The purpose of this study was to describe the experiences, symptoms, and effects of compassion fatigue among emergency nurses, and to identify potentially effective interventions. Compassion fatigue within the profession of nursing is of growing concern due to its negative impact on nurses' mental and physical health, productivity, and patient care. There is a notable paucity of available qualitative research related to compassion fatigue in nursing, but available quantitative data indicates that emergency nurses could be especially at risk for developing compassion fatigue. Compassion fatigue is commonly conceptualized as being composed of burnout and secondary traumatic stress; however, previous exploratory research indicated that this definition might not adequately fit emergency nurses. Focus group interviews were conducted with emergency department nurses from four local hospitals. The participants were asked about their experiences, symptoms, and perceptions of the effects of compassion fatigue, and about potentially effective interventions to address compassion fatigue within their work setting. A content analysis of the interview data was performed to identify categories, common threads and patterns, and related themes. Although the participants' average length of time working in the emergency setting was less than two years, they all reported having intense experiences related to professional burnout, secondary traumatic stress, and the negative effects of compassion fatigue. The development of compassion fatigue was contributed to both organizational (time pressure and lack of resources and leadership support) and patient (clinical uncertainty, reason for seeing care, and witnessing grief) factors. The main symptoms of compassion fatigue were exhaustion, impaired communication, decreased emotional tolerance, coping with dark humor, and detachment/dissociation. These symptoms affected the participants both at work and home. The suggested potential interventions comprised of self-care activities, debriefing with clinical staff, continuing education, and increasing awareness about compassion fatigue in the work setting. The data from this qualitative descriptive study expands our knowledge of the concept and ramifications of compassion fatigue in nursing, specifically in the emergency setting. It also offers potentially effective interventions to prevent and address the negative effects of compassion fatigue.

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The purpose of this investigation was to examine the directional relationship between practicing school counselors' level of professional quality of life and self-efficacy to their programmatic service delivery activities. This investigation tested the theoretical model that practicing school counselors' level of professional quality of life (as measured by the Professional Quality of Life Scale [ProQOLs; Stamm, 2010]) and their self-efficacy (as measured by the School Counselor Self-Efficacy Scale [SCSEs; Bodenhorn & Skaggs, 2005]) contributes to their service delivery activity (as measured by the School Counselor Activity Rating Scale [SCARS; Scarborough, 2005]). Specifically, this study examined the hypothesized directional relationship that school counselors who have higher ProQOL scores (e.g., less burnout and compassion fatigue and higher compassion satisfaction) and higher self-efficacy scores (e.g., more confident about counseling skills) have increased levels of programmatic service delivery facilitation (e.g., they provide high levels of school counseling activities for students and stakeholders). In addition, this investigation examined the relationship between practicing school counselors' demographic factors and the constructs of professional quality of life, self-efficacy, and programmatic service delivery. Furthermore, the investigation examined the difference in response rate and school counselors' total mean score (as measured by the ProQOLs, SCSEs, and SCARS) based upon the: (a) sampling method (e.g., email web-based, paper-pencil mail-out survey, face-to-face survey administration), (b) token incentive type (e.g., monetary [$1.00, $2.00, or no incentive] or non-monetary [$1.00 donation to the American Red Cross or