Inner Armor: Role of Spiritual and Psychological Well-Being on Compassion Fatigue Among Nursing Students
DOI:
https://doi.org/10.65339/ijsair.V2.I2.598Keywords:
Burnout, Compassion Fatigue, Existential Well-Being, Nursing Students, Psychological Resilience, Psychological Well-Being, Religious Well-Being, Secondary Traumatic Stress, Spiritual Well-Being, Trait MindfulnessAbstract
Compassion fatigue is an increasing concern in nursing education because students are exposed to academic demands, clinical responsibilities, patient suffering, trauma, and emotionally difficult care situations while still developing professional competence and coping capacity. This study aimed to determine the role of spiritual well-being and psychological well-being in compassion fatigue among third- and fourth-year nursing students at Capitol University. The study was anchored on Jean Watson’s Theory of Human Caring, Figley’s Compassion Fatigue Theory, and Betty Neuman’s Systems Model, which collectively framed spiritual well-being and psychological well-being as internal protective resources or “inner armor” against emotional exhaustion and trauma-related stress. A quantitative approach using descriptive, correlational, and causal-comparative designs was employed. The respondents were 243 third- and fourth-year nursing students selected through stratified random sampling. Data were gathered using standardized and adapted self-report instruments, including the Spiritual Well-Being Scale for religious and existential well-being, the Connor-Davidson Resilience Scale for psychological resilience, the Mindful Attention Awareness Scale for trait mindfulness, and the Professional Quality of Life Scale Version 5 for burnout and secondary traumatic stress. Data were analyzed using mean, standard deviation, Pearson’s correlation coefficient, and multiple regression analysis. Findings showed that nursing students had high levels of spiritual well-being and psychological well-being, while compassion fatigue was moderately high in terms of burnout and secondary traumatic stress. Religious and existential well-being had significant moderate negative correlations with compassion fatigue, while resilience and trait mindfulness had stronger significant negative correlations. Regression analysis showed that the combined model significantly predicted compassion fatigue, with resilience and trait mindfulness emerging as significant predictors, while religious and existential well-being were not significant predictors when entered simultaneously with the psychological variables. The study concludes that spiritual and psychological well-being function as protective internal resources, with psychological well-being, particularly resilience and mindfulness, playing the strongest role in reducing compassion fatigue. The study recommends strengthening student mental health support, resilience-building, mindfulness training, counseling services, spiritual care, reflective learning, mentoring, and supportive clinical supervision in nursing education and clinical training. The study aligns with SDG 3, Good Health and Well-Being, and SDG 4, Quality Education, because it supports nursing students’ mental health, emotional resilience, and learning readiness. Its sustainability impact lies in promoting institutional, educational, and public health sustainability by helping prepare emotionally stable, compassionate, and resilient future nurses.
References
Alharbi, J., Jackson, D., & Usher, K. (2022). The potential for resilience to reduce compassion fatigue among nursing students: A cross-sectional study. Nurse Education Today, 109, Article 105228. https://doi.org/10.1016/j.nedt.2021.105228
Al-Maadeed, S., & Al-Kaabi, R. (2021). Compassion fatigue, burnout, and resilience among nurses during COVID-19 pandemic. Journal of Nursing Management, 29(8), 2736–2744. https://doi.org/10.1111/jonm.13448
Aradilla-Herrero, A., & Tomás-Sábado, J. (2019). Psychological well-being, depressive symptoms and emotional intelligence in nursing students. Nurse Education Today, 76, 193–198. https://doi.org/10.1016/j.nedt.2019.02.017
Beck, C. T. (2011). Secondary traumatic stress in nurses: A systematic review. Archives of Psychiatric Nursing, 25(1), 1–10. https://doi.org/10.1016/j.apnu.2010.05.005
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Chan, R., Chung, L., Hung, K., & Chan, P. (2020). The effectiveness of mindfulness-based intervention in reducing stress and burnout among nurses: A systematic review. Nurse Education Today, 94, Article 104564. https://doi.org/10.1016/j.nedt.2020.104564
Chirico, F., Batra, K., Batra, R., Ferrari, G., Crescenzo, P., Nucera, G., Szarpak, L., & Magnavita, N. (2023). Spiritual well-being and burnout syndrome in healthcare: A systematic review. Journal of Health and Social Science, 8(1), 13–32. https://doi.org/10.19204/2023/sprt2
Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113
Davies, M. B. (2007). Doing a successful research project: Using qualitative or quantitative methods (2nd ed.). Palgrave Macmillan.
