Relationship between psychological flexibility and work-related quality of life for healthcare professionals: A systematic review and meta-analysis

Healthcare practitioners' work-related quality of life can be considered within the framework of compassion fatigue and compassion satisfaction. Compassion fatigue can have detrimental impacts for healthcare professionals, whereas compassion satisfaction relates to positive outcomes in ‘helping’ professions. Psychological flexibility has been identified as a resource that may buffer against compassion fatigue and promote compassion satisfaction. This systematic review aimed to examine associations between psychological flexibility and compassion fatigue and compassion satisfaction in healthcare professionals. Eligible studies were quantitative empirical studies aiming to assess these relationships. Four databases were searched (PsycINFO; Medline; CINAHL; EMBASE) along with reference lists and forward citations of eligible studies. Nine cross-sectional studies were included (2739 participants from various healthcare professions) and quality appraised using the AXIS tool. Meta-analyses (random effects model) indicated a significant medium negative association between psychological flexibility and compassion fatigue (r = −0.40; 95% CIs [-0.55, −0.29]; Z = −7.94, p = .001) and a significant small positive association between psychological flexibility and compassion satisfaction (r = 0.29; 95% CIs [0.23, 0.36]; Z = 10.56, p = .001). The significance and magnitude of these associations were robust to sensitivity analyses, undertaken to examine the influence of study heterogeneity on pooled estimates. Despite study variation in terms of measurement, sample size, and professional perspective of the sample, when heterogeneity is reduced following sensitivity analyses, significant associations remained. These findings may carry important implications for ranging healthcare professionals, in terms of the potential relationship between psychological flexibility and work-related quality of life