Integrative Review of Facility Interventions to Manage Compassion Fatigue in Oncology Nurses
ORIGINAL Inquiry
Describing compassion fatigue from the perspective of oncology nurses in Durban, Due south Africa
Dorien WentzelI; Anthony Collins2; Petra BrysiewiczI
ISchoolhouse of Nursing and Public Health, Nursing University of KwaZulu-Natal, Durban, South Africa
IISchoolhouse of Fine Fine art, La Trobe University, Melbourne, Australia
Correspondence
Abstruse
Groundwork: Caring for cancer patients tin can take a price on the emotional health of oncology nurses, which may lead to pity fatigue, resulting in decreased quality of nursing care, absence and decreased retentivity of staff
AIM: The aim of this study was to depict pity fatigue from the perspective of oncology nurses. This study is role of a larger mixed-methods action research written report to develop an in-facility intervention to manage compassion fatigue in oncology nurses
SETTING: This study was conducted at Durban, KwaZulu-Natal, South Africa.
METHODS: The research setting comprised one state hospital (with oncology clinics and wards), a private infirmary (with oncology wards) and a hospice in Durban, KwaZulu-Natal, S Africa. Semi-structured individual interviews (guided by Figley's Pity Fatigue Process, 2005) were conducted with eight participants. Information were analysed using manifest content assay.
RESULTS: 5 categories emerged from the data, namely, emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance.
Conclusion: The findings revealed that oncology nurses are affected emotionally in caring for their patients, thus making them decumbent to compassion fatigue. Oncology nurses need to acknowledge compassion fatigue and be able to self-reverberate on how they are managing (both positively and negatively) with the stressors encountered in the oncology wards or units.
Keywords: compassion fatigue; intervention; oncology nurses; self-care; support.
Introduction and background
Considering of prolonged and continual contact with recurrent deaths, grief and hopelessness experienced past patients and their families, the oncology nurse is at a high risk of developing pity fatigue (Coetzee & Klopper 2010; Gillespie 2013; Potter et al. 2013). Although nursing cancer patients tin provide personal and intellectual fulfilment, this tin can accept a toll on the oncology nurses' physical and emotional wellness (Gillespie 2013). The concrete and emotional demands of the patient-nurse relationship, the oncology unit, together with daily challenges of nursing patients diagnosed with cancer, tin can expose oncology nurses to severe stress (Gillespie 2013; Potter et al. 2013). Nurses commonly sympathize with patient deaths and may experience a personal sense of futility or failure in their nursing intendance (Potter et al. 2013; Slocum-Gori et al. 2011). The enduring and repeated patient losses and caring for bereaved families, together with caring for patients with life-threatening illnesses, experienced by oncology nurses predispose them to psychological stress (Gillespie 2013; Potter et al. 2013).
Pity fatigue is explained as a state of affairs of emotional fatigue stemming from encounters with compassion stress and can ascent abruptly without any warning, leaving the nurse feeling confused, secluded and helpless (Figley 2005). Figley (2005) further elaborated that pity fatigue involved obsession with patients' collective emotional and physical sufferings, which resulted in emotional stress. Figley (1995) softened the term secondary traumatic stress disorder (STSD) to the user-friendly expression pity fatigue, and associated it with compassion fatigue among health care practitioners in clinical do who are first to witness pain, suffering and distress. Compassion fatigue has frequently been referred to as the 'toll of caring' (Figley 2005). Nurses who are suffering from compassion fatigue tin can still care for their patients; however, their care may be less compassionate (Slocum-Gori et al. 2011). Symptoms of pity fatigue include physical, mental and emotional exhaustion, disconnection and depersonalisation, and isolation from peers, together with a lessened sense of personal achievement (Figley 2005). Adverse effects of compassion fatigue are an increase in staff turnover and absenteeism, a decrease in the quality of patient care, decreased patient satisfaction and patient safe, and it can accept a pregnant event on the healthcare professionals' personal life (Boyle 2011).
