Thompson, Ellysia-Grace and Fletcher, Ian and Huxley, Adam and Seager, Martin (2018) The cost of caring : what contributes to compassion fatigue. PhD thesis, Lancaster University.
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Abstract
A growing body of literature has attempted to understand the personal costs associated with professionally caring for others. This thesis aimed to balance both qualitative and quantitative methods to better understand compassion fatigue within mental health and drug and alcohol professions. A qualitative meta-synthesis was conducted in order to understand the lived experience of compassion fatigue, vicarious/secondary trauma, and burnout. Reviewing eleven papers demonstrated that feeling undervalued and lacking resources contributed to experiencing compassion fatigue, secondary trauma, and/or burnout; finding meaning, personal and professional growth, feeling supported, and proactively participating in self-care maintained compassion. The second aim of this thesis was to better understand compassion fatigue in professionals working in substance misuse services. An e-survey using established quantitative measures investigated the influence of individuals’ emotional skills on their responses to workplace and service user specific stressors, and compassion satisfaction and fatigue. A high prevalence of compassion fatigue was found in substance misuse services (57%), yet many more participants also experienced compassion satisfaction (81%). Compassion fatigue was predicted by professionals’ perception of the strain which working with substance use had on them, and this relationship was moderated by emotional suppression and emotion contagion (ΔR2 = .052, F(1, 80)= 5.62, p.005). The effects of workplace strain on compassion satisfaction was mediated by the meaning that professionals ascribe to their roles (b = 1.20, 95% BCa CI 2.01, -55). This thesis highlighted that professionals’ experiences of distress are linked to the context in which they work, and with their relationships with service users, their peers, and the wider organisational culture. Whilst awareness and support at an individual level are necessary to maintain compassion, it is important that compassion is also addressed at an organisational and cultural level.