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J Korean Acad Nurs Vol.42 No.6, 870-878

Korean Journal of Nursing Volume 42, Number 6, December 2012 http://dx.doi.org/10.4040/jkan.2012.42.6.870

Compassion satisfaction in the relationship between nurses’ compassion fatigue and burnout

Effect of social support

Younghee YeomOne·Hyeonjeong Kim2

Chung-Ang University Red Cross College of Nursing,2Chung-Ang University Graduate School

One

Effects of Compassion Satisfaction and Social Support in the Relationship between

Compassion Fatigue and Burnout inHospital Nurses

Yom, Young-HeeOne· Kim, Hyun-Jung2

One Red Cross College of Nursing, Chung-Ang University, Seoul
2Graduate School, Chung-Ang University, Seoul, Korea

Purpose:The purpose of this study was to identify the effects of compassion satisfaction and social support in the relationship
between compassion fatigue and burnout among hospital nurses.Methods:The participants were 430 nurses working in
general hospitals. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression.
Results:(a) Compassion fatigue had a significant positive effect on burnout; (b) social support and compassion satisfaction had
negative effects on burnout, and (c) social support and compassion satisfaction did not moderate the effects of compassion
fatigue on burnout.Conclusion:These findings provide strong empirical evidence for the importance of compassion fatigue,
compassion satisfaction and social support in explaining burnout of nurses. Also, it would be of great value to further define
compassion fatigue and compassion satisfaction even though these concepts are not accepted in the realities of health care.

Key words:Burnout; Fatigue; Social support; Nurses

Introduction In the process of contacting and helping the person closest, empathy for the pain the person is

complaining of arises, and post-traumatic stress syndrome (post-traumatic stress syndrome) that

1. Necessity of research the person experiences arises.post-traumatic stress disorder)You experience similar symptoms.

These similar symptoms are empathy fatigue (Figley, 1995).

Caring is the most fundamental value of nursing (Watson, 1988)It takes place in the Compassion fatigue ((compassion fatigue)It is secondary traumatic stress that can be

interactive human relationship between the nurse and the patient and is the nurse's active experienced in the process of helping others even if the person is not physically harmed

emotional involvement in the patient's experience.Kong, 2002).The nursing profession, or threatened. Because the term secondary traumatic stress can cause mental stigma, the

which can provide care, is a rewarding and satisfying job, but due to the nature of the same concept was renamed as empathy fatigue. (Figley, 1995).Therefore, compassion

work that provides nursing services through cooperative work between workers from fatigue is a high-stress event for people in the service field who have jobs that help others,

various occupations, stress is relatively high compared to other general organizations (Ko such as professional health care providers, social workers, teachers, police officers,

& Yom, 2003).Additionally, nurses are victims of various traumatic events. firefighters, flight attendants, and disaster and disaster relief workers.

Key words: burnout, fatigue, social support, nurses

* This paper2009This is supported by the Chung-Ang University academic research grant.

* This Research was supported by the Chung-Ang University Research Grants in 2009.
Address reprint requests to: Kim, Hyun-Jung
Daewon University College, 316 Daehak-ro, Jecheon, Chungbuk 390-702, Korea Tel:
+82-43-649-3207 Fax: +82-43-649-3689 E-mail: pighj0323@hanmail.net
Submission date:2012year4month12Date of review request:2012year4month28Confirmed date of publication:2012year11month15Day

© 2012 Korean Society of Nursing Science www.kan.or.kr|ISSN 2005-3673

The effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout in nurses. 871

This is a phenomenon experienced while caring for people who have experienced (Stamm, 2010). Meltzer, & Zelikovsky, 2009; Shin, 2007; Slocum-Gori, Hemsworth, Chan, Carson, &

Joinson (1992)While researching the burnout of nurses, he focused on the Kazanjian, 2011; Oh & Lim, 2006)It was reported that Looking at the results of these

phenomenon experienced by nurses forming empathic relationships with patients previous studies, it can be seen that the results of hospice care providers wereAlkemaetc(

and investing more energy in caring for them, and first introduced this 2008)Targeted at medical workers working at and Children's HospitalRobinsetc(2009)The

phenomenon by defining it as empathy fatigue. It was also said that symptoms of research results showed that the higher empathy fatigue, the lower empathy satisfaction

this phenomenon include anger, indifference, depression, inefficiency, and loss of and the higher burnout. In addition, a study was conducted targeting hospice-related

coping skills.Figley (2002)defined empathy fatigue as the emotional cost of care nurses, volunteers, and doctors.Slocum-Gorietc(2011)In the study, nurses who had the

experienced by professionals from helping traumatized or suffering people, and most contact with patients showed the highest level of empathy fatigue, and there was a

said it is similar to burnout. However, while empathy fatigue occurs in the process statistical difference in the level of empathy fatigue between hospice workers who

of helping a person who has experienced trauma and progresses quickly (Stamm, received emotional support and those who did not. And for counselors from child

