Table 1 Summary Table of Included Studies

Alkema et al. [1], USA

Outpatient palliative care settings: home hospice settings.

Quantitative (Cross sectional survey)

n = 37

Hospice Professionals including

17 Registered Nurse

5 Home Health Aide

4 Social Worker

2 Volunteer Coordinator

3 Bereavement Professional

2 Chaplain

1 Administrative Assistant

2 Medical Director

2 Other.

Examine the relationships among self-care, compassion fatigue, compassion satisfaction, and BO among hospice care workers.

Self-care strategies were associated with decreased levels of compassion fatigue and BO and higher levels of compassion satisfaction.

Barnett, Ruiz [16], USA

Both inpatient and outpatient palliative care settings

Inpatient – hospices, hospitals, nursing homes, other long-term care facilities,

Outpatient – home healthcare.

Quantitative (Cross sectional survey)

90 hospice nurses.

To study the role of self-esteem in mediating the relationship between compassion fatigue and psychological distress among hospice nurses.

Psychological distress can decrease self-esteem, and thereby increase the risk of compassion fatigue.

Bessen et al. [17], USA

Medical centre – unable to determine if includes both inpatient and outpatient settings.

Qualitative (semi-structured interviews)

13 physicians.

To describe compassionate care provision by physicians during end-of-life care.

There were variable ways for delivering compassionate care. Physicians need training in end-of-life care to overcome some barriers of providing care on organizational and individual level.

Frey et al. [18], New Zealand

Inpatient – hospital, hospice, residential aged care,

Outpatient – hospital, community hospice, district nursing, general practice, other community services.

Quantitative (Cross sectional survey)

256 registered nurses.

To investigate BO and compassion fatigue and their associated factors among nurses in New Zealand.

BO negatively associated with psychological empowerment & commitment & challenge components of psychological hardiness. STS negatively associated with palliative care education.

Compassion satisfaction positively associated with palliative care education, psychological empowerment, & both commitment & challenge components of psychological hardiness.

Galiana et al. [19], Brazil and Spain.

Inpatient and outpatient palliative care settings including hospice

(Home-based palliative care

Social-health center unit palliative care

Hospital support team

Hospice

Oncology unit

Intensive treatment unit

Pediatrics unit of palliative care

Others)

Psychometrics

Brazil/ (n = 161)

Spain/ (n = 385)

PCHP including doctors, nurses, psychologists, nursing assistants, social workers and other. (Individual providers number not specified)

To assess the reliability and validity of the Spanish and the Portuguese versions of the ProQOL scale.

Both Spanish and Portuguese versions of the ProQOL show good psychometric properties.

Heeter et al. [20], USA

Inpatient hospice and hospital palliative care settings

(Pre-Post) one group

36 Hospice and PCHP including nurses, managers from the respective home hospice and palliative care units, physicians, clerical, aides, social workers, and others. (Individual providers number not specified)

Examine the effects of 6-week technology-assisted meditation program on emotional awareness, compassion fatigue, and BO

The 6-week technology-assisted meditation technology successfully reduced compassion fatigue/BO and increased emotional awareness among the study participants.

Hill et al. [10]

Various settings

Systematic Review

547 PCHP across 9 studies 

To explore the effectiveness of interventions used to enhance psychological wellbeing of palliative care staff.

Few interventions were helpful to support palliative care staff and improve their well-being.

Hilliard [21], USA

Inpatient palliative care settings: hospice

Two groups pre-post-test group

n = 17 nurses, social workers, and chaplains (Individual providers number not specified)

To examine the effectiveness of music therapy to reduce compassion fatigue and improve team building of hospice workers.

Music therapy was effective to improve team building but not reduce compassion fatigue.

Hotchkiss [22], USA

Hospice settings from VITAS® Healthcare

Quantitative (Cross sectional survey)

324 Hospice care professionals including

68 Registered nurse

60 Chaplain

48 Social worker

40 Home health aid

28 Licensed vocational nurse

20 Administrative

16 Management

14 Nurse practitioners

8 Physician

4 Music therapists

18Other

Examine the relationship between compassion satisfaction, BO, STS, and mindful self-care

Participants had high levels of self-care and compassion satisfaction and low levels of STS and BO. Self-care strategies can improve compassion satisfaction.

Kaur et al. [23], India

Inpatient and Outpatient palliative care settings including hospice (hospital and hospice at cancer palliative care centers)

Quantitative (Cross sectional survey)

65 PCHP including doctor, nurse, counselor, psychologist, social worker, pharmacist, or physiotherapist. (Individual number not specified).

