Compassion fatigue (CF) is defined as a sudden onset of the inability to experience feelings or compassion for others that is triggered by a nurse's inability to separate his/her feelings of stress and anxiety associated with caring for patients who have suffered from a traumatic event. The practice problem addressed in this doctoral project was the lack of knowledge of emergency department nurses (EDNs) related to CF in the work setting, resulting in a negative impact on a nurse's ability to provide quality care to patients. The purpose of the project was to present an educational program on how to recognize, prevent, and manage CF. Framed within Stamm's theoretical model of compassion satisfaction and CF, the project was guided by the steps within the Walden University Manual for Staff Education Project and the practice question addressed whether the literature would support an evidence-based educational program on CF for EDNs. The evaluation/validation for the project included an evaluation of the curriculum by the three content experts (in which learning objectives were deemed met), content validation of the pre-/post-test items by the content experts (all test items were deemed relevant to the learning objectives, with the validity index scale analysis at 1.00), and finally, a paired t test to determine knowledge gained from pre- to post-test that resulted in a significant (p < 0.0001) improvement in knowledge. A potential positive social change resulting from the project is a healthy work environment where EDNs understand and reduce their risks for CF, which may ultimately promote optimal patient care and improved health outcomes.

Bakgrund: En genomgång av aktuellt kunskapsläge visar att sjuksköterskor har en risk att utveckla compassion fatiguepå grund av sitt empatiska engagemang gentemot patienterna. Compassion fatigueär då en person som konsekvens av sitt empatiska engagemang gentemot en patient blir emotionellt utmattad. Syfte:Syftet med denna studie är att belysa riskfaktorer för sjuksköterskor att drabbas av compassion fatiguesamt för att undvika detta tillstånd. Metod:En litteraturstudie gjordes med både kvalitativ och kvantitativ forskning. Resultatet analyserades och sammanfattades. Resultat:Resultatet visade att risken att drabbas var störst hos sjuksköterskor inom hemsjukvården, akutsjukvården, hospices sjuksköterskor och de sjuksköterskor som arbetade med kroniskt sjuka barn. Ett flertal strategier och åtgärder pekar på vikten att behålla en professionell distans till patienterna samt säga nej till arbete som ej tillhör ens specifika arbetsområde. Majoriteten av sjuksköterskorna delgav även support som en strategi för återhämtning, både från kollegor men även i form av kurator eller psykolog, speciellt vid traumatiska händelser. Slutsats: Compassion fatigueär ett problem både för sjukvården i stort och för den enskilda sjuksköterskan. Det påverkar både omvårdnaden, arbetssituationen och den enskilda sjuksköterskan negativt. Ett flertal faktorer spelar in i utvecklandet av compassion fatigue, detta gör även att det krävs ett brett urval av möjliga åtgärder för att förhindra det. / Background: A review of the field shows that nurses are at risk to develop compassion fatigueas a result of their empathic engagement with patients. Compassion fatigueis when a person as a consequence of their empathic engagement with patients suffers an emotional exhaustion. Purpose: The purpose of this study is to highlight risk factors in developing compassion fatigueand how to avoid this condition in the nursing profession. Method: A literature review with both qualitative and quantitative research. The result was then analysed and summarized. Result: The results showed that nurses in homecare, acute care, hospice and those working with chronically ill children were at the highest risk for Compassion fatigue.A number of strategies and preventive measures highlight the importance of having a professional distance to the patient as well as saying no to tasks that are not within the nurses specific profession. A majority of nurses stated support as a strategy for recovery, both from colleges as well as counselors or psychologists, especially after traumatic events. Conclusion: Compassion fatigue is a problem both for healthcare in general as well as for nurses themselves. It affects the patient care, the work situation and the nurse negatively. A number of factors contribute in the development of compassion fatigue, because of this a broad selection of possible preventive measures is required,

