An exploratory study on the factors affecting the mental health and well‐being of frontline workers in homeless services

Frontline workers in homeless services work in a high‐intensity, emotionally consuming environment, with frequent exposure to traumatic material with potentially significant consequences for their own mental health. This, in turn, may have a negative impact on the quality of care provided to homeless service users. Prevention of this trajectory may be achieved through psychologically informed environments for staff. This study aimed to explore factors that may influence the development of burnout, secondary traumatic stress (STS), depression, anxiety and stress in this population. Elevated levels of burnout and STS were predicted, as was an association between the predictor variables of professional experience, educational background, continuing professional development, access to organisational support structures and the outcome measures of compassion satisfaction, burnout, STS, depression, anxiety and stress. An online cross‐sectional survey design using the Professional Quality of Life Scale (Version V) and the Depression Anxiety and Stress Scale‐21 and scales designed for this study capturing occupational variables were distributed via email and national networks to a wide range of services across Scotland and the rest of the UK. Over 4 months in 2017, 112 frontline homelessness workers in health, social care and third sector organisations completed the survey. Results did not indicate elevated levels of burnout or STS, though depression and stress were found to be significantly elevated compared to population norms and were associated with burnout, compassion satisfaction and secondary traumatic stress. High levels of various types of supervision support and CPD were identified. There was no association between these and burnout or stress. We highlight the elevated levels of stress and depression and make a research recommendation to parse types of supervision to assess for optimal effectiveness and efficiency in ensuring that staff working in high‐stress homelessness settings receive optimal support to deliver high quality services.     

Social Work in the Veterans Administration Hospital System: Impact of the Work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

Self-care behaviours and their relationship with Satisfaction and Compassion Fatigue levels among social workers

Compassion fatigue is a syndrome resulting from an empathic listening to the client’s distress. Social workers, by the relational nature of their task, can be at risk and may suffer from adverse health effects. This quantitative research (N = 270) aimed to assess the efficiency of social workers’ self-care practices. The conclusion is that personal and professional self-care practices reduce compassion fatigue levels as well as increase satisfaction levels. Promoting self-care practices will bring benefits for the professional and, therefore, in the client and the institution.     

Compassion and empathy in community social workers: A qualitative study in Spain

Compassion and empathy are considered to be elements of paramount importance in professionals working with individuals in need. However, the term ‘compassion’ generates controversy among social workers, while the term ‘empathy’ seems to be more universally accepted among these professionals. This qualitative study used a hermeneutic approach and aimed to explore and understand social workers’ experiences with empathy and compassion in the community setting. Between January and June 2019, nine in-depth interviews and two focus group sessions were conducted with social workers from community social centres and primary healthcare centres in the province of Almería (Spain), with a total of 23 participants. The software Atlas.ti 8.0 was used for discourse analysis. Professionals reported that it was necessary for them to have an empathic attitude towards service users, and claimed that being empathic towards individuals in need was a moral obligation. They also reported that, although being empathic is a trait of these professionals, they have to avoid being affected by it, and that there are situations that block empathy. With respect to their perception of compassion, different interpretations of the concept were found: some professionals understand compassion as pity; other professionals have difficulty understanding the term and other professionals understand compassion as help. It has become necessary to change and develop the very conceptualisation of compassion and to create compassion promotion programmes, as this is fundamental for the protection and satisfaction of social workers themselves and for the sustainability of the support they provide to individuals who are in great distress.     

Abortion providers,stigma and professional quality of life

ObjectivesThe Providers Share Workshop (PSW) provides abortion providers safe space to discuss their work experiences. Our objectives were to assess changes in abortion stigma over time and explore how stigma is related to aspects of professional quality of life, including compassion satisfaction, burnout and compassion fatigue for providers participating in the workshops.Study DesignSeventy-nine providers were recruited to the PSW study. Surveys were completed prior to, immediately following and 1 year after the workshops. The outcome measures were the Abortion Provider Stigma Survey and the Professional Quality of Life (ProQOL) survey. Baseline ProQOL scores were compared to published averages using t tests. Changes in abortion stigma and aspects of professional quality of life were assessed by fitting a two-level random-effects model with repeated measures at level 1 (period-level) and static measures (e.g., demographic data) at level 2 (person-level). Potential covariates included age, parenting status, education, organizational tenure, job type and clinic type (stand-alone vs. hospital-based clinics).ResultsCompared to other healthcare workers, abortion providers reported higher compassion satisfaction (t= 2.65, p=.009) and lower burnout (t= 5.13, p<.0001). Repeated-measures analysis revealed statistically significant decreases in stigma over time. Regression analysis identified abortion stigma as a significant predictor of lower compassion satisfaction, higher burnout and higher compassion fatigue.ConclusionsParticipants in PSW reported a reduction in abortion stigma over time. Further, stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue, suggesting that interventions aimed at supporting the abortion providing workforce should likely assess abortion stigma.ImplicationsStigma is an important predictor of compassion satisfaction, burnout and compassion fatigue among abortion care providers. Therefore, strengthening human resources for abortion care requires stigma reduction efforts. Participants in the PSWs show reductions in stigma over time.     

The Well-Being of Peer Supporters in a Pandemic: A Mixed-Methods Study

BackgroundPeer support is an effective, well-received approach to caring for health care professionals who face stress, challenges, and reduced well-being. Peer supporters may be at risk for emotional exhaustion and secondary traumatic stress due to their primary roles and involvement as peer supporters during the COVID-19 pandemic.MethodsPeer supporters from five well-established peer support programs completed surveys (ProQOL and a five-item emotional exhaustion measure) to assess secondary traumatic stress, compassion satisfaction, and burnout during the pandemic. Analysis of variance models analyzed differences in these well-being outcomes by role, age, years in health care, and working in high-risk areas. Qualitative content analysis was performed for open-response questions about challenges, needs, and successful well-being strategies using Braun and Clarke's six-phase thematic analysis.ResultsA total of 375 peer supporters completed the survey between spring and summer 2021 for a response rate of about 38%. Most participants had low secondary traumatic stress and moderate to high compassion satisfaction; nearly 44% had concerning levels of emotional exhaustion. Compassion satisfaction was significantly lower (p = 0.003) and emotional exhaustion significantly higher (p < 0.001) among the youngest cohort, and both compassion satisfaction and emotional exhaustion differed across career stages (p = 0.003 and p = 0.04, respectively). Emotional exhaustion was significantly higher in peer supporters working in COVID units than in non-COVID units (p = 0.021). Peer supporters identified numerous protective and risk factors associated with serving as a peer supporter.ConclusionDespite having moderate to high levels of compassion satisfaction, peer supporters report high levels of burnout and numerous challenges and needs to sustain their well-being. To maintain effective peer support programs during the ongoing pandemic, health care organizations must study and support the well-being of health care professional peer supporters.     

Professional Quality of Life and Associated Factors Among Ugandan Midwives Working in Mubende and Mityana Rural Districts

Objective To explore the professional quality of life and associated factors among Ugandan midwives working in Mubende and Mityana rural district to recommend interventions to improve professional well-being and outcomes of midwifery care. Background Professional quality of life of midwives working in rural areas may be influenced by several personal and work setting factors of care professionals often impacting the quality and outcomes of patient care. Methods A cross-sectional study design was used to collect data from 224 midwives working in two rural districts of Uganda. Findings The majority of participants were female (80 %), with an associate degree in midwifery (92 %). The mean age and years of experience were 34 ± 6.3 and 4 ± 2.1 years, respectively. The mean scores on the professional quality of life scale showed average compassionate satisfaction (19 ± 4.88), burnout (36.9 ± 6.22) and secondary traumatic stress (22.9 ± 6.69). The midwives’ compassion satisfaction was related to psychological well-being (p < 0.01) and job satisfaction (p < 0.01). Conversely, their burnout levels and secondary traumatic stress were associated with education level (p < 0.01), marital status (p < 0.01), involvement in non-midwifery health care activities (p < 0.01), and physical well-being (p < 0.01). Conclusion and Implication to practice Midwives working in rural areas of resourcepoor countries have moderate professional quality of life and tend to experience moderate to high levels of burnout, secondary traumatic stress and compassion satisfaction in their professional work. Therefore, employers need to provide deliberate work based services such as counselling, debriefing, training and social support to enhance midwives professional quality of life and quality of midwifery care and practice.     

