Background: Compassion-fatigue is a condition which therapists are forced into as a consequence of the nature of their work. The phenomenon has historically, and to some extent currently, been described as secondary trauma, vicarious trauma, secondary traumatic stress and burnout. The goal of this paper is to bring clarity as to what the phenomenon is and how it has been used in research, how common it is, what factors have been identified in the research that increase or decrease risk of developing it and lastly if any attempts have been made to develop a specific approach in preventing and/or treating the condition. Method: This current paper is a scoping review with a systematic approach.12 published studies, quantitative and qualitative in nature, were included and passed for review. Results: The result of the review indicates a deficit in data regarding prevalence of the phenomenon in the population and a general lack of randomized and experimental data. Most of the published studies were exploring psychologist experiences and secondarily attempting to identify factors predicting the development of compassion-fatigue. In conclusion, the phenomenon, regardless of what term is used, seems to be clearly delineated from conditions more akin to exhaustion and depression. Discussion: According to this study compassion-fatigue seems to be a condition that is sparked by the extraneous use of one’s empathic abilities past a tolerable point. Increased exposure by psychologists to work with patients with trauma may increase the risk of developing compassion-fatigue. It is still unknown what the mechanisms are that causes the condition and its prevalence among the population and further research, preferably randomized and experimental with comparison groups, is needed in order for this area to be fully mapped and explained.

Background: The literature suggests a consensus that individuals can become traumatised through listening to another’s trauma. Much of this research, however, has focused on individuals who have had direct, face-to-face contact with the primary victims of trauma. It therefore appears that there is a paucity of research looking at contact which is less direct, such as telephone contact. Aims: The current research aimed to explore the levels of secondary traumatic stress and posttraumatic stress disorder in a sample of Samaritan telephone volunteers, with a view to understanding some of the correlates of trauma. It also aimed to explore the personal construct systems of a sub-sample of Samaritan telephone volunteers, and explore any relationships between personal construct systems and trauma. Method: A cross-sectional design was employed. Questionnaires were used to assess levels of secondary traumatic stress and posttraumatic stress in Samaritan telephone volunteers spread across the United Kingdom. Repertory grid technique was used with a sub-sample of Samaritan telephone volunteers to elicit bipolar constructs comparing themselves and others. Results: 299 Samaritan telephone volunteers completed or partially completed the questionnaires, and of these 50 volunteers completed the repertory grids. Levels of secondary trauma (as determined by the Modified Secondary Trauma Scale) correlated with discrepancy in construing of the current and ideal self, levels of posttraumatic stress and exposure to potentially traumatic events. The Samaritans were not found to be suffering with secondary trauma. Degree of elaboration of self-construing reduced after the named traumatic event, and there was a significant difference in degree of elaboration for ‘self after traumatic event’ on the emergent poles of constructs. Conclusions: This research appears to be the first dedicated to assessing secondary trauma in telephone crisis line volunteers, lending some support to Sewell and Cromwell’s (1990) personal construct model of posttraumatic stress. The findings of this study challenge crisis lines to think about secondary trauma, and to implement some teaching and training around this area. Additionally, it reinforces that further research in the area is needed, and highlights the relative merits of employing a repertory grid methodology alongside questionnaires in understanding trauma.

