. 2016 Jun 22;13(6):618. doi: 10.3390/ijerph13060618

Table 1.

Summary of included studies reporting on CF interventions (n = 13).

First Author, Year and Country	Occupational Group (N), % Female and Age	Target of Intervention ^a	Intervention Design/Content	Measure of CF	Other Measures ^c	Follow-Up	Effectiveness Against Targeted Outcomes	Conclusions
[31]	Social workers (n = 11) Intervention Group (n = 5) Control Group (n = 6) 90.9% female Age: M = 44.73, SD = 14.4	BO, CS and STS	Pre/Post—One hour yoga and mindfulness program once a week for 3 weeks.	ProQoL, V5 ^b	None	3 weeks post baseline	*INTERVENTION GROUP MEAN (pre vs.* post) CS (↑) (p = 0.121) BO (↓) (p = 0.249) STS (↓) (p = 0.155) CONTROL GROUP MEAN (pre vs. post)** CS (↓) (p = 0.004) BO (↓) (p = 0.352) STS (↓) (p = 0.866)	Significant decrease in CS for controls could suggest the absence of a coping resource (i.e., yoga, mindfulness). Lower CS could predict BO, STS and CF.
[32]	Oncology nurses (n = 15) 100% female Age: not reported	CF and CS	Pre/Post—16 min of structured meditation, using an audio CD, 5 days a week for 4 weeks.	ProQoL, V5	None	4 weeks post baseline	INTERVENTION GROUP ONLY (pre vs. post) CS (↑) (p = 0.27) BO (↓) (p = 0.003) STS (↓) (p = 0.47)	Effective in reducing stress and cultivating self-compassion. Time poor nurses suggest commitment might be difficult.
[33]	Nurses, social workers and chaplains (n = 17) 64.7% female Age Range = 28–60 years	CF	Pre/Post—1 h music therapy groups delivered weekly for 6 weeks. Treatment group 1 received an ecological music therapy approach; treatment group 2 received a didactic music therapy approach.	Compassion Fatigue Scale (CFS)	TBQ	6 weeks post baseline	INTERVENTION GROUP 1 (pre vs. post) CFS (↑) (p = n.s.) INTERVENTION GROUP 2 (pre vs. post) CFS (↓) (p = n.s.)	No significant difference in CFS. Significant improvement in team building in both groups.
[34]	Oncology staff (n = 154) 92.7% female Age: M = 40.5	CF	Pre/Post—90 min sessions on CF resiliency once a week for 5 weeks and a 2 day facilitator’s course.	ProQoL R-IV	MBI Revised Impact of Events Scale Nurse Job Satisfaction Scale	3 months	INTERVENTION GROUP 1 (pre vs. post) CS (↑) (p ≤ n.s.) BO (↓) (p ≤ 0.01) STS (↓) (p ≤ 0.01)	Staff rated the program highly, relevant to the job. BO and CF both decreased significantly.
[35]	Oncology nurses (n = 13) 85.7% female Age: M = 43.9	CF	Pre/Post—90 min sessions on CF resiliency once a week for 5 weeks.	ProQoL IV	MBI-Human Services Survey	5 weeks, 3 months and 6 months post baseline	INTERVENTION GROUP (pre- vs. post) CS (↑) (p = n.s.) BO (↓) (p = n.s.) STS (↓) (p = n.s.) INTERVENTION GROUP (pre-test vs. 3-mo FU) CS (↓) (p = n.s.) BO (↑) (p = n.s.) STS (↓) (p = n.s.) INTERVENTION GROUP (pre-test vs. 3-mo FU) CS (↑) (p = n.s.) BO (↓) (p = n.s.) STS (↓) (p ≤ 0.05)	STS scores declined immediately after the program. Maintained at 3- and 6-month follow up. Improved Impact of Event scores showing a statistically significant improvement in CF resilience.