Professional Quality of Life and Changes in Spirituality Among VHA Chaplains: A Mixed Methods Investigation

A mixed method design was implemented to examine the spirituality and emotional well-being of Veterans Health Administration (VHA) chaplains and how potential changes in spirituality and emotional well-being may affect their professional quality of life. Four distinct categories of changes emerged from the narrative statements of a nationally representative sample of 267 VHA chaplains: (1) positive changes (e.g., increased empathy), (2) negative changes (e.g., dysthymic mood, questioning religious beliefs), (3) combination of positive and negative changes, and (4) no change (e.g., sustenance through spirituality or self-care). Most chaplains reported positive (37%) or no change (30%) in their spirituality and/or emotional well-being. However, quantitative analyses revealed that chaplains who reported negative changes endorsed greater burnout and secondary traumatic stress. Overall, these findings suggest VHA chaplains are predominantly spiritually resilient, but negative changes in the spiritual domain can occur, potentially increasing the risk of adverse changes in professional quality of life.     

Abortion providers,stigma and professional quality of life

Objectives

The Providers Share Workshop (PSW) provides abortion providers safe space to discuss their work experiences. Our objectives were to assess changes in abortion stigma over time and explore how stigma is related to aspects of professional quality of life, including compassion satisfaction, burnout and compassion fatigue for providers participating in the workshops.

Study Design

Seventy-nine providers were recruited to the PSW study. Surveys were completed prior to, immediately following and 1 year after the workshops. The outcome measures were the Abortion Provider Stigma Survey and the Professional Quality of Life (ProQOL) survey. Baseline ProQOL scores were compared to published averages using t tests. Changes in abortion stigma and aspects of professional quality of life were assessed by fitting a two-level random-effects model with repeated measures at level 1 (period-level) and static measures (e.g., demographic data) at level 2 (person-level). Potential covariates included age, parenting status, education, organizational tenure, job type and clinic type (stand-alone vs. hospital-based clinics).

Results

Compared to other healthcare workers, abortion providers reported higher compassion satisfaction (t= 2.65, p=.009) and lower burnout (t= 5.13, p<.0001). Repeated-measures analysis revealed statistically significant decreases in stigma over time. Regression analysis identified abortion stigma as a significant predictor of lower compassion satisfaction, higher burnout and higher compassion fatigue.

Conclusions

Participants in PSW reported a reduction in abortion stigma over time. Further, stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue, suggesting that interventions aimed at supporting the abortion providing workforce should likely assess abortion stigma.

Implications

Stigma is an important predictor of compassion satisfaction, burnout and compassion fatigue among abortion care providers. Therefore, strengthening human resources for abortion care requires stigma reduction efforts. Participants in the PSWs show reductions in stigma over time.     

Social work in the veterans administration hospital system: impact of the work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

Against compassion: in defence of a “hybrid” concept of empathy

In this article, I argue that the recent emphasis on compassion in healthcare practice lacks conceptual richness and clarity. In particular, I argue that it would be helpful to focus on a larger concept of empathy rather than compassion alone and that compassion should be thought of as a component of this larger concept of empathy. The first part of the article outlines a critique of the current discourse of compassion on three grounds. This discourse naturalizes, individualizes, and reifies compassion leading to a decontextualized and simplified understanding of failures in healthcare practice. The second part uses resources from phenomenology and contemporary moral philosophy to construct a “hybrid” concept of empathy that includes both pre‐reflective/intuitive and cognitive/imaginative components. This “hybrid” concept of empathy leads to a more complex understanding of the multiple responses to others' distress. I conclude that there are no straightforward normative naturalistic responses to others' distress. Rather than conceptualizing compassion as a naturalistic impulse or a character‐based trait, we need to consider the complexity of our empathic recognition of vulnerable others.     

