Compassion Fatigue, Burnout, and Psychological Flexibility among Healthcare Workers: Emotional Strain in Sarawak Tertiary Hospitals

Authors

  • Ling Choo Chiew Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Malaysia
  • Yoke Yong Chen Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Malaysia
  • Mohamad Adam Bujang Sarawak General Hospital, Institute for Clinical Research (ICR), Ministry of Health, Malaysia
  • Keng Sheng Chew Department of Surgery (Emergency Medicine), Faculty of Medicine and Health Sciences University Malaysia Sarawak, Malaysia
  • Md Mizanur Rahman Department of Community Medicine and Public Health (Epidemiology & Statistics), Faculty of Medicine and Health Sciences University Malaysia Sarawak, Malaysia
  • Rekaya Vincent Balang Department of Nursing, Faculty of Medicine and Health Sciences University Malaysia Sarawak, Malaysia
  • Siok Ping Voon Department of Psychology, Faculty of Cognitive Sciences and Human Development, University Malaysia Sarawak, Malaysia
  • Raveca Ak Ridi Unit Psychology Counselling, Sarawak General Hospital, Malaysia

DOI:

https://doi.org/10.21834/e-bpj.v10iSI33.7085

Keywords:

Compassion fatigue, burnout, psychological flexibility, healthcare worker, Psychological Capital

Abstract

This cross-sectional study investigated the relationships between Compassion Fatigue (CF), Burnout (BO), and Psychological-Flexibility (PF) among Healthcare Workers (HCWs) in Sarawak government hospitals. Results showed that 45.7% of HCWs experienced CF, while 52.4% reported personal burnout (PB), 17.8% work-related burnout (WB), and 10.9% client-related burnout (CB). The mean PF score was 81.7 (SD = 16.3). Multivariate analysis revealed significant associations between gender and CF (p < .001), marital status and PB (p = .046), then work-position and CB (p = .025), suggesting that sociodemographic factors significantly influence occupational stress. These findings highlight the need for targeted interventions support HCWs well-being.

References

Figley, C. R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 3–28). Sidran Press.

Maslach, C., & Leiter, M. P. (2016). Burnout: A multidimensional perspective. Psychology Press. DOI: https://doi.org/10.1016/B978-0-12-397045-9.00149-X

Dyrbye, L. N., Shanafelt, T. D., & Sinsky, C. A. (2017). Burnout among health care professionals: A call to explore and address this underrecognized threat to safe, high-quality care. Journal of Patient Safety, 13(2), 82–88. https://doi.org/10.1097/PTS.0000000000000189 DOI: https://doi.org/10.1097/PTS.0000000000000189

Institute for Public Health. (2023). National Health and Morbidity Survey 2023 (NHMS 2023): Non-Communicable Diseases and Healthcare Demand: Technical Report.

Abdul Rashid, M. R., Syed Mohamad, S. N., Ahmad Tajjudin, A. I., Roslan, N., Jaffar, A., Syed Mohideen, F. B., Addnan, F. H., Baharom, N., & Ithnin, M. (2023). COVID-19 pandemic fatigue and its sociodemographic, mental health status, and perceived causes: A cross-sectional study nearing the transition to an endemic phase in Malaysia. International Journal of Environmental Research and Public Health, 20(5), 4476. https://doi.org/10.3390/ijerph20054476 DOI: https://doi.org/10.3390/ijerph20054476

Zhao, Y. J., Xing, X., Tian, T., Zhang, R., Chen, C., Zhang, M., Wang, Y., & Ng, C. H. (2022). Post COVID-19 mental health symptoms and quality of life among COVID-19 frontline clinicians: A comparative study using propensity score matching approach. Translational Psychiatry, 12(1), 376. https://doi.org/10.1038/s41398-022-02089-4 DOI: https://doi.org/10.1038/s41398-022-02089-4

World Health Organization. (2016). Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks. https://www.who.int/publications/i/item/9789241565196

Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. https://doi.org/10.3390/ijerph13060618 DOI: https://doi.org/10.3390/ijerph13060618

Ali, N. F., Nasution Raduan, N. J., Ismail, Z., & Razali, S. (2020). Coping skills and burnout among medical officers in a Malaysian tertiary hospital. Asian Journal of Environment-Behaviour Studies, 5(15), 1–15. https://doi.org/10.21834/aje-bs.v5i15.357 DOI: https://doi.org/10.21834/aje-bs.v5i15.357

