INTRODUCTION:

Nurses are in forefront of health care sector, their compassionate care makes more lives worthwhile. Although nurses working in different sectors of the hospital gains satisfaction by providing compassionate care to patient and families.

The nurses provide compassionate care to patients who experience illnesses and events that are often sudden, disfiguring and life threatening. Although nurses obtain professional satisfaction from their work, their repeated exposure to the aftermath of critical illness puts them a high risk for compassion fatigue (CF).¹

On the other side of compassion satisfaction can be compassion fatigue which is the negative aspect or a state of tension, of helping those who experience traumatic stress and suffering. CF is also called secondary traumatic stress disorder (STSD), among professional caregivers who care for “suffering patients” in general. Within the health professionals, burnout-BO has been defined as an experience of physical, emotional, and mental exhaustion, caused by long-term involvement in situations that are emotionally demanding. Although compassion fatigue is often used synonymously with burnout, the two concepts are derived from two separate failed survival strategies. Compassion fatigue arises from a rescue-caretaking response, and burnout arises from an assertiveness-goal achievement response (Valent, 2002).¹

In this modern era, the health care is demanding even though the technology is advanced here the importance of nurses and their balanced emotional as well as physical wellbeing must be made sure to ensure quality care. Nurses must be competent enough to render nursing care effectively. This time it is vital to assess their work field to obtain details about their physical and emotional attributes.² A survey study was conducted to identify possible correlations among compassion fatigue, burnout, and compassion satisfaction among 53 emergency room nurses. Results of the study indicated a negative relationship between compassion satisfaction and compassion fatigue as measured by the correlation coefficient and a positive, statistically significant correlation between burnout and compassion fatigue. Therefore, educating emergency room nurses about the recognition of compassion fatigue, burnout, and compassion satisfaction could help them to identify risks, recognize behaviors, apply interventions, and develop a better understanding for self-care and coping strategies. ³

A multicenter cross sectional study was conducted among 129 nurses from nine NICU across six cities of Gujarat and the study concluded that high compassion satisfaction, high burnout and high secondary traumatic stress were reported by 19.4 %, 23.3% and 23.3 % nurses respectively.⁴

STATEMENT OF THE PROBLEM:

“A study to determine the relationship of compassion satisfaction, compassion fatigue and burnout among nurses in MOSC Medical College Hospital, Kolenchery”.

OBJECTIVES OF THE STUDY:

Objective of the study are to,

1. to assess the compassion satisfaction, compassion fatigue and burnout among nurses in MOSC Medical College Hospital, Kolenchery.

2. to determine the relationship of compassion satisfaction, compassion fatigue and burnout among nurses in MOSC Medical College Hospital, Kolenchery.

OPERATIONAL DEFNITIONS:

Compassion Satisfaction:

Compassion satisfaction is the sum of all the positive feeling a person derives from helping others.

In the present study, it refers to compassion satisfaction among nurses working at MOSC Medical College Hospital, Kolenchery. Which is measured using compassion satisfaction subscale of Professional Quality Of Life Scale Version-5.

Compassion Fatigue:

Compassion fatigue is the stress resulting from helping or wanting to help a traumatized or suffering person.

In the present study, it refers to compassion fatigue among nurses working at MOSC Medical College Hospital, Kolenchery. Which is measured using compassion fatigue subscale of Professional Quality Of Life scale Version-5.

Burnout:

Burnout is a physical, emotional and mental exhaustion caused by long term involvement in emotionally demanding situation.

In the present study, it refers to burnout among nurses working at MOSC Medical College Hospital, Kolenchery. Which is measured using burnout subscale of Professional quality of life scale version-5.

Hypothesis:

All the hypothesis will be tested at 0.05 level of significance

H 1: There is a significant relationship of compassion satisfaction, compassion fatigue and burnout among nurses.

METHODOLOGY:

RESEARCH APPROACH:

The study adopted a quantitative research approach.

RESEARCH DESIGN:

The research design selected for the study was observational analytical study.

SETTING:

The study was conducted at MOSC Medical College Hospital, Kolenchery.

