, para a sua transmissão. As manifestações decorrentes da condição de envolvimento emocional e afetivo de um PAS ao sofrimento e às dores de seus pacientes vêm recebendo diversas nomeações e definições, como Fadiga e/ou Satisfação por Compaixão. Objetivos: investigar: a) se PAS de Unidades de Terapia Intensiva (UTIs) apresentam sofrimento decorrente da condição de envolvimento emocional e afetivo ao sofrimento e às dores dos pacientes a quem prestam assistência, compreendido por um dos componentes da Fadiga por Compaixão, o Estresse Traumático Secundário; b) as compreensões dos PAS a respeito das dificuldades relacionadas às práticas de controle de IRAS, as percepções de suas próprias participações nas práticas de controle de IRAS, as suas sugestões para diminuição de taxas de IRAS e as observações livres a respeito da participação na pesquisa. Método: Trata-se de estudo clínico transversal. Foram incluídos PAS da área de enfermagem ou médicos, atuantes ou que tenham atuado em UTIs e que tenham compreendido e assinado o termo de consentimento livre e esclarecido. Para o primeiro objetivo foram incluídos 168 PAS e, para o segundo, 96. Foram utilizados ficha de dados sócio demográficos, ProQol-BR e entrevistas semi-dirigidas. Os dados sócio demográficos foram 9 analisados por recursos do programa Excel; os do ProQol-BR foram analisados conforme orientações de Stamm (2010) e análise estatística; e os das entrevistas analisados conforme método de análise de conteúdo. Resultados: A maioria (53,6%) dos PAS avaliados não apresentou sofrimento decorrente da condição de envolvimento emocional e afetivo ao sofrimento e às dores dos pacientes a quem prestam assistência, compreendido por Estresse Traumático Secundário. Os dados das entrevistas foram agrupados em fatores institucionais e subjetivos. As compreensões das dificuldades dos PAS envolveram ambos fatores, mas os subjetivos (52%) sobressaíram os institucionais. Sobre as percepções, tenderam a não assumir dificuldades, mas quando as assumiram, atribuíram mais a fatores subjetivos (66%) do que institucionais. As sugestões foram mais relacionadas a ações institucionais (89%). E as observações a respeito da pesquisa apontaram que, apesar de algumas críticas, a pesquisa foi bem vista e aceita. Conclusão: Essa pesquisa permitiu identificar que as dificuldades de adesão dos PAS avaliados às práticas de controle de IRAS não estão relacionadas a um sofrimento decorrente de um envolvimento emocional e afetivo ao sofrimento e às dores de seus pacientes, mas a uma falta de envolvimento / Introduction: This research is part of the research project INVESTIGATION OF HUMAN DIFFICULTIES OF HEALTH PERSONNEL IN HEALTH CARE INFECTION CONTROL PRACTICES. Started off the hypothesis that the suffering resulting from the condition that a health care professional has to be emotionally involved to the suffering and pain of patients whom they assist, may be the primary cause of non-adherence to infection control practices related to health care, and the responsible for making them neglect putting the patient´s and their own lives at risk of death since this interferes on their work, increasing the possibility of errors and nonadherence, thus contributing to its transmission. The manifestations resulting from the emotional involvement condition of a health care professional to the suffering and pain of their patients are receiving several nominations and definitions such as fatigue and / or compassion satisfaction. Objectives: investigate: a) if health professionals of intensive care units show suffering resulting from the emotional involvement condition to the suffering and pain of patients whom they assist, comprehended by one of the compassion fatigue components, the Secondary Traumatic Stress; b) the comprehensions of health professionals about the difficulties related to health care infection control practices, the perceptions of their own performances in health care infection control practices, their suggestions for reducing health care infections rates and their free observations about participation in the research. Method: this is a cross-sectional clinical study, conducted in four ICUs of Hospital das Clínicas, School of Medicine, University of São Paulo. The study included professionals in the nursing field or doctors whom are working or have worked in ICUs and whom have understood and signed the free and informed consent. Were included 168 professionals for the first objective and 96 for the second. The instruments used were sociodemographic data, ProQol-BR and semi-structured interviews. The sociodemographic data were analyzed by Excel program features, the ProQol-BR data were analyzed according to Stamm guidelines (2010) and statistical analysis and the