Caring for the caregivers: Evaluation of the effect of an eight-week pilot mindful self-compassion (MSC) training program on nurses' compassion fatigue and resilience

Martin C Delaney, Martin C Delaney

Abstract

Background: Nurses vicariously exposed to the suffering of those in their care are at risk of compassion fatigue. Emerging research suggests that self-compassion interventions may provide protective factors and enhance resilience. This pilot study examined the effect of an eight-week Mindful Self-Compassion (MSC) training intervention on nurses' compassion fatigue and resilience and participants' lived experience of the effect of the training.

Methods: This observational mixed research pilot study adopted an evaluation design framework. It comprised of a single group and evaluated the effects of a pilot MSC intervention by analyzing the pre- and post-change scores in self-compassion, mindfulness, secondary trauma, burnout, compassion satisfaction, and resilience. The sample of the nurses' (N = 13) written responses to the question, "How did you experience the effect of this pilot MSC training?" were also analyzed.

Results: The Pre- to Post- scores of secondary trauma and burnout declined significantly and were negatively associated with self-compassion (r = -.62, p = .02) (r = -.55, p = .05) and mindfulness (r = -.54, p = .05). (r = -.60, p = .03), respectively. Resilience and compassion satisfaction scores increased. All variables demonstrated a large effect size: Mean (M) Cohen's d = 1.23. The qualitative emergent themes corroborated the quantitative findings and expanded the understanding about how MSC on the job practices enhanced nurses' coping.

Conclusion: This is the first study to examine the effect of a pilot (MSC) training program on nurses' compassion fatigue and resilience in this new area of research. It provides some preliminary empirical evidence in support of the theorized benefits of self-compassion training for nurses. However, further research, such as a Randomized Control Trial (RCT) with a larger sample size and a longitudinal study, is required to see if the benefits of self-compassion training are sustainable.

Conflict of interest statement

The author has declared that no competing interests exist.

Figures

Fig 1. Dialogue map of the emergent…
Fig 1. Dialogue map of the emergent themes and a sample of participants’ responses [49].

