Funded by the Canadian Institute of Health Research (CIHR), Who Will Care in the End: A Pan-Canadian Study of Palliative Care Providers is the first and only study to look at the national picture regarding the palliative care workforce. This research included the development and administration of a new survey to collect data on palliative care providers in Canada, as well as to examine and assess compassion satisfaction and compassion fatigue among them. The survey included validated scales that measure these phenomenon as well as questions to describe socio-demographic profile, work characteristics and practice culture.
Compassion Fatigue has often been referred to as the emotional “cost of caring” for others and has led professionals to abandon their work with traumatized victims in their care1. However, a demonstration of compassion in the long term does not always lead to negative emotional states or outcomes. Compassion Satisfaction stems from the emotional rewards of caring for others in a health care context; clinicians feel a sense of return or incentive by seeing a ‘change for the better’ in patients and families 2, 3. These constructs heretofore have seldom been applied to health personnel in palliative care.
After follow-ups with health care institutions and their officials, we obtained 630 usable surveys from the palliative care workforce across Canada. The average age of the respondents was 52.34 yrs (55.01 for male and 51.75 for female). Our analysis yielded important insight: Compassion Satisfaction is found to be negatively correlated with both Compassion Fatigue and Burn Out, and there is a positive association between Burn Out and Compassion Fatigue. That is, workers experiencing Compassion Satisfaction are less likely to experience Compassion Fatigue and Burn Out. Full time staff and RNs were more likely to experience higher Compassion Fatigue and Burn Out. Therefore, Practice Status and Professional Affiliation appear to denote the intensity and frequency of exposure to secondary stress, and may be considered as a dose-response measure. In addition, the impact of Principal Institution of practice was discernible on levels of Compassion Fatigue and Burn Out but not of Compassion Satisfaction. Details of overall results have been published in the journal of Palliative Medicine in December 2011. Further analysis is in progress and will involve modelling to determine the impact of types of organizational culture and how they can make up for any deficit in professional culture as well as the impacts of individual attributes on Compassion Satisfaction.
To share our study findings, a two day meeting of various stakeholder leaders was held in Vancouver last year. Discussions were held among participants to 1) determine which messages held value for the palliative care workforce, 2) determine who the audiences for each message were and 3) outline tools, venues, and platforms for bringing these messages to the target audiences. A two-fold approach, targeting both broad and specific audiences was decided upon. The broad approach incorporates leveraging existing platforms, forums and educational programs to disseminate the main messages at a national level. The targeted approach will involve specific workplaces (eg. Canuck Place – Vancouver, Victoria Hospice, Winnipeg Regional Program and Edmonton Regional Palliative Care Program), among others, to act as early adopters, and use the survey, discussion guides and vignettes as they become available. The second phase of this KT activity is the development and delivery of meaningful and applicable tools for dissemination of the research evidence. This end-of-grant KT phase was also funded by the CIHR.
1. Figley C. (1995a). Compassion fatigue: Toward a new understanding of the costs of caring. In B. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 3–28). Lutherville, MD: The Sidran Press.
2. Stamm BH. The ProQOL Manual. Retrieved from http://www.proqol.org/ProQOl_Test_Manuals.html (accessed Oct 2005)
3. Alkema K, Linton JM, Davies R. A study of the relationship between self-care, compassion satisfaction, compassion fatigue, and burnout among hospice professionals. J Soc Work End Life Palliat Care 2008; 4 (2): 101-119.