Toward a comprehensive, theoretical model of compassion fatigue: An integrative literature review

Nurs Health Sci. 2018 Mar;20(1):4-15. doi: 10.1111/nhs.12387. Epub 2017 Nov 20.


This study was an integrative literature review in relation to compassion fatigue models, appraising these models, and developing a comprehensive theoretical model of compassion fatigue. A systematic search on PubMed, EbscoHost (Academic Search Premier, E-Journals, Medline, PsycINFO, Health Source Nursing/Academic Edition, CINAHL, MasterFILE Premier and Health Source Consumer Edition), gray literature, and manual searches of included reference lists was conducted in 2016. The studies (n = 11) were analyzed, and the strengths and limitations of the compassion fatigue models identified. We further built on these models through the application of the conservation of resources theory and the social neuroscience of empathy. The compassion fatigue model shows that it is not empathy that puts nurses at risk of developing compassion fatigue, but rather a lack of resources, inadequate positive feedback, and the nurse's response to personal distress. By acting on these three aspects, the risk of developing compassion fatigue can be addressed, which could improve the retention of a compassionate and committed nurse workforce.

Keywords: compassion fatigue models; compassion satisfaction; empathy; nursing practice environment.

Publication types

  • Review

MeSH terms

  • Compassion Fatigue / physiopathology*
  • Compassion Fatigue / psychology*
  • Humans
  • Job Satisfaction*
  • Models, Theoretical*
  • Nurses / psychology*