Bakgrund: Sjuksköterskor som är medkännande till patienter och samtidigt utsätts för stress och press beskriver att de kan drabbas av compassion fatigue. Compassion fatigue påverkar sjuksköterskors hälsa negativt vilket kan orsaka att vissa lämnar professionen samt att patienter beskriver en sämre personcentrerad vård. Den personcentrerade vården påverkas av sjuksköterskornas mående, det är av vikt att lyfta fram vad som kan bidra till att få compassion energy. Compassion energy ger sjuksköterskorna kraften till att orka vara medmänniska till patienten och erfara välbefinnande i professionen. Syfte: Att skapa en översikt av sjuksköterskors erfarenheter av vad som kan bidra till compassion energy i omvårdnaden av patienter. Metod: En allmän litteraturöversikt utfördes. Datainsamling resulterade i 13 artiklar från databaserna Cinahl Plus och PubMed som analyserades. Resultat: Teman identifierades i resultatet som kunde bidra till sjuksköterskors compassion energy; Socialt stöd, Kunskap och erfarenhet och Egenvård. Slutsats: Examensarbetet lyfter fram betydelsen av socialt stöd, kunskap och erfarenhet samt egenvård som strategier för sjuksköterskan att få compassion energy. Sjuksköterskan kan uppnå compassion energy genom self-compassion, att ta hand om sig själv. När sjuksköterskor beskriver att de har välbefinnande kan det bidra det till en bättre personcentrerad vård. / Background: Nurses who are compassionate to patients and at the same time exposed to stress and pressure describes that they may suffer from compassion fatigue. Compassion fatigue has a negative effect on nurses’ health, which can cause some to leave the profession and patients to describes poorer person centered care. Person-centered care is affected by the nurses' health, it is important to illustrate what can contribute to find compassion energy. Compassion energy gives nurses the power to be a fellow human being to the patient and experience satisfaction in the profession. Aim: To create an overview of nurses’ experiences of what can contribute to compassion energy in the care of patients. Method: A General literature review. Data resulted in 13 articles from the databeses Cinahl Plus and Pubmed that were analyzed. Results: Themes were identified in the results that could contribute to nurses' compassion energy; Social support, Knowledge and experience and Self-care. Conclusion: The thesis highlights the importance of social support, knowledge and experience, and self-care as strategies for the nurse to receive compassion energy. The nurse can achieve compassion energy through self-compassion, taking care of oneself. When nurses describes having wellbeing, it may contributes to better person-centered care.

Abstrakt   Bakgrund: Akutsjuksköterskan förväntas bedriva en personcentrerad vård där vårdtagarens emotionella, medicinska och existentiella krav tillgodoses. Vid hög arbetsbelastning tvingas personal prioritera medicinska aspekter vilket leder till att etiska och psykosociala aspekter får vänta. Compassion fatigue är ett fenomen som uppstår i vårdanden yrken genom en långvarig exponering av empatiska påfrestningar. Compassion fatigue leder till beteende-, känslomässiga och fysiska förändringar hos sjuksköterskan vilket kan medföra svårigheter att identifiera vårdtagares upplevelser, eller reaktioner, både fysiskt, mentalt, socialt och existentiellt. Detta kan leda till en osäker och otrygg vårdmiljö och riskera att hota patientsäkerheten.  Syfte: Syftet var att identifiera och beskriva faktorer som bidrar till compassion fatigue hos sjuksköterskor på akutmottagningen.  Metod: En strukturerad litteraturöversikt med inspiration från en systematisk litteraturöversikt och en kvantitativ ansats. Sökningarna genomfördes i databaserna CINAHL, PubMed och PsychInfo vilket resulterade i 17 inkluderade artiklar. Dataanalys har genomförts utefter Bettany-Saltikov och McSherry. Resultat: Resultatet sammanställdes till fyra kategorier och presenteras i Demografiska faktorer, Arbetsrelaterade faktorer, Arbetsrelaterade känslor som faktor samt Yttre faktorer. Resultatet visar flertalet faktorer som bidrar till compassion fatigue bland annat att upplevd fysisk och psykisk hälsa inom demografiska faktorer minskade utfallet av compassion fatigue.  Inom yttre faktorer påvisas det att psykosocialt stöd från chefer och kollegor minskar förekomsten av compassion fatigue.   Slutsats: Litteraturöversikten identifierar och beskriver flertalet faktorer som statistiskt signifikant påverkar CF både negativt och positivt. Vidare forskning krävs då resultatet ger en spridd bild med betydande faktorer samt bristen av studier utförda på akutmottagningar i Sverige. / Abstract   Background: Emergency nurses are expected to provide person-centered care that meets the emotional, medical, and existential needs of patients. During times of high workload, staff members are forced to prioritize medical aspects, which results in ethical and psychosocial aspects being put on hold. Compassion fatigue is a phenomenon that occurs in caregiving professions due to prolonged exposure to empathic stressors. Compassion fatigue leads to behavioral, emotional, and physical changes in nurses, which can make it difficult to identify patients' experiences or reactions, both physically, mentally, socially, and existentially. This can lead to an insecure and unsafe care environment and pose a risk to patient safety. Purpose: The purpose was to identify and describe factors contributing to compassion fatigue in nurses in the emergency department.Method: A structured literature review inspired by a systematic literature review and a quantitative approach was conducted. Searches were conducted in the CINAHL, PubMed, and PsychInfo databases, resulting in 17 included articles. Data analysis was carried out according to Bettany-Saltikov and McSherry. Results: The results were compiled into four categories and presented as Demographic factors, Work-related factors, Work-related emotions as factors, and External factors. The results show several factors contributing to compassion fatigue, including perceived physical and mental health within demographic factors, which reduced the outcome of compassion fatigue.In the external factors category, it was found that psychosocial support from managers and colleagues reduces the incidence of compassion fatigue. Conclusion: The literature review identifies and describes several factors that statistically significantly affect CF both negatively and positively. Further research is needed as the results provide a scattered picture with significant factors, as well as the lack of studies conducted in emergency departments in Sweden.

The purpose of the study was to gain insight into how psychologists experience resiliency, satisfaction, and personal growth despite the challenges (e.g., vicarious trauma, compassion fatigue) of working with trauma survivors. While it cannot be ignored that many psychologists experience negative effects related to working with traumatized clients, it is important to acknowledge the potential to experience resiliency and growth from their work with trauma survivors. Interpretive phenomenological analysis (IPA) was used to explore the lived experiences of vicarious resiliency and growth in psychologists who work with trauma survivors. Data was collected through an in-depth individual semi-structured interview with six psychologists. The data generated was transcribed and analyzed using an interpretive phenomenological analysis (Smith & Osborn, 2003). Results revealed four major themes: privileging a shared journey, developing purpose and personal growth, deriving positive meaning, and serving humanity with an overarching theme of maintaining resiliency. The current study provided a valuable contribution to the limited literature on psychologists’ ability to foster positive outcomes for themselves through focusing on resiliency, satisfaction, and growth, despite the inherent risks of trauma work. Applications to practice and suggestions for future research are discussed.

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

The purpose of the study is to investigate social workers experiences of compassion fatigue as well as their thoughts about health and risk factors in the area. The method used is a qualitative interview study in which eight social workers, investigating child welfare matters, were individually interviewed. The study shows that most of the social workers describe their own experiences of burnout but not of secondary traumatic stress. The most important support for not suffer from compassion fatigue is to be supported and the possibility to ventilate with colleagues and managers. However, the social workers consider that the risk of burnout is primarily due to a heavy workload in terms of the number of cases and high staff turnover. Finally, the study indicates that social workers do not have experience of secondary traumatic stress because they are using tools that prevent this. However, the risk of experiencing burnout is high since they have not found strategies for managing workplace stress. / Syftet med studien är att undersöka socialarbetares upplevelser av sympatistress samt deras tankar om frisk- och riskfaktorer inom området. Metoden som använts är en kvalitativ intervjuundersökning där åtta socialarbetare, som utreder barnavårdsärenden, enskilt har intervjuats. Studien visar att de flesta av socialarbetarna beskriver att de har egna upplevelser eller erfarenheter av utbrändhet men inte av sekundär traumatisk stress. Det viktigaste stödet för att inte drabbas av sympatistress, uppger socialarbetarna, vara stöd från och möjligheten att ventilera med kollegor och chefer. Dock anser de att risken för att bli utbränd främst beror på hög arbetsbelastning, i form av mängden ärenden samt hög personalomsättning. Slutligen pekar studien på att socialarbetarna inte har upplevelser av sekundär traumatisk stress då de använder sig av verktyg som förhindrar detta. Dock är risken för att drabbas av utbrändhet hög då de ännu inte funnit strategier för att hantera påfrestningar som är kopplade till arbetsplatsen.

Some sections of the appendices are not available in the electronic copy of this thesis due to their format. The full version is available for consultation at the University of Leicester Library.

Background: Providing care to individuals with multifaceted mental health needs can be very demanding and in turn leave mental health professionals at an increased risk for compassion fatigue (CF). Comprised of Burnout (BO), Secondary Traumatic Stress (STS), and a lack of Compassion Satisfaction (CS), CF is the state of exhaustion and dysfunction, emotionally, biologically, and physiologically, due to prolonged exposure to compassion stress. CF can leave healthcare providers at an increased risk for experiencing their own health issues, contributing to tardiness and absenteeism, as well as increasing the risks for such adverse effects as clinical and medication errors, poor treatment planning, and decreased patient satisfaction. Purpose: The purpose of this paper is to identify the risk factors for CF and describe the perceptions of CF among outpatient mental health providers employed in urban community-based mental health outpatient organization. Method and Sampling: A qualitative descriptive study design utilizing two focus groups, each having four participants was conducted to assess outpatient mental health providers’perceptions of CF. Purposeful sampling of current providers in two community-based mental health outpatient organizations was performed to protect the privacy and enhance the comfort of each participant as they discussed elements of CF. Findings: Five themes were identified from the focus group analysis: the participant’s perceived definition of CF, participant perceptions of prevalence of CF in the mental health setting, participant perceptions regarding the triggers, perceived participant causes of CF, and self-care practices. These results reflect data collected in a mental health setting however, the findings are consistent with current research contributed from other specialties. Conclusion: Personal descriptions of the experiences and insights of these providers expand the current CF literature and will contribute to the development of quality improvement projects committed to reducing compassion fatigue among outpatient mental health providers.

