- Perceived duty difficulty is positively associated with compassion fatigue indirectly via end-of-life care stress.
- Peer support moderates this association; at high peer support duty difficulty relates to lower compassion fatigue.
- Duty importance and frequency were not significantly associated; recommend structured peer support, debriefing, mentoring and monitoring for hospice nurses.
J Nurs Manag. 2026;2026(1):e4850869. doi: 10.1155/jonm/4850869.
ABSTRACT
AIM: To examine associations between nurses’ appraisals of hospice care duties and compassion fatigue and the roles of end-of-life care stress (EOLCS) and peer support in these associations among hospice nurses in Korea.
BACKGROUND: Compassion fatigue is relevant to hospice nurses’ well-being and care quality, yet its associations with duty appraisals, EOLCS, and peer support remain insufficiently understood.
METHODS: This cross-sectional study analyzed survey data from 117 nurses recruited through 12 specialized inpatient hospice units in Korea. Compassion fatigue was operationalized using the secondary traumatic stress subscale of the Professional Quality of Life Scale. Cross-sectional indirect associations and interactions were examined using the PROCESS macro for SPSS. Reporting followed the STROBE guidelines.
RESULTS: Among nurses’ appraisals of hospice care duties, perceived duty difficulty showed a positive cross-sectional indirect association with compassion fatigue through EOLCS (effect = 2.82, 95% bootstrap CI [1.08, 4.73]). Its interaction with peer support was significant (B = -6.12, p = 0.009), showing a crossover pattern. The simple slope was nonsignificant at low peer support, and only 3.4% of participants fell within the significant positive region identified by the Johnson-Neyman analysis. At high peer support, duty difficulty was negatively associated with compassion fatigue. Corresponding indirect associations and interactions involving duty importance and frequency were nonsignificant.
CONCLUSION: Perceived duty difficulty showed a cross-sectional indirect association with compassion fatigue through EOLCS, while its conditional association varied across peer support levels. These findings highlight the relevance of considering perceived duty difficulty together with EOLCS and peer support when examining compassion fatigue among hospice nurses.
IMPLICATIONS FOR NURSING MANAGEMENT: Structured peer support, debriefing, mentoring, and monitoring approaches addressing difficult care duties and psychological distress warrant prospective development and evaluation.
PMID:42968467 | DOI:10.1155/jonm/4850869
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