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To determine compassion satisfaction among medical professionals. This study took 6 months to complete carried out at Isra University Karachi Campus. A total of 200 medical professionals were recruited for this study. The non-Convenient Sampling approach was adopted. Compassion satisfaction and compassion fatigue (ProQOL v5) were used for data collection. And data was analyzed through SPSS v 21. The mean age of the medical professionals who participated in this study was 29.99±7.89 and the working experience of 4.77±5.89 years. The majority of the were Physical therapist about 65%. A higher frequency of Average compassion satisfaction, burn out and secondary traumatic stress was observed which showed statistically non-significantly association with the area of practice of the medical professional at p-value 0.260 0.158, 0.170 respectively. Most medical professionals are encircled in average compassion satisfaction which showed a non-significant association with the area of practice.

Keywords

Compassion satisfaction, burnt out, stress, medical

Introduction

In an exceptional healthcare situation, providing care for others can result in emotional rewards. When physicians witness a "change for the better" in patients and families, they feel a sense of purpose or a sense of giving back. Stamm stated that the "resilience of the human spirit" may be explained by compassion satisfaction, which he saw as a solvable problem that offsets the hazards of compassionate exhaustion (Kazanjian, A., 2014). Through productive working connections with coworkers, one has the opportunity to assist others and advance society (Sterling, A, 2014).

Regardless of gender, doctors experience more compassion fatigue than other medical staff members. A sizable portion of healthcare workers experiences ordinary levels of compassion fatigue. This can have a negative effect on their mental health, which would impair their productivity (M. A., & Malik, N. J. 2017). According to mediation analysis, resilience somewhat mediated the link between burnout and compassion fatigue. These findings suggest that resilience is essential for minimizing the harmful effects of burnout as well as compassion fatigue. (Burnett Jr, H. J., & Wahl, K. 2015).

It's critical to look for strategies to lessen physician burnout and compassion exhaustion (Balhara, Y. P. S., & Kalra, S. 2014). Physicians experience burnout more frequently than other US workers. Speciality doctors who provide care at the front lines of access to care seem to be more in danger (Shanafelt, T. D., 2016). While for emergency physicians, things like doing their jobs properly, helping others, cooperating with coworkers, or being able to make a contribution to society are what make them happy. On the other hand, emergency physicians seem to experience negative emotions including fatigue, irritation, and rage more frequently (Chakravarthy, B., & Menchine, M. 2018).

Nurses started to defend themselves and put themselves at a distance from the pain of patients and families as they self-identified as having compassion fatigue. Although individuals reported dismissing or ignoring these feelings as the course of action to take to undertake to survive their workday, feelings of irritation, hostility, and negativity did arise. The participants' compassion fatigue created a sense of futility in regard to positive progress, despite the fact that several nurses mentioned strategies that appeared to help them cope with their compassion fatigue (Holttum, S., & Billings, J. 2019).

In a recent study conducted in the UK, it was discovered that therapists who work with trauma patients are at a high risk of developing secondary traumatic stress disorder as a result of their work. It is remarkable that exposure to trauma stories did not significantly predict secondary traumatic stress ratings, in contrast to what one may anticipate based on theory. The majority of respondents said they had an average chance of experiencing compassion satisfaction, which balances the possibility of a negative consequence while working with trauma victims. (Fulton, L. E., Cerier, L., Peña, A., 2020).

Regardless of the environment in which a therapist works, compassion fatigue can develop at any time in their career. Participants communicated with their patients about their CF symptoms while managing their productivity and other work-related pressures. The PROQOL's anchor measure of participant satisfaction was generally high. Many people were lured into CF sentiments despite the participants because of their personal or environmental conditions. The participants' primary coping mechanisms revolved around exercise and putting their attention on extracurricular interests that kept them away from their jobs. Teachers, coworkers, and supportive bosses at work were also beneficial. Supervisors at work, families, and to maintain a lasting and healthy work-life balance, therapists themselves must be aware of the support system needed to manage STS and avoid BO (Mijovic, B. 2020).

Family doctors who have large practices, many patients who are chronically ill, a lot of experience and compassion fatigue may occur in those who have chronic weariness. A thorough research of compassion fatigue in connection to working conditions could be a good place to start when creating preventative treatments (Sollenberger, L. M., and Harney, D. M., 2021). Although the smaller sample size of this pilot study limits the generalizability of the results, participants experienced beneficial impacts for CS and BO over time, demonstrating the realistic advantages of offering self-care advice to healthcare providers. To examine how resilience knowledge and treatments to support professional quality of life could further assist healthcare practitioners, more study with a bigger sample size is needed (Cocker, F., & Joss, N. 2016).

Although it is known that these at-risk employees have a higher prevalence of CF, CF in various occupational categories can be reduced by modifying its recognized personal and collective risk factors, but there is a paucity of information and statistics about practical workplace-based ways to do so. They consequently call for more studies to be done to establish the best protections for workers who are exposed to prevent CF as well as the potentially more severe health and economic repercussions linked to the succeeding mental and physical health issues (Biderman, A. 2019).

