Compassion fatigue and psychological resilience in nurses: A mixed method study

Aim: The aim of this study is to determine the level and factors affecting nurses' compassion fatigue, the relationship between compassion fatigue and psychological resilience and to examine the causes of high and low levels of compassion fatigue and to reveal the factors that cause the situation. Method: An explanatory design, one of the mixed method designs, was used. In the quantitative part of the study, the Compassion Fatigue-Short Scale and the Psychological Resilience Scale were applied to 56 nurses. Face-to-face in-depth interviews were conducted with three nurses with the highest and lowest scores on compassion fatigue. Analysis of quantitative data was made t-test, ANOVA and post-hoc tests; analysis of qualitative data was made descriptive analysis. Findings: According to the quantitative results of the study, nurses who are satisfied with their profession and the department they work in have lower levels of compassion fatigue. In addition, there is a weak negative correlation between compassion fatigue and psychological resilience total scores. According to the qualitative results, while giving care to a patient in need, nurses feel the desire to help, sadness and helplessness. Caring for these patients results in psychological fatigue, psychological trauma, feeling of emptiness, sympathy, and happiness due to positive feedback. Witnessing the helplessness of patients, sudden/young deaths, devaluation, patients with bad prognosis and dissatisfied patients are among the situations that trigger compassion fatigue. Nurses cope with compassion fatigue by participating in social activities, taking leave, meditating, and thinking that it is their duty. Conclusions: Nurses are a professional group that experiences compassion fatigue intensely due to exposure to traumas of patients. It is recommended to create environments and conditions where nurses and nurses can express their intense emotions, to establish and maintain the consultation-liaison psychiatry system in hospitals, to create conditions that will increase professional satisfaction, to increase awareness of compassion fatigue, and to create programs to prevent compassion fatigue. Aim: The aim of this study is to determine the level and factors affecting nurses' compassion fatigue, the relationship between compassion fatigue and psychological resilience and to examine the causes of high and low levels of compassion fatigue and to reveal the factors that cause the situation. Method: An explanatory design, one of the mixed method designs, was used. In the quantitative part of the study, the Compassion Fatigue-Short Scale and the Psychological Resilience Scale were applied to 56 nurses. Face-to-face in-depth interviews were conducted with three nurses with the highest and lowest scores on compassion fatigue. Analysis of quantitative data was made t-test, ANOVA and post-hoc tests; analysis of qualitative data was made descriptive analysis. Findings: According to the quantitative results of the study, nurses who are satisfied with their profession and the department they work in have lower levels of compassion fatigue. In addition, there is a weak negative correlation between compassion fatigue and psychological resilience total scores. According to the qualitative results, while giving care to a patient in need, nurses feel the desire to help, sadness and helplessness. Caring for these patients results in psychological fatigue, psychological trauma, feeling of emptiness, sympathy, and happiness due to positive feedback. Witnessing the helplessness of patients, sudden/young deaths, devaluation, patients with bad prognosis and dissatisfied patients are among the situations that trigger compassion fatigue. Nurses cope with compassion fatigue by participating in social activities, taking leave, meditating, and thinking that it is their duty. Conclusions: Nurses are a professional group that experiences compassion fatigue intensely due to exposure to traumas of patients. It is recommended to create environments and conditions where nurses and nurses can express their intense emotions, to establish and maintain the consultation-liaison psychiatry system in hospitals, to create conditions that will increase professional satisfaction, to increase awareness of compassion fatigue, and to create programs to prevent compassion fatigue. (Extended English summary is at the end of this document) Özet Amaç: Bu araştırmanın amacı, hemşirelerin merhamet yorgunluğu düzeyinin ve etkileyen faktörlerin, merhamet yorgunluğu ile psikolojik dayanıklılık arasındaki ilişkinin belirlenmesi, yüksek ve düşük merhamet yorgunluğu düzeyinin sebeplerinin irdelenmesi ve duruma neden olan faktörlerin ortaya çıkarılmasıdır. Yöntem: Karma yöntem desenlerinden açıklayıcı desen kullanılmıştır. Araştırmanın nicel bölümünde 56 hemşireye Merhamet Yorgunluğu-Kısa Ölçeği ve Psikolojik Dayanıklılık Ölçeği uygulanmıştır. Merhamet yorgunluğu düzey puanı yüksek ve en düşük olan üç hemşire ile yüz yüze derinlemesine görüşmeler yapılmıştır. Nicel verilerin analizi t-testi, ANOVA ve post-hoc testler; nitel verilerin analizi betimsel analiz kullanılarak yapılmıştır. Bulgular: Araştırmanın nicel sonuçlarına göre, mesleğinden ve çalıştığı bölümden memnun olan hemşirelerin merhamet yorgunluğu düzeyleri daha düşüktür. Ayrıca, merhamet yorgunluğu ile psikolojik dayanıklılık toplam puanları arasında negatif yönde zayıf düzeyde ilişki vardır. Nitel sonuçlarına göre, muhtaç olan bir hastaya bakım verirken hemşireler yardım etme isteği, üzüntü ve çaresizlik hissetmektedir. Bu hastalara bakım vermenin psikolojik yorgunluk, psikolojik travma, boşluk hissi, sempati, olumlu geribildirimlere bağlı mutluluk gibi geri dönüşleri olmaktadır. Hastaların çaresizliklerine şahit olma, ani/genç ölümler, değersizleştirme, prognozu kötü hastalar ve memnuniyetsiz hastalar merhamet yorgunluğunu tetikleyen durumlar arasındadır. Hemşireler, sosyal aktivitelere katılarak, izin kullanarak, meditasyon yaparak, görevi olduğunu düşünerek merhamet yorgunluğu ile baş etmektedirler. Sonuç: Hemşireler hastaların travmalarına maruz kalmaları nedeniyle merhamet yorgunluğunu yoğun yaşayan bir meslek grubudur. Hemşirelerin ve yaşadıkları yoğun duyguları ifade edebilecekleri ortamların ve koşulların oluşturulması, hastanelerde konsültasyon liyezon psikiyatri sisteminin kurulması ve işleyişinin sürdürülmesi, mesleki memnuniyeti artıracak koşulların oluşturulması, merhamet yorgunluğu farkındalığının artırılması, merhamet yorgunluğunu önleme programlarının oluşturulması önerilmektedir.