In the field of medicine, empathic providers have been found to bring numerous benefits to a clinical encounter as they are better able to elicit detailed and thorough case histories, build rapport and therapeutic alliance with patients, and foster greater compliance with treatment recommendations. Despite its multiple benefits, empathy has not been researched systematically within the field of speech-language pathology. In medical training, empathy has been found to decline by the time medical students are introduced to direct patient care. Currently, no information is available regarding the empathy trajectory of novice speech-language pathologists. The goal of the current project was to determine the effect of one semester of clinical experience on the perceived and self-reported empathy of novice speech-language pathology clinicians during their first semester of graduate school. A convergent parallel mixed-method design was used in two stages (pre/post). Both quantitative and qualitative data were gathered concurrently during two distinct moments in time (i.e. pre-test: during the first week of exposure to clients in clinic; post-test: at the end of the first semester of clinic). Quantitative and qualitative data analyses were completed separately at the conclusion of each stage, with data integration taking place during final interpretation. Quantitative findings revealed that novice speech-language pathology students were able to identify high vs. low levels of relational empathy as depicted in two video-recorded clinical interviews using a modified CARE measure (Mercer, Maxwell, Heaney, & Watt, 2004) even prior to exposure to clinical practice. In addition, these perceptions remained stable from pre-test to post-test. Qualitative comments written by novice clinicians regarding each video were analyzed using a-priori codes. Analysis of the qualitative data corroborated the quantitative findings except for mild nuances pertaining to observations about the caregiver in the video, which tended to occur more frequently at pre-test and less so at post-test. The significance of these qualitative findings was questionable, but it was hypothesized that clinicians may have become more “detached” from the caregiver’s perspective after they were exposed to direct work with clients in the clinic. Novice clinicians’ levels of self-reported empathy were also observed to remain stable from pre-test to post-test, as evidenced by quantitative findings from the Empathy Assessment Index (EAI – Gerdes, Segal, & Lietz, 2012). Analysis of the subtests from the EAI showed that all clinicians tended to have lower scores for emotional regulation as compared with other components such as affective response, affective mentalizing, perspective taking, or self-other awareness. Qualitative analysis of an exit interview in which novice clinicians were asked to list the most frustrating and most rewarding aspects of their semester showed that aspects of the semester which were perceived as frustrating were often balanced by those which were perceived as rewarding. In addition, direct work with clients and caregivers was listed by far as one of the most rewarding experiences for novice clinicians, particularly as it pertained to client progress. Factors which could potentially lead into burnout were noted in the list of frustrating items, but these occurred more infrequently. Further investigations into the empathy trajectory of novice speech-language pathology students are recommended especially using a cross-sectional or longitudinal design to determine if empathy remains stable over the course of training or whether it suffers a decline as academic, personal, and patient/caseload demands become more challenging and multifaceted. Possible investigations following clinicians after the completion of their clinical fellowship year would also be recommended as novice clinicians transition from trainees to full-fledged providers.

ABSTRACT High levels of trauma within the South African society affect the majority of the population either directly or indirectly. In order to assist individuals overcome such traumatic incidents, many companies in South Africa have contracted with Employee Assistance Programme (EAP) Providers to provide counselling to employees. These EAP counsellors are often the first mental health professionals to be exposed to a client’s traumatic story. Consequently, such counsellors may be vulnerable to compassion fatigue (CF). The consequences of EAP counsellors working with traumatised clients have been relatively unexplored. Therefore, this study proposed that EAP trauma counsellors are vulnerable within their scope of work and are an important group of professionals to be further investigated. Furthermore, leading authors in the field of trauma argue that both individual characteristics and environmental factors play a role in the development of CF. However, research into the process by which CF develops is extremely limited. Hence, this study attempted to explore this process through identifying possible core variables such as level of exposure, empathy and affect intensity and exploring their link to CF. The study was based on Figley’s (1995) Trauma Transmission Model, Dutton and Rubinstein’s (1995) Ecological Model and McRitchie’s (2006) Refined Model for Trauma Workers. The data was collected from 60 EAP counsellors, through self report measures. Data was analysed using descriptive statistics, correlations, a stepwise regression, two independent sample t-tests, and analysis of variance. Results revealed that 28.34% of the sample fell within the range for CF. There were significant correlations between Level of Exposure to traumatic material and CF; between levels of empathy and CF and between Affect Intensity and Empathy. There was no significant correlation between Affect Intensity and CF. Furthermore, the stepwise regression indicated that 56% of CF may be explained by a combination of four interacting variables, that is, Level of Exposure, Fantasy, Personal Distress and Perspective Taking.

