The Effects of Resilience and Self-efficacy on Nurses' Compassion Fatigue

NCT04911504 | Completed

• 1 other identifier: JZhang
• Study Type: observational
• Target: 978
• Locations: 1 country
• Sites: 1

Brief Summary

Among healthcare providers, nursing is a stressful and compassionate profession. Nurses empathetically support patients with pain, loneliness, disease and even confronted with death in line with their critically physical, mental, emotional, and spiritual needs and provide comfort, help, presence for them. Because nurses are frequently exposed to highly stressful and emotional situations, they suffer compassion fatigue (CF) over time under repeated exposures. CF will have a series of physiological, social, emotional, spiritual, and cognitive effects on nurses, threatening the existential integrity of them. The effects include high rates of anxiety and depressive disorders, decreased productivity, increased clinical errors, decreased quality of care and level of job satisfaction. Therefore, it is particularly important to pay attention to compassion fatigue to maintain mental health of nurses. Compassion fatigue refers to that in the process of providing assistance, the helper bears the pain of the recipient due to empathy, which reduces the helper's own energy or interest.Based on a widespread conceptual model, CF consists of two constructs: burnout and secondary traumatic stress. Nurses are at a great risk of compassion fatigue. CF is gradually becoming a serious problem which can affect nurses' physical and psychological health, performance, job satisfaction and quality of care . Thus, investigating the prevalence of CF among nurses and its related factors are warranted to prevent CF among nursing population. Research has studied the influencing factors of CF. Some studies have found that the demographic characteristics, worked related factors , the degree of exposure to traumatic events and psychological factors are important factors affecting nurses' compassion fatigue. Some studies suggest that resilience, social support, sense of control and meaningful recognition are negatively correlated with CF . Among them, resilience and self-efficacy are considered as important psychological factors affecting the individual's mental health, and they play an important role in the occurrence of CF. The working pressure of clinical nurses comes from the situations that they are exposed to patients' traumatic events and give excessive empathy for a long-term. CF among nurses is an undesirable outcome caused by maladaptation to this pressure. What's more, resilience, and self-efficacy play an important role in individual coping and psychological adjustment in face of stressful events. Therefore, it is necessary to explore the roles of resilience and self-efficacy in the process of CF. According to the theoretical path analysis of professional caregivers' quality of life, work environment, client environment and person environment factors have an influence on the development of compassion fatigue . Regarding to the psychological stress system , When confronted with stressful events, the individuals will have a stress response as a joint result of environmental factors and personnel factors. Thus, in accordance with the above two theories, being exposed to traumatic events is considered as a stressor, which could lead to CF. During this process, several external factors (work-related environmental factors) and internal factors (personality, social support) have effects on CF. In this study, resilience, and self-efficacy will be recognized as individual psychological characteristics and CF will be treated as a psychological change. Although there have been several studies on the predictors of CF in nurses around the world, limited knowledge exists in considering both internal factors (resilience and self-efficacy) and external predictive factors (demographic, work-related factors) of CF among nurses, especially in mainland China. The study aims to investigate the level of compassion fatigue among Chinese nurses and test the influences of demographic characteristics, work-related factors, resilience, and self-efficacy on compassion fatigue.

Conditions

Compassion Fatigue; Self Efficacy; Resilience

Keywords

Compassion fatigue; Self-efficacy; Resilience; Nurses

Outcome Measures

Primary Outcomes (4)

• General information of participants questionnaire

  The general information of participants was measured by social-demographic questionnaire which was self-compiled and aimed to collect participants' demographic characteristics such as age, gender, educational level, marital status, working department, years of nursing experience, professional title, monthly income, shift work and physical conditions and so on.

  baseline

• Compassion fatigue of participants

  The Professional quality of life scale was used to evaluate the level of compassion fatigue. The original version was developed by Stamm and then translated to Chinese by Zheng, which was authorized by Stamm. The scale has 30 items with three subscales including compassion satisfactory , burnout and secondary traumatic stress. Together, these latter two subscales measure compassion fatigue. A five-point Likert scale was used (1 = "never" to 5 = "very often") . A higher score of the compassion satisfaction subscale represents a higher level of compassion satisfaction, while a higher score of the burnout and secondary traumatic stress subscale indicates a higher risk of burnout and secondary traumatic stress. The score of each subscale lower than 22 represents a low level of compassion satisfaction, burnout, and secondary traumatic stress; score between 23 - 41 indicates an average level; and more than 42 suggests a high level. The Cronbach's alpha of the scale in this study was 0.722.

