Nurses’ Compassion Fatigue Linked to Weaker Patient Safety Attitudes

Nurses who feel emotionally worn down by caring for others may also hold less favorable views about patient safety, according to a cross-sectional study conducted at two public hospitals in eastern Turkey. The research, published in BMC Nursing, surveyed 368 nurses and found that higher scores on a compassion fatigue scale were associated with lower scores on a patient safety attitude scale, a relationship that persisted even after the researchers statistically accounted for demographic and occupational differences among participants.

The study recruited all 650 nurses working at the two hospitals between May and August 2025, using convenience sampling. A total of 368 nurses volunteered and fully completed the survey forms, yielding a participation rate of 56.6 percent. Data collection relied on three instruments: an identifying characteristics data form, the Compassion Fatigue Short Scale, and the Patient Safety Attitude Scale.

The mean total score on the Compassion Fatigue Short Scale was 60.79, with a standard deviation of 23.89, which the authors characterized as moderate. The Patient Safety Attitude Scale produced a mean total of 146.48, with a standard deviation of 27.09, also described as moderate. Statistical analysis revealed a moderate, negative correlation between the two measures (r = -.383; p < .001), meaning that nurses reporting greater compassion fatigue tended to express less positive attitudes toward patient safety.

To test whether this association held independently of other factors, the researchers performed a hierarchical regression controlling for demographic and occupational characteristics. Compassion fatigue remained a significant predictor of patient safety attitudes (β = -0.273; p < .001), contributing an additional 5.7 percent of explained variance (∆R2 = 0.057). The final model accounted for 28.6 percent of the variance in patient safety attitudes, with an adjusted R2 of 0.264.

Bivariate analyses added further context. Nurses who had chosen the profession voluntarily, reported greater professional commitment, and had children scored lower on compassion fatigue and expressed more positive attitudes toward patient safety. These findings suggest that personal investment in the nursing role and family circumstances may relate to both emotional resilience and safety-oriented thinking, although the cross-sectional design prevents any conclusion about direction or cause.

Compassion fatigue is widely recognized as an occupational risk in nursing, arising from prolonged exposure to patient suffering and the emotional demands of caregiving. The authors note in their background section that it has been associated with declines in the quality of care and with negative attitudes toward patient safety. The present study quantifies that association in a specific workforce, showing that the relationship is moderate in strength and statistically robust even after adjustment for other variables.

The authors conclude that high levels of compassion fatigue were associated with more negative attitudes toward patient safety in this sample. They propose that structured psychological support programs, resilience training, and patient safety education programs that address compassion fatigue could help strengthen nurses’ attitudes toward patient safety. However, because the data were collected at a single point in time, the study cannot establish whether compassion fatigue causes negative safety attitudes, whether negative attitudes contribute to fatigue, or whether both are shaped by other workplace conditions.

The research team acknowledges this limitation and recommends longitudinal, multicenter studies to clarify causal relationships. Such designs would allow researchers to track changes in compassion fatigue and safety attitudes over time within the same individuals, providing stronger evidence about the temporal sequence and potential mechanisms linking the two. Until then, the findings offer hospital administrators and nursing leaders a measurable signal: emotional exhaustion among nursing staff may coincide with a workforce that is less attuned to patient safety concerns.

For the nursing profession, the study underscores the interplay between caregiver well-being and system-level safety culture. Interventions that reduce compassion fatigue, whether through counseling services, peer support, or workload adjustments, may carry benefits beyond individual mental health, potentially reinforcing the attitudes that underpin safe care delivery. The authors’ call for education programs that explicitly address compassion fatigue reflects a growing recognition that patient safety initiatives and staff psychological support are not separate endeavors but intertwined components of healthcare quality.

Subject of Research: The relationship between nurses' compassion fatigue and their attitudes toward patient safety in a cross-sectional hospital survey.

Article Title: The relationship between nurses’ compassion fatigue and patient safety attitudes: a cross-sectional study

Article References: Güzel, A., Albayrak, E. A., & Metin, H. T. (2026). The relationship between nurses’ compassion fatigue and patient safety attitudes: a cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05615-7

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05615-7

Keywords: compassion fatigue, nurses, patient safety, cross-sectional study, BMC Nursing, occupational health, resilience training, psychological support, healthcare quality, nursing workforce, relationship, between