Management and health care practitioners are aware of the occupational stress experienced by health care practitioners; all the same, at that place is confusion concerning the formal definitions of fire out, secondary stress syndrome (secondary stress in traumatology), secondary victimisation, secondary traumatic stress, secondary survivor, pity fatigue and vicarious traumatisation (Boyle 2011; Coetzee & Klopper 2010). Pity fatigue has been proposed as a replacement for STSD; however, Coetzee and Klopper (2010) disagree, every bit they believe it does not embrace the fundamental pregnant of pity fatigue.
In South Africa, in that location is currently an increment in cancer patients and survivors and/or remission, together with an increase in HIV-related cancers, which further burdens overwhelmed oncology nurses. Because of the increment in cancer patients, in that location is an increased need for wellness intendance resource (Moten, Schafer & Ferrari 2014), including drugs, radiotherapy, hospitals, hospices, oncologists and oncology nurses. As advances in cancer treatment have increased dramatically, because each type of cancer is diverse from the other and treatment modalities are different for each type, and more patients are surviving cancer, there is a need for competent, empathetic and up-to-date nursing care (Moten et al. 2014).
The aforementioned factors exert additional pressure on oncology nurses to be able to care for their patients with compassion, which could predispose them to developing compassion fatigue (Potter et al. 2013).
Argument of research problem
Nurses in South Africa are confronted with 'unbearable workloads, poor working conditions, and lack of resources', which negatively touch on their physical and psychosocial well-being (Knobloch 2007:7). Oncology nursing is a worthwhile and gratifying profession; all the same, exposure to highly stressful incidents tin can affect psychological well-being (Zander, Hutton & King 2010). Oncology nurses are prime candidates for compassion fatigue because of their extended compassionate help to patients and their families, repeated exposure to patients experiencing trauma from the aggressive side-effects of cancer treatments and the severe symptoms experienced in the (Potter et al. 2013). This study therefore aimed at describing compassion fatigue from an oncology nurses' perspective.
Aim of the written report
The aim of this written report was to describe compassion fatigue from the perspective of oncology nurses practising in oncology departments in Durban, KwaZulu-Natal, S Africa. This study is function of a larger mixed-methods action research study to develop an in-facility intervention to manage compassion fatigue in oncology nurses in Durban, KwaZulu-Natal, South Africa.
Definitions of cardinal concepts
Compassion fatigue: It is defined as 'a state of burnout resulting from exposure to those suffering from the consequences of traumatic events' (Figley 1995:17). It is a natural issue of working with patients who are experiencing stressful events, and occurs because of the excessive energy and compassion given over a protracted time to patients who are suffering. The helpers, in offering empathy and compassion, become immersed in their patients' pain and trauma, and, in turn, become traumatised (Figley 2005).
Nurses working in oncology wards: Registered professional person nurses and nurses enrolled with the Due south African Nursing Council, with or without further oncology qualifications, who are currently employed in oncology units and wards/hospices and accept a minimum of 6 months experience in caring for oncology patients in Durban, KwaZulu-Natal.
Research methodology
This report is role of a major study that used action enquiry with a mixed-methods sequential explanatory design. An exploratory qualitative arroyo, using in-depth interviews, and manifest content analysis assisted the researchers in their exploration into compassion fatigue from the perspective of nurses working in oncology wards (Erlingsson & Brysiewicz 2017; Graneheim & Lundman 2003).
Enquiry setting and participants
This study was conducted in three settings in the Durban metropolitan area of S Africa. The settings included a hospice (not-government organisation [NGO]), oncology clinics (within a state infirmary) and oncology wards (inside state and individual hospitals). The different settings were chosen considering they reflect the medical continuum of cancer from diagnosis to death, and they represent the majority of cancer nursing care in Durban from the public and private sectors and an NGO:
-
Site 1 is a hospice (NGO) in Durban where patients receive palliative care from nurses, either in the patients' homes or in the in-patient unit of measurement.