2010),Burnout occurs gradually due to the emotional demands placed on health protection agencies,Shin (2007)Targeted at underemployed police officersOhandLim

care providers as the overall work environment and work-related problems (2006)In the research results, the less work experience and the lower the social support,

increase (Embriaco, Papazian, Kentish-Barnes, Pochard, & Azoulay, 2007). the higher the burnout. The higher the empathy fatigue and the lower the empathy

Additionally, because empathy fatigue is preventable and treatable (Lombardo & satisfaction, the higher the burnout. In addition, we studied the correlation between

Eyle, 2011)Early recognition and prevention are necessary, but if unresolved and compassion fatigue, compassion satisfaction, and burnout among oncology nurses and

continued, productivity may be lacking, resulting in burnout (Meadors, Lamson, emergency room nurses.Kimetc. (2010)classKim (2011)In the research results, traumatic

Swanson, White, & Sira, 2010). experience and empathy fatigue showed a positive correlation with burnout, and empathy

satisfaction and social support showed a negative correlation with burnout. In summary,

Burnout refers to emotional exhaustion, depersonalization, and lack of personal very little research has been conducted on compassion fatigue, compassion satisfaction,

accomplishment resulting from prolonged exposure to the demands of interpersonal social support, and burnout targeting nurses, and correlations have mainly been

relationships and stressful environments. (Adams, Figley, & Bosxarino, 2008).In addition, confirmed. Furthermore, no research has been conducted at all on not only the direct

burnout is a negative result of compassion fatigue and is related to work overload and an effects of compassion fatigue, compassion satisfaction, and social support on nurses'

unsupportive work environment, and for health care providers, conflict with colleagues or burnout, but also on whether compassion satisfaction and social support moderate the

superiors and low levels of social support can be important triggers of burnout (Stamm, effects of compassion fatigue on burnout.

2010).The result of this burnout not only causes a decline in the quality of patient care, but Therefore, this study examined the direct relationship between empathy satisfaction and social

also increases nurses' turnover intention and affects patient satisfaction and patient safety support in the relationship between empathy fatigue and burnout among nurses who are in close

(Meadors et al., 2010). contact with and assisting victims of various physical, mental, and emotional trauma incidents in

Stamm (2002)Many studies have been conducted on the negative effects of empathy hospital organizations. An attempt was made to provide basic data on human resource

fatigue on professionals whose job is to help others.Figley, 1995; Joinson, 1992)When this management that can harmonize the psychological well-being of individual nurses and the

was revealed, the concept of empathy satisfaction, which is a positive protective factor, development of the hospital organization by exploring the effects and moderating effects.

was introduced. Empathy satisfaction is a positive feeling that professionals who have a

job helping others get from helping injured or suffering people, and it is a pleasant feeling 2. Research purpose

that comes from knowing that one has the ability to help others. Therefore, when there is

support from colleagues or superiors in the workplace, one feels empathy satisfaction, This study2car,3The purpose is to understand the effects of empathy satisfaction and social support in the

which is a positive emotion, and empathy satisfaction has the effect of buffering or relationship between empathy fatigue and burnout of nurses at Cha General Hospital, and the specific

controlling the negative affect (artificial empathy fatigue).moderating effect)It was said purposes are as follows.

that there was (Stamm, 2010). One)Identify the general characteristics of the subject.

The results of a study that measured negative and positive influences, including 2)Determine the subject's level of compassion fatigue, compassion satisfaction, social support, and

empathy fatigue and empathy satisfaction or exhaustion, targeting professionals exhaustion.

who help various others and verified their relevance (Alkema, Linton, & Davies, 3)Identify the correlation between the subject's general characteristics, compassion fatigue, compassion

2008; Hooper, Craig, Janvrin, Wersel, & Reimels, 2010; Robins, satisfaction, social support, and exhaustion.

http://dx.doi.org/10.4040/jkan.2012.42.6.870 www.kan.or.kr
872 Younghee Yeom, Hyunjeong Kim

4)We analyze the direct effects of the subject's compassion fatigue, compassion satisfaction, developedCompassion satisfaction/Fatigue Self test for HelperscastStamm (2009)

and social support on burnout. Completed informationProfessional Quality of Life Scale (PROQOLS): Compassion

5)Analyze the moderating effects of empathy satisfaction and social support in the relationship between satisfaction/fatigue subscale version 5 (Korea)It was measured using the hollow gastric

empathy fatigue and burnout of subjects. fatigue scale. This tool is a negative concept and10door protest5It was composed of a dot

scale, and at the time of tool development,StammIn medical research, the reliability of the

Research Methods test results isCronbach's α = .81and in this study.74It was.

