Shoji Kotaro, Noguchi Norihito, Waki Fumiko, Saito Taku, Kitano Masato, Edo Naoki, Koga Minori, Toda Hiroyuki, Kobayashi Nobuhisa, Sawamura Takehito, Nagamine Masanori
College of Nursing, University of Human Environments, 3-220 Ebata, Obu 474-0035, Aichi, Japan.
Department of Nursing, National Defense Medical College, 3-2 Namiki, Tokorozawa 395-8513, Saitama, Japan.
Behav Sci (Basel). 2024 May 11;14(5):400. doi: 10.3390/bs14050400.
Burnout and secondary traumatic stress (STS), also referred to as compassion fatigue, are undeniable negative consequences experienced by healthcare professionals when working with patients. As frontline healthcare professionals are essential to communities, it is crucial to understand their mental health and how they cope with negative psychological responses. This study investigated the relationships between burnout, STS, compassion satisfaction, dispositional empathy, and stress management among Japanese healthcare professionals and students taking care of patients in clinical practice. The participants were 506 Japanese healthcare professionals and students (doctors, nurses, medical students, and nursing students) affiliated with Japanese Ministry of Defense Hospitals. The data were collected from March 2020 to May 2021. We assessed burnout, STS, and compassion satisfaction using the Professional Quality of Life Scale, dispositional empathy using the Interpersonal Reactivity Index, and coping with stress using the Coping Orientation to Problems Experienced Inventory (Brief-COPE). Exploratory factor analysis of the Brief-COPE yielded three factors: active coping; support-seeking; and indirect coping. Personal distress, a self-oriented emotional empathy index, was related to higher burnout and STS scores and lower compassion satisfaction. Empathic concern, an other-oriented emotional empathy index, was associated with lower burnout and higher compassion satisfaction. Active coping strategies were associated with lower burnout and higher compassion satisfaction, whereas indirect coping strategies were associated with higher burnout and STS scores. In a comparison of empathy in professional categories, nurses presented higher personal distress than nursing students, and medical doctors showed lower fantasy tendencies than medical students. These results imply the complex relationships between empathy, coping strategies, and psychological responses among healthcare professionals. Further longitudinal study is needed to explore these complex relationships and to develop more precise and effective psycho-educational interventions to prevent burnout and STS.
职业倦怠和继发性创伤压力（STS），也被称为同情疲劳，是医疗保健专业人员在与患者打交道时不可否认的负面后果。由于一线医疗保健专业人员对社区至关重要，了解他们的心理健康状况以及他们如何应对负面心理反应至关重要。本研究调查了日本医疗保健专业人员和在临床实践中照顾患者的学生的职业倦怠、继发性创伤压力、同情满意度、特质同理心和压力管理之间的关系。参与者为506名隶属于日本国防部医院的日本医疗保健专业人员和学生（医生、护士、医学生和护理学生）。数据收集于2020年3月至2021年5月。我们使用职业生活质量量表评估职业倦怠、继发性创伤压力和同情满意度，使用人际反应指数评估特质同理心，并使用经历问题应对取向量表（简版COPE）评估应对压力的情况。简版COPE的探索性因素分析产生了三个因素：积极应对；寻求支持；以及间接应对。个人困扰是一种自我导向的情感同理心指标，与较高的职业倦怠和继发性创伤压力得分以及较低的同情满意度相关。移情关注是一种他人导向的情感同理心指标，与较低的职业倦怠和较高的同情满意度相关。积极应对策略与较低的职业倦怠和较高的同情满意度相关，而间接应对策略与较高的职业倦怠和继发性创伤压力得分相关。在专业类别中的同理心比较中，护士的个人困扰高于护理学生，而医生的幻想倾向低于医学生。这些结果暗示了医疗保健专业人员中同理心、应对策略和心理反应之间的复杂关系。需要进一步的纵向研究来探索这些复杂关系，并制定更精确有效的心理教育干预措施以预防职业倦怠和继发性创伤压力。
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