J Korean Acad Nurs.  2016 Apr;46(2):260-270. 10.4040/jkan.2016.46.2.260.

Development and Application of an Overcoming Compassion Fatigue Program for Emergency Nurses

• Kim YA
• Park JS

• KMID: 2413156
• DOI: http://doi.org/10.4040/jkan.2016.46.2.260

Abstract

PURPOSE
This study was conducted to develop a program to help emergency nurses overcome compassion fatigue, and to analyze the effects of the program.
METHODS
A nonequivalent control group pretest-posttest design was used. There were 14 participants in the experimental group and 18 subjects in the control group. The program was comprised of five, weekly 80-minute sessions including understanding and assessment of compassion fatigue, enhancing positive affect, balancing work-life, planning self care, training in relaxation techniques and cognitive restructuring, and getting social support. Research variables were ego-resiliency, compassion satisfaction and compassion fatigue of the ProQOL 5, and salivary cortisol. Data were analyzed using Chi-square test, independent t-test, and paired t-test.
RESULTS
The first hypothesis, "There will be a difference in scores for ego resiliency between the experimental group and the control group". was not supported. The second hypothesis, "There will be a difference in scores for compassion satisfaction between the experimental group and the control group" was supported (t=2.15, p=.046). The third hypothesis, "There will be a difference in scores for compassion fatigue between the experimental group and the control group" was not supported.
CONCLUSION
The first program for emergency nurses to overcome compassion fatigue in Korea was effective in increasing emergency nurses' compassion satisfaction and decreasing salivary cortisol level in the experimental group. Therefore, this program for overcoming compassion fatigue is useful to increase emergency nurses' compassion satisfaction. However replication studies of short-term intensive program reflecting emergency nurses' opinion are needed.

Keyword

Nurses; Compassion fatigue; Psychological resilience; Stress; Cortisol

MeSH Terms

Adult
Burnout, Professional
Compassion Fatigue/*prevention & control
Ego
Emergency Service, Hospital
Enzyme-Linked Immunosorbent Assay
Female
Humans
Hydrocortisone/analysis
Male
Nursing Staff, Hospital/*psychology
Personal Satisfaction
*Program Development
Program Evaluation
Quality of Life
Resilience, Psychological
Saliva/metabolism
Self Care
Social Support
Stress, Psychological
Surveys and Questionnaires
Young Adult
Hydrocortisone

Reference

1. National Emergency Medical Center. 2013 statistics of emergency medical system [Internet]. Seoul: Author;2014. cited 2016 March 3. Available from: http://www.nemc.or.kr/egen/inf.bor42.do?flag=4&strid=72761&strnum=1&pageflag=2.

2. Kim SH. Severe emergency patients stay for 6 hours: 2013 emergency medical facility evaluation report [Internet]. Seoul: The Korean Nurses Association News;2014. cited 2016 March 3. Available from: http://www.nursenews.co.kr/Article/ArticleDetailView.asp?typ=11&articleKey=1057.

3. Dominguez-Gomez E, Rutledge DN. Prevalence of secondary traumatic stress among emergency nurses. J Emerg Nurs. 2009; 35(3):199–204. DOI: 10.1016/j.jen.2008.05.003.

4. Flarity K, Gentry JE, Mesnikoff N. The effectiveness of an educational program on preventing and treating compassion fatigue in emergency nurses. Adv Emerg Nurs J. 2013; 35(3):247–258. DOI: 10.1097/TME.0b013e31829b726f.

5. Figley CR. Compassion fatigue as secondary traumatic stress disorder: An overview. In : Figley CR, editor. Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York, NY: Brunner-Routledge;1995. p. 1–20.

6. Schulte-Rüther M, Markowitsch HJ, Fink GR, Piefke M. Mirror neuron and theory of mind mechanisms involved in face-to-face interactions: A functional magnetic resonance imaging approach to empathy. J Cogn Neurosci. 2007; 19(8):1354–1372. DOI: 10.1162/jocn.2007.19.8.1354.

7. Gentry JE, Baggerly J, Baranowsky A. Training-as-treatment: Effectiveness of the certified compassion fatigue specialist training. Int J Emerg Ment Health. 2004; 6(3):147–155.

8. Stamm BH. The concise ProQOL manual [Internet]. Pocatello, ID: ProQOL.org;2010. cited 2012 September 2. Available from: http://www.proqol.org/uploads/ProQOL_Concise_2ndEd_12-2010.pdf.

9. Joinson C. Coping with compassion fatigue. Nursing. 1992; 22(4):116118–120.

10. Radey M, Figley CR. The social psychology of compassion. Clin Soc Work J. 2007; 35(3):207–214. DOI: 10.1007/s10615-007-0087-3.

11. Klohnen EC. Conceptual analysis and measurement of the construct of ego-resiliency. J Pers Soc Psychol. 1996; 70(5):1067–1079. DOI: 10.1037/0022-3514.70.5.1067.

12. Chase MM. Emergency department nurses' lived experience with compassion fatigue [master's thesis]. Tallahassee, FL: Florida State University;2005.

13. Robertson S, Gow KM. How burned out employees perceive work stress and organizational burnout. In : Gow KM, Marek CJ, editors. Way finding through life's challenges: Coping and survival. New York, NY: Nova Science Publishers;2011. p. 385–402.

14. Sabo BM. Compassion fatigue and nursing work: Can we accurately capture the consequences of caring work? Int J Nurs Pract. 2006; 12(3):136–142. DOI: 10.1111/j.1440-172X.2006.00562.x.

15. Hooper C, Craig J, Janvrin DR, Wetsel MA, Reimels E. Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. J Emerg Nurs. 2010; 36(5):420–427. DOI: 10.1016/j.jen.2009.11.027.

16. Berger R, Gelkopf M. An intervention for reducing secondary traumatization and improving professional self-efficacy in well baby clinic nurses following war and terror: A random control group trial. J Emerg Nurs. 2011; 48(5):601–610. DOI: 10.1016/j.ijnurstu.2010.09.007.

17. Potter P, Deshields T, Berger JA, Clarke M, Olsen S, Chen L. Evaluation of a compassion fatigue resiliency program for oncology nurses. Oncol Nurs Forum. 2013; 40(2):180–187. DOI: 10.1188/13.onf.180-187.

18. Potter P, Deshields T, Rodriguez S. Developing a systemic program for compassion fatigue. Nurs Adm Q. 2013; 37(4):326–332. DOI: 10.1097/NAQ.0b013e3182a2f9dd.

19. Ahn YW. Adrenal exhaustion and fatigue due to chronic stress. J Korean Med Assoc. 2011; 54(1):81–87. DOI: 10.5124/jkma.2011.54.1.81.

20. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates;1988.

21. Park HJ. Perceived stress, coping process and depression to egoresilience [master's thesis]. Seoul: Korea University;1996.

22. Wilson J. Adrenal fatigue: The 21st century stress syndrome. Petaluma, CA: Smart Publications;2001.

23. Seels B, Richey R. Instructional technology: The definition and domains of the field. Washington, DC: Association for Educational Communications and Technology;1994.

24. Na EY. Experimental validation of 3-level attitude change model: Effects of in/outgroup sources and message strengths on the changes of weak, moderate, and strong attitudes. Korean J Soc Pers Psychol. 1999; 13(1):65–90.

25. Grafton E, Gillespie B, Henderson S. Resilience: The power within. Oncol Nurs Forum. 2010; 37(6):698–705. DOI: 10.1188/10.onf.698-705.

26. Lim JS, Yoon MS. Moderating effects of ego-resilience, social support on the relationship between secondary traumatic stress and job satisfaction among mental health social workers. Ment Health Soc Work. 2014; 42(1):31–60.

27. Pietrantoni L, Prati G. Resilience among first responders. Afr Health Sci. 2008; 8:Suppl 1. S14–S20.

28. Bartone PT, Hystad SW. Increasing mental hardiness for stress resilience in operational settings. In : Bartone PT, Johnsen BH, Eid J, Violanti JM, Laberg JC, editors. Enhancing human performance in security operations: International and law enforcement perspectives. Springfield, IL: Charles C. Thomas;2010. p. 257–272.

29. Choi SY. Effect of horticultural therapy on the changes of salivary cortisol density and blood pressure of the hospital staff [master's thesis]. Seoul: Korea University;2011.

30. Kim D, Chung YS, Park S. Relationship between the stress hormone, salivary cortisol level and stress score by self-report measurement. Korean J Health Psychol. 2004; 9(3):633–645.