Emotional exhaustion is a scaphoid fracture experienced by healthcare professionals that is similar to the concept of compassion. A review of the information on compassion fatigue that is currently available was done, and it included papers about nurses working in different care settings. It is not clear, though, whether emergency physicians can use the review's conclusions. Healthcare practitioners' inherent characteristics as well as systemic and environmental elements all have an impact on compassion fatigue. Even if the idea is vague, it is believed to be a major factor in the loss of compassion among medical practitioners and the potential for poorer care quality. The provision of compassionate care is crucial for the delivery of high-quality medical care, and empathic doctors have been found to increase patient satisfaction, health outcomes, treatment compliance, and lower legal disputes. However, it can be difficult to give compassionate care in an emergency situation where doctors are under pressure to perform high volumes of urgent services with constrained resources. According to research, having compassion for oneself as well as others improves well-being and lessens stress, anxiety as well as depression signs, This study aims to investigate the relationship between compassion, burnout, and secondary stress alongside the effects of a medical professional's area of profession and compassionate on the health of patients.

Method

Data were gathered from 200 medical professionals working at Karachi's Liaquat National Hospital, Abbasi Shaheed Hospital, Patel Hospital, and Al Mustafa Hospital using a non-probability sampling approach after receiving the required written informed consent. Data on compassion satisfaction and compassion exhaustion were gathered using Pro QOL version 5. The data were analyzed with SPSS v20, and the association significance of both associations was assessed using the chi-square test.

Results

The average age of the participants in the study was around 29.99 years old, and there was some variation in age among the participants (±7.88 years). This suggests that some participants were younger than 29.99 and some were older and the mean experience (in a particular field or task) among the participants was 4.77 years and that there was some variation in experience levels among the participants (±5.89 years). This suggests that some participants had less than 4.77 years of experience, and some had more (Table I).

A greater number of female participants were included compared to male participants. The percentage of female participants was 63%, which suggests that out of every 100 participants in the study, 63 were female and 37 were male (Table II).  

The study included participants from various areas of practice, such as physicians, physical therapists, dentists, RMO etc., and these participants were distributed almost equally among the different areas of practice (Table III).

The area of practice of participants was almost equally distributed (Table III).

The participants' areas of practice and the participants' level of compassion satisfaction were not significantly correlated, according to statistical analysis using the Pearson Chi-Square test. In other words, the results of the study did not show a clear pattern of how the participants' area of practice was related to their level of compassion satisfaction. The lack of statistical significance suggests that any differences observed were likely due to chance, rather than a true relationship between the variables (Table IV).

 

Table I:  Mean ± Age and Experience 

	Mean	SD
Age	29.99	7.899
Experience	4.77	5.893




Table II:  Gender distribution

		Frequency (%age)
Gender	Male	73 (36%)
	Female	127 (63%)

 

 

Table III:  Area of the practice of participant,




	Frequency (%)
Physician	41 (20.5)
Physical therapist	64 (32.0)
Dentist	39 (19.5)
RMO's	56 (28.0)




Table IV:  Association analysis of compassion satisfaction with the area of practice

		Area of the practice of the participants
		Physician	Physical therapist	Dentist	RMO's	Pearson Chi-Square	Df	p-Value
Compassion Satisfaction	Low	0	4	1	1	7.709	6	0.260
	Average	37	54	34	54
	High	4	6	4	1
Burn Out	Low	1	3	2	1	9.293	6	0.158
	Average	37	61	35	55
	High	3	0	2	0
Secondary Traumatic Stress	Low	11	25	15	133	9.067	6	0.170
	Average	30	39	23	43
	High	0	0	1	0



Discussion

The ProQOL survey is designed to measure three things: burnout, compassion satisfaction, and compassion fatigue. Burnout refers to feelings of exhaustion, cynicism, and reduced effectiveness that can result from prolonged exposure to stressors at work. Compassion satisfaction refers to the positive aspects of working with people in need, such as feeling fulfilled and making a difference in the lives of others. Compassion fatigue refers to the negative aspects of working with people in need, such as feeling overwhelmed and emotionally drained.

The goal of the current study was to evaluate medical professionals' work-related satisfaction and professional quality of life. A cross-sectional review was completed using 200 examples, and data from doctors, real specialists, dental experts, and RMOs from different open and private emergency clinics in Karachi, Pakistan, were obtained. The satisfaction of medical professionals with their work and profession was found to be high. Burnout and compassion fatigue were strongly correlated, however, there was no association between compassion fatigue and compassion satisfaction (CF) (Mahmoud, N. 2020)

The previous study, which focused on nurses, found that the work environment, typical working conditions, demands, obligations, and stressors, as well as the issues and patient stories, enhanced the nurses' risk of developing CF. Workplace pressures include things like paperwork, computerized medical records, and adjustments in management or personnel (Kamienski, M. 2018). In contrast, the current study examined the level of compassion satisfaction among medical specialists including dentists, physical therapists, doctors, and registered medical assistants (RMOs) in various private and public tertiary care facilities. The study's findings indicated that participants had positive attitudes toward doing good deeds.

