Salmond Erin, Salmond Susan, Ames Margaret, Kamienski Mary, Holly Cheryl
School of Nursing, Rutgers University, Newark, USA.
Jersey City Medical Center, RWJ/Barnabas Health, Jersey City, USA.
JBI Database System Rev Implement Rep. 2019 May;17(5):682-753. doi: 10.11124/JBISRIR-2017-003818.
The objective of this review was to describe the experiences of direct care nurses with work-related compassion fatigue.
The cumulative demands of experiencing and helping others through suffering have been considered to contribute to the potential of compassion fatigue. However, there is a lack of clarity on what specifically contributes to and constitutes compassion fatigue. Nurses suffering from compassion fatigue experience physical and emotional symptoms that leave them disconnected from patients and focused on the technical rather than the compassionate components of their role. This disconnect can also affect personal relationships outside of work.
This review included any qualitative studies describing the experiences of direct care nurses from any specialty or any nursing work setting.
This review followed the Joanna Briggs Institute (JBI) approach for qualitative systematic reviews. Studies included in this review include those published in full text, English and between 1992, when the concept of compassion fatigue was first described, and May 2017, when the search was completed. The main databases searched for published and unpublished studies included: PubMed, CINAHL, Academic Search Premiere, Science Direct, Scopus, PsycINFO, Web of Science and the Virginia Henderson Library.
Twenty-three papers, representing studies conducted in seven countries and 821 total nurse participants, met the criteria for inclusion. From these, a total of 261 findings were extracted and combined to form 18 categories based on similarity in meaning, and four syntheses were derived: i) Central to the work of nursing and the professional environment in which nurses work are significant psychosocial stressors that contribute to compassion stress and, if left unchecked, can lead to compassion fatigue; ii) Protection against the stress of the work and professional environment necessitates that the individual and team learn how to respond to "the heat of the moment"; iii) Nurses and other administrative and colleague staff should be alert to the symptoms of compassion fatigue that present as profound, progressive, physical and emotional fatigue: a feeling that the nurse just can't go on and a sense of being disconnected and drained, like a gas tank on empty; and iv) Keeping compassion fatigue at bay requires awareness of the threat of compassion fatigue, symptoms of compassion fatigue, and the need for work-life balance and active self-care strategies.
The major conclusions of this review are that compassion fatigue prevention and management must be acknowledged, and both personal and organizational coping strategies and adaptive responses are needed to keep nurses balanced, renewed and able to continue compassionate connection and caring.
本综述的目的是描述直接护理护士与工作相关的同情疲劳经历。
通过他人的痛苦去体验并提供帮助所带来的累积需求，被认为是导致同情疲劳的潜在因素。然而，对于具体是什么导致并构成同情疲劳，目前尚不清楚。患有同情疲劳的护士会出现身体和情绪症状，这使他们与患者脱节，且专注于工作中的技术层面而非同情关怀层面。这种脱节也会影响工作之外的人际关系。
本综述纳入了任何描述来自任何专科或任何护理工作环境的直接护理护士经历的定性研究。
本综述遵循乔安娜·布里格斯研究所（JBI）定性系统综述方法。本综述纳入的研究包括1992年（同情疲劳概念首次被描述的年份）至2017年5月（搜索完成时）期间以全文形式发表的英文研究。搜索的主要数据库包括已发表和未发表研究的数据库：PubMed、CINAHL、学术搜索高级版、科学Direct、Scopus、PsycINFO、科学网和弗吉尼亚·亨德森图书馆。
23篇论文符合纳入标准，这些研究来自7个国家，共有821名护士参与。从中总共提取了261项研究结果，并根据意义相似性合并为18个类别，得出了4个综合结论：i）护理工作及其所处的专业环境的核心存在重大的社会心理压力源，这些压力源会导致同情压力，如果不加以控制，可能会导致同情疲劳；ii）要抵御工作和专业环境带来的压力，个人和团队需要学习如何应对“当下的热度”；iii）护士以及其他行政和同事应警惕同情疲劳的症状，这些症状表现为深刻、渐进的身体和情绪疲劳：一种护士感觉无法继续下去的感觉，以及一种脱节和疲惫的感觉，就像油箱空了一样；iv）要防止同情疲劳，需要意识到同情疲劳的威胁、同情疲劳的症状，以及工作与生活平衡的必要性和积极的自我护理策略。
本综述的主要结论是，必须认识到同情疲劳的预防和管理，个人和组织的应对策略以及适应性反应都需要，以保持护士的平衡、恢复活力，并能够继续保持同情联系和关怀。