POPULATION:

The population in this study comprised of nurses working in MOSC Medical College Hospital, Kolenchery.

SAMPLE:

The sample selected for the study was nurses of MOSC Medical College Hospital, Kolenchery.

SAMPLE SIZE:

A total of 80 nurses working in MOSC Medical College Hospital, Kolenchery, participated in the study.

SAMPLING TECHNIQUE:

Sampling technique used for the study was convenient sampling technique.

SAMPLING CRITERIA:

Inclusion Criteria’s

· Nurses who are working in M.O.S.C Medical College Hospital, Kolenchery.

· Nurses who are available at the time of data collection.

· Nurses who are willing to participate the study.

Exclusion Criteria:

· Nurses who are not available at the time of data collection.

· Nurses who are not willing to participate.

TOOLS/ INSTRUMENTS:

Tool 1: The demographic proforma:

It included 11 items such as age, gender, marital status, educational level, year of experience, unit tenure and clinical role of a nurse.

Tool 2: Professional Quality Of Life Scale [PRoQOL]:

The Professional Quality of Life Scale revision V questionnaire was developed by Stamm, 2009. The PRoQOL is a revised version of Figley’s (1995) .The tool composed of 3 subscales compassion satisfaction, burnout and secondary traumatic stress used to measure compassion satisfaction and compassion fatigue. Of the 3 subscales, 2 (burnout and secondary traumatic stress) are components of compassion fatigue, whereas compassion satisfaction is a stand-alone measure. The PRoQOL is a 30-item self-report measure with 10 items per subscale. It is a 30-item Likert-type scale (0=never to 5=very often).

The reliability of the tool is already established and Cronbach’s alpha value for each subscales are 0.88 for compassion satisfaction, 0.75 for burnout, and 0.81 for secondary traumatic stress.

PILOT STUDY:

A pilot study was conducted among 15 nurses in MOSC Medical College Hospital, Kolenchery. The study subjects were informed in detail about the purpose and nature of the study and assured confidentiality and privacy. Researchers obtained signed informed consent from participants of the study. The study was found to be practicable and feasible. Plan of data collection and analysis was found feasible.

DATA COLLECTION PROCESS:

Ethical clearance was obtained from the institutional ethical committee. After obtaining permission from principal, MOSC College of Nursing, authority of medical and nursing department, data collection was initiated in the month of May. 80 subjects were selected as per the criteria. Initially the purpose of the study was explained to the subject. Confidentiality was assured to the participants. The investigators administered demographic proforma and Professional Quality Of Life Scale [PRoQOL] 5-point Likert scale to the nurses in MOSC Medical Hospital, Kolenchery.

RESULTS:

SECTION I: Analysis and interpretation of socio-demographic variables of subjects:

Among the 80 subjects, 42.5% belongs to the age group of 20 - 39 years. All subjects were females. With regard to the marital status of the subjects, 83.7% were married. Majority of nurses, (78.7 %) had educational qualification of general nursing. 38.7 % had 10 -15 years of experience. 37.5% nurses had unit tenure of 1–5 years and 51.2 % were senior staff.

Fig 1: Bar diagram showing the percentage distribution of years of experience of nurses

Fig 2: Bar diagram showing percentage distribution of unit of tenure of nurses

Fig 3 : Pie diagram showing percentage distribution of clinical role a nurse

SECTION II: Description of compassion satisfaction, compassion fatigue and burnout among nurses.

Analysis as per the objectives of study

4.1: To assess the compassion satisfaction, compassion fatigue and burnout among nurses in MOSC Medical College Hospital Kolenchery.

As data follow normality we have estimated mean and standard deviation for compassion satisfaction, compassion fatigue and burnout. Out of 80 subjects, 42 subjects had high compassion satisfaction (90.47 %), 67 subjects had high compassion fatigue (83.75%) and 80 subjects had average burnout (100%). The mean score of compassion satisfaction is 41.78 with standard deviation of 4.65. Compassion fatigue 29.55 with standard deviation of 5.98 and burn out 32.60 with standard deviation of 4.49.

Section III: Correlation between compassion satisfaction, compassion fatigue and burnout among nurses.

