Compassion Fatigue and Perceived Organizational Performance: Emergency Nurses’ Wellbeing as a Mediating Factor
Sally Mohammed Farghaly Abdelaliem, Haitham Mokhtar Mohamed Abdallah, Mohamed Ezzelregal AbdelgawadBackground
Compassion fatigue is a widespread professional issue in nursing practice, yet the wider organizational implications of compassion fatigue, especially its association with perceived organizational performance through nurses’ wellbeing, are not fully investigated in the context of Egyptian critical care. Clarifying this pathway is important for designing targeted managerial interventions that can maintain the wellbeing of the staff and the efficiency of the institution.
Aim
To investigate the mediating effect of nurses’ wellbeing on the relationship between compassion fatigue and perceived organizational performance among critical care and emergency nurses.
Method
A descriptive correlational cross‐sectional study was undertaken with 111 nurses who worked in intensive care (54.1%), emergency (13.5%), and other inpatient and outpatient units of Alexandria Main University Hospital, Egypt. Three validated data collection instruments were used to collect data between July and September 2024, namely, the Professional Quality of Life (ProQOL) Secondary Traumatic Stress (STS) subscale, used to measure compassion fatigue (10 items, 5‐point Likert scale; α = 0.868); the Organizational Performance Questionnaire, which captures perceived organizational performance (11 items, 5‐point Likert scale; α = 0.944); and the Nurse Wellbeing Scale (17 items, 10‐point Likert‐type scale; α = 0.945). The tools were subject to intensive translation, content validation, exploratory and confirmatory factor analysis (AMOS 23.0), and reliability testing. Associations were examined with Pearson correlation and regression‐based mediation analysis (PROCESS Model 4; 5000 bootstrap samples).
Results
Most nurses (65.8%) expressed a low degree of compassion fatigue (mean = 2.70 ± 0.74), and 44.1% perceived organizational performance as low (mean = 3.04 ± 0.84). Nurses’ wellbeing was low (mean = 4.02 ± 1.98 on the 1–10 scale), with the largest gaps in physical self‐care interventions, such as exercise, sleep, or mindfulness, and lack of manager–nurse communication about wellbeing. Compassion fatigue had a significant negative correlation with perceived organizational performance ( r = −0.400, p < 0.001) and wellbeing ( r = −0.513, p < 0.001). In the mediation analysis, higher compassion fatigue was significantly associated with lower wellbeing ( B = −2.329, p < 0.001), and that wellbeing was a positive predictor of perceived organizational performance ( B = 0.154, p < 0.001). After accounting for wellbeing, the direct effect of compassion fatigue on perceived organizational performance was nonsignificant ( B = −0.140, 95% CI [‐0.356, 0.077], p = 0.196), whereas the indirect effect through wellbeing was significant ( B = −0.360, 95% bootstrap CI [−0.545, −0.227]), indicating that wellbeing statistically mediated 72.0% of the total effect.
Conclusion
Nurses’ wellbeing statistically mediated the association between compassion fatigue and perceived organizational performance. Because of the cross‐sectional design, these findings indicate associations rather than causal effects, and longitudinal studies are needed to confirm the pathway.
Implications for Nursing Management
Systematic, frequent screening for compassion fatigue using instruments such as the ProQOL is recommended, together with organizational‐level interventions that address self‐care deficits such as protected scheduling and resources dedicated to wellbeing. Supporting leadership, creating psychologically safe workplaces, implementing formal peer support networks, and infusing compassion fatigue prevention into education are recommended to support nurse wellbeing and perceived organizational performance, although these recommendations require testing in longitudinal and interventional studies.