no donation]), and (c) sampling population (e.g., ASCA dataset or Common Core Dataset)? A review of the literature is presented, which provides conceptual theory and empirical research to support the constructs and their hypothesized relationship. A descriptive, correlational research design was employed to investigate the research hypothesis and exploratory research questions. The data was collected through diverse survey methodologies (e.g., email web-based, paper-pencil mail-out survey, face-to-face survey administration). The research hypothesis was tested through the utilization of structural equation modeling (SEM). In addition, multiple linear regression, spearmen rho correlation, Mann-Whitney U tests, Kruscal-Wallis H tests, and Chi Square tests of independence were used to analyze the data for the exploratory questions. The results of the investigation are presented and compared to current literature and prior research. Additionally, the limitations of the study are discussed and recommendations for future research are presented. Last, implications from this investigation are discussed in regards to practicing school counselors, school counselor educators, and school counseling researchers. The sample size for this investigation was 690 with 577 used for the data analysis after data cleaning. The results of the SEM analyses identified that practicing school counselors' professional quality of life contributed to their programmatic service delivery (1.21% of the variance explained). In addition, the results identified that practicing school counselors' self-efficacy contributed to their programmatic service delivery (34.81% of the variance explained). Furthermore, the analysis indicated that the covariance between professional quality of life and self-efficacy accounted for 26% of the shared variance between these two constructs of interest. Implications of the findings from the study include (a) school counselors' self-efficacy contributes to their programmatic service delivery (large effect size), (b) school counselors' professional quality of life and self-efficacy contribute to one another (medium to large effect size), and (c) school counselors' professional quality of life contributes to their service delivery (small effect size). Additionally, this study provides implications in regards to: (a) the psychometric properties of the ProQOLs, SCSEs, and SCARS with a national sample of practicing school counselors and (b) research methodology related to differences in school counselors' response rates and total mean score on the ProQOLs, SCSEs, and SCARS based upon the sampling method, incentive type, and sampling population.

Background: Intensive Care and Anaesthetists Nurses are, through their profession and the COVID-19 pandemic, predisposed to suffering from Compassion Fatigue (CF). CF develops as stressors exceed the ability to cope with the demands of caring and has been associated with organisational factors. When nurses develop CF, healthcare organisations and patients suffer. The individual nurse becomes negatively affected and may develop a turnover intention, which is particularly worrying due to the current shortage of specialist nurses. Motive: In Sweden, there is a lack of knowledge about Intensive Care and Anaesthesia Nurses’ CF with focus on organisational factors and turnover intention.  Aim: to measure Intensive Care and Anaesthesia nurses’ Compassion Fatigue and explore its correlation with organisational support and turnover intention in the context of Swedish healthcare in the aftermath of the COVID-19 pandemic. Methods: This is a cross-sectional correlation study. 79 specialist nurses answered a web-based survey which included, among other instruments, the Professional Quality of Life Scale. Spearman's rank, Kruskal-Wallis and Mann-Whitney U were used in the statistical analysis in jamovi. Result: Specialist nurses had moderate Compassion Satisfaction (CS) while CF, measured as Burnout (BO) and Secondary Traumatic Stress (STS), was low. CS was negatively correlated with BO. Intensive Care Nurses and female nurses had higher STS. Current job turnover intention was associated with CS, BO and Perceived Organizational Support (POS). Nursing profession turnover intention was associated with CS and CF. In addition to current-job turnover, POS was correlated to CS and BO.   