interviews analyzed according to the method of content analysis. Results: Most (53.6%) of the professionals evaluated showed no suffering from the emotional involvement condition to suffering and pain of the patients whom they assist, comprehended by Secondary Traumatic Stress. Interview data were grouped into institutional and subjective factors. The professional´s comprehensions about the difficulties involved both factors, but subjective (52%) exceeded the institutional. About their perceptions, they tended not to recognize difficulties, but when recognized, they attributed it more to subjective factors (66%) than to institutional. The suggestions were more related to institutional actions (89%). And the free observations about the research showed that, despite some criticism, the research was well regarded and accepted. Conclusion: This study identified that the difficulties in health care infection control practices of the health professionals evaluated are not related to a suffering resulting from an emotional and involvement to the suffering and pain of their patients but a lack of involvement

Introdução: Esta pesquisa é um recorte do projeto de pesquisa INVESTIGAÇÃO DAS DIFICULDADES HUMANAS DE PROFISSIONAIS DE SAÚDE NAS PRÁTICAS DE CONTROLE DE INFECÇÃO RELACIONADA À ASSISTÊNCIA À SAÚDE. Parte da hipótese de que o sofrimento decorrente da condição que um profissional de assistência à saúde (PAS) tem de se envolver emocionalmente e afetivamente ao sofrimento e às dores dos pacientes a quem prestam assistência possa ser a principal causa da não adesão às práticas de controle de infecções relacionadas à assistência à saúde (IRAS) e a responsável por fazer com que eles se descuidem, colocando a vida do paciente e a deles própria em risco de morte uma vez que o sofrimento decorrente dessa condição interfere em seus trabalhos, aumentando a possibilidade de erros e de não adesão, colaborando, assim, para a sua transmissão. As manifestações decorrentes da condição de envolvimento emocional e afetivo de um PAS ao sofrimento e às dores de seus pacientes vêm recebendo diversas nomeações e definições, como Fadiga e/ou Satisfação por Compaixão. Objetivos: investigar: a) se PAS de Unidades de Terapia Intensiva (UTIs) apresentam sofrimento decorrente da condição de envolvimento emocional e afetivo ao sofrimento e às dores dos pacientes a quem prestam assistência, compreendido por um dos componentes da Fadiga por Compaixão, o Estresse Traumático Secundário; b) as compreensões dos PAS a respeito das dificuldades relacionadas às práticas de controle de IRAS, as percepções de suas próprias participações nas práticas de controle de IRAS, as suas sugestões para diminuição de taxas de IRAS e as observações livres a respeito da participação na pesquisa. Método: Trata-se de estudo clínico transversal. Foram incluídos PAS da área de enfermagem ou médicos, atuantes ou que tenham atuado em UTIs e que tenham compreendido e assinado o termo de consentimento livre e esclarecido. Para o primeiro objetivo foram incluídos 168 PAS e, para o segundo, 96. Foram utilizados ficha de dados sócio demográficos, ProQol-BR e entrevistas semi-dirigidas. Os dados sócio demográficos foram 9 analisados por recursos do programa Excel; os do ProQol-BR foram analisados conforme orientações de Stamm (2010) e análise estatística; e os das entrevistas analisados conforme método de análise de conteúdo. Resultados: A maioria (53,6%) dos PAS avaliados não apresentou sofrimento decorrente da condição de envolvimento emocional e afetivo ao sofrimento e às dores dos pacientes a quem prestam assistência, compreendido por Estresse Traumático Secundário. Os dados das entrevistas foram agrupados em fatores institucionais e subjetivos. As compreensões das dificuldades dos PAS envolveram ambos fatores, mas os subjetivos (52%) sobressaíram os institucionais. Sobre as percepções, tenderam a não assumir dificuldades, mas quando as assumiram, atribuíram mais a fatores subjetivos (66%) do que institucionais. As sugestões foram mais relacionadas a ações institucionais (89%). E as observações a respeito da pesquisa apontaram que, apesar de algumas críticas, a pesquisa foi bem vista e aceita. Conclusão: Essa pesquisa permitiu identificar que as dificuldades de adesão dos PAS avaliados às práticas de controle de IRAS não estão relacionadas a um sofrimento decorrente de um envolvimento emocional e afetivo ao sofrimento e às dores de seus pacientes, mas a uma falta de envolvimento / Introduction: This research is part of the research project INVESTIGATION OF HUMAN DIFFICULTIES OF HEALTH PERSONNEL IN HEALTH CARE INFECTION CONTROL PRACTICES. Started off the hypothesis that the suffering resulting from the condition that a health care professional has to