Search Results (140)

Background: Critical care nurses are frequently exposed to traumatic clinical events and occupational stress, increasing the risk of post-traumatic stress disorder (PTSD), compassion fatigue, and compromised psychological well-being. However, the interrelationships among these variables in Saudi Arabia remain unclear. This study investigated the associations between PTSD symptoms, compassion fatigue, and psychological well-being among critical care nurses. Methods: A descriptive cross-sectional study was conducted between October and December 2025 with 210 critical care nurses from the Eastern and Riyadh regions of Saudi Arabia. Data were collected using the PTSD Checklist for DSM-5 (PCL-5), the Professional Quality of Life Scale, and the WHO-5 Well-Being Index. Data analysis included descriptive statistics, t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and multiple linear regression. Results: The mean PCL-5 score was 27.44, with 38.1% of participants meeting the cutoff for probable PTSD. Compassion fatigue was moderate. The mean WHO-5 score was 54.60, indicating moderate well-being, though a substantial proportion reported poor well-being. Psychological well-being was negatively correlated with both PTSD symptoms and compassion fatigue, while PTSD symptoms were strongly positively correlated with compassion fatigue. Both PTSD and compassion fatigue independently predicted lower well-being, explaining 21% of the variance. Sociodemographic variables were not significant predictors after adjustment. Conclusions: Critical care nurses experience moderate PTSD symptoms and compassion fatigue, adversely affecting psychological well-being. These findings underscore the interconnected nature of trauma-related distress and professional quality of life, highlighting the need for routine psychological screening, trauma-informed support, and resilience-focused interventions. Full article

Background: Healthcare professionals are exposed to high emotional demands, including repeated contact with suffering, death, moral distress, and organizational pressure. These factors are associated with psychological distress, burnout, and secondary traumatic stress. Expressive Writing (EW) has been proposed as a psychological intervention, but evidence of its effectiveness among healthcare professionals remains heterogeneous. Objectives: To examine the effects of EW on psychological health, psychophysical well-being, and professional satisfaction among healthcare professionals. Methods: A systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA 2020 guidelines. Searches were performed in PubMed, CINAHL, CENRAL, CENTRAL Scopus, Embase, and PsycINFO from database inception to January 2025. Quantitative studies involving healthcare professionals and evaluating structured expressive writing interventions were considered for inclusion, including randomized and non-randomized, controlled and uncontrolled designs. Studies reporting psychological, psychophysical, or work-related outcomes were eligible. Only full-text articles published in English or Italian were considered. The review protocol was registered and archived in the Open Science Framework. Methodological quality was assessed using CASP checklists, the RoB 2 tool, and the Newcastle–Ottawa Scale. Results: Seven studies published between 2017 and 2023 were included. EW interventions were associated with reductions in psychological distress, particularly perceived stress, depressive symptoms, and post-traumatic stress symptoms. Findings regarding burnout and compassion fatigue were mixed. Organizational and job-related outcomes, such as job satisfaction and organizational commitment, showed limited and heterogeneous improvements. No consistent effects were observed for resilience or social support. Overall, the methodological quality of the included studies was generally good. Conclusions: EW appears to be a promising, low-cost intervention for reducing psychological distress among healthcare professionals. However, heterogeneity in study designs, intervention protocols, and outcome measures limits the strength of the evidence. Further high-quality, controlled studies using standardized EW protocols are needed. Full article