1. Research design 2) Exhaustion

Burnout is a result of working in a stressful work environment and refers to a

This study2car,3This is a descriptive research study exploring the direct and moderating effects of state of physical, emotional, and mental exhaustion that has a negative impact on

empathy satisfaction and social support in the relationship between compassion fatigue and burnout among work performance (Figley, 1995).SojinFigleytentatively developedCompassion

nurses at Cha General Hospital. satisfaction/Fatigue Self test for HelperscastStamm (2009)This fix supplemented

PROQOLS: Compassion satisfaction/fatigue subscale version 5 (Korea)It was

2. Research object measured using the minor burnout subscale. This tool is a negative concept and10

of the question5It was composed of a dot scale, and at the time of tool

For this study2012yearOnemonth23From work2012year2month12Located in development,StammIn medical research, the reliability of burnout wasCronbach's

Seoul and Gyeonggi-do2car,3Nurse working at Cha General Hospital430Data were α = . 75, and in this study.73It was.

collected from the subjects. The number of subjects isG Power 3.0 analysis

softwarerequired for multiple regression analysis usingmedium effect size 0.15, 3) Empathy satisfaction

power 0.90The recommended sample size when calculated as154number of Empathy satisfaction is the pleasure of helping others, and is a pleasurable

people(Faul, Erdfelder, Lang, & Bunchner, 2007)The sample size used in this study feeling that results from goodwill toward colleagues and the ability to help others (

can be considered to be large enough to have no problems with statistical power. Stamm, 2002).Sympathetic satisfaction isFigley (1995)tentatively developed

Compassion satisfaction/Fatigue Self test for HelperscastStamm (2009)Sujeong Lee

3. Research tools supplementedPROQOLS: Compassion satisfaction/fatigue subscale version 5

(Korea)It was measured using the Empathic Satisfaction subscale. This tool is a

The instrument of this study used a structured self-report questionnaire and consisted of positive concept.10of the question5It was composed of a dot scale, and at the time

general characteristics, compassion fatigue, exhaustion, compassion satisfaction, and social of tool development,StammIn a study, the reliability of empathy satisfaction was

support questionnaires. doubleStamm (2009)Completed informationPROQOLThe tool has empathy Cronbach's α= .88It was, and in this study, .77It was.

fatigue, exhaustion, and empathy satisfaction as subconcepts. These subconcepts Stamm (2010)

silverThe concise PROQOL manualA theoretical path analysis model for professional quality of life 4) Social support

was presented, and based on this, compassion fatigue and compassion satisfaction were used as Social support refers to information that allows the recipient to believe

independent variables and burnout was used as an outcome variable in this study. Also, this tool that he or she is cared for and loved, has pride, and is a member of a

PROQOLIt is a Korean version that has been translated and back-translated by the institution itself. network of communication and responsibility.Cobb, 1976).social support

30of the question5It is composed of a dot scale diagram, and the score range for each subarea is10 PriceandMueller (1981)Developed temporarilyKo (1999)It was measured

-50by dot22The 'low' point is23-41The dot is ‘normal’,42More than one point means ‘high’ (Stamm, using the support tool provided by the company. This tool is4of the question

2009). 5It was composed of dotted roads,SonclassKo (2007)In a study, the reliability

of social support wasCronbach's α= .85, and in this study.77It was.

1) Compassion fatigue

Compassion fatigue is the same concept as secondary traumatic stress and 4. Data collection method

refers to indirect signs of trauma experienced in the process of helping a

traumatized or suffering person (Figley, 1995).Compassion fatigueFigleygo This study was conducted by the researcher's affiliated institution for ethical consideration.Cbig

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The effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout in nurses. 873

School's Research Ethics Committee (IRB No.: 2012-2-1-1)It was carried out after receiving approval from the Third, the position is a nurseOne,Responsible nurse award0,Have your own traumatic

tool developer. To collect data, locations in Seoul and Gyeonggi-do2 Cha General Hospital2place,3Cha General experiencesOne,There is no0,My health is goodOne,bad0It was converted to a dummy

Hospital4We contacted the nursing department at the site, explained the purpose and method of the study, variable to have the value of .

filled out a research plan, questionnaire, and data collection request form, and received permission to collect

data by visiting in person or sending it via email. The questionnaires were distributed and collected directly or Results
through the nursing department, and to protect the rights and interests of the subjects, each subject was

asked to fill out the enclosed research participation consent form and then respond to the survey. Data 1. General characteristics of the subject

collection involves preliminary investigation.2011year12monthOneFrom work12month10After carrying out

the2012yearOnemonth23 From work2012year2month12Nurse at Iltil General Hospital460A Lunar New Year The general characteristics of the subjects of this study were investigated: age, education, marital status,

questionnaire was conducted targeting people. The questionnaire is460In the middle of the day445wealth( religion, department, position, total years of service, number of years of service in the current department,

96.7%)were collected, and the total number of duplicate responses excluding insufficient data was430wealth( economic status, own trauma experience, trauma experience of others, and health status (Table 1).The

93.5%)Only this was used in the final analysis. average age of the study subjects was30.17It was three years old,25-29sega170number of people(39.5%)It

was the most. In the department, the ward178number of people(41.4%)The most common, and the position

was nurse. 364number of people(84.7%)There were a lot. The average of total years of service is7.51It was a

5. Data analysis method year,1-5less than a year139number of people(32.3%)It was the most. From your own traumatic experience,

there is no384number of people(89.3%),In good health229number of people(53.3%)There were a lot.