To explore the professional quality of life among PCHP.

The authors concluded that implementing specific interventions could be helpful to reduce STS and BO and enhance compassion satisfaction among PCHP.

Melvin [24], USA

Outpatient palliative care settings: home health agency

Qualitative (semi-structured interviews)

6 palliative care nurses

Assess prevalence of compassion fatigue, its consequences, and methods of coping with it among palliative care nurses.

Compassion fatigue had negative physical and emotional health impacts on palliative care nurses.

Montross-Thomas et al. [25], USA

Can not determine the participants were recruited online through a membership list serve of the National Hospice and Palliative Care Organization (NHPCO). All participants were hospice staff or volunteers who were emailed a description of the study and a Survey Monkey link

Quantitative (Cross sectional survey)

390 hospice staff and volunteers (Individual providers not specified)

To investigate the role of practicing rituals to improve professional quality of life among hospice care providers

Hospice care providers who practice rituals were found to have better professional quality of life.

Mota Vargas et al. [26], Spain

Can not determine (purposeful sample)

Qualitative (semi-structured individual interviews)

10 PCHP include nurses, doctors and psychologists.

Individual providers number not specified).

To describe experiences of palliative care workers over time

PCHP were found to go through various phases during their professional life.

O’Mahony et al. [27], USA

Can not determine

Participants were recruited from a group of 70 professionals participating in a continuing education program on palliative medicine in Midwest Academic Medical Center

Quantitative (Cross sectional survey)

66 PCHP including physicians, nurses, chaplains, social workers, and other. (Individual providers number not specified)

Examine the relationship between personality traits and compassion fatigue in PCHP.

Neuroticism was associated with STS and BO. Agreeableness was associated with compassion satisfaction. Experience in palliative care was associated with lower levels of BO and increased levels of compassion satisfaction.

Samson, Shvartzman [28], Israel

Both inpatient and outpatient palliative care settings (hospital-based and/or home-based palliative care units)

Quantitative (Cross sectional survey)

144 PCHP including

47 Physicians

97 Nurses

To identify the association between STS and peritraumatic dissociation among palliative workers.

STS was found to be significantly correlated with clinical levels of peritraumatic dissociation among palliative workers.

Samson, Shvartzman [29], Israel

Both inpatient and outpatient palliative care settings (end-of-life community- and hospital-based palliative care units)

Quantitative (Cross sectional survey)

241 participants providing palliative care and primary care including

84 Physician

157 Nurse

To assess the relationship between exposure to death and dying and professional quality of life in PCHP

There was a significant relationship between exposure to death and dying and professional quality of life among the study participants.

Samson et al. [30], Israel

Both inpatient and outpatient palliative care settings including hospice (home- and hospital-based hospice units and of primary health care providers, working in Clalit Health Care Services and Maccabi Health Care Services (the two largest health care organizations in Israel)

Quantitative (psychometric properties)

1100 health care providers

To assess the reliability and validity of the Hebrew version of the 30-item ProQol scale

The Hebrew version of the compassion satisfaction subscale was found to show good psychometric properties

Sansó et al. [31], Spain

Can not determine settings: member e-mail list of the Spanish Society of Palliative Care

Quantitative (Cross sectional survey)

387 PCHP include doctors, nurses, psychologists, nursing assistants, social workers. (Individual providers number not specified)

To assess the relationships among Self-Care, Awareness, professional quality of life, and Coping with Death among PCHP.

There was a significant relationship among the study variables consistent with the awareness-based model of self-care.

Slocum-Gori et al. [32], Canada

Can not determine: The Canadian Hospice Palliative Care Association (CHPCA) provided their membership mail-out for contacting managers and administrators of HPC organizations.

Quantitative (Cross sectional survey)

630 PCHP including clinical, administrative, allied health workers and volunteers. (Individual providers number not specified)

Examine the relationships among compassion fatigue, compassion satisfaction, and BO among palliative care workers

Compassion satisfaction was negatively associated with BO and compassion fatigue. BO and compassion fatigue were positively associated.

Compassion satisfaction, BO, and compassion fatigue differed significantly according to some characteristics of the sample.

Zambrano et al. [33], Australia.

Inpatient and outpatient palliative care settings including hospice (inpatient unit/ hospice, a consultation liaison into tertiary and other hospitals in the region and a community outreach program)

Qualitative (one-on-one interview)

7 palliative medicine physician specialists

To assess experiences of palliative medicine specialists who provide care for dying patients, as well as the impact of providing care for these patients

The study participants were at high risk for compassion fatigue. However, they used some coping strategies that reduced their stress.