Compassion satisfaction, compassion fatigue, and intention to leave among critical care nurses in private hospitals of the Cape Metropole

Date
2023-03
Journal Title
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Background: Global studies have found that compassion fatigue is a problem among critical care nurses, causing them to lose empathy and compassion for their patients and, moreover, to leave the profession. Since nurse recruitment and retention rates are already low in South Africa, compassion fatigue could have particularly serious consequences. This study investigated the levels of and relationships between compassion satisfaction, compassion fatigue, and intention to leave among critical care nurses in private hospitals in the Cape Metropole, South Africa. Methods: The study was conducted using a quantitative research approach with a cross-sectional descriptive correlational design. Critical care nurses were recruited through Facebook advertising and n=78 nurses completed the online survey. Our survey used a custom demographic and intention to leave scale in addition to the established Professional Quality of Life (ProQOL) instrument. The demographic, intention to leave, and ProQOL variables were described and visualized using descriptive statistics. The direction and strength of the relationships between variables were examined using Spearman's rank correlation coefficient. Ethical principles of autonomy, privacy, confidentiality, justice, beneficence, and nonmaleficence were maintained throughout the study. Results: The findings showed that the nurses experienced average levels of compassion satisfaction, burnout, and secondary traumatic stress. Compassion satisfaction and burnout had a strong negative correlation (r=-0.761, p<0.01). Likewise, compassion satisfaction and secondary traumatic stress had a moderate negative correlation (r=-0.539, p<0.01). Secondary traumatic stress and burnout had a strong positive correlation (r=0.743, p<0.01). Males scored significantly lower on compassion satisfaction (mean=38.6, SD=3.7) than females (mean=50.5, SD=9.9) (t=2.056, p=0.04). The mean scores of compassion satisfaction (t=-0.993, p=0.38), burnout (t=0.706, p=0.48), and secondary traumatic stress (t=1.249, p=0.22) did not differ between participants with or without a postgraduate critical care nursing diploma. However, nurses who were critical care trained had slightly higher compassion satisfaction mean scores (mean=51.1, SD=10.3) compared to nurses who were not critical care trained (mean 49.0, SD=9.7). Almost half of the nurses in the study expressed an intention to leave nursing (42.3%, n=33). Burnout was moderately positively correlated with intention to leave (r=0.633, p<0.01) and secondary traumatic stress (r=0.438, p<0.01), while compassion satisfaction was moderately negatively correlated with intention to leave (r=-0.615, p<0.01). Conclusion: Burnout and secondary traumatic stress were among the physical, mental, and emotional stresses critical care nurses experienced during the COVID-19 pandemic. However, despite the reported burnout and secondary traumatic stress, nurses still reported average levels of compassion satisfaction. Recommendations: The work environments of critical care nurses must be improved to prevent compassion fatigue, prevent nurse attrition, and assist them in finding fulfilment at work. Support and assistance should be provided to younger and less experienced critical care nurses as they grow in their careers to prevent anxiety and burnout, and postgraduate training should be encouraged to improve clinical competence and critical care knowledge. Compassion fatigue needs to be identified and combated by nurses and healthcare organizations to protect nurses and the nursing profession.
