Motivational interviewing for increasing physical exercise to influence compassion and fitness of nurses in emergency departments

Abstract

Background It is generally accepted in the literature and in the medical profession that emergency nursing places substantial vocational stress on ED nurses who nurse in often high-pressured, unpredictable, physically demanding and stressful environments with a high exposure to trauma and human suffering. The physical and psychological impact of this environment on ED nurses’ personal and professional lives has academic recognition and the subject of considerable research. One of the academically classified consequences of such impacts is that ED nurses are vulnerable to compassion fatigue with its two components, burnout and secondary traumatic stress. With this recognition the question arises on what should be done to mitigate such vocational stress and build resilience to manage the inescapable stressors of emergency nursing.

It is against this background that the general fitness and well-being of an ED nurse becomes critical in order to avoid compassion fatigue, with its two components of burnout and secondary traumatice stress, and maintain compassion satisfaction. There is universal evidence that physical fitness contributes to a person’s general well-being and this study sought to use motivational interviewing, to inspire a sample of ED nurses to improve their physical fitness and determine whether such fitness, after an intervention, has an influence on compassion levels.

The purpose of the study was to determine whether there was any correlation between compassion satisfaction in ED nurses and their health related physical fitness, using motivational interviewing and method, before and after the six week intervention.

Research Design and Methods The study adopted a prospective quantative design which consisted of a six week physical exercise intervention in a pre-test / post-test method of one group of ED nurses. Motivational interviewing was used for the intervention and introduced to the ED nurses as a method of exploring and resolving ambivalence and centres on motivational processes within a person to facilitate behavioural change. The sample population of ED nurses who volunteered to participate in the study were working in emergency departments in State and private hospitals in the Pretoria area. Demographical data was collected using a questionnaire and compassion levels data was collected and analysed using the ProQOL tool. The results of the physical fitness levels of the ED nurses relating to the five components of physical fitness, before and after the six week intervention, were collected using Microsoft Excel spreadsheets and analysed in terms of a data analysis plane using descriptive statistics such as means, standard deviations, ranges, and proportions.

Results The sample showed high levels, 44% (n=18) high, 56% (n=23) average levels of compassion satisfaction in the ED nurses pre- test with no levels of low compassion satisfaction. In the post-test 10% (n=3) of the ED nurses showed low compassion satisfaction 56% (n=23) scored average levels of compassion satisfaction and 44% (n=18) scored high levels of compassion satisfaction. However, despite the average to high levels of compassion satisfaction of ED nurses, a high percentage scored average levels of burnout pre-test70.7% (n=29) of the participants scored average levels of burnout; 2.4% (n=1) scored high levels of burnout, and 26.8% (n=11) scored low levels of burnout) , but there was a significant decrease post-test with none of the ED nurses scoring any burnout after the intervention. Notwithstanding a smaller sample post-test, secondary traumatic stress also reduced after the intervention. In thepre-test: 80.5% (n=33) had average, 19.5% (n=8) had low, and none (0%) had high levels of secondary traumatic stress and post-test 100% (N=30) of the participants scored low levels of burnout, and none scored high or average levels of burnout.The only correlation of significance between the data of the physical fitness measurement results and compassion levels pre- and post-test, was reduced waist circumference and reduced burnout post-test.

Conclusion Despite the limitations of the study, the study and findings justify that further research is necessary to find appropriate interventions, which include physical exercise, to build resilience and to mitigate the unavoidable stressors of emergency nursing and the negative effects of compassion fatigue. This justification for further research is additionally supported by the statistical trends of reduced compassion fatigue after the intervention albiet with a smaller sample.