References

    1. Figley CR. Compassion fatigue as secondary traumatic stress disorder: An Overview In: Figley, editor. Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner-Routledge; New York: 1995.
    1. Fortney L, Lucherland T, Zakletskaia L, Zgireska A, Rakel D. Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: A pilot study. Ann Fam Med. 2013; 11(5) 412–420.
    1. Rabb K. Mindfulness, self-compassion and empathy, among health care professionals: A review of the literature. J Health Care Chaplain. 2014; 20: 95–108.
    1. Olson MA, Kemper KJ, Mahan JD. What factors promote resilience and protect against burnout in first year pediatric and medicine-pediatric residents. J Evid Based Complementary Altern Med. 2015; 1–7. Sage Publications.
    1. Stamm BH. Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL); (2012). Available from: September 2014.
    1. Figley CR. Treating compassion fatigue. New York: Brunner Routledge; 2002b.
    1. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2002; 52: 379–422.
    1. Klimecki O, Lieberg S, Lamm C, Singer T. Functional neural plasticity and associated changes in positive affect after compassion training. Cereb cortex. 2012; By permission of Oxford University Press.
    1. Valents P. Diagnosis and treatment of helper stresses, traumas and illness In: Figley CR, editor. Treating compassion fatigue. Bruner Routledge; New York; 2002.
    1. Bride B. Secondary Traumatic Stress In Figley CR (Ed) Encyclopedia of Trauma. Sage Publications; 2012.
    1. Shapir L, Astin A, Bishop S, Cordova M. Mindfulness based stress reduction for health care professionals: Results from a randomized trial. Int J Stress Manag. 2005; 12(2): 164–176.
    1. Boellinghaus IA. Cultivating compassion in psychological therapists: The potential of loving-kindness meditation. D.Clin.Psych. 2011. thesis, Canterbury Christ Church University.
    1. Mac Beth A, Gumley A, Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clin Psychol Rev. 2012; 32 (6) pp.545–552. ISSN: 0272-7538.
    1. Barnard LK, Curry JF. The relationship of clergy burnout to self-compassion and other personality dimensions. Pastoral Psychol. 2011a; 61: 149–163.
    1. Neff KD. The science of self-compassion In: Germer C, Seigel R, editors. Compassion and wisdom in psychotherapy. New York: Guilford Press; 2012, pp. 79–92.
    1. Neff KD, Germer CK. A pilot study and randomized controlled trial of the mindful self-compassion program. J Clin Psychol. 2012; 69(1): 28–44.
    1. Thabane et al., (2010) A tutorial on pilot studies: The what, why and how. Available online @
    1. Teijlingen ER, Hundley V. The importance of pilot studies. Soc Res update: Department of Sociology Surrey. 2001; ISSN: 1360-7898.
    1. Leon AC, Davis LL, Kraemer HC. The role and interpretation of pilot studies in clinical research. J Psychiatr Res. 2011; May, 45(5): 626–629.
    1. Lee EC, Whitehead AL, Jacques RM, Julious SA. The statistical interpretation of pilot trials: Should significance thresholds be reconsidered? BMC Med Res Methodol. 2014; 14: 41
    1. Gilbert P. The compassionate mind. London: Constable & Robinson; 2010.
    1. Gilbert P, Choden, Mindful compassion: Using the power of mindfulness and compassion to transform our lives. London: Robinson; 2013.
    1. Neff KD, Mc Gehee P. Self-compassion and psychological resilience among adolescents and young adults. Self and Identity. 2010; (9): 225–240 Available from:
    1. Neff K. D. Self-compassion: An alternative conceptualization of a healthy attitude towards oneself. Self and Identity. 2003b; 2: 85–102.
    1. Nairn R. Diamond mind: A psychology of meditation. Boston: Shambhala; 2001.
    1. Neff KD, Dahm KA. Self-compassion: What it is, what it does, and how it relates to mindfulness [Unpublished]. In Robinson M, Meir B, Ostafin B, editors. Mindfulness and self-regulation. New York: Springer; 2013.
    1. Neale M. (2015) The psychology of the four immeasureables. Available @ June 2015.
    1. STROBE guidelines for observational studies. Equator-network observational studies guidelines 41, A checklist to improve reporting of group-based behavior-change interventions.[available @ 41]
    1. Brannen J. Mixed methods research: A discussion document paper. National Center for Research Methods. 2005. Available from: methods review paper
    1. Hanson WE, Creswell JW, Plano Clark VL, Petska KS, Creswell JD. Mixed methods research designs in counseling psychology. Available from:
    1. Tsshakkori A, Teddlie C, editors. Handbook of mixed methods in social and behavioral research. Thousand Oaks, CA: Sage; 2003.
    1. Leech NL, Onwuegbuzie AJ. Guidelines for conducting and reporting mixed research in the field of counselling and beyond. JCD. 2010; 88
    1. Smith JA. Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qual Res Psychol. 2004; 1,39–54.
    1. Brocki JM, Wearden AJ. A critical evaluation of the use of interpretative phenomenological analysis (IPA) in health psychology. Health Psychol. February 2006; 21(1): 87–108.
    1. Julious SA. Sample size of 12 per group rule of thumb for a pilot study. Pharmaceut. Statist. 2005; 4: 287–291.
    1. Belle GV. Statistical rules of thumb 2nd ed. New Jersey: John Wiley & Sons; 2008.
    1. Conroy RM. The RCSI sample size handbook: A rough guide. 2016; Available from:
    1. Palmer M, Fadden G, Larkin M, deVisser R. Developing an interpretative phenomenological approach to focus group data. Qual Res Psychol. 7(2): 99–121.
    1. Saldana J. The coding manual for qualitative researchers. London, UK: Sage Publications; 2009.
    1. Carlson LE. Mindfulness-based interventions for physical conditions: A narrative review evaluating levels of evidence. ISRN; 2012; ID 651583: 21, doi:
    1. Germer CK, Neff KD, Becker M, Hickman S. MSC teacher guide revised. Center for Mindful Self-Compassion; 2014.
    1. Neff KD. Development and validation of a scale to measure self-compassion. Self and Identity. 2003a; 2: 223–250.
    1. Walach H, Bucheld N, Buttenmuanller V, Kleinknecht N, Schmidt S. Measuring mindfulness, the Freiburg Mindfulness Inventory (FMI). Personality and Individual Differences. 2006; 40: 1543–1555.
    1. Connor KM, Davidson JR. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC) Depression and Anxiety. 2003; 18: 76–82.
    1. Simmons CA., Lehmann P., Tools for Strengths-Based Assessment and Evaluation, Springer Publishing; New York: 2013.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences (2. Auflage). Hillsdale, NJ: Erlbaum; 1988.
    1. Lenhard W, Lenhard A. Calculation of effect sizes. Available from: @. 2016; Dettelbach (Germany): Psychometrica. doi:
    1. Pearson Product-Moment Correlation available @
    1. Brightman J. Mapping methods for qualitative data. Available from: ; 2003.
    1. Neff KD, Rude SS, Kirkpatrick KL. An examination of self-compassion in relation to positive psychological functioning and personality traits. J Res Personality. 2007; 41(4)
    1. Birnie K, Speca M, Carlson LE. Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR) Stress and Health. 2010; 26: 359–371 2010 John Wiley & Sons, Ltd.
    1. Shapiro L, Astin A, Bishop S, Cordova M. Mindfulness based stress reduction for health care professionals: Results from a randomized trial. Int J Stress Manag. 2005; 12(2): 164–176.
    1. Shapiro L, Brown WK, Biegel GM. Teaching self-care to caregivers: Effects of mindfulness based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology. 2007; 1(2): 105–115.
    1. Kabat-Zinn J, Santorelli SK. Mindfulness based stress reduction professional training manual. University of Massachusetts Medical School; USA: Center for Mindfulness in Medicine, Health Care, and Society.; 2009.
    1. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L, Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006; 13(1): 27–45.
    1. Potter P, Faan TD, Berger JA, Clarke M, Pa C, Olsen S, Chen L. Evaluation of a compassion fatigue resiliency programme for oncology nurses. Oncology Nursing Forum. March 2013; 40(2).
    1. Cuijpers P, Smith F, Bohlmeijer E, Holson SD, Anderson G. Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: Meta-analytic study of publication bias. Br J Psychiatry. March 2010; 196(3): 173–178.
    1. Thomas G. How to do your research project. 2nd ed. Sage; London; 2013.
    1. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: Assessing the ability to bounce back. Int J Behav Med. 2008; 15: 194–200. Accessed from: . June 2015.
    1. Cayoun BA. Mindfulness integrated CBT for well-being and personal growth. Australia: Wiley Blackwell Publications; 2015.
    1. Hanson R. Hardwiring Happiness: The practical science of reshaping your brain and your life. London: Rider ebook; available
    1. Fredrickson BL. Cultivating positive emotions to optimize health and well-being: Prevention and treatment. APA. (March 7, 2000).
    1. Fredrickson BL, Cohn MA, Coffey KA, Pek J, Finkel SM. Open hearts build lives: Positive emotions induced through loving-kindness meditation build consequential personal resources. J Pers Psychol. 2008; 95(5): 1045–1062.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe