The Effect of Transcranial Direct Current Stimulation (tDCS) on Resilience, Compassion Fatigue, Stress and Empathy in Professional Nurses

Abstract

The purpose of the study is to determine the effect of Transcranial Direct Current Stimulation (tDCS) on measured levels of resilience and empathy in professional nurses with evidence of compassion fatigue and other stress related problems. Lowered levels of resilience, compassion fatigue and decreased empathy are significant predictors of burnout in nurses. Enhanced levels of resilience are associated with improved empathic responses and overall emotional well-being. Nurses who work in high stress environments often exhibit compassion fatigue and post-traumatic stress disorders that may reduce their ability to function effectively. Because tDCS has been used successfully in a number of chronic disease conditions, it would seem that there is potential for it to be useful in a broader context. The treatment with tDCS may be a potential strategy for improving resilience and eliminating chronic stress responses. A timed series counterbalanced research design was used for the study. Participants completed 18 sessions of tDCS over a six week period. They also completed a resilience, compassion fatigue, stress and empathy scale before and after each tDCS administration. A repeated measure analysis was used to determine if tDCS had an impact on scale scores. The analysis showed that tDCS amperage had significant positive effects on empathy. On the outcomes of resilience, compassion fatigue and stress, tDCS did not produce any significant changes. This research provides a new approach to compassion fatigue, an old problem with caregivers. Notably, when implemented with individuals experiencing problems that involve apathy or indifference, tDCS is a non-effortful intervention that offers a pathway that may improve symptoms and does not require extensive outlays of physical or mental energy.

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

“…Characteristics of included studies ( n = 13) are presented in Table 1 . Of the included studies n = 11 (84.6%) were conducted in the USA [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], one in Australia [ 42 ], and one in Israel [ 43 ]. Ten of the thirteen studies included nurses (76.9%), with three studies specifically focusing on oncology nurses [ 32 , 34 , 35 ], one on pediatric nurses [ 43 ], and one on emergency nurses [ 39 ].…”

“…The 13 studies included represented a total sample size of 671 ( M = 52, SD = 43), with sample sizes for the individual studies ranging from seven [ 36 ] to 154 [ 34 ]. Of those that reported mean age ( n = 7, 53.8%) [ 31 , 34 , 35 , 38 , 40 , 42 , 43 ], averages ranged from 40.5 years [ 35 ] to 49.3 years [ 43 ], and of those which reported sex distribution ( n = 11, 84.6%) [ 31 , 32 , 33 , 34 , 35 , 36 , 38 , 39 , 40 , 42 , 43 ], the majority of subjects were female (58.8% [ 42 ]–100% [ 43 ]). All included studies had a follow-up period ranging from three weeks [ 31 ] to six months [ 35 ] post-intervention.…”

“…Three (23.1%) of the included studies [ 31 , 32 , 39 ] measured only one type of outcome (e.g., ProQoL, Version 5, Manufacturer, City, Country). The remaining ten included articles [ 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 , 43 ] measured the following outcomes in addition to CF ( Table 1 ): (i) burnout [ 34 , 35 , 38 , 42 , 45 ]; (ii) team building [ 33 ]; (iii) impact of traumatic events [ 34 ]; (iv) satisfaction with work or life [ 34 , 42 ]; (v) empathy [ 36 ]; (vi) resilience [ 36 , 41 ]; (vii) depression, anxiety, stress, or perceived stress [ 36 , 37 , 38 , 42 ]; (viii) self-efficacy [ 43 ], self-esteem [ 43 ]; mastery and hope [ 43 ]; mindfulness [ 37 , 38 ], healthcare consumer assessment [ 37 ], general health [ 42 ]; grief [ 40 ]; work environment [ 40 ]; and coping [ 41 ].…”

Compassion Fatigue Among Healthcare, Emergency And Community Service Workers: A Systematic Review

“…Of the remaining four included studies, two evaluated interventions focused on building individual resilience [34,35], one aimed to build professional self-efficacy [43], and Stanton et al [36] used Transcranial Magnetic Stimulation to increase resilience and empathy, and reduce stress. Eleven studies described single-faceted interventions focusing on yoga, mindfulness, meditation, or music therapy [31][32][33]37,38,40,42], resilience and coping [34,35,41], or transcranial magnetic stimulation [36]. In contrast, Berger et al [43] and Flarity et al [39] described more complex interventions involving on multiple, interactive sessions focused on promoting professional self-efficacy, improving theoretical knowledge, and assigning homework tasks, and individual and group exercises, guided imagery, take home materials including print-outs, DVDs and music CDs, and access to educational resources and publications, respectively.…”

“…In contrast, Berger et al [43] and Flarity et al [39] described more complex interventions involving on multiple, interactive sessions focused on promoting professional self-efficacy, improving theoretical knowledge, and assigning homework tasks, and individual and group exercises, guided imagery, take home materials including print-outs, DVDs and music CDs, and access to educational resources and publications, respectively. The included studies differed in their methodology; ten studies (76.9%) [31][32][33][34][35][36][37]39,41,42] used a pre/post design, two studies (15.4%) used randomised controlled designs (RCTs), one with a waitlist control group [38], the other with a no treatment, concurrent control group [40]. Finally, Berger et al [43] used a quasi-random control trial with a wait list control group.…”