Compassion Fatigue and Spiritual Care Competence Amongst Palliative Care Nurses: A Moderated Mediation Model of Care Quality and Job Satisfaction

ABSTRACT

Aims

To examine the association between compassion fatigue and spiritual care competence amongst palliative care nurses, investigate the mediating role of palliative care quality and determine the moderating effect of job satisfaction.

Background

Palliative care nurses face intense emotional demands and end-of-life stressors, increasing their risk of compassion fatigue and potentially affecting care delivery. Spiritual care competence is central to holistic palliative nursing; however, its association with compassion fatigue and the organisational factors shaping this relationship remain unclear.

Design

A cross-sectional, correlational study.

Methods

Using a convenience sampling approach, 141 nurses working in palliative care units across hospitals in different regions of Türkiye were recruited. Data were collected between April and August 2024 via an online questionnaire including demographic variables and validated instruments measuring compassion fatigue, palliative care quality, spiritual care competence and job satisfaction. Data were analysed using SPSS and PROCESS macro.

Results

The mean spiritual care competence score was 107.9 ± 14.7. Compassion fatigue was negatively associated with palliative care quality and spiritual care competence, whereas palliative care quality was positively associated with spiritual care competence. Mediation analysis indicated a significant indirect association between compassion fatigue and spiritual care competence through palliative care quality. Moderated mediation analysis indicated that this indirect effect was significant only amongst nurses reporting higher job satisfaction.

Conclusions

Compassion fatigue was negatively associated with palliative care nurses' spiritual care competence. Mediation analysis suggested that this association was statistically explained by palliative care quality, whilst job satisfaction moderated the relationship between compassion fatigue and care quality.

Relevance to Clinical Practise

Addressing compassion fatigue as a critical occupational risk in palliative care nursing is essential. Organisational strategies that enhance job satisfaction and support high-quality care delivery may help sustain nurses' spiritual care competence and promote high-quality palliative nursing practise.

Patient or Public Contribution

No patients or members of the public were involved in this study. Palliative care nurses participated by completing online questionnaires.

Reporting Method

This cross-sectional study was reported in accordance with the STROBE Statement.