AFRIKAANSE OPSOMMING: Agtergrond: Wereldwye studies het bevind dat deernis-uitputting ʼn probleem onder kritieke-sorgverpleegkundiges is. Dit veroorsaak dat hulle meelewing en deernis teenoor hulle pasiente verloor, en selfs hulle beroep wil verlaat. Aangesien die werwing en behoud van verpleegkundiges in Suid-Afrika alreeds op ʼn lae vlak is, mag deernis-uitputting besonder ernstige gevolge inhou. Hierdie studie het die vlakke van, en onderlinge verhoudings tussen deernis-tevredenheid, deernis-uitputting, asook die voorneme om die beroep te verlaat onder kritieke-sorgverpleegkundiges in privaat-hospitale in die Kaapse Metropool, Suid-Afrika, ondersoek. Metodes: Die studie is uitgevoer deur ‘n kwantitatiewe navorsingsbenadering met ‘n deursnee beskrywende korrelasie ontwerp, te gebruik. Kritieke-sorgverpleegkundiges was deur middel van ʼn advertensie op Facebook gewerf en n=78 verpleegkundiges het die aanlyn opname voltooi. Ons opname het ʼn pasgemaakte demografiese en verlatingsvoorneme-skaal, tesame met die gevestigde “Professional Quality of Life” (ProQOL) vraelys, gebruik. Die demografiese, verlatingsvoorneme en ProQOL veranderlikes was beskryf en gevisualiseer deur beskrywende statistieke te gebruik. Die rigting en sterkte van die verhoudings tussen die veranderlikes was ondersoek deur Spearman se rang-korrelasie-koeffisient te gebruik. Etiese beginsels van outonomie, privaatheid, vertroulikheid, regverdigheid en weldadigheid was deurgaans in die studie gehandhaaf. Resultate: Die bevindinge het getoon dat die verpleegsters gemiddelde vlakke van deernis-tevredenheid, uitbranding en sekondere traumatiese stres ervaar het. Deernis-tevredenheid en uitbranding het 'n sterk negatiewe korrelasie gehad (r=-0.761, p<0.01). Net so het deernis-tevredenheid en sekondere traumatiese stres 'n matige negatiewe korrelasie gehad (r=-0.539, p<0.01). Sekondere traumatiese stres en uitbranding het 'n sterk positiewe korrelasie gehad (r=0.743, p<0.01). Mans het beduidend laer punte op deernis-tevredenheid (gemiddeld=38.6, SD=3.7) as vrouens (gemiddeld=50.5, SD=9.9) (t=2.056, p=0.04) behaal. Die gemiddelde tellings van deernis-tevredenheid (t=-0.993, p=0.38), uitbranding (t=0.706, p=0.48) en sekondere traumatiese stres (t=1.249, p=0.22) het nie tussen deelnemers met of sonder 'n nagraadse kritiekesorg-verpleegdiploma verskil nie. Verpleegkundiges wat kritieke sorg opgelei is, het egter effens hoer deernistevredenheid gemiddelde tellings (gemiddeld=51.1, SD=10.3) in vergelyking met verpleegsters wat nie kritieke sorg opgelei is nie (gemiddeld 49.0, SD=9.7), gehad. Byna die helfte van die verpleegkundiges in die studie het 'n voorneme uitgespreek om verpleging te verlaat (42,3%, n=33). Uitbranding was matig positief gekorreleer met voorneme om te verlaat (r=0.633, p<0.01) en sekondere traumatiese stres (r=0.438, p<0.01), terwyl deernis-tevredenheid matig negatief met voorneme om te verlaat (r=-0.615, p <0,01) gekorreleer was. Gevolgtrekking: Kritieke-sorgverpleegsters het tydens die COVID-19 pandemie fisiese, verstandelike en emosionele stresfaktore van onder meer uitbranding en sekondere traumatiese stres ervaar. Nieteenstaande, ongeag die gerapporteerde uitbranding en sekondere traumatiese stres, het verpleegkundiges te kenne gegee dal hulle gemiddelde vlakke van deernis-tevredenheid ervaar. Aanbevelings: Die werksomgewing van kritieke-sorgverpleegkundiges moet verbeter word om deernis-uitputting en algemene uitbranding te voorkom, asook om hulle te help om werksvervulling te vind. Bystand en ondersteuning moet aan jonger kritieke-sorgverpleegkundiges met minder ondervinding en wat nog in hulle beroep ontwikkel, voorsien word. Dit sal voorkom dat hulle angssimptome ontwikkel en ʼn punt van uitbranding bereik. Nagraadse opleiding moet aangemoedig word sodat kliniese bevoegdheid en ontwikkeling van kennis in die veld van kritieke-sorg bevorder word. Deernis-uitputting moet deur verpleegkundiges en gesondheidsorg-organisasies geidentifiseer en bestry word om verpleegkundiges en die verplegingsberoep te beskerm.
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Thesis (MNur)--Stellenbosch University, 2023.
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