The Practice of Compassion in Supervision in Residential Treatment Programs for Clients with Severe Mental Illness

ABSTRACT

Clinical supervision for residential care staff is essential and yet has rarely been studied. Drawing from the reflective practice tradition, we interviewed residential care supervisors about their clinical decision-making processes and analyzed the data qualitatively to identify common themes and distill their beliefs and reported practices. We found that supervisors prioritized a compassion-based model of supervision characterized by fostering staff self-care, developing staff's empathy and responsiveness to clients, helping staff with disappointments in their relationships with clients, accurately evaluating client progress, preserving safety, and nurturing teamwork. A supervisor's subjective experience of his caregiving of staff could be explained using a second-level analytic concept we termed a caregiving heuristic—one's beliefs, values, and guidelines for action as a caregiver—of which compassion was, for these supervisors, a foundational element. The supervisors envisioned compassion as a central means by which they could prevent compassion fatigue, develop their staff's caregiving heuristics, and improve job satisfaction and quality of client care.     

The effectiveness of a serious game to enhance empathy for care workers for people with disabilities: A parallel randomized controlled trial

Background

Empathic care is fundamental in healthcare settings and is associated to several positive outcomes for care workers (i.e. burnout, compassion satisfaction) and patients (i.e. therapeutic alliance, trust, wellbeing). Yet, studies showed a decrease in empathy in care workers, which is argued to be a product of personal distress. Thus, interventions should aim at enhancing empathy in care workers working for vulnerable populations to ensure optimal client-carer relationships.

心理一致感在护士工作压力与共情疲劳间的中介作用

目的 探讨心理一致感在肿瘤医院护士工作压力与共情疲劳间的中介作用.方法 2021年1—6月随机选取本院护士62名作为研究对象,使用护士工作压力源量表、心理一致感量表及护士专业生活品质量表评价护士的工作压力、心理一致感、共情疲劳,分析心理一致感在护士工作压力与共情疲劳间的中介作用.结果 护士工作压力与工作倦怠、二次创伤呈...     

Compassion fatigue and burnout: what managers should know

Most health care employees experience and are bolstered by compassion satisfaction as they deal with patients in need. However, the more empathetic a health care provider is, the more likely he or she will experience compassion fatigue. Compassion fatigue is a negative syndrome that occurs when dealing with the traumatic experiences of patients, and examples of symptoms include intrusive thoughts, sleeping problems, and depression. Compassion fatigue is different from burnout. Compassion fatigue is a rapidly occurring disorder for primary health care workers who work with suffering patients, whereas burnout, a larger construct, is a slowly progressing disorder for employees who typically are working in burdensome organizational environments. Managers can mitigate problems associated with compassion fatigue with a number of interventions including patient reassignments, formal mentoring programs, employee training, and a compassionate organizational culture. With burnout, health care managers will want to focus primarily on chronic organizational problems.     

Professional Commitment,Satisfaction and Quality of Life of Nurses During the COVID-19 Pandemic in Konya,Turkey

BackgroundThe COVID-19 pandemic has negatively affected nurses. The aim of this study was to assess professional commitment, satisfaction and quality of professional life of nurses during the COVID-19 pandemic in Konya city, Turkey.Methods and MaterialCross-sectional study was conducted through online survey in March 2021 in Konya province of Turkey. Current working nurses from 30 public health facilities participated in the study. Standard questionnaire was used, the questionnaire has four components, the first part of questionnaire for characteristics of the participants, the second part was Nursing Professional Commitment Scale, the third part was regarding Professional Satisfaction Scale and the fourth part was related to Employees'' Quality of Life Scale.ResultsTotal 407 nurses participated in the study, only 24% of the participants were male, 76% of them were married and 78% of them were undergraduate degree holders. About two-third (68%) of the nurses worked in COVID 19 treatment Unit serving/treatıng COVID 19 patients durıng this period. Some nurses (37%) have considered leaving their job during the Pandemic. Average scores of total nursing professional commitment 2.63±0.48. The nurses'' working quality of life level was above average of total satisfaction. Comparing the age groups of the participants with the scale and sub-dimensions, a difference was found only with the Compassion fatigue sub-dimension (p<0.05). There is a positive relationship between total nursing professional commitment, compassion satisfaction and professional satisfaction.ConclusionCOVID-19 pandemic negatively affected nurses'' professional commitment, professional satisfaction and quality of their professional life.     

