COMPASSION FATIGUE

Stress, Burnout and Compassion Fatigue Among Nurses in Ireland

Stress, Burnout and Compassion Fatigue Among Nurses in Ireland

Introduction

Functional status has been generally defined as the ability to perform various physical, social, and vocational activities and can be measured through the actual performance of tasks or through self-report functional assessment measures (Nelson et al., 1983). The assessment of functional status allows for the identification of individuals with compromised functional status and leads to methods for improving functional abilities. Clinical practices that incorporated functional status assessment into routine care demonstrated improved patient health status, satisfaction, and quality of life (Nelson et al., 1983; Wasson et al., 1992). Additionally, functional status measures quantify the impact of illness, particularly for individuals with chronic conditions (Wasson et al., 1992). Although many questionnaire-based assessments have been developed, a measure developed by the Dartmouth Primary Care Cooperative Information Project (known as the “COOP Charts”) has advantages over other functional status measures. The COOP Charts are brief, yet reliable and valid, compared with longer instruments (Beaufait et al., 1992; Nelson, Landgraf, Hays, Kirk, et al., 1990). There are nine COOP charts: four that assess specific dimensions of functioning (physical functioning, emotional functioning, role functioning, and social functioning), three that assess overall health (overall health, changes in health, and bodily pain), and two that are concerned with assessing quality of life (overall quality of life and degree of social resources and support; Dartmouth Primary Care COOP Project, 1992).

The COOP Charts have been administered to various medical and psychiatric populations and were found to be sensitive to the presence of illness. Among primary care patients, reported functional impairments on the COOP Charts were found to be associated with the presence of illness, increased utilization of medical services, and increased age (Krousel-Wood & Re, 1994; Nelson, Landgraf, Hays, Wasson, & Kirk, 1990; Olmos et al., 1994). Nelson, Landgraf, Hays, Wasson, and Kirk (1990) and Olmos et al. (1994) also found increases in functional impairments with increased age. Nelson, Landgraf, Hays, Kirk, et al.(1990) found that patients with self-reported major limitations in functioning most frequently had primary diagnoses of chronic conditions, such as atherosclerotic heart disease, diabetes, congestive heart failure, chronic obstructive pulmonary disease, and anxiety or depression.

The multiple effects of illness on various dimensions of an individual's functional status and well-being have been documented with the COOP Charts (Nelson, Landgraf, Hays, Kirk, et al., 1990). Fatigue, which is a common symptom secondary to most physical illnesses and psychiatric disorders (David et al., 1990; Valdini, Steinhardt, Valicenti, & Jaffe, 1988), has been associated with impairments in functional status. Kroenke, Wood, Mangelsdorff, Meier, and Powell (1988) were able to differentiate fatigued patients from controls on the basis of performance on a self-report measure of functional status and found that the global impairments in functional status reported by fatigued patients were similar to limitations reported by other medical populations.

Chronic fatigue has been defined as fatigue lasting for greater than 1 month. The most common causes of chronic fatigue include viral infections, cardiovascular disorders, and endocrine ...