-
Site 2 is a public-private partnership establishment in Durban, which comprises oncology clinics and v in-patient wards for oncology patients. In the clinics, patients are seen on an outpatient basis and receive chemotherapy and/or radiation therapy. In the in-patient wards, patients are admitted overnight, or for longer, and receive chemotherapy, radiation and palliative care, also as undergoing various medical and surgical procedures related to the cancer diagnosis.
-
Site 3 is a private institution for patients with private health insurance. This site has two in-patient oncology units consisting of an acute unit and a stride down/palliative unit of measurement. Both oncology units acknowledge patients for chemotherapy, radiations and palliative care.
To identify all nurses (including management) working in the oncology wards of the three settings, purposive sampling was utilised. The inclusion criteria included professional nurses (registered with 4 years of education and training) and enrolled nurses (with 2 years of general nursing education and training) with or without additional oncology/palliative care education and training; participants were selected based on results from the quantitative portion of the larger report (Wentzel & Brysiewicz 2018). The participants needed to take worked in i of the iii oncology settings for a minimum of half dozen months.
Data collection procedure
Information were collected over 5 months, from February to June 2017. Once permission was obtained from the individual institutions, communication with unit managers of the three institutions was established to discuss the purpose and objectives of the proposed study, and to request permission to access the oncology nurses. Dates and times were arranged with participants for interviews. On the request of the nurses, and with permission of the direction, interviews were conducted in a private room during protected time, which was unremarkably kept for in-service training, to ensure that patients' intendance was not affected. D.Due west. establish that the interviews revealed a keen deal about how nurses felt and their experiences of concrete and emotional fatigue in caring for cancer patients, and was able to probe for emotional and psychological stressors, protective mechanisms and resources used to manage compassion fatigue. Because of the prolonged interaction with participants, the researcher did not feel any concerns regarding the clarity of the questions posed to the participants.
Before commencement of the interviews, the researcher obtained written informed consent. Each interview, which was conducted in English language, lasted approximately 45-60 min. The interview questions were guided by the Compassion Fatigue Process (Figley 2005) and included 'What do you sympathise by compassion fatigue?' 'What emotional and psychological stresses contribute to compassion fatigue?' After interviewing eight participants and analysing the data, all three researchers concluded that redundancy and saturation of data had been reached.
Data assay
Analysis was conducted using manifest content analysis (descriptive analysis), which includes questions well-nigh who, what, when or where? (Erlingsson & Brysiewicz 2017; Graneheim & Lundman 2003). All interviews were recorded and transcribed verbatim, and a database of participants' transcripts was compiled and saved on a estimator protected by a password known only to the researchers. The data were read and re-read, then manually analysed to uncover significant units, which were so condensed, coded and grouped into specific categories (Erlingsson & Brysiewicz 2017) (see Table one).
Rigour
The researcher was guided by the 4 criteria of trustworthiness equally proposed by Guba and Lincoln (1994). By spending prolonged time with nurses working in the oncology wards for approximately 2 years, a skillful rapport was created with them. The participants were asked to be 'open and free' during the interviews to collect useful, rich and thick descriptions, thus achieving brownie. All iii researchers were involved in the information assay process, with ii of the researchers (inquiry supervisors) having expertise in qualitative inquiry and one in psychology (A.C.). Two researchers (D.West. and P.B.) independently reviewed the data, which were then discussed and verified with the codes and categories by all three researchers, thereby demonstrating confirmability. Participants also reviewed the categories and agreed that they were a true representation of their descriptions or perceptions. Participants did not propose any changes, thereby confirming the findings. The researcher provided a detailed methodological description, and an audit trail was used to constitute dependability (Guba & Lincoln 1994). To address transferability, the researcher strove to provide thick descriptions to let the reader to make up one's mind if these study findings could exist transferred to their own setting (Shenton 2004).
