Background/Objectives: Compassion fatigue (CF) is severe emotional and physical exhaustion resulting from unresolved burnout and/or secondary traumatic stress. Prevalent in registered nurses and physicians, CF negatively impacts both the caregiver and the care provided and is associated with job attrition. There is no direct measure for CF. Risk is assigned according to the intensity of each constituent part and the relationships between these parts. The purpose of this practice inquiry was to describe the risk for CF among doctor of nursing practice (DNP) students seeking nurse practitioner certification, a previously unstudied and potentially at-risk population. Design: A descriptive study was performed to describe: 1) the prevalence of compassion satisfaction; 2) the prevalence of burnout; 3) the prevalence of secondary traumatic stress; 4) the prevalence of risk profiles developed by Stamm (2010); and 5) the relationship between demographic characteristics and CF risk profiles in a sample of DNP students. Setting: The University of Arizona, College of Nursing between August 24, 2013 and November 19, 2013. Participants: 59 graduate nursing students seeking nurse practitioner certification and a DNP degree self-selected to participate in the study. Measurements: The Professional Quality of Life Scale-5 (ProQOL 5) was utilized to measure the components of CF: compassion satisfaction, burnout, and secondary traumatic stress. Patient demographics included: gender, age, years in nursing, nursing specialty, and employment status. Results: The DNP student population appears to be at-risk for CF, with 69% of the sample falling outside of the "low risk" CF profile. Stamm's (2010) five risk profiles were expanded to assign a level of risk to the 63% of participants who did not land in an existing profile. There were no statistically significant relationships between demographic variables and the expanded CF risk profiles, consistent with previous studies on the individual ProQOL components. A weak trend of increasing CF risk with years of nursing practice suggests that accumulated exposure to suffering increases CF risk. However, a small sample size and self-normalization in the ProQOL 5 limit the generalizability of the findings. Conclusion: DNP students are an at-risk population; therefore, we recommend incorporation of CF awareness and risk reduction into the DNP curriculum. Applicability of the ProQOL 5 test is hindered by scoring inconsistencies and self-normalization bias and we propose solutions. We additionally propose the concept of a single numeric index to quantify individual CF risk. Use of a single continuous variable pertaining to CF risk is likely to be crucial for future characterization, screening, and interventions.

Syftet med denna studie var att undersöka risken för Compassion Fatique hos sjuksköterskor vid Akademiska sjukhuset i Uppsala. Compassion Fatigue är då en person som konsekvens av sitt empatiska engagemang gentemot en annan person blir emotionellt utmattad. En enkätstudie bland psykiatrisjuksköterskor och sjuksköterskor inom den somatiska vården gjordes, dessa jämfördes i avseende på Compassion Fatique-risk. Huvudresultatet tyder på att nästan en fjärdedel av sjuksköterskorna som grupp är i riskzonen för att utveckla Compassion Fatique och att närmare 40 % av alla deltagare var i riskzonen för att utveckla utbrändhet. 21,9 % låg under referensvärdet för Compassion Satisfaction, vilket innebär att man ej känner sig tillfredställd med sin arbetssituation.  Risken för Compassion Fatigue och utbrändhet var lika för de båda grupperna, men värdet på Compassion Satisfaction skilde sig och var lägst bland psykiatrisjuksköterskorna. Det finns dock ingen signifikant skillnad mellan psykiatrisjuksköterskorna eller de sjuksköterskor som arbetade inom somatiken gällande risk för Compassion Fatique, risk för utbrändhet eller Compassion Satisfaction. Både sjuksköterskor inom den somatiska och psykiatriska vården vid Akademiska universitessjukhuset i Uppsala visar tecken på Compassion Fatique och utbrändhet. I studien kunde även ett samband mellan utbrändhet och Compassion Fatigue påvisas.

Despite concerted efforts to eradicate violence against women and challenge victim-blaming attitudes towards survivors of sexual assault, women continue to be sexually victimized and encounter negative and accusatory reactions by family, friends, and society at large. For many survivors, the consequences are internalizing blame and feelings of shame, which has been shown to be related to increased psychological distress, self-destructive coping mechanisms, depression, generalized anxiety, and post-traumatic stress (Arata, 1999; Davis & Breslau, 1994; Feiring, Taska, & Lewis, 2002; Frazier, 1990, 2000; Frazier & Schauben, 1994; Wyatt et al., 1990). New research in the area of self-compassion suggests that this way of self-relating can counter shame (Gilbert, 2005) and serve as a resiliency factor for coping with daily stressors (Leary, Tate, Adams, Allen, & Hancock, 2007) and contribute to well-being (Neff, 2003a). No study has yet empirically evaluated self-compassion among survivors of trauma, nor more specifically, victims of sexual assault. The present study investigated the relationships between self-compassion and various indicators of psychological health that have been associated with posttrauma adjustment. One hundred and forty-one women in North America who experienced a sexual assault in the past 5 years (aged 18 to 61, M age = 27 years) completed measures assessing trauma history (sexual trauma history, childhood trauma and stressful life experiences), posttrauma adjustment (psychological distress, negative posttraumatic cognitions, and shame), self-compassion, self-criticism, and life satisfaction. The results of the study showed that self-compassion was significantly negatively related to psychological distress, negative posttraumatic cognitions, shame and self-criticism, and was positively related to life satisfaction. Hierarchical linear regressions revealed that when controlling for earlier childhood trauma and other stressful life experiences, self-compassion was a strong and significant predictor, explaining between 19 to 42% of the variance in psychological distress, negative posttraumatic cognitions, shame, and self-criticism. Comparing groups based on severity of sexual assault revealed that women who experienced attempted rape reported significantly higher levels of self-criticism compared with women who experienced sexual coercion. These findings bolster recent studies that equate self-compassion with psychological resilience. The negative relationships revealed between self-compassion and measures reflecting posttrauma adjustment and self-criticism, along with the positive association with life satisfaction clearly demonstrate validity in the pursuit of self-compassion as an important psychological construct that may help women recover from sexual trauma.

