Compassion Fatigue: A Scoping Review of the Literature

SIGNIFICANCE: Health care professionals are faced with higher caseloads, diminishing resources, more documentation, and a growing emphasis on better outcomes. Without support, these changes lead to stress, job strain, increased illness, and decreased productivity in addition to higher levels of emotional exhaustion. As professional caregivers, these occupational stressors contribute to depleted physical and emotional resources necessary to cope, thereby affecting the provider’s well-being. These stressors can be costly to organizations, affect patient outcomes, increase attrition, and decrease quality of life for the health care professional.

INNOVATION: To meet the needs of the health care consumer, the health and well-being of the provider must be ensured. In the context of caregiver burden, the well-being of professional health care providers is often overlooked. Compassion fatigue (CF) results from provider exposure to suffering, and through empathetic relationships providers experience emotional strain leading to decreased compassion. Although CF has been assessed among other health care professionals, there is no discussion in the occupational therapy literature. There is a need to understand CF to decrease occupational therapy attrition, increase professional engagement, and enhance satisfaction. Thus, in this study, we aimed to examine CF among occupational therapy practitioners.

METHOD: Burnout (BO) among occupational therapy practitioners is well documented as a cause of provider attrition. CF, also associated with attrition, has not been explored within the occupational therapy profession. The purpose of this study was to conduct a scoping review to determine what is known from the current literature on the symptomology, risk factors, experience, and strategies for CF among health professionals. In our search, we used PubMed, PsycNET, CINAHL, ProQuest, and Google Scholar databases, yielding articles published from 2009 to 2014 in English. Inclusion criteria consisted of the following search terms: CF, vicarious traumatization, secondary traumatic stress, and compassion satisfaction among health care professional populations. Articles were excluded if they addressed BO, posttraumatic stress disorder, and acute stress disorder without including CF. The initial search produced 232 articles, of which 49 articles met the inclusion criteria.

RESULTS: Findings suggest that CF and BO are interrelated but are distinct concepts. Education as a means of promoting risk identification and risk reduction were common across studies. Three main themes of support were identified that could reduce or exacerbate CF: personal, professional, and organizational. Evidence-based practice was found to mitigate CF through validating clinical reasoning and increasing the practitioner’s self-efficacy.

CONCLUSION: There is a paucity of evidence documenting the prevalence of CF among occupational therapy providers. There are recognizable symptoms and strategies for prevention despite the heterogeneity of its presentation. Thus, there is a need for further research evaluating CF within the occupational therapy profession.

References

Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32. http://dx.doi.org/10.1080/1364557032000119616

Scanlan, J. N., & Still, M. (2013). Job satisfaction, burnout and turnover intention in occupational therapists working in mental health. Australian Occupational Therapy Journal, 60, 310–318. http://dx.doi.org/10.1111/1440-1630.12067