be emotionally involved to the suffering and pain of patients whom they assist, may be the primary cause of non-adherence to infection control practices related to health care, and the responsible for making them neglect putting the patient´s and their own lives at risk of death since this interferes on their work, increasing the possibility of errors and nonadherence, thus contributing to its transmission. The manifestations resulting from the emotional involvement condition of a health care professional to the suffering and pain of their patients are receiving several nominations and definitions such as fatigue and / or compassion satisfaction. Objectives: investigate: a) if health professionals of intensive care units show suffering resulting from the emotional involvement condition to the suffering and pain of patients whom they assist, comprehended by one of the compassion fatigue components, the Secondary Traumatic Stress; b) the comprehensions of health professionals about the difficulties related to health care infection control practices, the perceptions of their own performances in health care infection control practices, their suggestions for reducing health care infections rates and their free observations about participation in the research. Method: this is a cross-sectional clinical study, conducted in four ICUs of Hospital das Clínicas, School of Medicine, University of São Paulo. The study included professionals in the nursing field or doctors whom are working or have worked in ICUs and whom have understood and signed the free and informed consent. Were included 168 professionals for the first objective and 96 for the second. The instruments used were sociodemographic data, ProQol-BR and semi-structured interviews. The sociodemographic data were analyzed by Excel program features, the ProQol-BR data were analyzed according to Stamm guidelines (2010) and statistical analysis and the interviews analyzed according to the method of content analysis. Results: Most (53.6%) of the professionals evaluated showed no suffering from the emotional involvement condition to suffering and pain of the patients whom they assist, comprehended by Secondary Traumatic Stress. Interview data were grouped into institutional and subjective factors. The professional´s comprehensions about the difficulties involved both factors, but subjective (52%) exceeded the institutional. About their perceptions, they tended not to recognize difficulties, but when recognized, they attributed it more to subjective factors (66%) than to institutional. The suggestions were more related to institutional actions (89%). And the free observations about the research showed that, despite some criticism, the research was well regarded and accepted. Conclusion: This study identified that the difficulties in health care infection control practices of the health professionals evaluated are not related to a suffering resulting from an emotional and involvement to the suffering and pain of their patients but a lack of involvement

There are negative personal, psychological, and professional implications of working with individuals who have suffered from trauma, to include secondary trauma. A significant research gap exists in regard to how secondary trauma bears on psychosocial assistants (PAs). Bukavu, in the Democratic Republic of Congo (DRC), has a shortage of trained and licensed mental health providers, and as a result, mental health services have been shifted to PAs. Using Bandura's social cognitive theory and Orem's theory of self-care, this qualitative phenomenological study explored the lived experiences of secondary trauma, through face to face interviews with 13 PAs in Bukavu. The collected data was analyzed using Bryman's four stages of coding. This study found that PAs experienced symptoms of secondary trauma. In talking about their experiences, the themes that emerged included personal changes, perseverance, fear and insecurity, suffering, "thinking too much," nervousness, feeling lost, conflict of compassion, hopelessness, helplessness, religion, faith, the role of God and conflict. PAs had limited knowledge of secondary trauma, its effects and how to manage it. Loneliness, strength, faith, time, money and self-protection, were prominent themes around PAs' discussion of their training and experiences with coping. The findings of this research add to the understanding of secondary trauma of these PAs and may influence the personal and professional wellbeing of PAs through gaining knowledge about their experiences. Understanding secondary trauma in PAs may impact social change in the DRC through influencing the structuring of policies and delivery of mental health services to protect workers and beneficiaries.