  baseline

• Resilience of participants

  The Connor-Davidson resilience scale aimed to measure participants' resilience. The original version was developed by Connor and Davidson . Yu and Zhang translated it to Chinese after getting the authorization from the original developers. The Chinese version of CD-RISC consists of three dimensions (tenacity, strength, and optimism) with 25 items. A five-point Likert scale was used (0 = "never" to 4 = "almost always") . The scale can effectively measure the resilience among clinical nurses and has good reliability and validity. The reliability of the CD-RISC among Chinese residents was 0.91 and the Cronbach's alpha of the scale in this study was 0.966.

  baseline

• Self-Efficacy of participants

  The General Perceived Self-Efficacy scale developed by Scherbaum, was used to measured participants' self-efficacy. The Chinese version was translated by Wang . The scale consists of 10 items assessed by a four-point Likert scale (1=incorrect to 4=correct). The total scores range from 10 to 40, with higher total scores indicating higher levels of self-efficacy. The Cronbach's alpha of the scale in this study was 0.941.

  baseline

Study Arms (1)

Questionnaire survey group

All nurses were recruited from 3 tertiary hospitals in central China from 3rd October, 2019 to 15th December, 2019. A total of 992 clinical nurses from different nursing departments were recruited through convenience sampling. Data were collected using General information questionnaire, the Professional Quality of Life Scale, the Connor-Davidson Resilience Scale and General Perceived Self-Efficacy Scale.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

According to the calculation method of the sample size regarding to the linear multiple regression, fixed model in G power software 3.1 was used. In this calculation, effect size f2=0.15, α= 0.05, 1-β=0.95, the study included 13 demographic variables, resilience and self-efficacy, 15 independent variables in total. The sample size calculated by G power software 3.1 is 199. Considering the 20% loss to follow-up rate and sampling error, the sample size was expanded to 239.

You may qualify if:

• The hospital is a comprehensive hospital;
• Nurse have been registered and are on their duty;
• Nurses are currently engaged in clinical practice;
• Nurses are willing to participate in the study.

You may not qualify if:

• Nurses who are intern nurses or studying in other hospitals, or has been participated in other relevant studies.

Sponsors & Collaborators

• Central South University: lead

Study Sites (1)

Xiangya School of Nursing,Central South University

Changsha, Hunan, 410013, China

Location

Related Publications (18)

• Ariapooran S. Compassion fatigue and burnout in Iranian nurses: The role of perceived social support. Iran J Nurs Midwifery Res. 2014 May;19(3):279-84.

  PMID: 24949067 BACKGROUND

• Balinbin CBV, Balatbat KTR, Balayan ANB, Balcueva MIC, Balicat MGB, Balidoy TAS, Macindo JRB, Torres GCS. Occupational determinants of compassion satisfaction and compassion fatigue among Filipino registered nurses. J Clin Nurs. 2020 Mar;29(5-6):955-963. doi: 10.1111/jocn.15163. Epub 2020 Jan 13.

  PMID: 31887244 BACKGROUND

• Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977 Mar;84(2):191-215. doi: 10.1037//0033-295x.84.2.191. No abstract available.

  PMID: 847061 BACKGROUND

• Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: 10.1002/da.10113.

  PMID: 12964174 BACKGROUND

• Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009 Nov;41(4):1149-60. doi: 10.3758/BRM.41.4.1149.

  PMID: 19897823 BACKGROUND

• von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007 Oct 20;370(9596):1453-7. doi: 10.1016/S0140-6736(07)61602-X.

  PMID: 18064739 BACKGROUND

• Yao Y, Zhao S, Gao X, An Z, Wang S, Li H, Li Y, Gao L, Lu L, Dong Z. General self-efficacy modifies the effect of stress on burnout in nurses with different personality types. BMC Health Serv Res. 2018 Aug 29;18(1):667. doi: 10.1186/s12913-018-3478-y.

  PMID: 30157926 BACKGROUND

• Zhang J, Zhang JP, Cheng QM, Huang FF, Li SW, Wang AN, Su P. The resilience status of empty-nest elderly in a community: A latent class analysis. Arch Gerontol Geriatr. 2017 Jan-Feb;68:161-167. doi: 10.1016/j.archger.2016.10.011. Epub 2016 Oct 26.