Ethical considerations
The inquiry commenced subsequently receiving ethical clearance from the University Ethics Committee (BF140/xiv), from the three institutions (state and individual), from the KwaZulu-Natal Department of Health Research Unit and from Hospice Palliative Care Clan of South Africa. The research could maybe evoke recalling of emotionally deplorable incidents, so the researcher (D.W.) negotiated with the employee assistance programmes at the three settings regarding support available for participants who may need referral; three participants were referred. Prior to each interview, the aim of this study was explained, and using a participant data sheet written informed consent was obtained. Permission to audio-record the interview was obtained from the participants. Participants were bodacious that participation was voluntary and that they could withdraw from the written report with no repercussions. In guild to ensure that the information obtained cannot be traced back to the participants, pseudonyms were used to ensure confidentiality.
Findings
Participant demographics
All the participants were females, aged between 21 and 57 years (average age of 37 years), with between 2 and 27 years of work experience in oncology wards. Participants' qualifications included 2 enrolled nurses on twenty-four hours duty, 1 professional nurse on night duty and two professional nurses on day duty, and three unit managers of oncology units. 2 participants had an added oncology qualification and one participant had a palliative care qualification.
V categories emerged from the data, namely, emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance.
Emotional connection
Considering of the long and extensive nature of the management of cancer, patients spend a lot of time in the health care facilities receiving chemotherapy, radiation, surgery and care for complications. These prolonged and recurrent visits to health care facilities foster proficient and reciprocal relationships with oncology nurses. Excerpts from oncology nurses reinforced the close emotional relationship formed betwixt nurses and their patients:
'We have patients who have been with u.s. for so long, they get part of your family.' (Reshma, female, 36 years quondam)
'You lot build a relationship with them, yous know them and they know about your family.' (Jane, female, 23 years one-time)
'Nosotros have relationships with the family … we are part of the family unit.' (Sweetlips, female, 35 years old)
'You get to know your patients; we become so shut to patients.' (Rajayshri, female person, 46 years old)
The participants went on further to describe:
' … [T]hey pitter-patter into your heart.' (Veronica, female, 57 years onetime)
'Children take a fashion of creeping into your heart.' (Candidate 10, female, 45 years old)
Emotional fatigue
All the participants described feeling extremely tired. However, the tiredness was not simply physical tiredness but also emotional tiredness.
One participant illustrated this:
'It's tiredness … just not concrete as such … merely it's emotional and mental.' (Sweetlips, female person, 35 years old)
Sumeshni (female person, 33years old) explained further:
'Fatigue from within … from caring.'
Thoba (female, 33 years old) reinforced:
'So that'southward the fatigue nosotros experience fatigue from within … from caring.'
Lauren (female, 29 years old) echoed this past explaining how she became physically and emotionally involved in caring for her patients:
'Giving my all for the patients … encountering feeling for them.'
Emotional loss
Participants described the deep personal loss they felt later on the death of their cancer patients. They elaborated how they experienced this emotional loss.
Two participants stated:
'If they [the patient] have to pass on … it takes a bit of yous … it takes a small-scale slice of yous.' (Charlene, female, 51 years old)
'When nosotros lose a patient … especially one that has been with us a long time … nosotros do become affected … it's kept in your heed.' (Sumeshni, female person, 33 years old)
Sasha (female, 21 years old) explained what this did to her:
'It takes also much out of yous.'
Blurring boundaries
Participants agreed it was difficult not to take 'their patients and their work' domicile with them, and they had difficulty in separating their professional and personal lives as it was 'not easy to switch off'.
Devi (female, 41 years old) said:
'It takes cost on your personal life.'
Some other elaborated:
'When you lot get home, you go home with the stuff that is happening at the infirmary, you worry nearly the patients … non easy to switch off.' (Sweetlips, female person, 35 years erstwhile)
Another participant depicted her difficulty in separating her professional and personal life:
'I try not to have also much with me … I too try to separate the two … but you can't cutting completely.' (Thoba, female, 33 years erstwhile)
Lauren (female, 29 years old) explained how this affected her and resulted in a lack of empathy at abode:
'I'm not as empathetic in my home life as I could exist … because my listen is ongoing with the problems that I accept had at work.'