4.2: To assess the relationship of compassion satisfactions, compassion fatigue and burn out among nurses in MOSC Medical College Hospital Kolenchery.

In order to estimate correlation between compassion satisfaction, compassion fatigue and burnout. We perform Pearson correlation coefficient as data follows normality and it is observed that there is a very weak negative correlation between compassion satisfaction and compassion fatigue (r=-0.16) which is found to be not statistically significant (p=0.167) and compassion satisfaction and burn out (r=-0.114) which is found to be not statistically significant (p=0.312) and we observed that high positive correlation between compassion fatigue and burnout (r=0.732) which is found to be statistically significant (p=<0.001).

Table 1: Correlation of compassion satisfaction, compassion fatigue and burnout among nurses

Variables	Correlation	P value	Inference
Compassion Satisfaction and Compassion fatigue	-0.16	0.167	Weak negative correlation
Compassion Satisfaction and Burnout	-0.114	0.312	Weak negative correlation
Compassion Fatigue and Burnout	0.732	<0.001	High positive correlation

DISCUSSION:

Findings related to assessment of compassion satisfaction, compassion fatigue and burnout among nurses:

In the present study, out of 80 subjects, 42 subjects had high compassion satisfaction (90.47 %), 67 subjects had high compassion fatigue (83.75%) and 80 subjects had average burnout (100%). The average score of compassion satisfaction 41.78 with standard deviation of 4.65. Compassion fatigue 29.55 with standard deviation of 5.98 and burnout 32.60 with standard deviation of 4.49.

A non-experimental descriptive study was conducted in United States to determine the prevalence of compassion satisfaction, compassion fatigue, and burnout in emergency department nurses and to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty. The Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses. The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction among this group of emergency department nurses.²

Findings related to correlation of compassion satisfaction, compassion fatigue and burnout:

In the present study, Pearson coefficient correlation exact test was analysed among collected data, the result indicated that high positive correlation between compassion fatigue and burnout (0.732) which is found to be statistically significant (p=<0.001).

A survey study was conducted to identify possible correlations among compassion fatigue, burnout, and compassion satisfaction among 53 emergency room nurses. Results of the study indicated a negative relationship between compassion satisfaction and compassion fatigue as measured by the correlation coefficient and a positive, statistically significant correlation between burnout and compassion fatigue. Therefore, educating emergency room nurses about the recognition of compassion fatigue, burnout, and compassion satisfaction could help them to identify risks, recognize behaviours, apply interventions, and develop a better understanding for self-care and coping strategies. ³

CONCLUSION:

From the findings of the study it is clear that there is a significant correlation between compassion fatigue and burnout. Data was analysed using descriptive method and inferential statistics. The findings showed that out of 80 subjects, 42 subjects had high compassion satisfaction (90.47 %), 67 subjects had high compassion fatigue (83.75%) and 80 subjects had average burnout (100%). The study also revealed that the mean score of compassion satisfaction is 41.78 with standard deviation of 4.65. Compassion fatigue 29.55 with standard deviation of 5.98 and burnout 32.60 with standard deviation of 4.49.

REFERENCE:

1. J Harvey, Burnett. A survey of resilience, compassion fatigue, burnout and compassion satisfaction among trauma responders. International J of emergency mental health and human resilience.

2. Mathias CT, Wentzel DL. Descriptive study of burnout, compassion fatigue and compassion satisfaction in undergraduate nursing students at a tertiary education institution in KwaZulu-Natal. Curationis. 2017; Vol 40(1):1-6.

3. Available from: https://www.researchgate.net/publication/216017342

4. Amin AA, Vankar JR. Perceived Stress and Professional Quality of Life in Neonatal Intensive Care Unit Nurses in Gujarat, India.Indian J Pediatr. 2015 Nov; 82(11):1001-5. Available from: 10.1007/s12098-015-1794-3. Epub 2015 Jun 12.

Received on 09.08.2018 Modified on 06.09.2018

Int. J. Nur. Edu. and Research. 2019; 7(1):87-91.

DOI: 10.5958/2454-2660.2019.00018.8