Journal Article Ahead of print
PubMed: 42458063 DOI: 10.1007/s00127-026-03174-5
Association of compassion fatigue and work context with post-traumatic stress disorder symptoms among care aides in nursing homes.
Soc Psychiatry Psychiatr Epidemiol
Authors: Anni Wang, Yinfei Duan, Sung Hyun Kang, Holly Symonds-Brown, Seyedehtanaz Saeidzadeh, James Silvius, Sube Banerjee, Peter G Norton, Carole A Estabrooks
Affiliations
- School of Nursing, Fudan University, Shanghai, China.
- Faculty of Nursing, College of Health Sciences, University of Alberta, 5-183 Dianne and Irving Kipnes Health Research Academy, 11405 87 Ave NW, Alberta, T6G 1C9, Edmonton, Canada.
- Department of Medicine, University of Calgary, Calgary, AB, Canada.
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, England, UK.
- Department of Family Medicine, University of Calgary, Calgary, Canada.
- Faculty of Nursing, College of Health Sciences, University of Alberta, 5-183 Dianne and Irving Kipnes Health Research Academy, 11405 87 Ave NW, Alberta, T6G 1C9, Edmonton, Canada.
Abstract
PURPOSE
This study examined the associations of compassion fatigue and unit-level work environment with post-traumatic stress disorder (PTSD) symptoms among nursing home care aides, a workforce providing essential care yet understudied for mental health risks, particularly during crises like the COVID-19 pandemic.
METHODS
This cross-sectional study used 2021 data from the Translating Research in Elder Care (TREC) program in Alberta, Canada. Participants included 568 care aides from 53 units within 20 nursing homes. PTSD symptoms were assessed using the PTSD Checklist-6 (PCL-6; score ≥ 14 indicating a positive screen). Primary predictors were compassion fatigue (Professional Quality of Life Scale-9 subscale) and seven unit-level work context factors (Alberta Context Tool). Analyses employed three-level multivariable logistic regression.
RESULTS
Of the 568 participating care aides, 127 (22.4%) screened positive for PTSD symptoms. In multivariable three-level logistic regression analyses, a 1-unit increase in compassion fatigue score was associated with a 44% increase in the odds of a positive PTSD screen (adjusted odds ratio [AOR] = 1.44; 95% CI, 1.24-1.68; P < 0.01). None of the seven elements of the unit-level working environment showed a statistically significant association with PTSD symptoms.
CONCLUSIONS
Compassion fatigue was significantly associated with PTSD symptoms among nursing home care aides, while unit‑level work environment did not show statistically significant associations, though these null findings should be interpreted with caution. During systemic crises such as the pandemic, interventions targeting compassion fatigue at the individual level may offer more immediate benefit than broader environmental modifications for this vulnerable frontline workforce.
MeSH
Epidemiology, Stress Disorders, Post-Traumatic, Compassion Fatigue, Mental Disorders, Nursing, Stress, Physiological, Signs And Symptoms, Nursing Homes, Fatigue, Work, Stress Disorders, Traumatic, Home Health Aides, Pandemics, Environment, Workforce