In a previous study, interventions for nurses included resilience training, awareness training, mentor-mentee connections, mindfulness-based stress reduction, reward and recognition programmes, and other sorts of interventions. (Klappa, S. G., 2018). In contrast, the current study examined participants' levels of compassion satisfaction and discovered that they were incredibly satisfied with their work and daily lives. 

The study was conducted by Rita Howayek et al., and it included recently graduated physical therapists. It used a mixed-method approach to address the research issues by using phenomenological interviews and an electronic ProQOL-R-IV survey. According to the research's findings, BO levels were low and mean values for CS were high (Hashim, R. 2015). The current study comprised medical professionals with a year's worth of experience who were actively involved in the clinics. Version 5 of the Professional Quality of Life Scale was used to gather the data and it was shown that experienced therapists used a wider range of coping mechanisms than less experienced therapists in Pakistan's Karachi, medical professionals had high CS. (Wang, Y., Huang, Y., 2023).

Rahman Hashim used a self-administered questionnaire with 14 questions to conduct research on engineers' job satisfaction. More than two-thirds of engineers indicated satisfaction with their workplace, as seen by the total proportion of 73%. The ProQOL measure, the data for the current study, which was done on medical professionals, was gathered using a 30-item questionnaire about the professional quality of life. The findings showed a favourable correlation between job satisfaction and continued commitment (Howell, A. M. 2012) Professionals claim that helping others makes them happy.

According to the statement, the majority of respondents in the first investigation using the ProQOL R-IV survey reported valuing the work of their peers and feeling engaged in meaningful work. This implies that they experienced low levels of burnout and compassion fatigue and high levels of compassion satisfaction. In the second investigation, which used ProQOL version 5, participants reported even higher levels of satisfaction with their profession and work environment. The statement suggests that this type of workplace promoted the development of compassion fulfilment, which refers to the positive impact that helping others can have on an individual's sense of purpose and well-being. Overall, the statement indicates that employees who work with homeless individuals generally have high levels of job satisfaction and fulfilment and that their work can be both meaningful and challenging.

An earlier investigation on homeless assistance providers employed the ProQOL R-IV survey by Beth Hudnall Stamm. It was applied to measure compassion fatigue, contentment with one's ability to help others, and employee burnout. The majority of respondents to the job satisfaction survey said they valued the work of their peers and were engaged in meaningful work. Using ProQOL version 5, the participants in the current study reported high levels of satisfaction with their profession and work environment, whereas this type of workplace promoted the development of compassion fulfilment (Kaur, A., Sharma, M. P., & Chaturvedi, S. K. 2018).

Among the study population, more than half reported having an average level of BO, and around half reported having a higher level of BO (scores above the 75th percentile), suggesting that they were "at risk" personally, according to a 2018 study on professional care providers in cancer palliative care settings. (Rigas, N., Soldatou, A., Dagla, M., Nanou, C., & Antoniou, E. 2023) Participants in the current study, on the other hand, reported that they frequently felt as though their work could make a difference and that they frequently had comforting thoughts and feelings about the people they helped every day. The decision to complete the task made by the members made them happy. (Quinn, A. W. 2023).

Particularly, there is a minimal study on the effects of empathy, on the well-being of emergency physicians, according to the scoping review that was undertaken. Evidence does, however, point to a link between empathy and burnout in emergency room doctors, which is consistent with research on emergency nurses and medical students. While a study on emergency nurses found a link between empathy and well-being the evaluation found no direct evidence of a similar link between compassion and emergency physicians' well-being. Research on how compassion affects others have shown that it enhances psychological health and lessens the body's reaction to stress. Moreover, self-compassion has been shown to improve well-being and lessen burnout (Shdaifat, E., Al-Shdayfat, N., & Al-Ansari, N. 2023).

The review admits its limitations, including the lack of reliable measurements and results for both compassion and well-being as well as the paucity of evidence indicating the relationship between compassion and emergency physicians' well-being. The study argues that given the significance of emergency physicians in delivering high-quality care, there is a need for more substantial evidence of their compassion and well-being. A new systematic review reveals less compelling evidence and an ambiguous definition of the notion, despite several small studies' claims that self-compassion improves doctors' well-being, empathy, and patient satisfaction. While a study on emergency nurses discovered a relationship between empathy and well-being, the evaluation revealed no concrete evidence of a similar relationship between compassion and emergency physicians' well-being. The growing interest in the topic and It is advisable to put more effort into evaluating prospective therapies to increase compassion (Varrasi, S., and Guerrera, C. S., 2022).

Conclusion

Quality of life is vital in the daily lives of medical professionals since it is linked to delivering care to patients. Medical practitioners are better able to care for patients if they have a high quality of life. On the other side, if their quality of life is poor, they will become disinterested in caring for patients, which will ultimately affect the care they offer. The study came to the conclusion that the lowest rate of compassion fatigue was observed among medical staff members working in several hospitals in Karachi, Pakistan. 

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