COVID-19疫情背景下医务工作人员职业倦怠情况及其影响因素的分析

  目的  了解COVID-19疫情背景下定州市和青岛市两地医务工作人员发生职业倦怠情况及其影响因素。  方法  2021年7月―2021年8月对定州市和青岛市的医务工作者进行横断面调查。利用职业倦怠调查普适量表(maslach burnout inventory general survey, MBI-GS)评价职业倦怠水平,采用Kruskal-Wallis H秩和检验和二分类logistic回归分析模型分析医务工作者职业倦怠水平的影响因素。  结果  982名被调查者中,发生职业倦怠的比例为91.1%,其中达到轻中度、重度的比例分别为71.5%和19.6%。多因素分析显示工作满意度感觉一般或者比较不满意(OR=3.108, 95% CI: 1.653~5.843)、应对方式为消极应对(OR=1.129, 95% CI: 1.071~1.191)人群发生重度职业倦怠者风险更高;同时睡眠时间缩短(OR=0.331, 95% CI: 0.166~0.662)的人群发生重度职业倦怠者风险更低。Spearman相关分析中,医务工作者的积极应对方式、消极应对方式与职业倦怠呈正相关(P < 0.001),社会支持情况、生活满意度情况与职业倦怠呈负相关(P < 0.001)。  结论  定州市和青岛市大部分的医务工作人员职业倦怠水平较高,需提高工作和生活满意度等关怀和社会支持力度,同时也要考虑适当增加防疫工作中的认同感和积极性以促进职业健康水平。     

Association between low empathy and high burnout among primary care physicians and nurses in Lleida,Spain

Background: Burnout is a growing problem among healthcare professionals and may be mitigated and even prevented by measures designed to promote empathy and resilience.

Objectives: We studied the association between burnout and empathy in primary care practitioners in Lleida, Spain and investigated possible differences according to age, sex, profession, and place of practice (urban versus rural).

Methods: All general practitioners (GPs) and family nurses in the health district of Lleida (population 366 000) were asked by email to anonymously complete the Maslach Burnout Inventory (MBI) and the Jefferson Scale of Physician Empathy (JSPE) between May and July 2014. Tool consistency was evaluated by Cronbach’s α, the association between empathy and burnout by Spearman’s correlation coefficient, and the association between burnout and empathy and sociodemographic variables by the χ² test.

Results: One hundred and thirty-six GPs and 131 nurses (52.7% response rate) from six urban and 16 rural practices participated (78.3% women); 33.3% of respondents had low empathy, while 3.7% had high burnout. The MBI and JSPE were correlated (P?P?Conclusion: Although burnout was relatively uncommon in our sample, it was associated with low levels of empathy. This finding and our observation of lower empathy levels in rural settings require further investigation.

KEY MESSAGES

• More empathic primary care practitioners have lower burnout scores.

• Practitioners working in rural areas have significantly lower levels of empathy than their urban counterparts have.

• Interventions designed to foster attributes and skills such as empathy, resilience, and doctor–patient communication may help to reduce and prevent burnout.

     

The learning environment and medical student burnout: a multicentre study

Objectives  Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout.
Methods  All medical students ( n  = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout. Students were also asked about the aforementioned factors.
Results  A total of 1701 medical students (response rate 55%) completed the survey. Learning climate factors were associated with student burnout on univariate analysis (odds ratio [OR] 1.36–2.07; all P  ≤ 0.02). Being on a hospital ward rotation or a rotation requiring overnight call was also associated with burnout (ORs 1.69 and 1.48, respectively; both P  ≤ 0.02). Other workload characteristics (e.g. number of admissions) had no relation to student burnout. Students who experienced a positive personal life event had a lower frequency of burnout (OR 0.70; P  ≤ 0.02), whereas those who experienced negative personal life events did not have a higher frequency of burnout than students who did not experience a negative personal life event. On multivariate analysis personal characteristics, learning environment and personal life events were all independently related to student burnout.
Conclusions  Although a complex array of personal and professional factors influence student well-being, student satisfaction with specific characteristics of the learning environment appears to be a critical factor. Studies determining how to create a learning environment that cultivates student well-being are needed.