BACKGROUND Although critical care nurses gain satisfaction from providing compassionate care to patients and patients' families, the nurses are also at risk for fatigue. The balance between satisfaction and fatigue is considered professional quality of life. OBJECTIVES To establish the prevalence of compassion satisfaction and compassion fatigue in adult, pediatric, and neonatal critical care nurses and to describe potential contributing demographic, unit, and organizational characteristics. METHODS In a cross-sectional design, nurses were surveyed by using a demographic questionnaire and the Professional Quality of Life Scale to measure levels of compassion fatigue and compassion satisfaction. RESULTS Nurses (n = 221) reported significant differences in compassion satisfaction and compassion fatigue on the basis of sex, age, educational level, unit, acuity, change in nursing management, and major systems change. CONCLUSIONS Understanding the elements of professional quality of life can have a positive effect on work environment. The relationship between professional quality of life and the standards for a healthy work environment requires further investigation. Once this relationship is fully understood, interventions to improve this balance can be developed and tested. (Critical Care Nurse. 2015;35[4]:32-44)

SummaryAsthma morbidity in adolescents often results from inadequate asthma self-management. This study was to explore barriers to self-management perceived by adolescents and to examine the associations between barriers and psychosocial factors including knowledge, attitude and self-efficacy. This cross-sectional study included a total of 126 adolescents with asthma (13-21 years) representing diverse race/ethnicity groups with a wide range of socioeconomic status. Self-reported data were analyzed using descriptive statistics, factor analysis and hierarchical regression. The most frequently endorsed barrier (63%) was adolescents' unwillingness to give up "the things the doctors say I have to give up," followed by difficulty in remembering to take care of their asthma (53%), and then "trying to forget" that they have asthma (50%). Psychosocial factors accounted for 32% of the variance in total barrier perceptions. Factor analysis revealed barriers in four domains including negativity toward providers and the medication regimen, cognitive difficulty, peer/family influence and denial. Self-efficacy was found to be the most influential factor that showed strong negative association with all four barrier subscales independent of the levels of asthma control and sociodemographic characteristics. Poor attitudes toward asthma were also associated with barriers of cognitive difficulty and social influence after adjusting for other factors. Males consistently reported higher total barriers and barriers of negativity, social influence and denial. The gender differences were not explained by psychosocial and sociodemographic factors. This study suggests that psychosocial factors are strong predictors of barriers to self-management in adolescents. Particularly, promoting self-efficacy may be beneficial in addressing the barriers. Special attention is needed to address the higher propensity for barriers in males.

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The ideal time frame for frequency of resuscitation skills training has yet to be determined. Results obtained from this performance improvement project using hands-on practice sessions suggest that 6 months may be an adequate time frame for retention of resuscitation skills. Professional development educators may want to consider 6-month retraining intervals for low-volume/high-risk skills such as cardiopulmonary resuscitation to optimize nurses' proficiency in these life-saving competencies.