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.

The population consisted of 9,000 Gulf Coast Licensed Professional Counselors. Surveys were returned by 609 participants. In the researcher-developed demographic survey, 586 individuals responded to the questions regarding age, gender, ethnicity, and years of counseling experience; 585 individuals responded to questions about exposure to prior trauma, and personal Katrina-related losses; 578 individuals responded to the question about the percentage of their work week that was spent counseling victims, and 579 individuals responded to questions regarding the type of mental health care strategy they participated in. There were 439 usable surveys for the PTSD Checklist-Civilian Version (PCL-C) (Weathers, Litz, Huska, & Keane, 1994) and 448 for the Compassion Fatigue Subscale of The Compassion Fatigue and Satisfaction Self-Test for Helpers (Figley & Stamm, 1996). The PTSD Checklist-Civilian Version (PCL-C) (Weathers, Litz, Huska, & Keane, 1994) was utilized to evaluate Gulf Coast Licensed Professional Counselors for vicarious traumatization within the first year of working with Hurricane Katrina survivors. A total score of 30 or above on the PCL-C is required to meet criteria for PTSD. A total of 32.1% of respondents (141 individuals) scored 30 or above- criteria for vicarious traumatization. Respondents were evaluated for current compassion fatigue symptoms using the Compassion Fatigue. A score of 36-40 indicates high risk for compassion fatigue and a score of 41 and above indicates an extremely high risk for compassion fatigue. When the participants were evaluated based on their symptoms 5 years after Hurricane Katrina, 5.1% scored 36 or above, indicating high or extremely high risk for compassion fatigue. The strategies examined were traditional clinical psychotherapy (individual, group, couples or family) and non-clinical self-care (prayer, meditation, exercise, yoga, engaging in pleasurable activities). The relationship between these types of mental health care and CFS scores were examined, and the results indicated that participation in traditional mental health counseling is associated with lower CFS scores, which indicate a lower risk for compassion fatigue, and participation in non-clinical self-care is also associated with lower CFS scores, which indicates a lower risk for compassion fatigue; however, participation in traditional mental health counseling is more strongly associated with lower CFS scores than non-clinical self-care.

Purpose: Describe the meaning of compassion fatigue (CF) as experienced by the U.S. military registered nurse (RN) post-deployment from Iraq and Afghanistan. Background: CF is characterized by deep emotional and physical exhaustion, and may resemble posttraumatic stress disorder (PTSD). Often this causes a shift in confidence and clouds RN perceptions. Symptoms include difficulty concentrating, intrusive imagery, hopelessness, exhaustion, and irritability leading to profound alterations in one's view of the world, patients, family, and friends. Outcomes include depersonalizing patients, poor coping mechanisms, lowered standards, clinical errors, and blurring boundaries, all can contribute to a toxic work environment and RNs leaving the profession. Method: Hermeneutic phenomenological methodology facilitated a description of CF in words and meaning expressed by U.S. military RNs (i.e., Army, Navy). The sample was obtained through the snowball method and aided by key informants. Data were collected through interviews and observations with each active duty or reservist RN (N = 8) on three occasions. Participants described their military and nursing backgrounds and experiences of CF through hermeneutic interview. Analysis was ongoing during the interview process and included continual questioning, reflecting, and validating. This process allowed for understanding through engagement of text (e.g., dialogue, transcriptions). Journaling and self-reflection assisted with trustworthiness. Findings: Participants shared many experiences. While some had unique experiences, their feelings and perceptions resonated with other participants and informed the emergence of four shared meanings and shared concerns: (a) the term CF does not fit me, manifested by expressions of the meaning of CF; (b) compassion fatigue as all encompassing, manifested by physical, emotional, relational, and spiritual experiences; (c) compassion fatigue will not interfere with my military duty, manifested by the pervasive military lens that the meaning of the experiences are filtered, and (d) compassion fatigue affects people long after deployment . . . gone, but not forgotten, manifested by the lasting effects of CF. Implications: While CF among military RNs has many similarities with the general nursing population, the practice environment appears to create additional triggers and manifestations. This study provides an understanding of the progression of CF in this population. Implementing interventions before and after trauma exposure can preserve the care in military caregivers.