Conclusion: The Professional Quality of Life is a useful tool to monitor the trends in specialist nurses’ wellbeing. POS has the potential to improve several issues simultaneously, increasing CS and reducing BO and turnover intention. Future research should therefore focus on POS as well as explore CS potential to minimise BO. / Bakgrund: Intensivvårds- och Anestesisjuksköterskor är, genom deras yrke och COVID-19-pandemin, predisponerade att lida av empatitrötthet. Empatitrötthet utvecklas i takt med att stressfaktorer överstiger förmågan att klara av omvårdnads utmaningar och har förknippats med organisatoriska faktorer. När sjuksköterskor utvecklar empatitrötthet drabbas hälso- och sjukvårdsorganisationer samt patienter. Den individuella sjuksköterskan blir negativt påverkad och intention till egenuppsägning kan utvecklas, vilket är särskilt oroande på grund av den rådande bristen på specialistsjuksköterskor. Motiv: I Sverige, saknas det kunskap om Intensivvårds- och Anestesisjuksköterskors empatitrötthet med fokus på organisatoriska faktorer och intention till egenuppsägning. Syfte: Att mäta Intensivvårds- och Anestesisjuksköterskors empatitrötthet och utforska dess korrelation med organisatoriskt stöd och intention till egenuppsägning i kontexten av svensk hälso- och sjukvård efter COVID-19-pandemin. Metod: En korrelationsstudie har genomförts med tvärsnittsstudiedesign. 79 specialistsjuksköterskor besvarade en webbaserad enkät som bland annat inkluderade skalan Professional Quality of Life (ProQOL). Spearman's rank, Kruskal-Wallis och Mann-Whitney U användes för genomförandet av statistikanalysen i dataprogrammet jamovi. Resultat: Specialistsjuksköterskorna hade måttlig medkänsle-tillfredsställelse medan empatitrötthet, mätt som utbrändhet och sekundär traumatisk stress, var låg. Medkänsletillfredsställelse var negativt korrelerat med utbrändhet. Intensivvårdssjuksköterskor och kvinnliga sjuksköterskor hade högre sekundär traumatisk stress. Egenuppsägningsintention från nuvarande jobbet var associerad med medkänsletillfredsställelse, utbrändhet och upplevt organisatoriskt stöd. Egenuppsägningsintention från sjuksköterskeyrket var associerat med medkänsletillfredsställelse och empatitrötthet. Utöver egenuppsägningsintention från nuvarande jobbet så var upplevt organisatoriskt stöd korrelerat till medkänsletillfredsställelse och utbrändhet. Slutsats: ProQOL är ett användbart instrument för att bevaka förändringar i specialistsjuksköterskornas välbefinnande. Organisatoriskt stöd har potential att förbättra flera problem samtidigt genom att öka medkänsletillfredsställelse och reducera utbrändhet samt egenuppsägningsintention. Framtida forskning bör därför fokusera på upplevt organisatoriskt stöd samt att utforska potentialet av medkänsletillfredsställelse för att minimera utbrändhet.

Compassion fatigue (CF), also known as secondary traumatic stress (STS), impacts critical care nurses (CCN) through exposure to pain, suffering, and loss of those for whom they provide care and results in a reduction of compassion satisfaction (CS). High incidence of CF and turnover (TO) rates at the project site were identified among CCNs. The institution's CCN TO rate was at 81% in comparison to peers in other areas at 29%–35%. The practice-focused question asked whether leadership education on CF might ameliorate CF at the project site. The purpose of the Doctor of Nursing Practice project was to reduce the incidence of CF and TO among CCN through leadership education. Watson's theory of human caring was used as a framework. Two hundred twenty-nine CCNs completed the Professional Quality of Life survey that measures CS, STS, and burnout (BO). Comparison of 28 nursing leaders' pretest scores to posttest scores indicated a statistically significant improvement (z = -4.625, p < .001) and knowledge acquisition. BO and CF taken together explained 86% (adjusted R2 = .86) of the variance in CS (F [2, 227] = 691.33, p < .001). Identifying the nursing units with the highest CF scores and providing CF education to the leadership provides a path to reduce turnover and provide needed support to CCNs, a positive social change.

Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-10-25T12:35:40Z No. of bitstreams: 1 PDF - Helyssa Luana Lopes.pdf: 38159610 bytes, checksum: da35a688591aa9586a0d6b102735eb0e (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-10-26T16:56:03Z (GMT) No. of bitstreams: 1 PDF - Helyssa Luana Lopes.pdf: 38159610 bytes, checksum: da35a688591aa9586a0d6b102735eb0e (MD5) / Made available in DSpace on 2017-10-26T16:56:03Z (GMT). No. of bitstreams: 1 PDF - Helyssa Luana Lopes.pdf: 38159610 bytes, checksum: da35a688591aa9586a0d6b102735eb0e (MD5) Previous issue date: 2017-07-12 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Work as a helper involves as many positive factors (Compassion Satisfaction) as it does negatives (Compassion Fatigue). A Professional Quality of Life (ProQOL) is a result of the balance between such aspects, it reflects the internal wellbeing of an individual as a result of the nature of the profession (supporting people or animals which are suffering). The following study aims to evaluate the extent of the impact which Social Support at the Workplace and the Deterioration of Self-Efficacy has on the Professional Quality of Life of firefighters. The tools used include: Professional Quality of Life Scale (ProQOL-IV), Scale of Perception of Social Support at the Workplace (SPSSW), Deterioration of Self-Efficacy factor from the General Health Questionnaire (GHQ-12), a Sociodemographic Record and an Interview Script. The data from que standardized questionnaires was applied to the Statistical Package for Social Science (SPSS) software, the data was categories as either descriptive, varying or regressive. In order to analyses the interview, the content analysis technique was applied. The results identified four groups which matched the following ProQOL profiles: Apathetic, Stable, Moderate and Deficient. The Compassion Satisfaction (CS) score remained similar amongst groups, however, the Burnout scores of two groups (Moderate and Deficient) were significantly higher, affecting 43,5% of relevant samples. When looking at the regression analysis, the Deterioration of Self-Efficacy factor stood out as the most relevant predictor of Burnout, being capable of explaining up to 23% of the variation between groups. Information Support stood out as the second most relevant predictor of Burnout. During the interview analysis, two aspects of workplace life were identified as positive (Acknowledgement of profession/work; Psychological reward) alongside a negative factor (The relationship between work and fatigue). These factors respectively corroborate the results of CS and Burnout found from the sample. It was found that, regardless of Burnout levels, firefighters do not present signs of Compassion Fatigue as CS remained high amongst all groups, this leads to the conclusion that the sample’s ProQOL remains high, being sustained by their sense of competence, pride in their profession and willingness to help. It is important that the responsible corporations set out targets to combat high levels of Burnout and to maintain CS amongst firefighters at a high level. This can be done by investing in training which aims to increase workplace self-efficacy, to improve the interpersonal relationships and to improve accuracy of information. All these factors were found to be favorable to the ProQOL levels of firefighters. / O trabalho de ajuda envolve tanto aspectos positivos (Satisfação por Compaixão) como negativos (Fadiga por Compaixão). A Qualidade de Vida Profissional (QVP) resulta do equilíbrio entre tais aspectos e remete a quanto o indivíduo se sente bem, internamente, por ajudar pessoas ou animais em sofrimento. O presente estudo teve como objetivo avaliar o impacto do Suporte Social no Trabalho e da Deterioração da Autoeficácia sobre a Qualidade de Vida Profissional em bombeiros militares. Foram utilizados os instrumentos: Escala de Qualidade de Vida Profissional (ProQOL-IV), Escala de Percepção de Suporte Social no Trabalho (EPSST), o fator Deterioração da Autoeficácia do Questionário de Saúde Geral (QSG-12), uma Ficha Sociodemográfica e um Roteiro de Entrevista. Os dados dos questionários padronizados foram lançados no programa Statistical Package for Social Science (SPSS) e aplicadas as análises estatísticas descritivas, de variância e de regressão. Para análise das entrevistas, foi aplicada a técnica de análise de conteúdo. Os resultados identificaram quatro grupos com os seguintes perfis de QVP: Apático, Estável, Deficitário e Moderado. Nestes perfis, a Satisfação por Compaixão (SC) prevaleceu; no entanto, o Burnout obteve escores elevados em dois perfis (Deficitário e Moderado), afetando 43,5% da amostra. Nas análises de regressão, o fator Deterioração da Autoeficácia se destacou como o melhor preditor direto do Burnout, explicando sozinho 23% da variância. O Suporte Informacional se destacou como segundo melhor preditor inverso do Burnout. Nas análises das entrevistas, foram identificadas duas categorias com conteúdos de vivências positivas no trabalho (Reconhecimento social do trabalho/profissão; Recompensas psíquicas) e uma categoria com vivências negativas (Relação com o trabalho e fontes de desgaste). Estas categorias corroboram, respectivamente, os resultados de SC e de Burnout encontrados na amostra. Observou-se que, apesar dos indícios de Burnout, os bombeiros não apresentam Fadiga por Compaixão. Prevaleceu entre eles elevada SC, podendo-se concluir que a QVP está resguardada na amostra, sendo sustentada pelo senso de competência, orgulho profissional e prazer em ajudar. É importante que a Corporação trace planos de combate ao Burnout e de manutenção da SC entre os bombeiros, investindo em treinamentos para incrementar a autoeficácia no trabalho, os relacionamentos interpessoais e a precisão das informações, visto que esses elementos se mostraram favoráveis à QVP dos bombeiros.

