Compassion fatigue among family caregivers of individuals with end-state heart failure

Abstract

<p><strong>Background:</strong> Compassion fatigue is a phenomenon identified in family caregivers. Heart failure is a public health crisis, affecting over six million people in the United States. The need for family caregivers, and the need for them to be supported by health care professionals, is expected to rise. Social distancing during COVID-19 may have added further challenges to caregiving routines.</p> <p><strong>Aim:</strong> The purpose of this study was to examine the relation between family caregiver demographic characteristics and compassion fatigue for caregivers who were caring for family members with end-stage heart failure. Specifically, the study examined the relation of compassion satisfaction, social desirability, and the relationship between the family caregiver and nursing provider on compassion fatigue. The research was conducted during the COVID-19 pandemic and examined the family caregiver perception of the effect of COVID-19 on caregiving routines.</p> <p><strong>Method:</strong> The Interaction Model of Client Health Behavior was adapted to guide the cross-sectional study. Braun and Clark&rsquo;s method guided open-ended response thematic analysis. The survey was comprised of four instruments: the Professional Quality of Life Scale, the Caregiver-Provider Relationship Assessment, the Marlowe Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. To determine caregiver perception of COVID-19&rsquo;s impact, one Likert question and one open-ended response were asked.</p> <p><strong>Findings:</strong> One hundred twenty-seven participants completed the entire survey. Increased compassion satisfaction, positive caregiving effects, and a satisfactory family caregiver-provider relationship were associated with decreased compassion fatigue (<em>ps</em> &lt; .001), while increased social desirability was associated&nbsp;with&nbsp;increased&nbsp;compassion&nbsp;fatigue&nbsp;(<em>p</em> &lt; .001). An increase in the family caregiver-nursing provider relationship resulted in decreased compassion fatigue, increased social desirability, greater positive effects of being a caregiver, and increased compassion satisfaction (<em>p</em> &lt; .001). Reported less spiritual support yielded an increase in&nbsp;compassion&nbsp;fatigue&nbsp;(<em>p</em> &lt; .001). The COVID-19 open-response question replies (113) yielded themes such as social isolation, added fear, anxiety, or worry, changed appointments, wearing masks, and living status change. Social isolation (46.1%) was the most common theme; the most significant theme was living status change (<em>p</em> = .003) and&nbsp;family&nbsp;caregivers&nbsp;reported the pandemic affected their routines either negatively or somewhat negatively (62.1%).</p> <p><strong>Conclusion:</strong> Although this study focused on family caregivers of individuals with end-stage heart failure, there are applications to family caregivers of other chronic diseases. FCGs may not recognize needing help; fostering relationship with FCGs will help identify assistance needs. Future research can continue to explore how some family caregivers experience compassion fatigue while others do not. Further, research is needed for the development of standard assessment and uniform services and to guide policies that support care transitions for family caregivers in the heart failure population. Nursing provider assessment of family caregivers is indicated at all points of care for needs in physical, psychological, social, and particularly, spiritual domains to prevent the negative consequences of compassion fatigue and residual effects of COVID-19 on caregiving practices.</p>