Compassion blandt sygeplejersker på intensiv afdelinger

Resumé
Baggrund
Arbejdet som sygeplejerske på en intensiv afdeling indebærer høje kliniske krav, komplekse patientforløb og kontinuerlig eksponering for lidelse, hvilket øger risikoen for compassion fatigue og lignende belastningsreaktioner (1,2). Compassion fatigue beskrives som en gradvis udtømning af evnen til at udvise medfølelse som følge af længerevarende følelsesmæssig belastning (3). Self‑compassion, defineret som en kombination af selvvenlighed, fælles menneskelighed og mindfulness (4), fremhæves i flere studier som en central psykologisk ressource, der kan øge trivsel og beskytte sundhedsprofessionelle mod emotionel udmattelse (5,6).

Formål
Formålet med dette mixed‑methods studie var at undersøge graden af self‑compassion blandt sygeplejersker på intensiv afdelinger i Danmark samt at belyse deres oplevelser af self‑compassion og compassion fatigue i klinisk praksis.

Metode
Der blev anvendt et mixed methods-design. Delstudie 1 bestod af en spørgeskemaundersøgelse blandt 196 sygeplejersker ansat på intensiv afdelinger, hvor spørgeskemaet Self-Compassion Scale – Short Form (SCS‑SF) blev anvendt (4). Lineære regressionsanalyser blev gennemført for at undersøge sammenhænge mellem self-compassion og demografiske samt arbejdsmæssige faktorer. Delstudie 2 omfattede syv semistrukturerede interviews med sygeplejersker ansat på intensiv afdelinger, som blev analyseret ved hjælp af Braun og Clarkes tematiske analyse (7).

Resultater
Delstudie 1 viste, at deltagerne generelt udviste moderat til høj self‑compassion, og at hyppige administrative dage  var signifikant forbundet med højere self-compassion scores, mens der ikke blev fundet statistiske forskelle baseret på alder, køn eller erfaring.

Delstudie 2 resulterede i fem temaer: 1. At være i balance for at kunne yde sygepleje, 2. At leve op til sin forpligtelse, 3. Rum, rammer og tid, 4. Følelsen af at give uden at få igen, og 5. Ærlighed og realisme. Temaerne indikerer, at self‑compassion formes i samspillet mellem individuelle ressourcer, kollegiale relationer og organisatoriske rammer, og at compassion fatigue opstår i krydsfeltet mellem etiske krav, tidspres og følelsesmæssig eksponering.

Konklusion
Studiet peger på, at self-compassion er en betydningsfuld ressource i relation til trivsel og faglig bæredygtighed hos sygeplejersker på intensiv afdelinger. Kombinationen af kvantitative og kvalitative data bidrager til en integreret forståelse af både niveau, sammenhænge og oplevede mekanismer, hvorved self-compassion fremstår som et fænomen, der formes i et samspil mellem individuelle og organisatoriske forhold. Organisatoriske strukturer, der understøtter refleksion, debriefing, kollegial støtte og opgavevariation, synes centrale, men resultaterne bør fortolkes i lyset af studiets design og datagrundlag.

Søgeord: Self‑compassion, Intensivsygepleje, Compassion fatigue, Psykisk arbejdsmiljø, Mixed methods, Self‑Compassion Scale – Short Form.

Abstract
Background
Nurses in the Intensive Care Unit (ICU) are continually exposed to emotionally challenging and high‑pressure clinical situations, which increases the risk of compassion fatigue and similar stress-related reactions (1,2). Compassion fatigue reflects a depletion of emotional resources following repeated exposure to suffering (3). Self-compassion, defined as a combination of self-kindness, common humanity, and mindfulness (4), has been highlighted in several studies as a central psychological resource that can enhance well-being and protect healthcare professionals from emotional exhaustion (5,6).

Aim
To examine levels of self‑compassion among ICU nurses in Denmark and to explore how they experience self‑compassion and compassion fatigue in clinical practice.

Methods
A mixed‑methods design was used. Study 1 consisted of a survey among 196 nurses using the Self‑Compassion Scale – Short Form (SCS‑SF) (4). Linear regression analyses were performed to examine associations between self-compassion and demographic/occupational factors. Study 2 involved seven semi‑structured interviews analysed using Braun & Clarke’s thematic analysis (7).

Results
Substudy 1 showed that participants generally exhibited moderate to high levels of self-compassion and that frequent administrative workdays were significantly associated with higher self-compassion scores, with no statistically significant differences by age, gender, or experience. Substudy 2 resulted in five themes: Being in balance to provide nursing care; Meeting one’s professional obligation; Space, structure, and time; The feeling of giving without receiving; and Honesty and realism. The themes illustrate how self-compassion is shaped by the interplay among individual resources, collegial relationships, and organisational conditions, and how compassion fatigue arises at the intersection of ethical demands, time pressure, and emotional exposure.

Conclusion
The study indicates that self-compassion is a significant resource for well-being and professional sustainability among intensive care nurses. The combination of quantitative and qualitative data contributes to an integrated understanding of levels, associations, and mechanisms experienced, whereby self-compassion emerges as a phenomenon shaped by the interplay between individual and organisational factors. Organisational structures that support reflection, debriefing, collegial support, and task variation appear to be central; however, the results should be interpreted in light of the study’s design and data foundation.

Keywords: Self‑compassion, Intensive care nursing, Compassion fatigue, Psychosocial work environment, Mixed methods, Self‑Compassion Scale – Short Form.