[36]	Professional nurses (n = 7) 85.7% female Age Range = 30–45 years	CF	Pre/Post—Transcranial Direct Current Stimulation (tDCS) Timed series counterbalanced research design. 18 sessions of tDCS over a 6 week period.	Compassion Fatigue Scale (CFS)	EAI Resilience Scale PSS	6 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CFS (↓) (p = 0.46)	No effect on resilience, CF or stress. Lowered levels of resilience, CF and decreased empathy are significant predictors of BO.
[43]	Pediatric nurses (n = 80) Intervention Group (n = 42) Control Group (n = 38) 100% female IG Age: M = 49.3 CG Age: M = 47.7	BO, CS, CF	Quasi-random control trial—six, 1 h sessions once a week for 12 weeks. Sessions aimed to improve professional self-efficiency and included theoretical knowledge, experiential exercises, and homework tasks.	ProQoL, V5	DHSES Traumatic Event Questionnaire RSE Mastery Scale Hope Scale	12 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CS (↑) (36.52 vs. 53.64) (p ≤ 0.001) BO (↓) (51.18 vs. 45.34) (p = n.s.) STS (↓) (51.46 vs. 46.78) (p = n.s.) CONTROL GROUP (pre- vs. post-test) CS (↑) (40.24 vs. 45.97) (p ≤ 0.001) BO (↓) (48.69 vs. 52.93) (p = n.s.) STS (↓) (48.38 vs. 51.33) (p = n.s.) IG vs. CG CS (p ≤ 0.001, ES ^b = 0.35) BO (p ≤ 0.001, ES ^b = 0.22) CF (p ≤ 0.001, ES ^b = 0.14)	Largest improvements were in the CS measure. Suggests focusing on trauma-related skills to reduce STS. This present-oriented, skill-focused intervention, that incorporates self-maintenance techniques as is future-oriented through development of positive outlook and hope, affects all aspects of STS – BO, CF and CF.
[37]	Staff nurses, nurse aides, secretaries, unit managers, supervisors (n = 74) Intervention Group (n = 46) Control Group (n = 28) Sex: Not reported Age: Not reported	CS, BO	Pre/Post—Mindfulness education and practice in 30 min classes once a week for 10 weeks.	ProQoL, V5	MAAS HCAHPS Individual and Work-Unit Level Stress	10 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CS (↓) (53.20 vs. 52.93) (p = 0.76) BO (↓) (46.20 vs. 45.71) (p = 0.55) CONTROL GROUP (pre- vs. post-test) CS (↑) (53.77 vs. 54.25) (p = 0.58) BO (↓) (46.05 vs. 45.00) (p = 0.22)	BO scores improved in the IG, but both CS and BO scores improved in the CG. Hospital may benefit from incorporating mindfulness training to reduce stress among nursing staff. Possible the intervention period was too short to see change in these measures.
[38]	Medical center personnel (n = 32) Intervention Group (n = 16) Control Group (n = 16) 87.5% female Age: M = 44.2	CS, STS, BO	RCT—mindfulness meditation, yoga movements, relaxation through music seven 1 h sessions and one 2 h session once a week for 8 weeks.	ProQoL, V5	Stress Biomarkers (Salivary α-amylase) PSS DASS MBI FFMQ	8 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CS (↑) (p = 0.0314) BO (↓) (p = n.s.) CONTROL GROUP (pre- vs. post-test) CS (↑) (p = n.s.) BO (↓) (p = n.s.)	Intervention period too short to detect an effect. Specific aspects of mindfulness may be associated with better control of the deleterious effects of work stress.
[39]	Emergency nurses (n= 73) 81% female Age: 57% aged 31–50 years	CS, BO, STS, CF	Pre/Post—4 h interactive group seminar followed by individual and group exercises e.g., guided imagery, and multimedia resources (printed handouts, DVD, guided imaging/music CD, website with CF, CS and resiliency educational resources and publications.	ProQoL, V5	None	3–4 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CS (↑) (40.3 vs. 42.2) (p = 0.004) BO (↓) (23.9 vs. 20.0) (p ≤ 0.001) STS (↓) (23.5 vs. 21.4) (p = 0.001)	10% reported higher CS, 34% reported fewer BO symptoms, 19% reported fewer STS symptoms. Organizational prevention programs may help maximize caregivers level of CS and reduce the risks of developing CF. Short pre/post period does not indicated long term improvement.
