Eichorst Morgan K, Fromenthal Ashley L, Harris Grant M, Reel Candice D, Allen Rebecca S
VA Northern Indiana Health Care System, Mishawaka, IN, USA.
Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
Aging Ment Health. 2025 Mar;29(3):452-461. doi: 10.1080/13607863.2024.2399089. Epub 2024 Sep 8.
Certified Nursing Assistants (CNAs) are responsible for 80-90% of direct-to-resident care in skilled nursing facilities (SNFs), and may develop close, family-like relationships with their residents. With SNFs becoming a common place of death for older adults, CNAs now find themselves engaging in end-of-life caregiving with limited training and institutional support for emotional outcomes. This study aimed to understand and evaluate the relations between bereavement, death exposure, and compassion fatigue among CNAs, hypothesizing that (a) experiential avoidance moderates the relation between death exposure and negative death attitudes and (b) death attitudes moderate the relation between death exposure and compassion fatigue.
One hundred and ten CNAs across all shifts from four skilled nursing facilities in the southeastern United States participated in surveys and, potentially, focus groups.
Results failed to find support for death exposure being related either to experiential avoidance or negative death attitudes. However, results supported the relation between negative death attitudes and compassion fatigue.
Implications highlight the need to develop interventions focusing on palliative skills-based training and emotional support of CNAs in their role as end-of-life caregivers. By reducing compassion fatigue, it may be possible to decrease job turnover and increase quality-of-care for residents.
在专业护理机构（SNFs）中，注册护理助理（CNAs）负责80%-90%的直接面向居民的护理工作，并且可能与他们的居民建立亲密的、类似家人的关系。随着SNFs成为老年人常见的死亡场所，CNAs现在发现自己在临终护理方面的培训有限，且在情感方面缺乏机构支持。本研究旨在了解和评估CNAs中丧亲之痛、死亡暴露与同情疲劳之间的关系，假设（a）经验性回避调节死亡暴露与消极死亡态度之间的关系，以及（b）死亡态度调节死亡暴露与同情疲劳之间的关系。
来自美国东南部四个专业护理机构的110名各轮班的CNAs参与了调查，并可能参与焦点小组讨论。
结果未能发现死亡暴露与经验性回避或消极死亡态度之间存在关联的证据。然而，结果支持消极死亡态度与同情疲劳之间的关系。
研究结果强调了开展干预措施的必要性，这些措施应侧重于基于姑息治疗技能的培训以及对CNAs作为临终护理人员角色的情感支持。通过减少同情疲劳，有可能降低人员流动率并提高居民的护理质量。