Gómez‐Urquiza, J. L., Vargas, C., De la Fuente, E. I., Fernández-Castillo, R., & Cañadas-De la Fuente, G. A. (2017). Age as a risk factor for burnout syndrome in nursing professionals: A meta‐analytic study. Research in Nursing & Health, 40(2), 99–110. https://doi.org/10.1002/nur.21774 DOI: https://doi.org/10.1002/nur.21774

Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865–878. https://doi.org/10.1016/j.cpr.2010.03.001 DOI: https://doi.org/10.1016/j.cpr.2010.03.001

Kristensen, T. S., Borritz, M., Villadsen, E., & Christensen, K. B. (2005). The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 19(3), 192–207. https://doi.org/10.1080/02678370500297720 DOI: https://doi.org/10.1080/02678370500297720

Chin, R. W. A., Chua, Y. Y., Chu, M. N., Mohd Rasdi, H. F., Lee, S. S., Wong, M. S., et al. (2017). Investigating validity evidence of the Malay translation of the Copenhagen Burnout Inventory. Journal of Taibah University Medical Sciences, 13(1), 1–9. https://doi.org/10.1016/j.jtumed.2017.06.003 DOI: https://doi.org/10.1016/j.jtumed.2017.06.003

Ben-Itzhak, S., Bluvstein, I., & Maor, M. (2014). The Psychological Flexibility Questionnaire (PFQ): Development, reliability, and validity. WebmedCentral Psychology, 5(4), WMC004606

Bujang, M. A. (2025). The dilemma and wisdom in translating p values: A collaborative approach to strengthening scientific validity. BioMed Research International, 2025, Article 6703756. https://doi.org/10.1155/bmri/6703756 DOI: https://doi.org/10.1155/bmri/6703756

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688. https://doi.org/10.1016/j.beth.2011.03.007 DOI: https://doi.org/10.1016/j.beth.2011.03.007

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press.

Austin, C. L., Saylor, R., & Finley, P. J. (2017). Moral distress in physicians and nurses: Impact on professional quality of life and turnover. Psychological Trauma, 9(4), 399–406. https://doi.org/10.1037/tra0000201 DOI: https://doi.org/10.1037/tra0000201

Lombardo, B., & Eyre, C. (2011). Compassion fatigue: A nurse's primer. Online Journal of Issues in Nursing, 16(1), 3. https://doi.org/10.3912/OJIN.Vol16No01Man03 DOI: https://doi.org/10.3912/OJIN.Vol16No01Man03

Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1), 652–666. https://doi.org/10.3390/ijerph120100652 DOI: https://doi.org/10.3390/ijerph120100652

Courtenay, W. H. (2000). Constructions of masculinity and their influence on men's well-being: A theory of gender and health. Social Science & Medicine, 50(10), 1385–1401. https://doi.org/10.1016/S0277-9536(99)00390-1 DOI: https://doi.org/10.1016/S0277-9536(99)00390-1

West, C. P., Dyrbye, L. N., & Shanafelt, T. D. (2018). Physician burnout: Contributors, consequences and solutions. Journal of Internal Medicine, 283(6), 516–529. https://doi.org/10.1111/joim.12752 DOI: https://doi.org/10.1111/joim.12752

Van Mol, M. M., Kompanje, E. J., Benoit, D. D., Bakker, J., & Nijkamp, M. D. (2015). The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review. PLoS One, 10(8), e0136955. https://doi.org/10.1371/journal.pone.0136955 DOI: https://doi.org/10.1371/journal.pone.0136955

Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2016). An official Critical Care Societies Collaborative statement: Burnout syndrome in critical care health care professionals: A call for action. American Journal of Critical Care, 25(4), 368–376. https://doi.org/10.4037/ajcc2016133 DOI: https://doi.org/10.4037/ajcc2016133

Hunsaker, S., Chen, H. C., Maughan, D., & Heaston, S. (2015). Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. Journal of Nursing Scholarship, 47(2), 186–194. https://doi.org/10.1111/jnu.12122 DOI: https://doi.org/10.1111/jnu.12122

Downloads

Published

2025-06-15

How to Cite

Chiew, L. C., Chen, Y. Y., Bujang, M. A., Chew, K. S., Rahman, M. M., Balang, R. V., Voon, S. P., & Ridi, R. A. (2025). Compassion Fatigue, Burnout, and Psychological Flexibility among Healthcare Workers: Emotional Strain in Sarawak Tertiary Hospitals . Environment-Behaviour Proceedings Journal, 10(SI33), 203–210. https://doi.org/10.21834/e-bpj.v10iSI33.7085