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long COVID (LC) are complex multisystem conditions with significant functional disability. Many patients experience symptoms of orthostatic intolerance, which can be captured in some cases as Orthostatic Hypotension (OH) or Postural orthostatic Tachycardia Syndrome (PoTS) on objective testing. Conservative treatments are recommended for first-line symptom management, but there is a lack of efficacy evidence. This study aims to assess the feasibility of an 8-week clinically supervised, personalised Dysautonomia Management Protocol (DMP) in a cohort of ME/CFS and LC patients with subjective and objective evidence of orthostatic intolerance (dysautonomia). Methods: ME/CFS and LC patients with objective dysautonomia on the 10 min active Lean Test (LT) were recruited to an 8-week DMP, with interventions introduced cumulatively every two weeks. Interventions included increasing daily fluid intake to 3 litres and salt intake to 10 g, pacing to avoid crashes and calf activation. Baseline and weekly data collection included the LT, Composite Autonomic Symptom Score questionnaire (COMPASS-31) and Yorkshire Rehabilitation Scale (YRS). Results: Sixteen participants completed the 8-week program, five discontinued during the program, and one was withdrawn following a severe crash. The COMPASS-31 improved by 7.7 points from week 1 to week 8 (p = 0.045), with a medium Cohen’s d effect size of 0.55. For the same period, there was a non-significant (p = 0.16) improvement in the YRS symptom severity score by 2 points. Comparing the final two weeks of the program with the first two weeks, mean heart rate during the LT decreased by 4.8 beats per minute (p = 0.032), with a medium Cohen’s d effect size of 0.44. Adherence to the interventions was highly variable, with none of the patients able to fully employ all four recommendations. Conclusions: The results suggest that targeted conservative interventions could influence autonomic function and symptom reduction. However, the magnitude of change was limited, and statistical significance might not necessarily relate to a clinically significant improvement in symptoms. Full article

Given the critical role of national authorities in the asylum process, sociolinguistic research on inequalities in narrative assessment has prioritised the high-stakes hearings within the official process. It is, however, also crucial to analyse how non-state actors play a central role in asylum bureaucracies. Accordingly, this article focuses on “helping encounters” with social workers, guardians and lawyers on the “backstage side” of the asylum procedure. Drawing on linguistic-ethnographic fieldwork data in the form of participant observation, interviews and audio-recordings, the article reveals striking parallels between the interactional conditions of different social work settings in which service providers familiarise applicants with narrative expectations. Bureaucratic ideologies permeate these environments where mutual trust is indispensable, and applicant/practitioner relationships risk being compromised as a result. This culminates in “compassion fatigue”, a tension between service providers’ frustrations with procedural constraints and their sincere desire for the applicant to succeed. Social workers, limited by the legal boundaries of the system they operate in, can be seen mimicking officials’ interrogation-like style to reanimate the asylum authorities’ judicial reasoning. In this way, they (unintentionally) reproduce the frontstage “culture of disbelief” in the “trusting” backstage. Full article

Background/Objectives: University faculty in health sciences are an underexplored population despite facing significant emotional, occupational, and organizational demands due to their dual role as educators and health professionals. These demands may increase vulnerability to perceived stress, burnout, and reduced professional quality of life. Although previous research has primarily focused on stress and burnout, evidence integrating occupational balance and personal resources, such as sense of coherence, from an occupational health perspective remains limited. This study aimed to examine perceived stress, professional quality of life, occupational balance, and satisfaction with meaningful occupations among health sciences faculty in Spain, and to analyze their associations with individual, occupational, and organizational factors within an occupation-centered and salutogenic framework. Methods: A cross-sectional observational study following STROBE guidelines was conducted with 253 health sciences faculty members from Spanish universities. Data were collected through an anonymous online questionnaire including validated instruments (PSS-10, OBQ-E, ProQoL, SOC-13) and items on occupational satisfaction and perceived institutional support. Descriptive statistics, t tests, one-way ANOVA, and Pearson correlation analyses were performed. Results: Participants reported moderate levels of perceived stress and occupational balance, high overall professional quality of life satisfaction, and moderate levels of compassion fatigue. Higher perceived stress scores were observed among women and younger faculty members. Occupational balance, burnout, and satisfaction measures showed significant differences according to age and years of teaching experience. Perceived institutional support differed across organizational domains, academic positions, and types of institution. Conclusions: Health sciences faculty in Spain experience notable psychosocial demands affecting stress, occupational balance, and professional quality of life. Occupational balance and sense of coherence emerged as relevant constructs associated with lower perceived stress and burnout and higher professional satisfaction. By integrating these occupation-centered and salutogenic resources, the study extends existing research beyond traditional stress–burnout models and contributes to a more comprehensive understanding of professional well-being among health sciences faculty. Full article

