Kumiko Kishimoto

Background/Objectives: Nurses are frequently exposed to emotionally demanding situations, placing them at risk of adverse psychological outcomes such as secondary traumatic stress (STS) and burnout. Personality traits, particularly perfectionism, may influence these outcomes. Submissive compassion, characterized by caring behavior motivated by a desire for approval or avoidance of rejection, may play an explanatory role in these relationships. Methods: This study examined whether submissive compassion was statistically associated with the relationship between perfectionism and professional quality of life (ProQOL) among hospital nurses, while accounting for potential confounding and moderating factors. A cross-sectional online survey was conducted among ward nurses working in hospitals in Japan. Participants completed measures of perfectionism, submissive compassion, and ProQOL. Data from 218 nurses were analyzed using structural equation modeling. Results: Socially prescribed perfectionism was positively associated with submissive compassion and STS. Submissive compassion was significantly associated with the indirect relationship between socially prescribed perfectionism and STS. Age moderated the association between submissive compassion and STS, with stronger indirect effects observed among older nurses. Additionally, self-oriented perfectionism showed a relationship with stress-related outcomes, whereas socially prescribed perfectionism was associated with burnout. Conclusions: The findings suggest that submissive compassion may contribute to the association between perfectionism and adverse psychological outcomes among nurses. These results underscore the potential importance of maladaptive compassion motives in understanding how perfectionism relates to STS in this population and may help inform interventions aimed at supporting nurses’ psychological well-being.

AIM: This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self-compassion, fears of compassion, and attachment styles. METHODS: This cross-sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web-based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self-compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors. RESULTS: Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R2 = .31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self-compassion, anxiety, and avoidance (R2 = .63). Compassion satisfaction was impacted by self-compassion, anxiety, and fears of compassion for self (R2 = .31). Additionally, self-compassion (R2 = .28) and fears of compassion for self (R2 = .55) were influenced by anxiety and avoidance. CONCLUSIONS: Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self-compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction.