The Dual-Path Analysis of the Effect of Difficult Nurse-Patient Relationship on Compassion Fatigue and Compassion Satisfaction in Nurses

BACKGROUND: Although compassion fatigue has received significant attention in nursing management, compassion satisfaction has been less studied. PURPOSE: This study was designed to elucidate the positive and negative trends in nursing empathy from a dialectical perspective and investigate the impact of difficult nurse-patient relationship on compassion fatigue and satisfaction, and the underlying mechanisms. METHODS: A cross-sectional study was conducted from November to December 2022 at a tertiary hospital in a northeastern province of China on 1,756 nurses. A moderated mediation model was constructed using structural equation modeling, and multi-group comparative analysis was used to examine the differences in the proposed model. RESULTS: After adjusting for controlled variables, empathic concern and personal distress were shown to mediate the relationship between difficult nurse-patient relationship and, respectively, compassion satisfaction and burnout. Personal distress was found to mediate the relationship between difficult nurse-patient relationship and secondary traumatic stress, while self-reflection was found to moderate the effect of difficult nurse-patient relationship on empathic concern. Finally, differences in the structural model were detected between those with and without hospital traumatic experience. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings reveal the mechanisms and boundary conditions underlying difficult nurse-patient relationship that influence compassion fatigue and compassion satisfaction. Interventions that increase the level of self-reflection and empathic concern may help reduce burnout and increase compassion satisfaction in nurses.