Background/Objectives: In recent years, quiet quitting has attracted increasing attention in nursing research and is conceptualized as a phenomenon in which nurses perform their professional duties at a minimal level without physically leaving their jobs. This study aimed to adapt the Quiet Quitting Scale into Turkish, evaluate its psychometric properties, and examine the relationships between stress of conscience, compassion fatigue, and quiet quitting among nurses. Methods: This is a descriptive, correlational, and methodological study. This study was conducted between 20 February and March 2025 with the participation of 205 nurses working in a university hospital in Turkey. The data were collected using the Nurse Descriptive Information Form, Stress of Conscience Questionnaire, Compassion Fatigue-Short Scale, and Quiet Quitting Scale. Results: The results indicated positive associations between stress of conscience, compassion fatigue, and quiet quitting. Mediation analysis revealed that compassion fatigue had a significant indirect effect on the association between stress of conscience and quiet quitting, while the direct relationship remained significant, suggesting partial mediation. Conclusions: These findings highlight the importance of supportive work environments where nurses can address ethical concerns and access interventions aimed at preventing compassion fatigue. Organizational strategies that promote psychological well-being may help sustain nurses’ work engagement and reduce quiet quitting. Full article

Background/Objectives: Professional quality of life influences patient care, staff well-being, and organizational efficacy. The COVID-19 pandemic placed pressure on healthcare professionals, disrupting their professional quality of life and imposing a psychological burden. In Greece, these issues were intensified by a decade of economic crisis, marked by constrained healthcare budget, personnel shortages, and insufficient resources. This study investigates the pandemic’s impact on the professional quality of life of Greek healthcare professionals to support targeted interventions. Methods: A cross-sectional study was conducted using descriptive statistics. The participants were a convenience sample of 246 healthcare professionals from a Greek regional university hospital with at least one year of experience and who had worked with COVID-19-positive or potentially exposed but asymptomatic patients. Data were collected between March and June 2021 using the Professional Quality of Life Scale (version 5). Results: Of the 246 participants, 81.3% were women and 33.8% were aged 50 or older. Moderate concern and fear regarding COVID-19 were reported, with 34.6% extremely afraid of transmitting the virus to family or friends and 22.8% to patients or their families. Overall professional quality of life was moderate: compassion satisfaction was moderate to high, while burnout and secondary traumatic stress were moderate to low. Higher compassion satisfaction was linked to holding a position of responsibility. Burnout was associated with having children, permanent employment, years of experience, and increased pandemic-related fear. Higher secondary traumatic stress was associated with older age, more years of experience, and greater pandemic-related fear. Conclusions: These findings support international research and highlight that the moderate levels observed indicate intrinsic motivation based on professionalism in patient care, providing evidence of resilience and coping mechanisms that reduce psychological consequences on well-being due to the pandemic. Full article

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Russia’s 2022 invasion precipitated one of Europe’s largest episodes of forced academic mobility, compelling universities to shift from emergency access to durable inclusion. This article investigates how Ukrainian students are integrated into Romanian higher education through a qualitative case study at Ovidius University of Constanta, undertaken within the Erasmus+ EIUS project. We analysed a participatory focus-group workshop (“Building Bridges,” May 2024) involving 72 participants (15 Ukrainian students, 31 Romanian students, 26 academic staff). Transcripts were coded via reflexive thematic analysis and interpreted through a SWOT lens to connect lived experience with institutional strategy. Findings indicate that integration generates tangible pedagogical and social value—diversity enriches coursework, empathy strengthens peer collaboration, and exposure to multilingual classrooms catalyses instructional innovation. Yet systemic fragilities persist: language anxiety (“translation silence”), fragmented support pathways, and limited access to counselling shift emotional labour onto faculty and peers. Opportunities cluster around Erasmus+ infrastructures, bilingual materials, and co-created projects that transform access into participation; threats include latent prejudice, social isolation, compassion fatigue, and policy discontinuity as crisis attention wanes. We advance the concept of institutionalised solidarity—a multi-level inclusion model that couples emotional infrastructures (mentoring, trauma-informed pedagogy, counselling) with organizational infrastructures (integration offices, linguistic scaffolding, adaptive assessment). The study contributes an empirically grounded framework for moving from humanitarian reaction to sustainable academic inclusion and offers actionable guidance for European universities seeking resilience under protracted disruption. Full article

