Compassion fatigue, watching patients suffering and emotional display rules among hospice professionals: a daily diary study

Abstract

Background: Hospice workers are required to regularly use emotional regulation strategies in an attempt to encourage and sustain terminally ill patients and families. Daily emotional regulation in reaction to constantly watching suffering patients may be intensified among those hospice professionals who have high levels of compassion fatigue. The main object of this study was to examine the relationship between daily exposition to seeing patient suffering and daily emotional work, and to assess whether compassion fatigue (secondary traumatic stress and burnout) buffers this relationship.Methods: We used a diary research design for collecting daily fluctuations in seeing patients suffering and emotional work display. Participants filled in a general survey and daily survey over a period of eight consecutive workdays. A total of 39 hospice professionals from two Italian hospices participated in the study.Results: Multilevel analyses demonstrated that daily fluctuations in seeing patients suffering was positively related to daily emotional work display after controlling for daily death of patients. Moreover, considering previous levels of compassion fatigue, a buffering effect of high burnout on seeing patients suffering -daily emotional work display relationship was found. Conclusions: A central finding of our study is that fluctuations in daily witness of patients suffering are positively related to daily use of positive emotional regulations. Further, our results show that burnout buffers this relationship such that hospice professionals with high burnout use more emotional display in days where they recurrently witness patients suffering.

Dealing With COVID-19 Patients: A Moderated Mediation Model of Exposure to Patients' Death and Mental Health of Italian Health Care Workers

“…Specifically, our findings suggested that, the emotional involvement in reassuring patients who were distressed or upset for their health, as well as seeing patients dying without their families beside them (Daphna-Tekoah et al, 2020 ), had the potential to trigger trauma and thus increase the risk of developing intrusion symptoms. This is in line with previous studies that showed how exposure to patient-related stressful situations makes HCWs susceptible to PTS (Kerasiotis and Motta, 2004 ; Adriaenssens et al, 2012 ; de Wijn and van der Doef, 2020 ; Portoghese et al, 2020 ). Furthermore, our results confirmed that, during pandemics, HCWs are exposed to different kinds of job and emotional demands that may reduce their well-being and expose them to intrusion thoughts (PTS symptom) (Aghili and Arbabi, 2020 ; Blanco-Donoso et al, 2020 ; Cai et al, 2020 ; Chevance et al, 2020 ; Daphna-Tekoah et al, 2020 ; Pappa et al, 2020 ).…”

Worries, Preparedness, and Perceived Impact of Covid-19 Pandemic on Nurses' Mental Health

“…In addition, the important demands that nurses have to face during the pandemic usually add further emotional requests. Continuous exposure to patients' death and suffering can lead to vicarious trauma and secondary traumatic stress ( 12 , 45 ). Furthermore, our study shows that crying at work is associated with higher levels of job stress and rumination about the pandemic.…”

Concerns, Perceived Impact, Preparedness in Coronavirus Disease (COVID-19) Pandemic and Health Outcomes among Italian Physicians: A Cross-Sectional Study

“… 66 In this sense, to reduce ruminative thoughts about the pandemic, distraction techniques such as coping strategies may help HCWs to lessen job stress and recover after work. 65 Finally, we found that crying at work was strongly associated with job stress, rumination, and watching colleagues crying at work. Crying at work is more frequent when job stress is too high and physicians feel overwhelmed by excessive demands and emotional pressure.…”

“…For example, high exposure to patients’ death, patients’ suffering, and witnessing extreme physical pain in patients may result in emotional clashes, such as secondary traumatic stress. 64 , 65 Then, we considered ruminations about the pandemic and crying at work as HCWS health outcomes. Regarding rumination about the pandemic, we found that concerns about perceived impact on personal life were the main risk factor.…”