The aim of this research was to longitudinally and quantitatively investigate sense of coherence (SOC) and coping strategies as predictors of compassion satisfaction (CS) and compassion fatigue (CF) as measured by secondary traumatic stress (STS) and burnout (BT) during the first six months of training in a professional psychology training programme. Trainee therapists’, “dramatically shift” their “focus of functioning over time” to adorn the personality and self of the therapist (Rønnestad & Skovholt, 2003, p. 28). This adaptive process may initially unravel over six months as trainees balance client and workload stressors (Hill, Sullivan, Knox & Schlosser, 2007; Tryssenaar & Perkins, 2001). However, research on the developmental processes behind the negative (CF) and positive (CS) avenues of therapeutic stressors is lacking in the trainee therapists’ population, especially quantitatively (Schwing, LaFollette, Steinfeldt & Wong, 2010; Thériault, Gazzola & Richardson, 2009). This research aimed to explore these issues in relation to professional development through SOC and coping as predictors of CS and CF over a six month training period. Variables were investigated quantitatively through the Professional Quality of Life Scale (ProQOL) (Stamm, 2010) the Brief COPE (BCOPE) (Carver, 1997) and the 29-item self-report Orientation to Life Questionnaire (OLQ) (Antonovsky, 1987). As such, the primary focus of this research was on how SOC and coping strategies were utilised by trainee therapists as process variables in predicting the positive (CS) and negative (CF) avenues of therapeutic work over a six month period of psychotherapy training. Findings suggested that, at the beginning of training, sense of coherence was directly associated with the core outcome variables (CS and CF (as measured by STS and BT). When trainee therapists started seeing clients two months later, the effect of SOC was mediated by coping. At the end of training, only coping was directly associated with outcome variables as the effect of SOC on CS and CF disappeared. These implications are further discussed in the research.

abstract: Traditionally when the topic of secondary traumatic stress (STS) is discussed, it is often in regard to medical professionals and first responders. People who have STS or compassion fatigue, as it has been renamed, have been defined as people who are dealing with traumatic stress and/or emotional burdens via their “patients.” This study, conducted at a major university in the southwest, measured educators’ perceptions of the extent of their compassion fatigue using the Professional Quality of Life Scale (ProQOL) before and after a voluntary online support training during last four weeks of the semester. Educators who were full time scored better than the educators who worked part time on the three components of the Compassion Fatigue Scale. Results from this study suggest that additional training surrounding compassion fatigue may be needed in the future. / Dissertation/Thesis / Doctoral Dissertation Educational Leadership and Policy Studies 2019

The purpose of this study is to explore Filipino service care providers’ experience of compassion fatigue. Compassion fatigue is a common experience among health care professionals and can contribute to feelings of hopelessness and adverse behaviors in caring for patients. In California, there are a large number of Filipinos who are employed as care providers for older adults; however, there is limited research available regarding Filipino workers in the United States. This study took on a qualitative design that utilized face-to-face interviews to gain more insight into Filipino service care providers’ experience of compassion fatigue in relation to their employment. Factors that were explored in interviews were exposure to terminally ill individuals, coping and self-care strategies, and working environments. The results of this study indicated participants appeared to experience compassion satisfaction, rather than compassion fatigue. Furthermore, recommendations for future research were discussed. These recommendations included the need to explore experiences of compassion satisfaction in this population and to look into the experience of Filipino service care providers who were born in the United States, rather than in the Philippines, to determine whether Filipino cultural values of caring can act as a buffer against the effects of compassion fatigue.