The collected data isSPSS 18.0It was analyzed using a program, and the specific

method is as follows. 2. Degree of compassion fatigue, compassion satisfaction, social support, and exhaustion

One)Descriptive statistics were used for the general characteristics and measurement variables

of the subjects. The degree of empathy fatigue, empathy satisfaction, social support, and exhaustion perceived by the

2)To determine the relationship between measured variablest-test, ANOVA, subject isTable 2It’s the same. Compassion fatigue is average26.51The point was that the moderate level of

Scheffé, Pearson Correlation CoefficientIt was confirmed. compassion fatigue was83.0%and exhaustion was average27.59It was a point, and the level of exhaustion was

3)Hierarchical multiple regression analysis was performed to identify the effects of compassion fatigue, moderate.88.1%It was. Empathy satisfaction is average30.37It was a point, and the level of empathy

compassion satisfaction, and social support on burnout, and further confirm the moderating effect of satisfaction was moderate.95.1%and social support was average3.45It was a point.

compassion satisfaction and social support in the relationship between compassion fatigue and

burnout. (Hierarchical Multiple Regression)It was analyzed using . Looking at the detailed procedure 3. Correlation between the subject’s general characteristics, compassion fatigue, compassion satisfaction,

of hierarchical multiple regression analysis, in the first step, the outcome variable, burnout, is first social support, and exhaustion

regressed on the control variables (age, department, health status) (modelOne),In the second step,

the empathy fatigue variable (model The relationship between the subject's general characteristics, compassion fatigue, compassion

2),In the third step, the empathy satisfaction variable (model3),In the fourth step, satisfaction, social support, and burnout isTable 3Same as The dependent variable, exhaustion,

the social support variable (model4)It was regressed on, and finally, it was created showed a correlation between all variables, including control variables, and burnout showed a

as the product of empathy fatigue, empathy satisfaction, empathy fatigue, and positive (+) correlation with empathy fatigue, and a negative (-) correlation with empathy

social support variables.2It was regressed on the dog interaction term (model5). satisfaction and social support (p< .001).

During regression analysis, specification error (specification error)Compilation of Among them, the correlation between empathy satisfaction and burnout was

regression coefficient estimates that need to be done (bias)To minimize , demographic the highest (r= -.53;p< .001),Compassion fatigue (r = .50;p< .001),Health status (r=

variables were generally used as control variables. This is because in almost all cases, -.41; p< .001)Appeared in order.

demographic variables are related to the social phenomenon being studied. (Ko & Seo,

2002).Therefore, in this study, when using regression analysis, the three variables of age, 4. Direct effects of compassion fatigue, compassion satisfaction, and social support on burnout

department, and health status that showed statistically significant differences in the

difference analysis for burnout were used as control variables. For analysis, the wards and

special departments in the department areOne,Other departments0,average age30.17 Diagnose multicollinearity, residuals, and singular values to perform regression analysis

http://dx.doi.org/10.4040/jkan.2012.42.6.870 www.kan.or.kr
874 Younghee Yeom, Hyunjeong Kim

Table 1.General Characteristics of the Participants (N=430)

Characteristics Categories n(%) M±SD

Age (year) <25 59 (13.7) 30.17±5.87
25-29 170 (39.5)
30-34 110 (25.6)
35-39 52 (12.1)
≥40 39 (9.1)

Education <University 327 (76.0)

≥Graduate school 103 (24.0)

Marital status Married 143 (33.3)

Unmarried 287 (66.7)

Religion Yes 239 (55.6)

No 191 (44.4)

Department Wards 178 (41.4)

Special departments (ER, ICU, OR, RR, AKC) Others (OPD, 160 (37.2)
explanation nurse, nurse practitioner, other) 92 (21.4)

Type of position Nurse 364 (84.7)

Manager (≥Charge nurse) 66 (15.3)

Total work experience (year) <1 47 (10.9) 7.51±5.89

1- <5 139 (32.3)
5- <10 131 (30.5)
10- <15 63 (14.7)
≥15 50 (11.6)

Present work experience (year) <1 126 (29.3) 3.86±3.52

1- <5 187 (43.5)
5- <10 85 (19.8)
≥10 32 (7.4)

Yearly income (10,000 won) 2,000-3,000 80 (18.6)

3,001-4,000 201 (46.7)
4,001-5,000 107 (24.9)
> 5,000 42 (9.8)

Trauma experience to self Yes 46 (10.7)

No 384 (89.3)

Trauma experience to others Yes 142 (33.0)

No 288 (67.0)

Health status Bad 201 (46.7)

Good 229 (53.3)

ER=Emergency room; ICU=Intensive care unit; OR=Operating room; RR=Recovery room; AKC=Artificial kidney center; OPD=Outpatient department.

