Grief as a mediator of the relationship between empathy and compassion fatigue

Oncology nurses are at high risk of developing compassion fatigue (CF) because of the persistent exposure to patients' suffering and death. Empathy is a prerequisite cognitive reaction for CF. Nurses with greater empathy levels are more prone to develop an emotional connection with patients. However, it is this kind of close bonds that led nurses to experience a deep sense of grief. Cumulative grief may eventually develop into CF. This study examined the levels of grief, empathy and CF, evaluated the correlation among empathy, grief and CF, and verified the role grief as a mediator of the relationship between empathy and CF.

Participants were 794 Chinese oncology nurses in a cross-sectional study. We measures consisted a demographic questionnaire, the Interpersonal Reactivity Index, the Texas Revised Inventory of Grief-Present, and the Professional Quality of Life Scale.

Oncology nurses showed moderate levels of empathy and grief, moderate to high levels of CF. Perspective taking was negatively related to grief and secondary traumatic stress (STS). Empathic concern was negatively related to burnout (BO). Personal distress was positively related to grief, STS and BO. Grief was positively related to STS and BO. Grief played a partial mediating role between empathy and STS.

Oncology nurses commonly experience CF. There is a need to provide interventions and effective supports for oncology nurses to improve their empathy ability, and help them cope with grief and CF.