Daniel 1

1. Project Goals:

Compassion fatigue is the emotional consequence of hearing the traumatic stories of others (Figley, 1995) and a job hazard of the helping professions. Compassion fatigue is similar to burnout. Like compassion fatigue, symptoms of burnout can include exhaustion and depersonalization, it can accrue slowly over time and it is among the sources of dissatisfaction that can lead to an employee’s desire to leave the organization (Begley, 1998; Du Plooy& Roodt, 2010). Unlike burnout, however, compassion fatigue only occurs in the helping professions (Joinson, 1992) and only as a response to exposure to trauma (Figley, 1995).

The proposed study will survey the prevalence of compassion fatigue (aka secondary traumatic stress) among mental healthcare workers at a behavioral health organization in SW Missouri. The purpose of the study will be to determine the degree to which compassion fatigue is associated with lowered job satisfaction and intent to leave the organization. By tying the phenomenon of compassion fatigue to organizational outcomes, like decreased job satisfaction and turnover, the researcher hopes to demonstrate the organizational costs of unaddressed compassion fatigue with the goal of establishing justification for organizations to address compassion fatigue and improve the quality of the workplace experience.

2. Research Protocol:

Participants: Data will be collected from mental healthcare workers employed by mental health and behavioral health facilities in Southwest Missouri including Burrell Behavioral Health. Permission will also be sought to deliver this survey to a wider sample comprising mental healthcare workers from across the state of Missouri. Eligible participants will be employed by a mental health or behavioral health facility in Missouri in a job capacity that involves working with mental health clients, such as psychologists, psychiatrists, social workers, counselors nurse practitioners and case managers. The survey should take no more than 20 minutes. A minimum sample size sought will be n = 200, with no maximum number of subjects. No form of treatment will be employed in this survey data collection.

Procedures: Potential participants will receive an e-mail from their own organization’s Human Resources administrator and inviting them to participate in the research. This e-mail will contain a link to the survey that participants can click to access the survey. E-mails will be sent to the identified classes of workers. Employees of the mental health organization who do not work directly with clients and residential staff will be excluded.

The survey will be conducted using the Qualtrics survey software package licensed through Missouri State University. Upon clicking on the link sent in an e-mail, potential participants will be presented with a welcome page followed by a informed consent form. All participants must click a box indicating they have read and understood their rights and protections, and consent to voluntary participation in the survey. The survey cannot be conducted and no data will be collected unless the participant expresses willingness to participate in the study.

No setting for testing is specified, but respondents will most likely be in a work setting with a private office and email connection. The survey will include questions about demographics (see attached data collection tool). Data will be collected on demographics including gender, age range, employment classification, location of employment and highest level of education.

The variables of interest in this analysis are compassion fatigue, compassion satisfaction, burnout, job satisfaction, and intent to leave (turnover intent). These variables will be measured using three survey instruments: The 30-Item Professional Quality of Life Questionnaire (ProQOL; Stamm, 2010), the Job Satisfaction Survey (JSS; Spector, 1997), and Michigan Organizational Assessment Questionnaire – Intent To Turnover Measure which is a subscale of the Michigan Organizational Assessment Questionnaire Job Satisfaction instrument (Bowling & Hammond, 2008). Upon completing the survey, the participant will view an exit page that thanks them for their participation and contains information relating to contacting the researcher with any questions.

The results of this research will be submitted for publication in a peer-reviewed research journal. The results, in an anonymous and aggregated format, will be provided to (a) Dr. Beth Hudnall-Stamm, PhD, ProQOL.org Director and Institute of Rural Health, Idaho State University, Pocatello, Idaho, USA as a stipulation of using the ProQOL instrument. The data will be included in a ProQOL data set, (b) Dr. Paul E. Spector, Department of Psychology, University of South Florida, Tampa, FL for norming and bibliography purposes as a stipulation of using the Job Satisfaction Survey (JSS), (c) Dr. Paul Tomlinson, Burrell Behavioral Health, Springfield, Missouri, for the purpose of understanding workforce development issues in Missouri mental health organizations. This data may then be disseminated to human resource departments at each mental health facility to help them understand levels of the five variables at their organization. The archival dataset could then be used by the researcher in his doctoral dissertation. The anonymous data will be kept for at least 5 years in a secured electronic format, although there is no plan to destroy the data after that time.

3. Benefits:

Individual participants will not benefit directly from completing the survey. The purpose of the survey is to identify levels of compassion fatigue and other potentially adverse work conditions with the goal of demonstrating the potential costs to the organization. If the study shows that compassion fatigue is a problem that affects the organization’s turnover and job satisfaction levels, it is conceivable that the organization will take steps to reduce compassion fatigue and thereby improve working conditions for all mental healthcare workers. If so, this would benefit individual participants and others.

4. Risks:

This being an online survey, there are no physical risks to participants. Potentially, participants who are already experiencing low job satisfaction or compassion fatigue might experience some level of emotional distress by reflecting upon their pre-existing negative job affect. Since the participants are themselves mental health professionals, it should be assumed that they are already aware of mental health resources available to them. Participants will be reminded of the availability of Employee Assistance Programs provided to Missouri mental heath professionals.

5. Analysis of Risk: Benefit Ratio When Relevant:

There are no physical risks to subjects. Emotional risks to subjects could potentially include emotional distress for employees who already feel badly about the circumstances of their employment. Potential benefits include identifying the prevalence of compassion fatigue among mental health workers, identifying the organizational implications for compassion fatigue thereby increasing awareness of the phenomenon of compassion fatigue along with the importance of addressing it within the organization to reduce turnover.

6. Procedures for Minimizing Risk:

Participants will be protected by being allowed to give informed consent before participating, participating only voluntarily, being able to withdraw at any time, and having their responses protected both by anonymity and confidentiality. Informed consent forms will be kept separately from data and will not be able to be linked to individual participants’ responses. Data collected during this experiment will not have any identifying information attached to it.

7. Procedure for Obtaining Informed Consent:

Participants will be asked to read and electronically sign the attached Consent Form. No data will be collected on any participant who is unwilling to sign the consent form.

8. Statement of Compliance

I hereby agree to conduct this study in accordance with the procedures set forth in my project description, to uphold the ethical guidelines as set forth in the Code of Federal Regulations 45 CFR 46, 45 CFR 160 and 164, and the Missouri State University HIPAA Policy, and to report to the IRB any outcomes or reactions to the experiment which were not anticipated in the risks description which might influence the IRBs decision to sustain approval of the project.

______

Helen Reid, PhDTodd Daniel, PhD

Dean of CHHSPrincipal Investigator

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Dr. D. Wayne MitchellOther Investigator

Faculty Advisor

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DateDate

References

Begley, T. M. (1998). Coping strategies as predictors of employee distress and turnover after an organizational consolidation: A longitudinal analysis. Journal of Occupational & Organizational Psychology, 71(4), 305-329. Retrieved from EBSCOhost. ISSN: 09631798

Du Plooy, J., & Roodt, G. (2010). Work engagement, burnout and related constructs as predictors of turnover intentions. SAJIP: South African Journal of Industrial Psychology, 36(1), 1-13. doi:10.4102/sajip.v36i1.910

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

Joinson, C. (1992). Coping with compassion fatigue. Nursing, 22 (4), 116-122.

Spector, P. E. (1997). Job satisfaction: Application, assessment, causes, and consequences. Thousand Oaks, CA.: Sage.

Stamm, B.H. (2010). The Concise ProQOL Manual, 2nd Ed. Pocatello, ID: ProQOL.org.

Consent to Participate in a Research Study

Missouri State University

College of Health & Human Services

Compassion Fatigue and Job Satisfaction

Principal Investigator: Todd Daniel. PhD

Introduction:

You have been invited to participate in a research study about compassion fatigue, compassion satisfaction, burnout, job satisfaction and intent to leave an organization (employer). Before you agree to participate in this survey, it is important that you read about and understand the study and the procedures it involves. If you have any questions about the survey or your role in it, be sure to ask the investigator. If you have more questions at a later time, Todd Daniel will be happy to answer them for you. You may contact the investigator at:

Todd Daniel: 1-417-836-4631

You will need to sign this form giving us your permission to be involved in the survey. Taking part in this survey is entirely your choice. If you decide to take part, but later change your mind, you may stop at any time. If you decide to stop, you do not have to give a reason and there will be no negative consequences to you for ending your participation.

Purpose of this Study:

The purpose of this survey is to understand workforce development issues in Missouri mental health organizations. Specifically, this study seeks to understand the prevalence of compassion fatigue among mental health professions and show the consequences to the organization with the goal of improving job satisfaction among mental health professionals. This study will include, at minimum, 200 participants.

Description of Procedures

If you do agree to participate in this survey, you will be presented with a series of questions. Answer honestly, following the directions provided for you. The entire survey should take less than 20 minutes.

What are the risks?

The study has minimal risks. Your physical safety is not affected by completing an online survey. Potentially, if you were already dissatisfied with your work, you could experience emotional distress from being reminded of that fact. This emotional distress would be considered minimal. If you choose not to complete the survey, there will be no consequence to you; however, your answers will not be included in the analysis. Should you feel the need to talk to a mental health professional after completing this survey, you should contact <information will vary>.

What are the benefits?

You may not benefit directly from this study; however, the information from this study will help further the knowledge about compassion fatigue among mental health professionals and potentially lead to efforts to reduce compassion fatigue and increase job satisfaction in your organization.

How will my privacy be protected?

The results of this study are confidential and only the investigators will have access to the information which will be kept in a locked facility at the University. Data obtained during the experiment will be identified by code numbers only; there will be no way to associate any code number with any participant. Your name or personal identifying information will not be used in any published reports of this research. All information gathered during this study will be kept for a minimum of five years after the completion of this project.

Consent to Participate

If you agree to participate in this survey, Compassion Fatigue and Job Satisfaction, please sign below:

I have read and understand the information in this form. I have been encouraged to ask questions and all of my questions have been answered to my satisfaction. By electronically signing this form, I agree tovoluntarily participate in this study. I know that I can withdraw from the study at any time. I have the option to download a copy of this form for my own records.

By typing your name in this box you electronically sign the consent form. After you click Continue, your name will not be attached to your responses and the researcher will have no way to identify how you responded to the questionnaire.

Todd Daniel, PhD

Principal Investigator

Data Collection Tool

Variables: Compassion Fatigue, Compassion Satisfaction and Burnout

Professional Quality of Life Scale (ProQOL)

Compassion Satisfaction and Compassion Fatigue (ProQOL) Version 5 (2009)

When you [help] people you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days.

  1. I am happy.
  2. I am preoccupied with more than one person I [help].
  3. I get satisfaction from being able to [help] people.
  4. I feel connected to others.
  5. I jump or am startled by unexpected sounds.
  6. I feel invigorated after working with those I [help].
  7. I find it difficult to separate my personal life from my life as a [helper].
  8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help].
  9. I think that I might have been affected by the traumatic stress of those I [help].
  10. I feel trapped by my job as a [helper].
  11. Because of my [helping], I have felt "on edge" about various things.
  12. I like my work as a [helper].
  13. I feel depressed because of the traumatic experiences of the people I [help].
  14. I feel as though I am experiencing the trauma of someone I have [helped].
  15. I have beliefs that sustain me.
  16. I am pleased with how I am able to keep up with [helping] techniques and protocols.
  17. I am the person I always wanted to be.
  18. My work makes me feel satisfied.
  19. I feel worn out because of my work as a [helper].
  20. I have happy thoughts and feelings about those I [help] and how I could help them.
  21. I feel overwhelmed because my case [work] load seems endless.
  22. I believe I can make a difference through my work.
  23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help].
  24. I am proud of what I can do to [help].
  25. As a result of my [helping], I have intrusive, frightening thoughts.
  26. I feel "bogged down" by the system.
  27. I have thoughts that I am a "success" as a [helper].
  28. I can't recall important parts of my work with trauma victims.
  29. I am a very caring person.
  30. I am happy that I chose to do this work.

© B. Hudnall Stamm, 2009. Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). /www. isu. edu/~bhstamm or www. proqol. org. This test may be freely copied as long as (a) author is credited, (b) no changes are made, and (c) it is not sold.

Variables: Job Satisfaction

JOB SATISFACTION SURVEY
Paul E. Spector
Department of Psychology
University of South Florida
Copyright Paul E. Spector 1994, All rights reserved.
PLEASE CIRCLE THE ONE NUMBER FOR EACH QUESTION THAT COMES CLOSEST TO REFLECTING YOUR OPINION
ABOUT IT. / Disagree very much
Disagree moderately
Disagree slightly
Agree slightly
Agree moderately
Agree very much
1 / I feel I am being paid a fair amount for the work I do. / 1 2 3 4 5 6
2 / There is really too little chance for promotion on my job. / 1 2 3 4 5 6
3 / My supervisor is quite competent in doing his/her job. / 1 2 3 4 5 6
4 / I am not satisfied with the benefits I receive. / 1 2 3 4 5 6
5 / When I do a good job, I receive the recognition for it that I should receive. / 1 2 3 4 5 6
6 / Many of our rules and procedures make doing a good job difficult. / 1 2 3 4 5 6
7 / I like the people I work with. / 1 2 3 4 5 6
8 / I sometimes feel my job is meaningless. / 1 2 3 4 5 6
9 / Communications seem good within this organization. / 1 2 3 4 5 6
10 / Raises are too few and far between. / 1 2 3 4 5 6
11 / Those who do well on the job stand a fair chance of being promoted. / 1 2 3 4 5 6
12 / My supervisor is unfair to me. / 1 2 3 4 5 6
13 / The benefits we receive are as good as most other organizations offer. / 1 2 3 4 5 6
14 / I do not feel that the work I do is appreciated. / 1 2 3 4 5 6
15 / My efforts to do a good job are seldom blocked by red tape. / 1 2 3 4 5 6
16 / I find I have to work harder at my job because of the incompetence of people I work with. / 1 2 3 4 5 6
17 / I like doing the things I do at work. / 1 2 3 4 5 6
18 / The goals of this organization are not clear to me. / 1 2 3 4 5 6
19 / I feel unappreciated by the organization when I think about what they pay me. / 1 2 3 4 5 6
20 / People get ahead as fast here as they do in other places. / 1 2 3 4 5 6
21 / My supervisor shows too little interest in the feelings of subordinates. / 1 2 3 4 5 6
22 / The benefit package we have is equitable. / 1 2 3 4 5 6
23 / There are few rewards for those who work here. / 1 2 3 4 5 6
24 / I have too much to do at work. / 1 2 3 4 5 6
25 / I enjoy my coworkers. / 1 2 3 4 5 6
26 / I often feel that I do not know what is going on with the organization. / 1 2 3 4 5 6
27 / I feel a sense of pride in doing my job. / 1 2 3 4 5 6
28 / I feel satisfied with my chances for salary increases. / 1 2 3 4 5 6
29 / There are benefits we do not have which we should have. / 1 2 3 4 5 6
30 / I like my supervisor. / 1 2 3 4 5 6
31 / I have too much paperwork. / 1 2 3 4 5 6
32 / I don't feel my efforts are rewarded the way they should be. / 1 2 3 4 5 6
33 / I am satisfied with my chances for promotion. / 1 2 3 4 5 6
34 / There is too much bickering and fighting at work. / 1 2 3 4 5 6
35 / My job is enjoyable. / 1 2 3 4 5 6
36 / Work assignments are not fully explained. / 1 2 3 4 5 6

Variables: Intent to Leave