Credence
Despite the inevitably of the patients' outcomes, participants placated themselves that they had to accept that 'life must go on' and they should 'movement on':
'We are and then used to everything that happens … at the back of my head, I knew that this would happen.' (Thoba, female, 33 years former)
'I'thou at that stage of credence, that it was inevitable … kind of pacified myself in saying that this patient is no longer suffering.' (Sasha, female, 21 years old)
'So what must be, must be … this is the nature of our job.' (Lauren, female person, 29 years onetime)
Participants admitted that over time, the deaths of their patents forced them to become stronger and to come to terms with the reality, which prepared them for the next death:
'In time, it makes you grow, you lot learn from previous [deaths] and you grow. You acquire from it … and yous talk about it … and y'all Have to move on … It makes you learn and grow and helps you for the next one … that'due south how we cope.' (Devi, female, 41 years one-time)
'It [deaths] makes you stronger.' (Charlene, female, 51 years old)
Discussion
This written report described compassion fatigue from oncology nurses' perspectives. Categories that emerged from the data included emotional connection, emotional fatigue, emotional loss, blurring boundaries and acceptance.
Considering of the numerous hospitalisations, oncology nurses take increased opportunities to develop empathetic connections and trust with their patients (Rohani, Kesbakhi & Mohtashami 2018). Listening empathetically to their patients promotes patients' self-disclosure, which improves emotional connexion and ultimately patient outcomes (Rohani et al. 2018). Participants spoke positively about forming emotional connections with their patients. Wittenberg-Lyles, Goldsmith and Reno (2014) and Boyle (2011) noted that emotional connections can develop when staff feel close emotional attachments to patients, and this can pb to over-identification with the patient without foreseeing the emotional consequences.
Maja (2016) concurs with this study's findings that nurses, reportedly overwhelmed by emotional burdens and the deaths of patients, described themselves as feeling physically and emotionally wearied, expressing information technology every bit 'fatigue from within'. Researchers suggest that this emotional exhaustion experienced past oncology nurses tin progress to emotional fatigue and distress (Barbour 2016; Leung et al. 2012). One protective mechanism oncology nurses could develop to overcome feelings of helplessness and the inability to assist patients during their traumatic incidents is self-compassion and self-kindness. Self-compassion is associated with positive psychological traits (namely, well-existence and emotional intelligence) and could promote resilience in oncology nurses and have an influence on patient satisfaction (Duarte & Pinot-Gouveia 2017). Wolf et al. (2015) propose that this deep emotional fatigue is a form of unacknowledged moral distress.
Participants described the feelings of deep personal loss following the death of their oncology patients, expressing it as 'information technology takes a bit of y'all'. Slocum-Gori et al. (2011) concur that nurses who are unable to assist their dying patients ofttimes experience loss of cocky. This emotional loss can result in nurses harbouring a sense of distress and anxiety, with the consequent emotional turmoil that can lead to loss of self-efficacy, loss of self professionally and loss of self personally (Duarte & Gouveia 2017). Because of the traumatic nature of caring for cancer patients, oncology nurses frequently have negative and intrusive thoughts, and in an attempt to cope with these thoughts, they resort to detachment and avoidance strategies to reduce the issue of hard internal experiences - a response pattern referred to as psychological inflexibility (Duarte & Pinto-Gouveia 2017). Although providing short-term relief, psychological inflexibility could become psychologically maladaptive (Duarte & Pinto-Gouveia 2017). Information technology is important to note that distancing and de-personalisation from the emotional requirements of patients lead to a lack of empathy in caring, which eventually increases the take chances of developing compassion fatigue (Maja 2016). Boyle (2011) describes this emotional disconnection every bit a response nurses utilize to cope with emotional attachments to patients. Contrary to the findings in this current study, it is noted that repeated and constant exposure to misfortune renders some nurses unable to disassemble from their patients. Disengagement and over-identification stand for 2 extremes in coping responses that oncology nurses may use; however, this also highlights the tension the oncology nurse must deal with, namely, is there a take a chance of over-identifying with the patient or does one prevent oneself from over-identifying? Oncology nurses often feel helpless and vulnerable, and resort to self-blame when they witness patients in intractable pain, or when patients die (Maja 2016). Nolte et al. (2017) explain the notion of loss of self every bit encompassing feelings of emotional disablement and isolation, coupled with a sense of professional and personal failure. A suggestion for coping with loss of self is to promote psychological flexibility - the power to encompass the negative experiences (Duarte & Pinto-Gouveia 2017). Oncology nurses who display psychological flexibility are concerned nearly their patients' suffering and are able to encompass negative experiences associated with seeing their patients' distress (Duarte & Pinto-Gouveia 2017).
Wittenberg-Lyles et al. (2014) support this study's findings that emotional stressors encountered at piece of work are often relived at home, influencing personal relationships and resulting in sleeplessness and fatigue. Maja (2016) suggests that over-identifying with a patient reduces nurses' ability to balance their professional and personal life. Kushnir Talma, Stanley and Azulai (1997) country that long hours at work, coupled with the disability to ready professional and personal boundaries, cause emotional exhaustion in oncology nurses. Leung et al. (2012) reiterate the importance of being able to delineate 1's professional and personal boundaries to cope with existential concerns encountered in the care of cancer patients, and maintaining a professional boundary may help oncology nurses to develop empathy with their patients' distress.
Participants described the inevitable outcome for their patients by voicing 'life must become on'. Flarity et al. (2013) stated that nurses are motivated to exist emotionally strong to project a professional person image of being able to cope with whatever situations they may see. This imposed motivation to adhere to hospital culture and display stoicism could exacerbate the development of compassion fatigue (Brint 2017; Flarity et al. 2013). Participants acknowledged that the deaths of their patients compelled them to come to terms with information technology and motility on. Contrary to the study'southward findings, Kubler-Ross (1969) proposed that part of the acceptance process is to remember, internalise and come up to terms with patients' diagnoses and eventual death.
Limitations
The limitations of this study were that all the participants were female, it was conducted in only three settings in Durban and the researcher was known to some of the participants, which may take influenced them to provide socially acceptable answers.
Determination
Because of the numerous physical and emotional demands of nursing cancer patients, there is currently business concern regarding oncology nurses potentially succumbing to psychological stress, thereby putting themselves at risk of developing compassion fatigue. Nurses working in oncology wards described compassion fatigue, the stresses encountered in these settings, emotional connections, emotional fatigue, emotional loss, blurring of boundaries and acceptance while nursing oncology patients. The findings from this written report back up the fact that oncology nurses are affected in many ways when caring for their patients, making them prone to compassion fatigue.
Recommendations
This study's findings demonstrated the need to equip nurses working in oncology wards with the necessary knowledge and skills to recognise and manage pity fatigue and burn out. Institutions should provide regular professional educational programmes to assistance nurses to cope with the emotional demands of nursing. Institutional management should exist aware of the possibility of their oncology nurses developing pity fatigue, and policies, guidelines and strategies should be in place to offering psychological support to oncology nurses.
Acknowledgements
Competing interests
The authors have alleged that no competing interests exist.
Authors' contributions
D.W., P.B. and A.C. were responsible for the study conception and design, analysis, drafting of the article and disquisitional revision of the intellectual content. D.Due west. and P.B. were responsible for data drove.
Funding data
This publication was made possible through grant number R24TW008863 from the Office of the US Global AIDS Coordinator and the United states Department of Health and Human Services, National Institutes of Health (NIH OAR and NIH ORWH). Its contents are solely the responsibleness of the authors and do not necessarily represent the official views of the government.
