title: Prevalence, causes and consequences of compassion satisfaction and compassion fatigue in emergency care: a mixed-methods study of UK NHS Consultants.
abstract: OBJECTIVE
  To estimate prevalence and explore potential causes and consequences of compassion satisfaction and compassion fatigue in UK emergency medicine consultants.
  
  
  METHODS
  A sequential mixed-methods design. Cross-sectional e-survey to all UK NHS emergency medicine consultants (n=1317) including Professional Quality of Life (ProQOL) (compassion satisfaction/fatigue), followed by interviews with consultants scoring above (n=6) and below (n=6) predefined ProQOL thresholds.
  
  
  RESULTS
  681 (52%) consultants responded. Most (98%) reported at least 'average' compassion satisfaction. Higher scores were associated with type of workplace (designated trauma centres faring better) and number of years worked as a consultant (gradually worsen over time, except 20 years onwards when it improves). Consultants with lower (worse) compassion satisfaction scores were more likely to report being irritable with patients or colleagues and reducing their standards of care (a third reported these behaviours at least monthly) and were more likely to intend to retire early (59% had such plans). Key features distinguishing 'satisfied' from 'fatigued' interviewed consultants included having strategies to deal with the high work intensities associated with their role and having positive views of the team within which they worked. The degree of variety in their roles and the ability to maintain empathy for their patients were also distinguishing features between these groups.
  
  
  CONCLUSIONS
  Findings support an urgent review of workforce and resources in emergency medicine and suggest that a multifactorial approach to identification, prevention and treatment of occupational stress in the workforce is required that considers individual, job and organisational factors, particularly those that impact on perceived control and support at work.
authors.affiliation: Emergency Department, St George's Healthcare NHS Trust, London, UK.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dasan
authors.affiliation: Freelance researcher, London, UK.
authors.forename: Poonam
authors.initials: P
authors.lastname: Gohil
authors.affiliation: Department of Primary Care and Public Health Sciences, King's College London, London, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Cornelius
authors.affiliation: Florence Nightingale Faculty of Nursing & Midwifery King's College London, London, UK.
authors.forename: Cath
authors.initials: C
authors.lastname: Taylor
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000453:epidemiology; D000068376:Compassion Fatigue / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D003253:Consultants / Q000523:psychology*; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D004645:Empathy; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D015995:Prevalence; D012307:Risk Factors; D013222:State Medicine; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D017132:Workplace / Q000523:psychology; D055815:Young Adult
keywords: clinical care; emergency departments; psychology, staff support