Palliative Care Professionals' Inner Life: Exploring the Relationships Among Awareness, Self-Care, and Compassion Satisfaction and Fatigue, Burnout, and Coping With Death

J Pain Symptom Manage. 2015 Aug;50(2):200-7. doi: 10.1016/j.jpainsymman.2015.02.013. Epub 2015 Feb 18.


Context: Professionals working in the landscape of death and dying frequently are exposed to existential issues, psychological challenges, and emotional distress associated with care at the end of life. Identifying factors that help professionals cope with frequent exposure to issues related to mortality could enhance palliative care providers' and patients' quality of life.

Objectives: To improve our understanding of the factors associated with professionals' inner life, through the assessment of an adapted version of Kearney and Kearney's awareness model of self-care. The main assumptions of the study were that competence in coping with death and awareness would be positively related to compassion satisfaction and negatively to compassion fatigue and burnout; moreover, participating in a specific training program aimed at facing suffering and death, and self-care would positively predict coping with death.

Methods: A cross-sectional online survey of Spanish palliative care professionals was conducted through the member e-mail list of the Spanish Society of Palliative Care. A total of 387 professionals completed the survey, which included demographic data, and personal and professional scales on the mentioned constructs.

Results: Data fit reasonably well with the estimated model. Whereas the hypothesis relating spiritual training to coping with death was not supported by the data, all other aspects of the hypotheses were supported, namely self-care and awareness positively predicted professionals' competence in coping with death, and this, together with awareness, positively predicted compassion satisfaction and negatively predict compassion fatigue and burnout.

Conclusion: The awareness-based model of self-care was successfully tested in a multidisciplinary sample of Spanish palliative care professionals. This research applies a quantitative evaluation of the model, providing evidence of a constellation of key variables for health professionals' quality of life, such as specific training, self-care, awareness and coping with death competency.

Keywords: Palliative care professionals; awareness; burn out; compassion fatigue; compassion satisfaction; self-care.

MeSH terms

  • Adaptation, Psychological
  • Attitude of Health Personnel
  • Awareness
  • Burnout, Professional / psychology
  • Compassion Fatigue / psychology
  • Cross-Sectional Studies
  • Death
  • Empathy
  • Health Personnel / psychology*
  • Humans
  • Models, Psychological
  • Palliative Care / psychology*
  • Personal Satisfaction
  • Spain