Background/Objectives: Nursing professionals were among the most affected groups during the COVID-19 pandemic, exposed to simultaneous physical demands and emotional strain. This study examined the interplay between work engagement, compassion fatigue, and musculoskeletal symptoms among frontline nurses in a Brazilian public hospital. Methods: A cross-sectional study (n = 77) was conducted between February and April 2022 using validated instruments (Work Stress Scale, ProQoL-BR, Nordic Musculoskeletal Questionnaire, and UWES-9). Descriptive and inferential analyses were performed (p ≤ 0.05). Results: Most participants did not report occupational stress (84.4%). No profiles of compassion fatigue were identified, although notable rates of burnout (26.0%) and secondary traumatic stress (23.4%) were observed. Engagement scores were very high in vigor and dedication. Musculoskeletal symptoms were prevalent, especially in the lumbar region (chronic: 60.0%). Female sex, statutory employment, and lack of physical activity were associated with a higher prevalence of symptoms and sick leave. Work engagement (vigor and overall score) showed negative correlations with absenteeism. Conclusions: The coexistence of high engagement and emotional vulnerability, in the absence of compassion fatigue, suggests that higher levels of engagement may be associated with lower occupational stress. These findings highlight the importance of integrated strategies, including ergonomic interventions, health promotion, and organizational support, to preserve the physical and mental health of frontline nursing professionals. This study provides new evidence of engagement as a potential protective factor that may mitigate physical and emotional burden among nurses in resource-limited settings. Full article

Background/Objectives: Nurses and nursing technicians are essential providers of patient care but remain highly vulnerable due to the demands of their profession, which can profoundly affect their professional quality of life. Understanding the risk and protective factors underlying different aspects of professional quality of life is crucial for fostering healthcare professionals’ overall well-being and ensuring high-quality care for patients. The aim of this study was to explore the relationships between professional quality of life, work-related factors, PTSD symptomatology and individual resources, including resilience and coping strategies. Methods: This cross-sectional study included 119 nurses from various nursing departments. A questionnaire comprising sociodemographic and work-related variables and four validated instruments, Professional Quality of Life Scale-5 (ProQOL-5), PTSD Checklist for DSM-5 (PCL-5), Brief-COPE and Brief Resilience Scale, was used for data collection. Results: Findings revealed moderate to high compassion satisfaction among nurses and technicians, as well as low to moderate burnout and moderate levels of secondary traumatic stress. Compassion satisfaction was positively associated with problem-focused and emotion-focused coping, whereas higher levels of compassion fatigue (burnout and secondary traumatic stress) were associated with avoidant coping, greater PTSD symptom severity, and lower resilience. Resilience, problem-focused coping, and PTSD symptom severity were identified as significant predictors of professional quality of life. Conclusions: To support nurses’ and technicians’ well-being, healthcare organizations should encourage open conversations about the emotional demands of patient care and provide interventions that promote effective coping and address PTSD symptoms, ultimately helping to reduce compassion fatigue and enhance compassion satisfaction. Full article

Vicarious Posttraumatic Growth (VPTG) is a critical yet underexplored phenomenon among trauma-focused helping professionals. While secondary trauma (ST), compassion fatigue, and burnout are widely recognized negative aspects of working with trauma survivors, less is known about the potential benefits of this work and its contributions to well-being. This qualitative study explored peer-support specialists’ perceptions of growth arising from indirect exposure to trauma and examined how these experiences relate to well-being. Using interpretative phenomenological analysis, researchers conducted semi-structured interviews with 13 participants, independently coded transcripts, and developed themes through consensus. Findings suggest VPTG may follow a similar path to Posttraumatic Growth (PTG), with participants reporting challenges to core beliefs, emotional distress, and transformative cognitive-emotional shifts that facilitated growth across domains that appear to mirror the five PTG domains. Outcomes of working with trauma survivors extended beyond the PTG domains to include compassion satisfaction, hope, expanded coping skills, and improved mental health. Taken together, these findings illustrate the participants’ subjective experiences of both challenge and transformation through their work with trauma survivors, offering preliminary insight into how indirect trauma exposure may contribute to VPTG and well-being. Full article

