Defense styles employed by healthcare professionals experiencing compassion fatigue
DOI:
https://doi.org/10.53713/nhsj.v5i2.485Keywords:
compassion, compassion fatigue, defense styles, health workersAbstract
The healthcare sector operates under relentless demands, requiring uninterrupted service delivery amid high-stress environments. Compassion fatigue manifests as a complex interplay of burnout and secondary traumatic stress. To mitigate the psychological toll of compassion fatigue, healthcare professionals often adopt defense mechanisms. This study examines the defense styles used by healthcare professionals experiencing compassion fatigue. This study is a descriptive quantitative study. The study sample consisted of 499 actively working healthcare professionals (422 nurses, 77 doctors). A Personal Information Form consisting of 12 questions, the Compassion Scale (CQ), and the Defense Style Questionnaire-40 (DSQ-40) were used to collect data. The study was conducted using the survey method (Online link) and the snowball sampling method. According to the study results, the level of compassion increases as the number of children in the participants increases. The level of compassion decreases as the level of education increases. In addition, it was determined that participants with low levels of compassion resort to immature defense styles and may experience compassion fatigue. In order to prevent compassion fatigue in healthcare professionals who play very important roles in protecting, developing, and improving community mental health, The management should support and support healthcare professionals in problems experienced in clinical environments, improve difficult working conditions, and take measures to prevent violence in healthcare.
References
Alodhialah, A. M., Almutairi, A. A., & Almutairi, M. (2023). Exploring Nurses’ Emotional Resilience and Coping Strategies in Palliative and End-of-Life Care Settings in Saudi Arabia: A Qualitative Study. Healthcare, 12(16), 1647. https://doi.org/10.3390/healthcare12161647
Azam, H., Rehman, M., & Rehman, M. (2023). Burnout, Compassion Fatigue and Vicarious Traumatic Experiences Among Social Workers: Emotional Regulation as a Protective Factor. Pakistan Journal of Humanities and Social Sciences, 11(4), 4694–4710. https://doi.org/10.52131/pjhss.2023.v11i4.1772
Cao, X., & Chen, L. (2021). Relationships between resilience, empathy, compassion fatigue, work engagement and turnover intention in haemodialysis nurses: A cross-sectional study. Journal of Nursing Management, 29(5), 1054-1063. https://doi.org/10.1111/jonm.13243
Chu, C. (2024). Effect of compassion fatigue on emotional labor in female nurses: Moderating effect of self-compassion. PLOS ONE, 19(3), e0301101. https://doi.org/10.1371/journal.pone.0301101
Compton, L., & Patterson, T. (2025). Absorption vulnerability: A new look at compassion fatigue. Traumatology, 31(1), 65–73. https://doi.org/10.1037/trm0000503
Di Giuseppe, M., Nepa, G., Prout, T. A., Albertini, F., Marcelli, S., Orrù, G., & Conversano, C. (2020). Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms. International Journal of Environmental Research and Public Health, 18(10), 5258. https://doi.org/10.3390/ijerph18105258
Dowdell, E. B., Alderman, S. E., Foushee, N., Holland, E., & Reedy, E. A. (2022). Expressions of Compassion Fatigue by Emergency Department Nurses Caring for Patients With Opioid and Substance Use Disorders. Journal of Emergency Nursing, 48(6), 688-697. https://doi.org/10.1016/j.jen.2022.07.006
Edwards, K., & Goussios, A. (2021). Who is Responsible for Compassion Satisfaction? Shifting Ethical Responsibility for Compassion Fatigue from the Individual to the Ecological. Ethics and Social Welfare, 15(3), 246–262. https://doi.org/10.1080/17496535.2021.1888141
Feng, Y., Li, S., Ma, W., Chen, Y., Zhang, J., Luo, H., & Xue, B. (2025). The relationship between compassion fatigue, engagement and decent work among nurses: a cross-sectional study. BMC nursing, 24(1), 74. https://doi.org/10.1186/s12912-025-02721-w
Fontin, F. M. B., Pino, E. C., Hang, J., & Dugan, E. (2020). Compassion Satisfaction and Compassion Fatigue among Violence Intervention Caseworkers. Journal of Social Service Research, 47(4), 486–495. https://doi.org/10.1080/01488376.2020.1839628
Garnett, A., Hui, L., Oleynikov, C., & Boamah, S. (2023). Compassion fatigue in healthcare providers: a scoping review. BMC health services research, 23(1), 1336. https://doi.org/10.1186/s12913-023-10356-3
Hashish, E. A. (2025). Compassion through technology: Digital empathy concept analysis and implications in nursing. DIGITAL HEALTH. https://doi.org/10.1177/20552076251326221
Hochwarter, W., Jordan, S., Kiewitz, C., Liborius, P., Lampaki, A., Franczak, J., ... & Khan, A. K. (2022). Losing compassion for patients? The implications of COVID-19 on compassion fatigue and event-related post-traumatic stress disorder in nurses. Journal of Managerial Psychology, 37(3), 206-223. https://doi.org/10.1108/JMP-01-2021-0037
Kartsonaki, M. G., Georgopoulos, D., Kondili, E., Nieri, A. S., Alevizaki, A., Nyktari, V., & Papaioannou, A. (2023). Prevalence and factors associated with compassion fatigue, compassion satisfaction, burnout in health professionals. Nursing in Critical Care, 28(2), 225-235. https://doi.org/10.1111/nicc.12769
Kendrick, A. (2022). Compassion fatigue, burnout, and the emotional labor of educational workers. The International Journal of Health, Wellness and Society, 13(1), 31. https://doi.org/10.18848/2156-8960/CGP/v13i01/31-55
Kesbiç, Ş., & Boz, İ. (2021). Experiences of perinatal nurses regarding compassion fatigue and compassion satisfaction: a phenomenological study. Journal of Psychosomatic Obstetrics & Gynecology, 43(3), 359–367. https://doi.org/10.1080/0167482X.2021.1967927
Khoury, B., Lesage, M., Kasprzyk, A., Sadowski, I., Manova, V., Benchimol-Elkaim, B., ... & Rej, S. (2025). Embodied and Embedded Mindfulness and Compassion Framework. Mindfulness, 1-25. https://doi.org/10.1007/s12671-025-02561-4
Leung, T., Schmidt, F., & Mushquash, C. (2023). A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychological Trauma: Theory, Research, Practice, and Policy, 15(Suppl 2), S213–S221. https://doi.org/10.1037/tra0001277
Merlo, E. M., McNabney, S. M., Frisone, F., Sicari, F., Paunica, M., Motofei, C., & Settineri, S. (2020). Compassion and suppression in caregivers: twin masks of tragedy and joy of caring. Journal of Mind and Medical Sciences, 7(1), 61-68. https://doi.org/10.22543/7674.71.P6168
Moreno-Jiménez, J. E., Demerouti, E., Blanco-Donoso, L. M., Chico-Fernández, M., Iglesias-Bouzas, M. I., & Garrosa, E. (2023). Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion. Current Psychology, 42(33), 29387-29402. https://doi.org/10.1007/s12144-022-03986-z
Oberg, G., Carroll, A., & Macmahon, S. (2023). Compassion fatigue and secondary traumatic stress in teachers: How they contribute to burnout and how they are related to trauma-awareness. Frontiers in Education, 8, 1128618. https://doi.org/10.3389/feduc.2023.1128618
Ormiston, H. E., Nygaard, M. A., & Apgar, S. (2022). A systematic review of secondary traumatic stress and compassion fatigue in teachers. School Mental Health, 14(4), 802-817. https://doi.org/10.1007/s12310-022-09525-2
Paiva-Salisbury, M. L., & Schwanz, K. A. (2022). Building compassion fatigue resilience: Awareness, prevention, and intervention for pre-professionals and current practitioners. Journal of Health Service Psychology, 48(1), 39-46. https://doi.org/10.1007/s42843-022-00054-9
Pérez-García, E., Ortega-Galán, Á. M., Ibáñez-Masero, O., Ramos-Pichardo, J. D., Fernández-Leyva, A., & Ruiz-Fernández, M. D. (2021). Qualitative study on the causes and consequences of compassion fatigue from the perspective of nurses. International Journal of Mental Health Nursing, 30(2), 469-478. https://doi.org/10.1111/inm.12807
Preston, P. J., Sanchez, D., & Preston, K. S. (2022). Exploring Mindful Self-Care as a Potential Mediator between Compassion Satisfaction and Compassion Fatigue among Student Services Professionals. Trauma Care, 2(4), 535-549. https://doi.org/10.3390/traumacare2040044
Shehata, H., & Samy Elsaieed Elsheikh, M. (2023). Defense Mechanisms and its relationship to Resilience, Compassion Satisfaction and Fatigue among Nurses Working at El Azazi Mental Health Hospital. Egyptian Journal of Health Care, 14(2), 590-607. https://dx.doi.org/10.21608/ejhc.2023.300785
Shuai, T., Xuan, Y., Jiménez-Herrera, M. F., Yi, L., & Tian, X. (2024). Moral distress and compassion fatigue among nursing interns: a cross-sectional study on the mediating roles of moral resilience and professional identity. Bmc Nursing, 23(1), 638. https://doi.org/10.1186/s12912-024-02307-y
Sinclair, S., Bouchal, S. R., Schulte, F., T. Guilcher, G. M., Kuhn, S., Rapoport, A., Punnett, A., Fernandez, C. V., Letourneau, N., & Chung, J. (2021). Compassion in pediatric oncology: A patient, parent and healthcare provider empirical model. Psycho-Oncology, 30(10), 1728-1738. https://doi.org/10.1002/pon.5737
Tandon, P. M., & Chaturvedi, V. (2024). Workforce Well-Being and Resilience in Healthcare Leadership. In Healthcare Administration and Managerial Training in the 21st Century (pp. 283-318). IGI Global. http://dx.doi.org/10.4018/979-8-3693-5523-7.ch009
Velasco, J., Sanmartín, F. J., Gálvez-Lara, M., Cuadrado, F., & Moriana, J. A. (2023). Psychological Effects of Professional Exposure to Trauma and Human Suffering: Systematic Review and Meta-Analysis. Trauma, Violence, & Abuse. https://doi.org/10.1177_15248380221074314
Wallace, C. L., Wladkowski, S. P., Gibson, A., & White, P. (2020). Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers. Journal of Pain and Symptom Management, 60(1), e70-e76. https://doi.org/10.1016/j.jpainsymman.2020.04.012
Yi, L., Liu, Y., Tang, L., Cheng, L., Wang, G., Hu, S., Liu, X., Tian, X., & F., M. (2022). A Bibliometric Analysis of the Association Between Compassion Fatigue and Psychological Resilience From 2008 to 2021. Frontiers in Psychology, 13, 890327. https://doi.org/10.3389/fpsyg.2022.890327
Yu, H., Qiao, A., & Gui, L. (2021). Predictors of compassion fatigue, burnout, and compassion satisfaction among emergency nurses: A cross-sectional survey. International Emergency Nursing, 55, 100961. https://doi.org/10.1016/j.ienj.2020.100961









