The effect of perceived organizational support and ego-resilience on the relationship between occupational stressors and compassion fatigue in COVID-19 frontline nurses: a cross-sectional study in Sichuan, China.

Aim: To investigate the level of compassion fatigue among frontline nurses during the COVID-19 pandemic and to explore the relationship between occupational stressors and compassion fatigue among frontline nurses based on structural equation modelling.

Background: Three years into the COVID-19 pandemic, nurses on the frontlines of the battle were overwhelmed by affective and emotional inputs while caring for patients, and they generally experienced varying degrees of psychological problems. High levels of compassion fatigue can affect nursing quality and patient safety and therefore should be taken seriously by nursing managers.

Methods: A cross-sectional survey of 1432 frontline nurses in Sichuan Province, China, was conducted from January to March 2023 via convenience sampling methods. The General Information Questionnaire, the Nurses' Occupational Stressors Scale, the Ego-Resilience Scale, the Chinese version of the Compassion Fatigue Brief Scale, and the Perceived Organizational Support Scale were used to collect the data. Hypotheses were tested using structural equation models and bootstrapping methods.

Results: Nurse occupational stressors had a significant direct effect on compassion fatigue (B = 2.429, p < 0.001). Perceived organizational support exerted a mediating effect of 11.36% between occupational stressors and compassion fatigue. In addition, ego-resilience had a moderating role in the relationship between nurses' occupational stressors and compassion fatigue, between nurses' occupational stressors and perceived organizational support, and between perceived organizational support and compassion fatigue. Multiple linear regression analysis revealed that the most influential dimension of occupational stressors on compassion fatigue was work-family conflict (β = 0.253, p < 0.001), followed by organizational issues (β = 0.153, p < 0.001), work demands (β = 0.103, p < 0.001) and difficulty taking leave (β = 0.102, p < 0.001).

Conclusion: Nurse occupational stressors are positively associated with compassion fatigue and influence nurse compassion fatigue through the mediating effect of perceived organizational support and the moderating mechanism of ego-resilience. Managers can reduce nurses' compassion fatigue levels by reducing occupational stressors, promoting nurses' perceived organizational support, and fostering ego-resilience.

Implications for nursing management: This study further integrated the external and internal factors affecting compassion fatigue and constructed a structural equation model of the mechanism of compassion fatigue in frontline nurses, which has implications for the early identification and intervention of compassion fatigue in nurses.