Bakgrund: Sjuksköterskan har stor del i den nära patientvården och förväntas vara en god lyssnare genom sitt personcentrerade vårdgivande. Händelser som är traumatiska drabbar förutom den direkt berörda patienten även sjuksköterskan genom sekundär exponering. Syfte: Syftet med studien var att belysa förekomst av STS hos sjuksköterskor samt beskriva hur det påverkar vårdkvalitet och personcentrerad vård. Metod: Litteraturstudie med en översikt av relevanta artiklar i databaserna PubMed och CINAHL. Resultatet baseras på 14 artiklar som uppfyllde inklusionsoch kvalitetskrav. Resultat: Sjuksköterskan påverkas av STS på flera plan, både professionellt och personligt. Vårdkvaliteten blir lidande om STS påvisas. Den personcentrerade vården utgör grunden i sjuksköterskans yrkesutövande men om medvetenhet saknas för STS finns risken att sjuksköterskan påverkas så till den grad att hen väljer att sjukskriva sig och/eller byta arbetsplats. Slutsats: STS är ett relativt okänt begrepp och det kan vara svårt att se tecken på begynnande symtom. Sjuksköterskan kan utsättas för STS oberoende arbetsplats. Detta kan sänka effekten i yrkesutövandet genom personliga symtom som; irritabilitet, trötthet, minskad empati, depression, återupplevelser av tidigare upplevda traumatiska händelser med flera. Arbetsplatsens ledarskap inverkar på identifieringen av sjuksköterskans utveckling/hanterande av STS. / Background: The nurse has a large responsibility in the near patient care and is expected to be a good listener within the person-centered care. Events that are traumatic affects both the directly affected patient but also the nurse through their secondary exposure. Aim: The purpose of this study is to highlight the incidence of STS in nurses as well as to describe how it affects the quality of care and person-centered care. Method: Literature review of relevant articles in databases PubMed and CINAHL. The results of this literature study are based on 14 articles that met the inclusion and quality criteria. Results: The nurse is affected by STS on several levels, both professionally and personally. The quality of the fundamental person-centered care will be affected if STS is noted and the risk is imminent that the nurse affects to such an extent that they may choose to call in sick and/or change their jobs. Conclusion: STS is a relatively unknown concept. The nurse may face STS independent of workplace and the results can be showed in a lower quality of care and personal symptoms such as; irritability, fatigue, decreased empathy, depression, re- experiences of previously experienced traumatic events, and others. Leadership influence on identification of nurse’s STS development and handling.

Bakgrund: Den globala sjuksköterskebristen och omsättningen av sjuksköterskor är idag ett stort problem som bland annat leder till ökade kostnader och svårigheter att behålla en hög kvalitet på vården. En av anledningarna till att sjuksköterskor sjukskriver sig är den emotionella påfrestning som yrket medför. Compassion fatigue är ett begrepp som belyser de negativa effekter som kan komma av en långvarig exponering för andras lidande. Förutom sjukskrivningar kan compassion fatigue leda till högre benägenhet att begå kliniska misstag, försämrad vård och social isolering. Syfte: Syftet med denna litteraturstudie var att belysa compassion fatigue inom sjuksköterskeyrket genom att utforska de resurser och strategier som sjuksköterskor använder sig av för att motverka compassion fatigue. Metod: En litteraturöversikt baserad på 13 vetenskapliga artiklar. Resultat: Resultatet delades upp i två domäner: resurser och strategier. Att få stöd var den mest förkommande resursen, att ventilera genom samtal var den vanligaste strategin och denna resurs respektive strategi förekom i 12 av de 13 artiklarna. Övriga resurser som framkom var: att ges möjlighet till reflektion och att ha tid och plats för vila. Övriga strategier som framkom var att utöva religion och andlighet, att motionera, att ägna sig åt fritidsaktiviteter, att undvika svåra situationer, att förändra sin inställning samt att sätta gränser och hitta balans. Konklusion: Utifrån denna studie kan slutsatsen dras att sjuksköterskor verksamma inom olika verksamheter och i olika länder anser att socialt stöd samt att ventilera genom samtal på ett informellt sätt är betydelsefulla resurser och strategier för att motverka compassion fatigue. Vidare finns det en otydlighet kring begreppet. För fortsatt forskning är det viktigt att tydligt definiera och särskilja compassion fatigue från liknande begrepp. / Background: Shortage and turnover of nurses is currently a major problem, leading to increased costs and difficulties maintaining high quality care. Emotional stress caused by the nature of the profession is one reason for sick leave amongst nurses. Compassion fatigue as a concept sheds light upon the negative effects caused by long-term exposure to the suffering of others. Compassion fatigue is linked to an increased tendency for clinical mistakes, reduced quality of care and social isolation. Aim: The purpose of this review of literature was to shed light on compassion fatigue within the nursing profession while exploring the strategies and resources that nurses use to deal with this. Method: A literature review based on 13 articles. Findings: The findings of this study were divided into two domains: resources and strategies. The resource and strategy most frequently mentioned by nurses, was to get support and to ventilate their emotions. Both occurred in 12 of the 13 articles. Other resources that emerged were: to be given the opportunity to reflect and to have a time and place for rest. Other strategies that emerged were: to practice religion and spirituality, to exercise, engaging in hobbies, to avoid difficult situations, to change their attitude, to set limits and to find a work-life balance. Conclusion: Based on this study it can be concluded that nurses in several different settings and countries consider social support and to ventilate their feelings in an informal way valuable resources and strategies in managing compassion fatigue. The definition of compassion fatigue suffers from a great ambiguity and needs to be further defined and separated from similar terms.