Despite concerted efforts to eradicate violence against women and challenge victim-blaming attitudes towards survivors of sexual assault, women continue to be sexually victimized and encounter negative and accusatory reactions by family, friends, and society at large. For many survivors, the consequences are internalizing blame and feelings of shame, which has been shown to be related to increased psychological distress, self-destructive coping mechanisms, depression, generalized anxiety, and post-traumatic stress (Arata, 1999; Davis & Breslau, 1994; Feiring, Taska, & Lewis, 2002; Frazier, 1990, 2000; Frazier & Schauben, 1994; Wyatt et al., 1990). New research in the area of self-compassion suggests that this way of self-relating can counter shame (Gilbert, 2005) and serve as a resiliency factor for coping with daily stressors (Leary, Tate, Adams, Allen, & Hancock, 2007) and contribute to well-being (Neff, 2003a). No study has yet empirically evaluated self-compassion among survivors of trauma, nor more specifically, victims of sexual assault. The present study investigated the relationships between self-compassion and various indicators of psychological health that have been associated with posttrauma adjustment. One hundred and forty-one women in North America who experienced a sexual assault in the past 5 years (aged 18 to 61, M age = 27 years) completed measures assessing trauma history (sexual trauma history, childhood trauma and stressful life experiences), posttrauma adjustment (psychological distress, negative posttraumatic cognitions, and shame), self-compassion, self-criticism, and life satisfaction. The results of the study showed that self-compassion was significantly negatively related to psychological distress, negative posttraumatic cognitions, shame and self-criticism, and was positively related to life satisfaction. Hierarchical linear regressions revealed that when controlling for earlier childhood trauma and other stressful life experiences, self-compassion was a strong and significant predictor, explaining between 19 to 42% of the variance in psychological distress, negative posttraumatic cognitions, shame, and self-criticism. Comparing groups based on severity of sexual assault revealed that women who experienced attempted rape reported significantly higher levels of self-criticism compared with women who experienced sexual coercion. These findings bolster recent studies that equate self-compassion with psychological resilience. The negative relationships revealed between self-compassion and measures reflecting posttrauma adjustment and self-criticism, along with the positive association with life satisfaction clearly demonstrate validity in the pursuit of self-compassion as an important psychological construct that may help women recover from sexual trauma.

Compassion Focused Therapy är en integrativ transdiagnostisk behandlingsform som syftar till att öka self-compassion och minska skam och självkritik hos individer med psykisk ohälsa. Skam och självkritik har i hög grad identifierats hos personer med ätstörningar, som också ofta anses svårbehandlade. Denna studie syftade till att undersöka huruvida CFT kan vara ett behandlingsalternativ vid ätstörningar. En single-subject design med upprepade mätningar användes (n=5). Studien visade på tvetydiga resultat men indikerar att en del individer kan vara hjälpta av denna behandling. Fortsatt forskning är således motiverad / Compassion Focused Therapy (CFT) is an integrative transdiagnostic treatment aiming at increasing self-compassion, and reducing levels of shame and self-criticism in individuals with psychiatric illness. High levels of shame and self-criticism have been identified in people suffering from eating disorders, disorders who are usually considered difficult to treat. The aim of the present study was to investigate if CFT could be considered a treatment option for eating disorders. A single-subject design with repeated measures was used (n=5). The results were ambiguous, though indicating that CFT could be helpful for some individuals with eating disorders. Further research is warranted.

Research has shown that desirable responding can be detrimental to social relationships, achievement and health. This study used an experimental design to (a) induce an increase in desirable responding through threat to self-image and then (b) compare the effectiveness of self-compassionate and self-affirming writing in attenuating that increase. Control groups included no threat exposure, threat exposure alone and threat exposure plus neutral writing. Desirable responding was measured along two dimensions: self-enhancement and exaggerated virtue. Results show the threat did not result in the predicted increase in desirable responding so the effectiveness of the two strategies with regards to attenuating increases in desirable responding could not be examined and compared. However, results do reveal a difference in the mechanism of these two strategies. Engaging in self-compassionate writing resulted in a significant decrease in exaggerated virtue whereas being self-affirmed resulted in a significant increase, suggesting a possible benefit of a self-compassion strategy.

Self-compassion has consistently been found to contribute significantly to psychological well-being, and previous research has found that it can be increased using a simple writing task. As the mechanism underlying task efficacy is unknown, this study investigated the role of belief. Belief was found to predict change in self-compassion, self-esteem, and depression, with higher levels being associated with less improvement, an effect in the opposite direction as hypothesized. However, increase in belief across the three trials was positively correlated with improvement in self-compassion, depression, anxiety, and stress, indicating that change in belief represents a different psychological effect than absolute level of belief. Further, those who increased in belief reported improvement in well-being, while those who decreased did not. Results suggest that task efficacy, at least in part, depends on the degree to which perspectives are reappraised to become more congruent with self-compassionate perspectives, as opposed to simply depending on task repetition.

Thesis (D. Min.)--Ashland Theological Seminary, 2007. / Abstract. Includes bibliographical references (leaves 230-238).

Thesis (D. Min.)--Ashland Theological Seminary, 2007. / Abstract. Includes bibliographical references (leaves 230-238).

Thesis (Ph.D.)--Ohio University, November, 2007. / Title from PDF t.p. Includes bibliographical references.