Table 2.Descriptive Statistics of Variables (N=430)

Variables n(%) Range M±SD Cronbach's α

Compassion fatigue 430 (100.0) 10-50 26.51±4.41 . 74

Low 73 (17.0) ≤22
Moderate 357 (83.0) 23-41

Burnout 430 (100.0) 10-50 27.59±4.31 . 73

Low 50 (11.6) ≤22
Moderate 379 (88.1) 23-41

High 1 (0.2) ≤42

Compassion satisfaction 430 (100.0) 10-50 30.37±4.97 . 77
Low 16 (3.7) ≤22
Moderate 409 (95.1) 23-41

High 1 (0.2) ≤42

Social support 430 (100.0) 1-5 3.45±0.60 . 77

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The effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout in nurses. 875

did. The multicollinearity index between independent variables is empathy fatigue.82, Model 3Eunsojin mutation57%explanation(F =114.29;p< .001)Satisfied with empathy, Lee

Satisfied with empathy.83,Social support.89The tolerance limit is1.0Since it is below, it can So-jin's mutation20%was additionally explained. Control variables, compassion fatigue,

be said that there is no problem of multicollinearity.Durbin-WatsonThe value is1.96, compassion satisfaction, and social support were added.Model 4of exhaustion variant58%

Dispersion expansion factor (variance inflation factor, VIF)Empathy fatigue1.08,Empathy explain (F = 97.80,p< .001)Therefore, social support is a factor in the exhaustion variant.

Satisfaction1.20,social support1.11Ronatana standard10It was found to be significantly One%was additionally explained.Model 4Looking at the variables that affect burnout,

smaller and there was no problem of multicollinearity (Ko & Seo, 2002). among the control variables, health status (β = -.18,p< .001)is a statistically significant

The results of a hierarchical regression analysis to determine the direct effects of compassion fatigue, negative (-) variable for burnout and compassion fatigue (β = .46,p< .001) was found to be

compassion satisfaction, and social support on burnout were as follows:Table 4It’s the same.Model 1The three a statistically significant positive (+) variable for burnout, and empathy satisfaction (β =

control variables are of the exhaustion variation.21%Description(F =37.78;p< .001) and control variables and -.46,p< .001)Hypersocial support (β = -.09,p= .008)was found to be a negative (-) variable

empathy fatigue were added.Model 2In the exhaustion mutation, 37%explanation(F = 64.04;p< .001)Therefore, that was statistically significant for burnout. In other words, the higher the compassion

empathy fatigue is a variant of burnout.16%was additionally explained. Control variables, compassion fatigue fatigue, the higher the burnout, and the better the health, the higher the empathy

and compassion satisfaction were added. satisfaction and social support, the lower the burnout.

Table 3.Correlation among Variables (N=430)

Health Compassion Compassion Social

Age Department Burnout
Variables status fatigue satisfaction support

r (p) r (p) r (p) r (p) r (p) r (p) r (p)

Age One
Department . 31 One
(< .001)

Health status . 04 . 05 One

(.449) (.327)

Compassion fatigue - . 14 - . 15 - . 16 One

(.004) (.002) (.001)

Compassion satisfaction . 18 15 . 29 . 03 One

(< .001) (.002) (< .001) (.608)

Social support . 08 . 07 . 22 - . 11 . 27 One

(.118) (.127) (< .001) (.019) (< .001)

Burnout - . 20 - . 21 - . 41 . 50 - . 53 - . 31 One
(< .001) (< .001) (< .001) (< .001) (< .001) (< .001)

Table 4.Moderating Effect of Compassion Satisfaction and Social Support between Compassion Fatigue and Burnout

Model 1 Model 2 Model 3 Model 4 Model 5

Variables
ß (p) ß (p) ß (p) ß (p) ß (p)

Age - . 15 (.001) - . 11 (.006) - . 04 (.278) - . 04 (.290) - . 04 (.200)

Department . 10 (.022) . 06 (.164) . 01 (.709) . 01 (.724) . 01 (.872)

Health status - . 39 (< .001) - . 33 (< .001) - . 19 (< .001) - . 18 (< .001) - . 18 (< .001)

CF . 42 (< .001) . 47 (< .001) . 46 (< .001) . 48 (.026)

C.S. - . 48 (< .001) - . 46 (< .001) - . 74 (< .001)

Social support - . 09 (.008) . 23 (.178)

CF × CS . 41 (.164)

CF × SS - . 42 (.050)

Adjusted R2 . 21 . 37 . 57 . 58 . 58
F statistic (p) F (37.78) = 37.78 F (112.99) = 64.04 F (197.08) = 114.29 F (7.15) = 97.80 F (3.63) = 74.28
(< .001) (< .001) (< .001) (< .001) (< .001)

CF=Compassion fatigue; CS=Compassion satisfaction; SS=Social support.

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876 Younghee Yeom, Hyunjeong Kim

5. Moderating effects of compassion satisfaction and social support in the relationship between compassion fatigue and For this reason, it is said that it is being continuously studied in medical institutions.

burnout Accordingly, understanding the relationship between compassion fatigue and burnout of

nurses, who are the largest members of the hospital organization and have the primary

Table 4ofModel 5In each interaction term between compassion fatigue and empathy role of helping various patients, is important because it affects patient safety, satisfaction

satisfaction, compassion fatigue and social support2Although the dog did not additionally explain with nursing services, and quality of nursing in medical institutions. Awareness of

the exhaustion variable, it showed statistically significant results (F =74.28;p< .001)indicated. In compassion fatigue and burnout is important, and it is believed that it will be important

other words, it was found that compassion satisfaction and social support did not moderate the data in developing human resource management measures that can harmonize the

effect of compassion fatigue on burnout. development of hospital organizations. Second, empathy satisfaction and exhaustion

showed a negative correlation. These results areRobinsetc. (2009), Slocum-Gorietc(2011),

