Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic
Open accessAbstract
Background Nurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic.Aims This study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality.Design An online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines.Results Overall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = -0.145, p = 0.019), lower job satisfaction (β = -0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = -0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = -0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001).Conclusion Frontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.
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Resilience acted as a protective mechanism against factors that contributed to turnover intention.
“with two studies concluding that it acted as a protective mechanism against factors that contributed to turnover intention [43, 44].”
From A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions (2022) · cites this paper as [43]
Turnover intention was positively correlated with compassion fatigue among nurses.
“A study that surveyed nurses from the Philippines found that turnover intention was positively correlated with compassion fatigue [43].”
From A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions (2022) · cites this paper as [43]
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- Authors
- Labrague, L. J., & de los Santos, J. A. A.
- Affiliations
- Sultan Qaboos University (OM)
- Corresponding author
- Labrague, Leodoro J.
- ORCID
- Labrague, Leodoro J.
- Venue
- Applied Nursing Research
- Publisher
- Elsevier BV
- Published
- 2021-10
- Volume
- 61
- Pages
- 151476
- ISSN
- 0897-1897 (ISSN-L)
- PMC
- PMC8448586
- OpenAlex
- W3180739435
- Cited by
- 221
- References
- 58
- Citations by year
- 2026: 34 · 2025: 48 · 2024: 46 · 2023: 41 · 2022: 50 · 2021: 2
- FWCI
- 23.70
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Applied Nursing Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- compassion fatigue, resilience, nurses, COVID-19 pandemic, job satisfaction, turnover intention, quality of care, frontline nursing, mediating effect, nurse retention, nurse mental health
- MeSH terms
- Compassion Fatigue, COVID-19, SARS-CoV-2, Cross-Sectional Studies, Humans, Job Satisfaction, Nurses, Nursing Staff, Hospital, Personnel Turnover, Quality of Health Care, Surveys and Questionnaires, Pandemics
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