Does self-compassion mitigate the relationship between burnout and barriers to compassion? A cross-sectional quantitative study of 799 nurses

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Abstract

Background

Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this association.

Hypothesis

Consistent with prior work, the authors expected greater burnout to predict greater barriers to compassion. We also expected self-compassion – the ability to be kind to the self during times of distress – to weaken the association between burnout and barriers to compassion among nurses.

Methods

Registered nurses working in New Zealand medical contexts were recruited using non-random convenience sampling. Following consent, 799 valid participants completed a cross-sectional survey including the Copenhagen Burnout Inventory, the Barriers to Physician Compassion scale, and a measure of dispositional self-compassion.

Results

As expected, greater burnout predicted greater barriers to compassion while self-compassion predicted fewer barriers. However, self-compassion mitigated the association between burnout and burnout related barriers to compassion (but not other barriers). The interaction suggested that suggested that the association was stronger (rather than weaker) among those with greater self-compassion.

Discussion

Understanding the lack of compassion and the effects of burnout in patient care are priorities in health. This report extends evidence on the association between burnout and compassion-fatigue to show that burnout also predicts the experience of specific barriers to compassion. While self-compassion predicted lower burnout and barriers, it may not necessarily reduce the extent to which burnout contributes to the experience of barriers to compassion in medicine. Implications for understanding how burnout manifests in barriers to clinical compassion, interventions and professional training, and future directions in nursing are discussed.

Section snippets

What is already known about the topic?

  • Burnout is widespread among nurses and thought to have numerous negative correlates, including those related to their ability to deliver compassionate care.

  • Prior researchers have typically linked burnout with other compassion-related forms of burnout (such as compassion fatigue) and have failed to illuminate factors that might buffer or attenuate this relationship.

What this paper adds

  • The paper extends knowledge beyond compassion fatigue to consider how burnout may manifest in specific barriers to compassionate patient care.

  • The development of self-compassion (the ability to care for the self in times of stress) may reduce the experience of carer, patient, environmental, and clinical barriers to compassion.

Participants

Of the 799 registered nurses included in this report, 93.90% were female. The participants’ average age was 45.47 years (SD = 11.81), average clinical experience was 26.12 years (SD = 12.77), and they predominantly identified as New Zealand European (65.30%), followed by British (12.80%) (see Table 1 for details). Nearly three quarters (73.8%) were New Zealand educated, the remainder being educated in the United Kingdom (14.30%) and elsewhere. Approximately half (54.80%) of the sample worked

Correlational analysis

Preliminary correlational analysis (see Fig. 1 and Table 2) showed that while increased experience was positively associated with lower barriers and greater self-compassion, being female predicted less self-compassion. Interestingly, workload was positively associated with burnout and environmental barriers but not with patient/family or clinical barriers; these three variables were retained as controls in primary analyses. As expected, there was a positive association between greater burnout

Discussion

In extending prior research linking professional burnout to compassion-related outcomes, the current report found the expected association in which greater burnout predicted greater burnout-related, patient and family, clinical, and environmental barriers to compassion in a large sample of nurses. In seeking to identify personal, resiliency-type factors of relevance, we also tested whether self-compassion (a) predicted lower barriers and (b) might weaken these relationships. However, while

Limitations, future directions, and practical implications

Although this report provides a useful contribution to work linking burnout and compassion in the helping professions, it has several limitations. The report relies on a convenience sample completing self-report measures, employed a cross-sectional and observational design, and did not evaluate specific types of burnout and self-compassion. The associations among self-report measures may be exaggerated by method factors (Podsakoff et al., 2012) or by social desirability, self-presentational,

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