Resilience as a mediator between compassion fatigue, nurses' work outcomes, and quality of care during the COVID-19 pandemic

Leodoro J. Labrague*, Janet Alexis A. de los Santos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)


Background: Nurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic. Aims: This study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality. Design: An online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines. Results: Overall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = −0.145, p = 0.019), lower job satisfaction (β = −0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = −0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = −0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001). Conclusion: Frontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.

Original languageEnglish
Article number151476
Pages (from-to)151476
JournalApplied Nursing Research
Publication statusPublished - Oct 1 2021


  • Compassion fatigue
  • COVID-19 pandemic
  • Job satisfaction
  • Nursing
  • Quality of care
  • Resilience
  • Turnover intention
  • Pandemics
  • Cross-Sectional Studies
  • Humans
  • Personnel Turnover
  • Nursing Staff, Hospital
  • Job Satisfaction
  • COVID-19
  • SARS-CoV-2
  • Nurses
  • Surveys and Questionnaires
  • Quality of Health Care
  • Compassion Fatigue

ASJC Scopus subject areas

  • General Nursing


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