Daya, Z., & Hearn, J. H. (2018). Mindfulness interventions in nursing: An integrative review of the literature. Nurse Education in Practice, 28, 12–21. https://doi.org/10.1016/j.nepr.2017.09.002
Delgado, C., Upton, D., Ranse, K., Furness, T., & Foster, K. (2017). Nurses’ resilience and the emotional labour of nursing work: An integrative review. International Journal of Nursing Studies, 70, 71–88. https://doi.org/10.1016/j.ijnurstu.2017.02.008
De los Santos, J. A. A. (2023). Compassion fatigue influences the mental health and turnover intention of nurses in the COVID-19 pandemic. Acta Medica Philippina, 57(8), 19–24. https://doi.org/10.47895/amp.vi0.5137
Fernández-Pascual, M. D., Reig-Ferrer, A., Santos-Ruiz, A. M., & Martínez-Rodríguez, L. (2025). Spirituality in managing perceived stress and promoting self-care: A descriptive study on nursing students in Spain. Journal of Religion and Health, 64(2), 882–898. https://doi.org/10.1007/s10943-024-02232-z
Field, A. (2018). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.
Figley, C. R. (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. Brunner/Mazel.
Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology, 58(11), 1433–1441. https://doi.org/10.1002/jclp.10090
Gauthier, T., Meyer, R. M. L., Grefe, D., & Gold, J. I. (2016). An on-the-job mindfulness-based intervention for pediatric ICU nurses: A pilot. Journal of Pediatric Nursing, 31(6), 798–806. https://doi.org/10.1016/j.pedn.2016.07.011
Gravetter, F. J., & Wallnau, L. B. (2017). Statistics for the behavioral sciences (10th ed.). Cengage Learning.
Grove, S. K., & Gray, J. R. (2019). Understanding nursing research: Building an evidence-based practice (7th ed.). Elsevier.
Henshall, C., Davey, Z., & Jackson, D. (2020). Nursing resilience interventions: A way forward? Nurse Education Today, 94, Article 104578. https://doi.org/10.1016/j.nedt.2020.104578
Jeong, H. C., Jang, S. H., Kim, Y., & Kim, J. S. (2020). Impact of academic stress and emotional intelligence on nursing students’ well-being. Journal of Nursing Education, 59(6), 354–361. https://doi.org/10.3928/01484834-20200520-03
Lee, H., & Kim, J. (2024). The role of life purpose in psychological well-being among nursing students. Journal of Nursing Education, 63(2), 89–96. https://doi.org/10.3928/01484834-20240115-03
Neuman, B., & Fawcett, J. (2011). The Neuman systems model (5th ed.). Pearson Education.
Özyurt, B., Dereli, E., & Keleş, S. (2018). The relationship between spiritual well-being and compassion fatigue among healthcare students. Journal of Religion and Health, 57(4), 1403–1414. https://doi.org/10.1007/s10943-017-0462-6
Paloutzian, R. F., & Ellison, C. W. (1982). Loneliness, spiritual well-being, and quality of life. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 224–237). John Wiley & Sons.
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Reyes, A. T., Andrusyszyn, M. A., Iwasiw, C., Forchuk, C., & Babenko-Mould, Y. (2020). Resilience in nursing education: An integrative review. Journal of Nursing Education, 59(12), 659–666. https://doi.org/10.3928/01484834-20201118-08
Rizqi, M. A., & Wirawan, H. (2020). Spirituality and work burnout among nurses: The mediating role of work meaningfulness. Journal of Health Psychology, 25(6), 846–855. https://doi.org/10.1177/1359105317730303
Siedlecki, K. L. (2020). Research designs and methods for nursing and healthcare. Springer Publishing.
Sorenson, C., Bolick, B., Wright, K., & Hamilton, R. (2017). Understanding compassion fatigue in healthcare providers: A review of current literature. Journal of Nursing Scholarship, 49(3), 295–303. https://doi.org/10.1111/jnu.12291
Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.). ProQOL.org. https://proqol.org/proqol-manual
Tabachnick, B. G., & Fidell, L. S. (2019). Using multivariate statistics (7th ed.). Pearson.
Valenstein-Mah, H., Anderson, T., Bylsma, L. M., Rudy, B. M., & Ginty, A. T. (2020). Effectiveness of mindfulness interventions for emotional regulation among nursing students. Mindfulness, 11(5), 1234–1247. https://doi.org/10.1007/s12671-020-01334-7
van der Riet, P., Levett-Jones, T., & Aquino-Russell, C. (2018). The effectiveness of mindfulness meditation on stress, anxiety, and depression in nursing students. Journal of Advanced Nursing, 74(12), 2997–3010. https://doi.org/10.1111/jan.13717
Villanueva, A. S., & Bernardo, M. G. (2019). Burnout and secondary traumatic stress among Filipino nurses: A cross-sectional study. Philippine Journal of Nursing, 89(1), 56–64.
Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). University Press of Colorado.
Watson, J. (2018). Unitary caring science: The philosophy and praxis of nursing. University Press of Colorado.
Xie, W., Chen, L., Feng, F., Okoli, C. T. C., Tang, P., Zeng, L., Jin, M., Zhang, Y., & Wang, J. (2021). The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis. International Journal of Nursing Studies, 120, Article 103973. https://doi.org/10.1016/j.ijnurstu.2021.103973