Background: Compassion fatigue (CF) is a state of emotional and physical exhaustion in the caregiving relationship, which can negatively impact patient safety and quality of care. Maternity care professionals are particularly vulnerable to CF due to their continuous empathetic engagement with patients in an unpredictable, high-stress work environment. Despite its significance, research on CF in maternity care is limited. The aim of this study is to explore experiences of CF among maternity care professionals. Methods: A thematic analysis of semi-structured in-depth interviews was conducted. The sample consisted of seven midwives and three gynecologists from different hospitals and outpatient care in Flanders (Belgium). Results: Experiences, risk factors and protective factors were identified as three organizing themes and further refined into 12 subthemes. Participants showed limited familiarity with the term CF but recognized its symptoms, including emotional exhaustion, reduced empathy, and a diminished ability to provide care, ‘as one normally would’. Key risk factors included high workload, emotional strain from ‘energy-consuming’ patients, fear of errors, and administrative burden. A supportive team environment, compassion satisfaction (CS), job autonomy and personal coping skills were identified as protective factors. Participants emphasized the need to recognize and address signals of CF. Conclusions: CF among maternity care professionals is underrecognized but appears to impact both caregiver well-being and patient care quality. Interventions should target awareness, team communication, psychological safety, and organizational context. A multilevel approach—combining individual, team, and systemic strategies—is needed to sustainably mitigate CF in maternity care. Full article

Compassion fatigue is a widely recognized phenomenon in human care settings, but it has been little explored in the veterinary field, despite sharing many of the same determinants. This study aimed to (1) identify distinct emotional risk profiles in veterinarians based on their levels of compassion fatigue and satisfaction; (2) estimate the relative prevalence of compassion fatigue in each of these profiles; and (3) analyze the predictive value of sociodemographic variables (gender, age, cohabitation) on belonging to these profiles. A cross-sectional study was conducted with 135 practising veterinarians. An abbreviated version of the ProQOL scale, adapted to the animal context, was used. Its two-dimensional structure (compassion fatigue and satisfaction) was validated using confirmatory factor analysis. Hierarchical cluster and k-means analyses were performed on the factor scores, which identified four emotional profiles: (1) intense emotional involvement, (2) emotional detachment, (3) functional distancing, and (4) high emotional risk. The latter grouped 23% of the sample, while 50.4% presented significant levels of emotional exhaustion. Finally, an ordinal regression was applied, which showed that being over 44 years of age (OR = 2.11) and living with a partner (OR = 1.94) increase perceived emotional risk, with no significant effects of gender. The findings highlight the need for training initiatives that enhance emotional regulation and communication with animal guardians or owners, while promoting sustainable, ethically responsible, and emotionally healthy professional practice. Full article

Background/Objectives: Symptoms of autonomic dysfunction are common in infection-associated chronic conditions and illnesses (IACCIs), including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This study aimed to evaluate autonomic symptoms and their impact on ME/CFS illness severity. Methods: Data came from a multi-site study conducted in seven ME/CFS specialty clinics during 2012–2020. Autonomic dysfunction was assessed using the Composite Autonomic Symptom Scale 31 (COMPASS-31), medical history, and a lean test originally described by the National Aeronautics and Space Administration (NASA). Illness severity was assessed using Patient-Reported Outcomes Measurement Information System measures, the 36-item short-form, as well as the CDC Symptom Inventory. This analysis included 442 participants who completed the baseline COMPASS-31 assessment, comprising 301 individuals with ME/CFS and 141 healthy controls (HC). Results: ME/CFS participants reported higher autonomic symptom burden than HC across three assessment tools (all p < 0.0001), including the COMPASS-31 total score (34.1 vs. 6.8) and medical history indicators [dizziness or vertigo (42.6% vs. 2.8%), cold extremities (38.6% vs. 5.7%), and orthostatic intolerance (OI, 33.9% vs. 0.7%)]. Among ME/CFS participants, 97% had at least one autonomic symptom. Those with symptoms in the OI, gastrointestinal, and pupillomotor domains had significantly higher illness severity than those without these symptoms. Conclusions: ME/CFS patients exhibit a substantial autonomic symptom burden that correlates with greater illness severity. Individualized care strategies targeting dysautonomia assessment and intervention may offer meaningful improvements in symptom management and quality of life for those with ME/CFS and similar chronic conditions. Full article