Bakgrund: Sjuksköterskor är genom sitt yrke utsatta för risken att drabbas av empatitrötthet, vilket innebär avsaknad av empatiskt engagemang. Den empatiska förmågan ses som en grundläggande del av omvårdnaden, men sjuksköterskor som regelbundet utsätts för situationer där det krävs ett högt empatiskt engagemang kan tillslut utveckla empatitrötthet. Det kan medföra svårigheter, som påverkar sjuksköterskans välbefinnande och förmåga att utföra arbete, och på sikt kan empatitrötthet leda till konsekvenser både för patienten, arbetsplatsen och organisationen i stort.  Syfte: Syftet var att sammanställa faktorer som har visat sig ha en koppling till empatitrötthet hos sjuksköterskor och således skulle kunna minska eller öka risken för utveckling av empatitrötthet.  Metod: En litteraturstudie baserad på 10 vetenskapliga artiklar med kvantitativ ansats, samtliga studier utförda med mätinstrumentet ProQOL 5. Artikelsökning har genomförts i databaserna CINAHL och PubMed. Studierna har genomgått kvalitetsgranskning och evidensgradering. Resultatet har analyserats genom deskriptiv analys. Resultat: Två huvudteman har presenterats i resultatet: Demografiska faktorer samt arbetsplatsrelaterade faktorer, varav fem demografiska faktorer och tre arbetsplatsrelaterade faktorer. I sex av studierna framgick det att sjuksköterskans utbildningsnivå kan påverka utvecklingen av såväl empatisk tillfredsställelse som empatitrötthet. I fem av studierna framgick det att stöd från chef och kollegor är en annan påverkande faktor.  Konklusion: Sjuksköterskor som känner stöd från sin chef och sina kollegor samt sjuksköterskor som vidareutbildar sig och/eller får utbildning på arbetsplatsen löper mindre risk att drabbas av empatitrötthet. Nyckelord: Empati, Empatisk tillfredsställelse, Empatitrötthet, Omvårdnad, Professionell livskvalitet, Sjuksköterska / Background: Through their profession, nurses are exposed to the risk of suffering from compassion fatigue, which means a lack of empathic commitment. The empathic ability is seen as a fundamental part of nursing, but nurses who are regularly exposed to situations where a high level of empathic commitment is required can eventually develop compassion fatigue. It can lead to difficulties which affect the nurse's well-being and ability to perform work-related tasks, and in the long run, compassion fatigue can lead to consequences for the patient, the workplace and the organization. Aim: The aim was to compile factors that have been shown to be linked to compassion fatigue in nurses and thus could reduce or increase the risk of developing compassion fatigue. Method: A literature review based on 10 scientific articles with a quantitative approach, all studies performed with the measuring instrument ProQOL 5. Article searches have been performed in the databases CINAHL and PubMed. The studies have undergone quality review and evidence grading. The result has been analyzed by descriptive analysis. Results: Two main themes have been presented in the results: demographic factors and workplace-related factors, of which five demographic factors and three workplace-related factors. In six of the studies, it was shown that the nurse's educational level can affect the development of both compassion satisfaction and compassion fatigue. Five of the studies showed that support from managers and colleagues is another influencing factor. Conclusion: Nurses who feel supported by their manager and colleagues, as well as nurses who further their education and / or receive training in the workplace, are less likely to suffer from compassion fatigue. Keywords: Compassion fatigue, Compassion satisfaction, Empathy, Nurse, Nursing, Professional quality of life

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