  PMID: 27810664 BACKGROUND

• Sinclair S, Raffin-Bouchal S, Venturato L, Mijovic-Kondejewski J, Smith-MacDonald L. Compassion fatigue: A meta-narrative review of the healthcare literature. Int J Nurs Stud. 2017 Apr;69:9-24. doi: 10.1016/j.ijnurstu.2017.01.003. Epub 2017 Jan 12.

  PMID: 28119163 BACKGROUND

• Zhang YY, Han WL, Qin W, Yin HX, Zhang CF, Kong C, Wang YL. Extent of compassion satisfaction, compassion fatigue and burnout in nursing: A meta-analysis. J Nurs Manag. 2018 Oct;26(7):810-819. doi: 10.1111/jonm.12589. Epub 2018 Aug 20.

  PMID: 30129106 BACKGROUND

• Alharbi J, Jackson D, Usher K. Personal characteristics, coping strategies, and resilience impact on compassion fatigue in critical care nurses: A cross-sectional study. Nurs Health Sci. 2020 Mar;22(1):20-27. doi: 10.1111/nhs.12650. Epub 2019 Oct 31.

  PMID: 31670474 RESULT

• Arimon-Pages E, Torres-Puig-Gros J, Fernandez-Ortega P, Canela-Soler J. Emotional impact and compassion fatigue in oncology nurses: Results of a multicentre study. Eur J Oncol Nurs. 2019 Dec;43:101666. doi: 10.1016/j.ejon.2019.09.007. Epub 2019 Sep 12.

  PMID: 31590071 RESULT

• Cetrano G, Tedeschi F, Rabbi L, Gosetti G, Lora A, Lamonaca D, Manthorpe J, Amaddeo F. How are compassion fatigue, burnout, and compassion satisfaction affected by quality of working life? Findings from a survey of mental health staff in Italy. BMC Health Serv Res. 2017 Nov 21;17(1):755. doi: 10.1186/s12913-017-2726-x.

  PMID: 29162095 RESULT

• Guo YF, Luo YH, Lam L, Cross W, Plummer V, Zhang JP. Burnout and its association with resilience in nurses: A cross-sectional study. J Clin Nurs. 2018 Jan;27(1-2):441-449. doi: 10.1111/jocn.13952. Epub 2017 Sep 4.

  PMID: 28677270 RESULT

• Kelly L, Runge J, Spencer C. Predictors of Compassion Fatigue and Compassion Satisfaction in Acute Care Nurses. J Nurs Scholarsh. 2015 Nov;47(6):522-8. doi: 10.1111/jnu.12162. Epub 2015 Aug 19.

  PMID: 26287741 RESULT

• Nolte AG, Downing C, Temane A, Hastings-Tolsma M. Compassion fatigue in nurses: A metasynthesis. J Clin Nurs. 2017 Dec;26(23-24):4364-4378. doi: 10.1111/jocn.13766. Epub 2017 Apr 20.

  PMID: 28231623 RESULT

• Shen J, Yu H, Zhang Y, Jiang A. Professional quality of life: A cross-sectional survey among Chinese clinical nurses. Nurs Health Sci. 2015 Dec;17(4):507-15. doi: 10.1111/nhs.12228. Epub 2015 Aug 24.

  PMID: 26303265 RESULT

• Wang J, Okoli CTC, He H, Feng F, Li J, Zhuang L, Lin M. Factors associated with compassion satisfaction, burnout, and secondary traumatic stress among Chinese nurses in tertiary hospitals: A cross-sectional study. Int J Nurs Stud. 2020 Feb;102:103472. doi: 10.1016/j.ijnurstu.2019.103472. Epub 2019 Nov 13.

  PMID: 31810017 RESULT

MeSH Terms

Conditions

Compassion Fatigue

Condition Hierarchy (Ancestors)

Mental Fatigue; Fatigue; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Behavioral Symptoms; Behavior; Occupational Stress; Stress, Psychological

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 27, 2021
• First Posted: June 3, 2021
• Study Start: October 3, 2019
• Primary Completion: November 10, 2019
• Study Completion: December 15, 2019
• Last Updated: June 3, 2021

Record last verified: 2021-06

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)