Information availability statement
The data that support the findings of this study are available from the corresponding author, upon reasonable request.
Disclaimer
The views expressed in this article are the researchers' own and not an official position of the institution or the funder.
References
Barbour, L.C., 2016, 'Exploring oncology nurses' grief: A cocky-written report', Asia Pacific Journal of Oncology Nursing 3(3), 233-240. https://doi.org/x.4103/2347-5625.189817 [ Links ]
Boyle, D.A., 2011, 'Countering pity fatigue: A requisite nursing calendar', The Online Journal of Bug in Nursing 16(1), 2. https://doi.org/x.3912/OJIN.Vol16No01Man02 [ Links ]
Brint, S., 2017, 'Obligated to care: A personal narrative of compassion fatigue in an oncology nurse', Journal of Holistic Nursing American Holistic Nurses 35(3), 296-309. https://journals.sagepub.com/doi/abs/10.1177/0898010116661391. [ Links ]
Coetzee, S.Thou. & Klopper, H.C., 2010, 'Compassion fatigue within nursing practice: A concept analysis', Nursing and Health Sciences 12(2), 235-243. https://doi.org/x.1111/j.1442-2018.2010.00526.x [ Links ]
Duarte, J. & Pinto-Gouveia, J., 2017, 'The office of psychological factors in oncology nurses' burnout and compassion fatigue symptoms', European Periodical of Oncology Nursing 28, 114-121. https://doi.org/x.1016/j.ejon.2017.04.002 [ Links ]
Erlingsson, C. & Brysiewicz, P., 2017, 'A hands-on guide to doing content analysis', African Periodical of Emergency Medicine 7(iii), 93-99. https://doi.org/ten.1016/j.afjem.2017.08.001 [ Links ]
Figley, C.R., 1995, Compassion fatigue coping with secondary traumatic stress disorder in those who care for the traumatized, Brunner Mazel, New York. [ Links ]
Figley, C.R., 2005, 'Compassion fatigue: An expert interview with Charles R. Figley, Medscape, pp. 1-5, viewed 05 July 2012, from https://www.medscape.com/viewarticle/513615. [ Links ]
Flarity, J., Larity, J., Gentry, E. & Mesnikoff, Due north., 2013, 'The effectiveness of an educational plan on preventing and treating compassion fatigue in emergency nurses', Advanced Emergency Nursing Periodical 35(3), 247-258. https://doi.org/10.1097/TME.0b013e31829b726f [ Links ]
Gillespie, M.R., 2013, 'Compassion fatigue and cancer nurses: A national survey of cancer nurses in New Zealand', Master'due south dissertation, Eastern Institute of Technology, Taradale, New Zealand, viewed 05 March 2014, from https://repository.digitalnz.org. [ Links ]
Graneheim, U.H. & Lundman, B., 2003, 'Qualitative content assay in nursing inquiry: Concepts, procedures and measures to achieve trustworthiness', Nurse Education Today 24(ii), 105-112. https://doi.org/10.1016/j.nedt.2003.10.001 [ Links ]
Guba, E.G. & Lincoln, Y.Southward., 1994, 'Competing paradigms in qualitative inquiry', in North.K. Denzin & Y.S. Lincoln (eds.), Handbook of qualitative research, pp. 105-117, Sage Thousand Oaks, CA. [ Links ]
Knobloch, Due south., 2007, 'Compassion fatigue within the nursing profession: A concept analysis', Thesis dissertation, North West Academy, Potchefstroom, South Africa. [ Links ]
Kubler-Ross, Eastward., 1969, On decease and dying, Macmillan, New York. [ Links ]
Kushnir, T. Rabin, S. & Sima, A., 1997, 'A descriptive study of stress management in a group of pediatric oncology nurses', Cancer Nursing 20(6), 414-421. https://journals.lww.com/cancernursingonline/toc/1997/12000. [ Links ]