Argument Kimetc(2010), Kim (2011)It was consistent with the research of, and it was said that

empathy satisfaction, which is a positive effect, plays a role in making it possible to

Nurses work in various physical areas in hospital organizations.·mental·You can balance the elements of empathy fatigue, which is a negative effect, and is also for the

feel rewarding in the process of contacting and helping the person who is the human spirit's ability to overcome.Stamm (2010)I think this is a result that supports the

victim of an emotionally traumatic event (Stamm, 2010),Due to the nature of the research. Third, social support and burnout showed a negative correlation.Kim (2011),

work that provides nursing services through collaborative work between workers ByunclassYom (2009)It was consistent with the research results. These results mean that

from various occupations, the stress is relatively high (Ko & Yom, 2003). the higher a nurse's social support from superiors in the workplace, the less burnout

The subject of this study2car,3Results of analysis of compassion fatigue, empathy satisfaction occurs as a result of negative influence, and that nurses who do not receive social support

and burnout among nurses at Cha General Hospital,83.0%shows moderate empathy fatigue,88.1% experience more burnout while caring for patients in the workplace. In addition, I believe

showed moderate burnout,95.1%A moderate level of empathy and satisfaction was found. that this result suggests that the support of a superior who understands difficulties and

Comparing these research results with previous studies, it can be seen that oncology nurses77.6%, supports each other through protocols and emotional exchanges is a major social support

75.3%, 74.8%showing moderate empathy fatigue, exhaustion, and empathy satisfaction.Kimetc( resource. Therefore, it is considered necessary to prevent burnout by creating an

2010)It was higher than the research results. Additionally, the results of this study show that organizational culture in which superiors encourage and recognize.

emergency room nurses84.1%Moderate empathy fatigue, Regression analysis results,3The control variables of the dogs are the exhaustion

82.4%to moderate burnout, and90%showed a moderate level of sympathy satisfaction. variation.21%explained, and the control variables age, department, and health status had

Kim (2011)The results were similar to those of the study. It is believed that follow-up a significant effect on burnout. In other words, it was confirmed that the younger the age,

research is needed to confirm whether these research results are differences in the results the higher the burnout, the higher the burnout was in nurses working in wards and

of conducting research on nurses working in various departments compared to previous special departments, and the poorer their health, the higher the burnout. These results

research targeting nurses in one department. In addition, because the negative emotions show that age has an effect on burnout.ByunclassYom (2009)It was consistent with the

felt by nurses, such as fatigue and burnout, are linked to the quality of nursing services research results. Therefore, it is necessary to develop an intervention program that can

and affect the safety and satisfaction of patients (Meadors et al., 2010)It is believed that reduce burnout for younger nurses, and the role of preceptors and mentors should be

intervention measures for negative emotional fatigue and burnout are needed. activated.

All variables are enteredModel 4As a result of parliamentary ear analysis, the

As a result of correlation analysis, nurses' empathy fatigue showed a positive (+) 58%was found to explain, and health status, a control variable, was found to have

correlation with burnout, and a negative (-) correlation between empathy satisfaction and an effect on burnout. These results can be seen as confirmation that nurses' health

social support was confirmed with exhaustion. The specific discussion on this is as follows. status, among the control variables of general characteristics, has a direct impact

First, nurses' burnout with empathy fatigue showed a positive (+) correlation, and this on burnout. In addition, the health status of nurses is an important factor in caring

result shows thatRobinsetc(2009), Slocum-Gorietc(2011), Kimetc(2010), Kim (2011)It was for patients and not only affects the quality of nursing services, but also affects the

consistent with medical research.Figley (1995)It was said that if unresolved empathy work of other fellow nurses, so it is believed that a work environment for health

fatigue persists among professionals who help others, it can lead to burnout.Meadorsetc( management should be created. And empathy fatigue has been shown to have an

2010)The phenomenon of empathy fatigue and burnout increases nurses’ turnover effect on burnout.Model 2As a result of the decision, Seo So-jin's mutation16%was

intention and is correlated with patient satisfaction and patient safety. additionally explained. These results sympathize with