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.

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.

Occupational stress is a major concern in Canadian society, and nurses have been identified as a high-risk population. In this study, levels of occupational stress (vicarious trauma, secondary traumatic stress, and burnout) were examined in Sexual Assault Nurse Examiners (SANEs) and Emergency nurses. Our objectives were: 1) to compare levels of occupational stress between groups, 2) examine the relationship between occupational stress and job satisfaction, and 3) examine the relationship between job satisfaction, intention to leave, and absenteeism. Results showed no significant group differences on vicarious trauma and secondary traumatic stress, but significantly higher levels of burnout in Emergency nurses, and intention to leave one’s job significantly predicted job satisfaction in Emergency nurses. Although SANEs did not experience greater occupational stress, open-ended data indicated negative consequences to this work. However, both groups also spoke to the positive rewards of helping those in need. Implications for nursing practice are also discussed.

Occupational stress is a major concern in Canadian society, and nurses have been identified as a high-risk population. In this study, levels of occupational stress (vicarious trauma, secondary traumatic stress, and burnout) were examined in Sexual Assault Nurse Examiners (SANEs) and Emergency nurses. Our objectives were: 1) to compare levels of occupational stress between groups, 2) examine the relationship between occupational stress and job satisfaction, and 3) examine the relationship between job satisfaction, intention to leave, and absenteeism. Results showed no significant group differences on vicarious trauma and secondary traumatic stress, but significantly higher levels of burnout in Emergency nurses, and intention to leave one’s job significantly predicted job satisfaction in Emergency nurses. Although SANEs did not experience greater occupational stress, open-ended data indicated negative consequences to this work. However, both groups also spoke to the positive rewards of helping those in need. Implications for nursing practice are also discussed.

A non-experimental survey design was used to study participant self-identified presence of secondary traumatic stress (STS) in Canadian school counsellors (N = 57) in relation to counsellors’ education and training, trauma-specific training, work experience, supervision, number of trauma clients and coping strategies. Counsellors were not necessarily protected from STS if they spent time using coping strategies, but were much less likely to be affected by STS if they engaged in supervision. Many school counsellors (59.6%) who participated in this research do engage in supervision, and those with trauma-specific training were less likely to have a peer-identified trauma disorder. Peer-identified trauma disorder played a large role in the results of this study. Participants identified as suffering from a trauma disorder were very likely to have a formal trauma diagnosis and were also likely to have higher traumatic stress scores. Implications for future research and education and training are discussed.

A non-experimental survey design was used to study participant self-identified presence of secondary traumatic stress (STS) in Canadian school counsellors (N = 57) in relation to counsellors’ education and training, trauma-specific training, work experience, supervision, number of trauma clients and coping strategies. Counsellors were not necessarily protected from STS if they spent time using coping strategies, but were much less likely to be affected by STS if they engaged in supervision. Many school counsellors (59.6%) who participated in this research do engage in supervision, and those with trauma-specific training were less likely to have a peer-identified trauma disorder. Peer-identified trauma disorder played a large role in the results of this study. Participants identified as suffering from a trauma disorder were very likely to have a formal trauma diagnosis and were also likely to have higher traumatic stress scores. Implications for future research and education and training are discussed.