[42]	Disability sector workers (n = 34) Group 1 (n = 8) Group 2 (n = 6) Group 3 (n = 20) 58.8% female Age: M = 42.9, SD = 9.6	CS, BO, STS	Pre/Post—Training focused group meets once weekly for 8 session, each of 2 h duration. Group Work: Core mindfulness practices e.g., mindful breathing, body scan meditation, and mindful stretching, walking and sitting. Home Work: 40 mins/day, 6 days/week of mindfulness practice.	ProQoL, V5	PHQ-9 FFMQ PSS DASS PANAS SWLS CBI	8 weeks post baseline	INTERVENTION GROUP (pre- vs. post-test) CS (↓) (50.87 vs. 50.39) (p = n.s.) BO (↓) (49.76 vs. 48.59) (p = n.s.) STS (↓) (52.98 vs. 49.68) (p = n.s.)	Participants reported enhanced awareness of the signs and sources of stress. Positive changes in self-care attitudes, behaviours and interactions with colleagues and clients.
[40]	Hospice workers (n = 68) Intervention Group (n = 34) Control Group (n = 34) 84% female IG Age: M = 46.5, SD,14.8 CG Age: M = 42.0, SD,12.0	CS, BO	RCT—Single session Group Music Intervention for Grief Resolution (GMR-GR) to allow: Expression of grief feelings; Connect socially with colleagues experiencing similar feelings; and Participate in a grief ritual to farewell patients who’d died.	Compassion Satisfaction and Fatigue (CSF) Test	HCGI WES	Immediately post baseline and 30 days post baseline	BETWEEN GROUP DIFFERENCES (IG vs. CG) BO (p = 0.98) CF (p = 0.91)	No significant differences in BO, CF. Single session format could be a limitation. Results not generalizable.
[41]	Military and civilian RNs, LPNs ^d, and medics (n = 93) Sex: Not reported Age: Not reported	CS, BO, STS	Pre/Post—Care Provider Support Program (CPSP) training on resiliency, coping, and CF.	ProQoL, V5	WCQ CD-RISC	30 days post session	A paired-samples t-test determined that CPSP CS (↓) (39.64 vs. 39.18) (p = 0.62) BO (↓) (28.71 vs. 19.79) (p ≤ 0.001) STS (↑) (19.25 vs. 20.14) (p = 0.20)	Research required with larger samples at multisite locations. CPSP training decreases BO in military and civilian RNs, LPNs, medics. Decreased BO may lead to a decrease in overall CF.

^a BO = burnout, CS = compassion satisfaction, STS = secondary traumatic stress/secondary traumatization, CF = compassion fatigue; ^b ES = Effect Size; ^c TBS = Team Building Questionnaire; MBI = Maslach Burnout Inventory; EAI = Empathy Assessment Inventory; PSS = Perceived Stress Scale; DHSES = Disaster-Helper Self-Efficacy Scale; RSE = Rosenberg Self-Esteem Scale; HS = Hope Scale; MAAS = Mindful Attention Awareness Scale; HCAHPS = Hospital Consumer Assessment of Healthcare Providers and Systems; DASS = Depression Anxiety Stress Scale; FFMQ = Five Facet Mindfulness Questionnaire; PHQ-9 = Patient Health Questionnaire (9); PANAS = Positive and Negative Affect Schedule; SWLS = Satisfaction With Life Scale; CBI = Copenhagen Burnout Inventory; HCGI = Hospice Clinician Grief Inventory; WES = Work Environment Scale; WCQ = Ways of Coping Questionnaire; CD-RISC = Connor-Davidson Resilience Scale; ^d Licensed Practical Nurses.