Managing compassion fatigue : implications for medical education

Abstract

Compassion fatigue is a term used in health and psychological literature to characterise the emotional distress health care workers may experience as a result of continuing exposure to traumatic events experienced by their patients. Compassion fatigue is a construct that has been subject to relatively little research; and especially research examining compassion fatigue in doctors. This study aims to determine how common compassion fatigue is in a group of hospital-based junior doctors in New Zealand, to identify possible protective processes against developing compassion fatigue, and to identify undergraduate curriculum nterventions that might enhance a future doctor's ability to protect themselves from developing compassion fatigue. Other constructs that may be associated with compassion fatigue are also examined in this study, including compassion satisfaction, burnout, resilience, empathy, spirituality, and emotionality. This research gathers information about compassion fatigue and associated constructs in order to provide information to assist with the design of educational programmes that will assist doctors to identify and manage the effects of compassion fatigue. Quantitative data is gathered in a voluntary survey using existing validated instruments, and qualitative data is obtained through an open-ended question in the survey, as well as through a small number of one-on-one interviews. The study population are junior medical staff in four New Zealand District Health Boards. Statistically significant relationships were found between the dependant and independent variables with the strongest significant negative relationship being between both resilience and emotionality, and compassion fatigue. Peers and family were identified as the most significant sources of support. Recommendations for change in the undergraduate medical curriculum include enhanced communication skills and emotional competence training, identification of certain peers as supporters, involvement of student's family in the life of the Faculty, and training aimed at raising awareness of compassion fatigue and the development of strategies for managing it.