Psychological Distress and Compassion Fatigue among Hospice Nurses: The Mediating Role of Self-Esteem and Negative Affect

Background: Compassion fatigue among health care professionals has negative effects on patient care. Providing end-of-life care, hospice nurses may be particularly at risk for compassion fatigue. Objective: The purpose of this study was to investigate self-esteem and affect as mediators between psychological distress and compassion fatigue among hospice nurses (N=90). Design and Measurements: Hospice nurses working in a health care setting were recruited to complete a survey. Multiple mediation analysis was used to explore associations between variables of interest. Results: Psychological distress was associated with greater compassion fatigue and had an indirect effect on compassion fatigue through lower self-esteem and higher negative affect, but not through positive affect. Conclusion: Among hospice nurses, psychological distress may reduce self-esteem and create negative feelings, thereby increasing the risk of compassion fatigue. Interventions that target both the cognitive and affective links between psychological distress and compassion fatigue may be most effective.