Estudo da fadiga por compaixão nos cuidados paliativos em Portugal

: tradução e adaptação cultural da escala "Professional Quality of Life 5"

Abstract

The palliative heath care providers, in the daily practice are often exposed to stressors that result from their activity, and that emerge from their relationship with the patient or from structural job aspects. While caring the traumatized or suffering patients, the burden of that stress is inevitably greater raising the risk for an exhaustion state called compassion fatigue, which might bring personal, professional, institutional and quality care prejudices. We recognize that this is a less known phenomenon in Portugal and we consider being important to culturally adapt, for the Portuguese population, a tool that allows its evaluation and monitoring. With this study we wish to answer the question: “Is there compassion fatigue among Portuguese palliative care providers?”. We present the results from the cultural adaptation and validity study for the Beth Stamm’s “Professional Quality of Life” Scale, version 5 (ProQOL5) and from compassion fatigue’s study in the context of palliative care. For the ProQOL5’s cultural adaptation study we gathered a group of experts in translation and used the forward translation, back translation and pre-test procedures. For the validity study we have analyzed the adapted version’s psychometric properties, employed an exploratory factorial analysis and a study of concurrent validity using the scores of the GHQ28. We have obtained a multidisciplinary sample composed by 73 caregivers from 9 palliative care settings employing an intentional sampling. We have obtained similar internal consistency values to those in the original version. The obtained cut points and correlation relations between the ProQOL5 dimensions are also similar between those versions. The exploratory factorial analysis supports Stamm’s original structure for 3 dimensions, and as her, we haven’t found statistical differences for compassion satisfaction (CS), burnout (BO) e secondary traumatic stress (STS) scores depending on age, gender, total time of practice in health care and total time of practice in palliative care. We verified, as expected in the concurrent validity, positive correlations between BO and STS with GHQ28 dimensions, and a negative correlation between the last ones and CS. In the compassion fatigue’s study, we found that 67.1% of the participants presented moderate to high levels of Compassion Fatigue, including doctors, nurses, social workers, nursing auxiliaries, one physiotherapist and one chaplain. We found that those caregivers that perceive to be exposed 35 or more hours to patient’s suffering/traumatic experiences present higher scores for BO and STS, in relation to those who consider to be less exposed, associated to low health related complaints. The set of results obtained from the validity and compassion fatigue studies allows us to suggest that the Portuguese adapted version of ProQOL5 offers a good validity for the evaluation of the phenomenon on palliative heath caregivers and confirm the presence of relevant levels of compassion fatigue in that context.

Date of Award	4 Apr 2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Luís Sá (Supervisor)