Latent profiles of nurses' moral resilience and compassion fatigue

Nurs Ethics. 2023 Dec 26:9697330231222594. doi: 10.1177/09697330231222594. Online ahead of print.

Abstract

Background: Compassion fatigue is often associated with moral distress in the nursing practice among registered nurses. Moral resilience is an important ability to maintain, restore, or promote their physical and mental health in response to ethical dilemmas in nursing. Moral resilience can be utilized as a potential solution to aid registered nurses in effectively managing compassion fatigue.

Aim: To identify latent profiles of moral resilience among registered nurses and to explore the relationships of these profiles with compassion fatigue.

Research design: From August 2022 to December 2022, 569 nurses were recruited in two general hospitals, in China. A Rushton Moral Resilience Scale and the Chinese version of Compassion Fatigue-Short Scale were given to the participants. A latent profile analysis was conducted to explore moral resilience latent profiles. Predictors of profiles membership was evaluated using multinomial logistic regression analysis, and the compassion fatigue scores of each latent profile were compared using a one-way analysis of variance.

Ethical considerations: We obtained ethical approval from the Institution Review Board of Xiangya School of Nursing, Central South University (IRB No. E202293, approved 15/July/2022).

Results: A four-profile moral resilience model best fit the data. Different levels and shapes differentiated the four profiles: high moral resilience (28.7%), moderate moral resilience (52.3%), low responses and high efficacy (16.2%), and low moral resilience (2.8%). Nurses with bachelor's degrees were more likely to belong to the high moral resilience (OR = 0.118, p = .038) and moderate moral resilience (OR = 0.248, p = .045); Nurses who were divorced or separated (OR = 11.746, p = .025) and very dissatisfied with their work (OR = 0.001, p = .049) were more probably belonging to low moral resilience. Nurses who had received ethical training in the hospital were more likely involved in high moral resilience (OR = 5.129, p = .003) and low responses and high efficacy (OR = 5.129, p = .003). In each profile of moral resilience, compassion fatigue was experienced differently by the participants (F = 13.05, p < .001).

Conclusions: Developing and implementing interventions tailored to each nurse's moral resilience profile would maximize interventions' effectiveness and reduce nurses' compassion fatigue.

Keywords: Compassion fatigue; latent profile analysis; moral resilience; registered nurses; subgroups.