Work Environmental Factors Associated with Compassion Satisfaction and End-of-Life Care Quality Among Nurses in General Wards, Palliative Care Units, and Home Care Settings: A Cross-Sectional Survey

Abstract

Background: Nurses providing end-of-life care experience not only burnout and compassion fatigue, but also positive effects such as compassion satisfaction. Nurses’ compassion satisfaction was shown to be related to job satisfaction, work engagement, and nurse caring. Studies in emergency departments, intensive care units, oncology wards, and general wards have identified work environmental factors associated with nurses’ compassion satisfaction, but no similar studies have been conducted in palliative care units or home care settings. It is also unknown whether work environmental factors associated with compassion satisfaction contribute to end-of-life care quality.

Objective: To explore work environmental factors associated with nurses’ compassion satisfaction and end-of-life care quality in three types of workplaces: general wards, palliative care units, and home care settings.

Design: A cross-sectional survey of nurses providing end-of-life care.

Settings: Sixteen general wards, 14 palliative care units, and 25 home-visit nursing agencies in Japan.

Participants: There were 347 study participants: 95 nurses in general wards, 128 in palliative care units, and 124 in home care settings.

Methods: Compassion satisfaction was assessed using the Professional Quality of Life Scale, and end-of-life care quality was rated on a 4-point scale. Work environments were assessed using the Areas of Worklife Survey, which measures the fit between an individual and their work environment in six areas: workload, control, reward, community, fairness, and values.

Results: Compared to nurses in general wards and palliative care units, home care nurses scored statistically significantly higher on all work environmental factors except reward. Work environmental factors that were significantly positively associated with higher compassion satisfaction were values in general wards (β = 0.335, P = 0.007), reward and workload in palliative care units (β = 0.266, P = 0.009 and β = 0.179, P = 0.035), and community and control in home care settings (β = 0.325, P = 0.001 and β = 0.261, P = 0.004). In addition, higher scores for workload in general wards (odds ratio = 5.321; 95% confidence interval, 1.688–16.775) and for community in palliative units (odds ratio = 2.872; 95% confidence interval, 1.161–7.102) were associated with higher end-of-life care quality. No associated work environmental factors were found in home care settings.

Conclusions: Work environmental factors associated with nurses’ compassion satisfaction and end-of-life care quality varied between workplaces. These results may contribute to creating work environments that are appropriate for each workplace type to maintain both nurses’ compassion satisfaction and end-of-life care quality.

Note:
Funding declaration: This work was supported by JSPS KAKENHI Grant Number JP20K18842 (Grant-in-Aid for Early-Career Scientists). The funders had no role in the study design, implementation, manuscript development, or decision to publish.

Conflict of Interests: None

Ethical Approval: This study was approved by the ethics board of University of Tsukuba Hospital (No. R04-056).

Keywords: Compassion satisfaction, Cross-sectional survey, end-of-life care, work environment, Workplaces