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The effects of compassion satisfaction and social support in the relationship between compassion fatigue and burnout in nurses.
It is said that fatigue has a direct effect on burnout.Stamm (2010)It was consistent with
medical research. In addition, although it is difficult to directly compare this study and the
subjects because the subjects are different, it was conducted on firefighters.OhandLim
(2006)It was consistent with medical research. This means that if the artificial fatigue,
which is the feeling of helplessness, confusion, and isolation caused by the tension and
concentration that suddenly arises while caring for a patient, is not resolved and
continues, burnout will occur. In addition, burnout causes physical, mental, and emotional
exhaustion caused by continuous emotional demands, resulting in a decrease in the
quality of patient care and increasing nurses' turnover intention, resulting in increased
work costs for hospital organizations. . To prevent these outcomes, regular seminars are
held and ongoing research is being conducted in the United States, and a program to deal
with and overcome empathy fatigue is being developed.The Accelerated Recovery
Program for Compassion Fatigue (ARP)It has been provisionally developed and is being
implemented (Gentry, Baranowsky, & Dunning, 2002).Therefore, as this study revealed
that compassion fatigue is a variable that affects nurses' burnout, awareness and
continuous research on nurses' compassion fatigue and burnout are needed, and training
programs to overcome compassion fatigue and burnout should be developed. I think so.
Among the variables, empathy satisfaction was found to have an effect on burnout.
Model 3In the results of the decision, the exhaustion mutation20%was additionally
explained. These results suggest that empathy satisfaction has a direct effect on burnout.
Stamm (2010)It was consistent with medical research. In order to maximize the
satisfaction of empathy, a positive protective factor that occurs in professionals whose job
is to help others, an organizational culture should be created within the workplace that
can increase satisfaction as well as pride in having the ability to help others as a nurse.
Social support has been shown to have an effect on burnout. Model 4In the results of the
decision, the exhaustion mutationOne%was additionally explained. Although social
support showed minimal additional explanatory power compared to other variables, a
study verified that conflict with superiors and low social support in the workplace are
factors causing burnout (Byun & Yom, 2009; Oh & Lim, 2006)coincided with the others.
Therefore, it is believed that nurses who take care of patients in the workplace need
continuous support from their superiors and that mutual communication should take
place, and it is believed that a safe work environment for nurses should be created to
further strengthen this social support system.
The main interest of this study was to explore the role of empathy satisfaction and
social support in the relationship between compassion fatigue and burnout. However, the
research results showed that empathy satisfaction and social support had a direct effect in
the relationship with empathy fatigue and burnout, but did not have a buffering effect.
Based on these results, rather than assuming that empathy satisfaction or social support
only has a direct effect on burnout, in order to reach a firmer conclusion about the role of
empathy satisfaction or social support, nurses' work environment and personal
http://dx.doi.org/10.4040/jkan.2012.42.6.870
877
I think research that includes personal characteristics and support from colleagues
and family is needed.
Summarizing the above results, in the relationship between nurses' compassion fatigue and
burnout, the effect of compassion satisfaction and social support was found to be direct, but there
was no moderating effect, and the factors affecting burnout were compassion fatigue and
compassion satisfaction. , social support, and general characteristics confirmed that the person
was in good health. Therefore, it is expected that this study will provide basic data for nurses'
human resource management considering variables highly correlated with nurses' burnout in
hospital organizations.
conclusion
This study was attempted to explore the direct and moderating effects of compassion
satisfaction and social support in the relationship between compassion fatigue and burnout in
nurses. As a result of the study, compassion satisfaction and social support did not show a
moderating effect in the relationship between compassion fatigue and burnout, but compassion
fatigue, compassion satisfaction, social support, and the health status of nurses among general
characteristics showed a direct effect on burnout.58%It was shown to have explanatory power, and
it was confirmed that nurses' compassion fatigue, compassion satisfaction, and social support are
factors that have a significant impact on burnout.
Therefore, the significance of this study is that it identified the effect of empathy satisfaction
and social support in the relationship between compassion fatigue and burnout, which has rarely
been conducted on nurses in existing studies on compassion fatigue, compassion satisfaction, and
burnout. I think there is. In addition, it is believed that the need for a human resource
management plan that can reduce nurses' empathy fatigue and increase empathy satisfaction and
social support to reduce burnout is suggested.
Based on the above results, I would like to suggest the following. In the relationship between
compassion fatigue and burnout in nurses, research is needed to verify various antecedent
variables that affect compassion fatigue. We also suggest that research should be conducted to
analyze the path including empathy fatigue and empathy satisfaction in the relationship between
various variables that affect empathy fatigue and burnout.
REFERENCES
Adams, R. E., Figley, C. R., and Boscarino, J. A. (2008). The compassion fatigue
scale: Its use with social workers following urban disaster.Research on
Social Work Practice, 18(3), 238-250. http://dx.doi.org/10.1177/10
49731507310190
Alkema, K., Linton, J. M., & Davies, R. (2008). A study of the relationship
between self-care, compassion satisfaction, compassion fatigue, and
burnout among hospice professionals.Journal of Social Work in End-
of-Life & Palliative Care, 4(2), 101-119. http://dx.doi.org/10.1080/
15524250802353934
www.kan.or.kr
878
Byun, D. S., & Yom, Y. H. (2009). Factors affecting the burnout of clinical trials
nurses -focused on emotional labor- .Journal of Korean Academic
Nursing Administration, 15(3), 444-454.
Cobb, S. (1976). Social support and the buffering hypothesis.Psychological
Bulletin, 98(2), 310-357.
Embriaco, N., Papazian, L., Kentish-Barnes, N., Pochard, F., & Azoulay, E.
(2007). Burnout syndrome among critical care healthcare workers.
Current Opinion in Critical Care, 13(5), 482-488. http://dx.doi. org/
10.1097/MCC.0b013e3282efd28a
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G power 3: A flexi-
ble statistical power analysis program for the social, behavioral, and
biochemical sciences.Behavior Research Methods, 39(2), 175-191.
http://dx.doi.org/10.3758/BF03193146
Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress dis-
order: An overview. In C. R. Figley (Ed.),Compassion fatigue: Coping with
secondary traumatic stress disorder in those who treated the
traumatized(pp. 107-119). New York: Brunner-Mazel.
Figley, C. R. (2002).Treating compassion fatigue.New York: Brunner-Rout-
ledge.
Gentry, J. E., Baranowsky, A. B., & Dunning, K. (2002). ARP: The acceler-
ated recovery program (ARP) for compassion fatigue. In C. R. Figley
(Ed.),Treating compassion fatigue(pp. 123-137). New York: Brunner-
Routledge.
Hooper, C., Craig, J., Janvrin, D.R., Wetsel, M.A., & Reimels, E. (2010).
Compassion satisfaction, burnout, and compassion fatigue among
emergency nurses compared with nurses in other selected inpatient
specialties.Journal of Emergency Nursing, 36(5), 420-427. http://dx.doi.
org/10.1016/j.jen.2009.11.027
Joinson, C. (1992). Coping with compassion fatigue.Nursing, 22(4), 116,
118-119, 120.
Kim, H. J. (2011).The relationships between traumatic events, compassion fa-
tigue, burnout and compassion satisfaction in emergency nurses.
Unpublished master's thesis, Konkuk University, Seoul.
Kim, S., Kim, JH, Park, JY, Suh, EY, Yang, HJ, Lee, SY, et al. (2010).
Oncology nurses' professional quality of life in a tertiary hospital.Journal
of Korean Clinical Nursing Research, 16(3), 145-155.
Ko, J. W. (1999). The effects of personality traits on job satisfaction.The
Korean Journal of Sociology, 33(2), 359-387.
Ko, J. W., & Seo, Y. J. (2002). Work rewards and occupational commitment
of hospital nurses.Korea Journal of Health Policy & Administration, 12
(13), 77-98.
Ko, J. W., & Yom, Y. H. (2003). The role of social support in the relationship
between job stress and job satisfaction/organizational commitment
www.kan.or.kr
Younghee Yeom, Hyunjeong Kim
among hospital nurses.Journal of Korean Academy of Nursing, 33(2),
265-274.
Kong, B. H. (2002). Aesthetical-ethical paradigm of care ethics in nursing.
Journal of Korean Academy of Nursing, 32(3), 364-372.
Lombardo, B., & Eyre, C. (2011). Compassion fatigue: A nurse's primer.The
Online Journal of Issues in Nursing, 16(1), 3. http://dx.doi.org/10.3912/
OJIN.Vol16No01Man03
Meadors, P., Lamson, A., Swanson, M., White, M., & Sira, N. (2010). Sec-
ondary traumatization in pediatric healthcare providers: Compassion
fatigue, burnout, and secondary traumatic stress.Omega (Westport), 60
(2), 103-128.
Oh, J. H., & Lim, N. Y. (2006). Analysis of factors influencing secondary
Traumatic stress, burnout, and physical symptoms in firefighters.Journal of
Korean Academy of Fundamentals of Nursing, 13(1), 96-106. Price, J. L., &
Mueller, C. W. (1981).Professional turnover: The case of nurses.
New York: SPMedical and Scientific Books.
Robins, P. M., Meltzer, L., & Zelikovsky, N. (2009). The experience of seconds-
ondary traumatic stress upon care providers working within a children's
hospital.Journal of Pediatric Nursing, 24(4), 270-279. http://dx.doi.org/
10.1016/j.pedn.2008.03.007
Shin, M. J. (2007).Compassion fatigue, burnout, and compassion satisfaction
Among child protection agency workers in Korea.Unpublished master's
thesis, Sookmyung Women's University, Seoul.
Slocum-Gori, S., Hemsworth, D., Chan, W.W., Carson, A., & Kazanjian, A.
(2011). Understanding compassion satisfaction, compassion fatigue and
burnout: A survey of the hospice palliative care workforce.Palliative
Medicine,1-7. Advanced online publication. http://dx.doi.org/10.
1177/0269216311431311
Son, K. A., & Ko, J. W. (2007). The moderating effect of social support on
the relations between teachers' job stress and job satisfaction, and
organizational commitment.The Journal of Educational Administration,
25(4), 73-94.
Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue:
Developmental history of the compassion fatigue and satisfaction test.
In C. R. Figley (Ed.),Treating compassion fatigue(pp. 107-119). New York:
Brunner-Routledge.
Stamm, B. H. (2009).The concise proQOL manual(2nd ed.). Pocatello, ID:
Professional Quality of Life (ProQOL). org.
Stamm, B. H. (2010).The concise proQOL manual.Pocatello, ID: Profes-
sional Quality of Life (ProQOL). org.
Watson, J. (1988).Nursing: Human science and human care, A theory of nurses-
ing.New York: National League for Nursing.
http://dx.doi.org/10.4040/jkan.2012.42.6.870