A multi-method quasi-experimental study to assess compassion satisfaction/fatigue in nurses, midwives and allied health professionals receiving a narrative medicine intervention

J Adv Nurs. 2023 Sep;79(9):3595-3608. doi: 10.1111/jan.15686. Epub 2023 Apr 23.

Abstract

Aims: To: (1) measure the impact of a narrative medicine intervention on compassion fatigue and compassion satisfaction of nurses, midwives and allied health professionals; (2) explore participants' working experiences and (3) their impressions of the intervention.

Design: Multi-methods, quasi-experimental before-after intervention design.

Methods: The intervention consisted of 20 narrative medicine sessions (60 h). Healthcare providers (N = 48) from a mother-and-child hospital in Italy completed the 'Professional quality of life' questionnaire before and after the intervention (January 2020-April 2021). Baseline scores served as internal controls. Open-ended questions explored participants' touching experiences at work and their evaluation of the intervention. A thematic content analysis was performed. Reporting followed the TREND and SRQR guidelines.

Results: The differences before-after intervention in compassion satisfaction or fatigue scores were not statistically significant. Three themes emerged from participants' touching experiences: "Witnessing death and sufferance"; "Witnessing violence" and "Organizational stressors during COVID-19". A statistically significantly higher median score for post-intervention compassion satisfaction was found among participants who reported at least one touching experience compared to those who had no touching experience. Four themes emerged from the reported strengths of the program: "Learning to exteriorize feelings"; "Team building"; "Useful to rework personal/professional journey" and "Develops professional empowerment". Two themes emerged from reported weaknesses: "Programme organization" and "Participants' difficulties in sharing experiences".

Conclusion: A time-limited narrative medicine intervention is not sufficient to produce significant changes in satisfaction or compassion fatigue, especially if implemented during a pandemic. However, such an intervention holds promise for supporting nurses and midwives' professional empowerment and promoting continuity of compassionate care.

Impact: For those at risk of compassion fatigue, policymakers need to invest in training in narrative medicine, which promotes team building, and employee well-being and thus favours compassionate care. Such programmes should be offered to undergraduate students to nurture compassion and attention to self.

Patient or public contribution: Does not apply as the study only includes health care providers.

Keywords: burnout; compassion; compassion fatigue; compassionate care; narrative medicine; nursing care; personal narratives; ‘nurses’, ‘midwives’.

MeSH terms

  • Allied Health Personnel
  • Burnout, Professional* / prevention & control
  • COVID-19*
  • Compassion Fatigue* / prevention & control
  • Empathy
  • Female
  • Humans
  • Job Satisfaction
  • Midwifery*
  • Narrative Medicine*
  • Nurses*
  • Personal Satisfaction
  • Pregnancy
  • Quality of Life
  • Surveys and Questionnaires