Leung, D., Fillion, L., Duval, S., Brown, J. & Howell, D., 2012, 'Significant in bone marrow transplant nurses' piece of work: Experiences before and after a "meaning-centered" intervention', Cancer Nursing 35(5), 374-381. https://doi.org/x.1097/NCC.0b013e318232e237 [ Links ]
Maja, B.K., 2016, 'Exploring palliative caregivers' experiences of pity fatigue in a hospice', Dissertation, University of South Africa, UNISA, Pretoria, viewed 03 November 2018, from https://hdl.handle.internet/10500/22291. [ Links ]
Moten, A., Schafer, D. & Ferrari, M., 2014, 'Redefining global health priorities: Improving cancer intendance in developing settings', Journal of Global Health 4(ane), 010304. https://doi.org/10.7189/jogh.04.010304 [ Links ]
Nolte, A., Downing, C., Temane, A. & Hastings-Tolsma, M., 2017, 'Pity fatigue in nurses: A metasynthesis', Journal of Clinical Nursing 26(23), 4364-4378. https://doi.org/10.1111/jocn.13766 [ Links ]
Potter, P., Deshields, T., Berger, J., Clarke, M., Olsen, South. & Chen, I., 2013, 'Evaluation of a compassion fatigue resiliency program for oncology nurses', Oncology Nursing Forum 40(two), 180-187. https://doi.org/x.1188/13.ONF.180-187 [ Links ]
Rohani, C., Kesbakhi, One thousand.S. & Mohtashami, J., 2018, 'Clinical empathy with cancer patients: A content analysis of oncology nurses' perception', Patient Adopt Adherence 12, 1089-1098. https://doi.org/10.2147/PPA.S156441 [ Links ]
Shenton, A., 2004, 'Strategies for ensuring trustworthiness in qualitative research projects', Education for Information 22(2), 63-75. https://doi.org/10.3233/EFI-2004-22201 [ Links ]
Slocum-Gori, S., Hemsworth, D., Chan, West.Y., Carson, A. & Kazanjian, A., 2011, 'Agreement pity satisfaction, compassion fatigue and exhaustion: A survey of the hospice palliative care workforce', Palliative Medicine 27(ii), 172-178. https://doi.org/10.1177/0269216311431311 [ Links ]
Wentzel, D.L. & Brysiewicz, P., 2018, 'A survey of pity satisfaction, burnout and compassion fatigue in nurses practicing in iii oncology departments in Durban, South Africa', International Journal of African Nursing Sciences viii(one), 82-86. https://doi.org/ten.1016/j.ijans.2018.03.004 [ Links ]
Wittenberg-Lyles, E., Goldsmith, J.5. & Reno, J.E., 2014, 'Perceived benefits and challenges of an oncology nurse support group', Clinical Journal of Oncology Nursing 18(four), E71-E76. https://doi.org/10.1188/xiv.CJON.E71-E7 [ Links ]
Wolf, L.A., Perhats, C., Delao, A.Grand., Moon, D., Clark, P.R. & Zavotsky, M.E., 2015, '"It's a burden y'all bear." Describing moral distress in emergency nursing', Periodical of Emergency Nursing 42(one), 37-46. https://doi.org/10.1016/j.jen.2015.08.008 [ Links ]
Zander, M., Hutton, A. & Rex, I., 2010, 'Coping and resilience factors in pediatric oncology nurses', Journal of Pediatric Oncology 27(ii), 94-108. https://doi.org/ten.1177/1043454209350154 [ Links ]
Dorien Wentzel
wentzel@ukzn.ac.za
Received: 11 December. 2018
Accepted: 18 July 2019
Published: 15 Oct. 2019
Source: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362019000100039&lng=en&nrm=iso&tlng=en
0 Response to "Integrative Review of Facility Interventions to Manage Compassion Fatigue in Oncology Nurses"
Post a Comment