Compassion fatigue (CF) and burnout (BO) in the novice nurse population can negatively affect the organization, patient safety, patient satisfaction, and the individual. Novice nurses are susceptible to the development of CF and BO due to a lack of knowledge about the causes and the stress experienced as the novice nurse transitions to practice. The purpose of this staff education project was to fill the gap in practice by creating awareness about CF and BO during the nurse orientation process and by providing prevention strategies. The relationship-based care model and the theory of planned behavior were used to guide the project development and to discover motivational factors to encourage self-care and improve the well-being and resiliency of the novice nurse. The post-education evaluation was an anonymous, 10-question, Likert-type survey. All participants scored each question based on the course learning objectives, feasibility, and efficacy of the program, with a (5) strongly agree or (4) agree. A descriptive analysis of the data collected from the survey scores provided information that positively supported the practice-focused question that staff education on CF, BO, and prevention strategies would add value to the novice nurses' orientation program by validating the stressors of working with patients and providing tools to promote self-care as they transition from student to practicing registered nurses. Future recommendations would be to offer this education to staff nurses in all units during the annual skills day, huddles, and staff meetings. This project has the ability to create positive social change by educating novice nurses early in their career about the symptoms and self-care measures designed to promote resiliency, thus preventing CF and BO.

<p>Denna studie har till syfte att genom kvalitativa intervjuer studera om brottsofferstödjare upplever att deras hälsa påverkas av arbetet, och i så fall hur detta yttrar sig. Detta är ett ganska nytt område att forska inom, därför finns det ett stort behov av ytterligare kunskap inom området, och därav kommer mitt intresse.</p><p>Uppsatsen redogör för utvecklingen inom brottsstatistiken och uppkomsten av några olika brottsofferstödjande verksamheter. Tidigare forskning visar på att personer som arbetar med brottsofferstöd löper en stor risk att drabbas av negativa hälsoeffekter till följd av arbetet, dessa symptom benämns som compassion fatigue.</p><p>I studien intervjuades sex personer som arbetar inom brottsofferstödjande verksamhet, varav tre är anställda och tre arbetar ideellt. Intervjuerna analyserades utifrån Karasek och Theorells krav-kontroll-stöd modell. Resultaten av dessa intervjuer visar att dessa personer ibland känner att arbetet har en negativ inverkan på hur de mår, men detta är bara under korta perioder och inträffar inte särskilt ofta. Genom erfarenhet och stöd från arbetskamrater har man lärt sig att hantera de jobbiga situationer som kan uppstå, så att de inte ger någon långvarig inverkan. Det visats att trots att det finns brister i verksamheterna, t.ex. när det gäller ekonomi och möjligheten till handledning i arbetet, så upplevs arbetet ändå generellt sett som positivt. Den störta anledningen till detta är den glädje man upplever i och med att man lyckas hjälpa någon annan. Det goda överväger det onda. Det var dock en intervjuperson som skilde sig från de andra, genom att hon en gång hade blivit sjukskriven p.g.a. utbrändhet som följd av arbetssituationen, denna person var en av de som arbetade med brottsofferstöd som fast anställd. Detta är 17% av alla intervjupersonerna, och 33% av de anställda.</p>

<p><p>Studiens syfte var att utifrån tidigare forskning (Hallén, 2007, 2008) undersöka konsekvenser av att känna empati. Genom en faktoriell inomgruppsdesign (2x2) besvarade 51 frisörer en enkät om hur de påverkas på kort och lång sikt av att känna empati med sina kunder. Resultaten visade att empati med någon som mår dåligt upplevdes leda till betydligt mer negativa effekter än empati med någon som mår bra, på både kort och lång sikt. Vidare upplevdes effekterna som mer intensiva på kort sikt än på lång, oavsett om individen man empatiserat med mått dåligt eller bra. En tänkbar förklaring till skillnaden över tid är att de emotioner vi specifikt erfar genom andra avtar på samma sätt såsom minnen av egna emotioner gör generellt.</p></p>