Impact of a secondary prevention program on compassion fatigue among healthcare professionals working in COVID-19 units: a quasi-experimental study

Abstract

Background

Compassion fatigue is a common condition among healthcare professionals continuously exposed to patient suffering, especially in high-pressure care settings such as those experienced during the COVID-19 pandemic. Evidence highlights its negative impact on mental health of staff and quality of care, as well as the need to implement effective preventive programs. Therefore, the aim of this study was to evaluate the impact of a pilot program of secondary prevention of compassion fatigue in healthcare professionals working in COVID-19 units at the Nuestra Señora de Candelaria University Hospital Complex (CHUNSC).

Methods

A quasi-experimental, longitudinal and prospective study was carried out, with pretest-posttest measures in a single group. By initial screening with the IDE-ESAPE and ProQOL-IV tools, 30 professionals with high scores of compassion fatigue or burnout were selected. The psychoeducational program, consisting of five group sessions, included mindfulness, emotional regulation and self-care. The results were evaluated at six months.

Results

Significant reductions in compassion fatigue (p < 0.01; r = 0.48) and burnout (p < 0.01; r = 0.53) were observed, as well as an increase in compassion satisfaction (p < 0.01; r = 0.46). A total of 100% of the participants completed the intervention. Improvements were maintained at six-month follow-up.

Conclusion

The program was associated with significant reductions in compassion fatigue and burnout, together with an increase in compassion satisfaction. This suggests its feasibility and potential usefulness for integration into institutional strategies aimed at supporting professional well-being.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s12912-026-04974-5.

Introduction

Compassion fatigue is a form of emotional distress that affects healthcare professionals who are exposed for prolonged periods to the suffering of patients and families [1, 2]. It is characterized by a progressive reduction in empathic capacity, emotional exhaustion and decreased professional satisfaction. Clinical manifestations may include intrusive thoughts related to patients’ experiences, emotional numbing, irritability, sleep disturbances, reduced concentration and a diminished sense of professional efficacy. Unlike burnout, which is primarily associated with organizational stressors such as workload or lack of control, compassion fatigue arises as a direct consequence of sustained exposure to others’ suffering and is frequently associated with secondary traumatic stress [3]. Burnout has been classically conceptualized by Maslach et al. [4], whose multidimensional model remains a seminal reference in occupational health research with subsequent developments highlighting its impact on physicians and nurses [5].

Recent conceptual and psychometric developments have further refined compassion fatigue as a multidimensional construct in nursing populations, emphasizing its cognitive, emotional and behavioral dimensions [6]. The development of specific measurement tools for nurses has strengthened its empirical assessment and construct validity [7, 8].

During the COVID-19 pandemic, the intensity, duration and complexity of clinical situations generated an unprecedented context of emotional demand for healthcare professionals. International evidence has documented elevated levels of acute stress, anxiety, sleep disturbances and emotional exhaustion among frontline staff [9–11]. In this context, high prevalence rates of compassion fatigue have been reported globally, particularly among nurses and professionals working in high-acuity settings. A recent systematic review and meta-analysis estimated substantial prevalence rates of compassion fatigue among registered nurses and nursing students [12], consistent with earlier systematic reviews in healthcare professionals [13]. Similar findings have been reported during the COVID-19 crisis in specific hospital contexts [14, 15]. These conditions have been associated with reduced quality of care, increased intention to leave the profession and deterioration in mental health outcomes.

Despite the clinical and organizational impact of compassion fatigue, institutional strategies for its prevention and management are still scarce, partial or reactive. There are interventions based on mindfulness, resilience training and self-care practices that have shown positive effects on the emotional regulation of caregivers, but their systematic integration in healthcare settings remains limited [16–18]. Qualitative studies have also highlighted the need for structured institutional responses to address the causes and consequences of compassion fatigue in nurses [19, 20]. Therefore, it is essential to develop and evaluate intervention programs that are structured, sustainable and adapted to contexts of high emotional vulnerability.

In this context, secondary prevention refers to the early identification and intervention among healthcare professionals already exposed to high emotional burden and presenting elevated levels of compassion fatigue or burnout, with the aim of preventing symptom progression and long-term psychological consequences. Structured interventions targeting emotional regulation, resilience and self-care may contribute to mitigating these risks and promoting professional well-being in high-demand healthcare environments.

The aim of this study was to evaluate the effectiveness of a structured secondary prevention psychoeducational program designed to reduce compassion fatigue and burnout and to enhance compassion satisfaction among healthcare professionals working in COVID-19 units at a tertiary hospital. Through a longitudinal design, we explore the effect of the program on three key dimensions: compassion fatigue, burnout and compassion satisfaction.

Methods

Study design

A quasi-experimental, longitudinal and prospective study was designed, with pretest-posttest measures in a single group, aimed at evaluating the impact of a psychoeducational intervention in the secondary prevention of compassion fatigue in healthcare professionals exposed to COVID-19 units. The study was conducted between March and November 2022 at the Hospital Universitario Nuestra Señora de Candelaria (HUNSC) (Santa Cruz de Tenerife, Spain).

Ethical considerations

The study was approved by the Ethics Committee for Research with Medicines (CEIm) of the University Hospital Complex of the Canary Islands and complied with the ethical principles of the Declaration of Helsinki. All participants signed the informed consent form and their data were treated confidentially. Participation was entirely voluntary, and no financial or material incentives were provided to participants.

Participants and sampling

In a preliminary screening phase, 148 healthcare professionals who had worked in COVID-19-related services (Emergency department, inpatient ward, Intensive Care Unit/Operating Room) were assessed using the Professional Quality of Life Scale (ProQOL-IV) and the Empathic Distress Inventory (IDE-ESAPE). Eligible participants were those who:

1. Presented elevated levels of compassion fatigue or burnout according to ProQOL-IV cut-off points (Compassion Fatigue ≥ 17; Burnout > 27 indicating high risk);

2. Were classified as Profile 3 (risk of compassion fatigue) or Profile 4 (compassion fatigue) according to IDE-ESAPE;

3. Were actively working in COVID-19 care units during the pandemic period;

4. Voluntarily agreed to participate.

Professionals temporarily on medical leave or occupational incapacity during the recruitment period were excluded.

Thirty professionals met eligibility criteria and agreed to participate in the intervention phase. No participants were lost to follow-up during the study period (retention rate 100%).

Procedure

Following baseline assessment (T0), participants were enrolled in a structured psychoeducational program consisting of five weekly face-to-face sessions of 120 min each (total duration: 10 h). The intervention was delivered entirely in person.

To facilitate interaction and optimize group dynamics, participants were divided into two groups of 15 professionals.

The program combined psychoeducation, emotional regulation strategies, resilience training and mindfulness-based techniques. The sessions were structured as follows:

• Session 1: Psychoeducation on compassion fatigue, burnout and emotional triggers.

• Session 2: Coping strategies and conflict management through experiential exercises and role-play.

• Session 3: Resilience enhancement using appreciative inquiry and peer reflection.

• Session 4: Stress-reduction techniques including mindfulness practice, progressive muscle relaxation and breathing exercises.

• Session 5: Self-monitoring, emotional processing and consolidation of self-care strategies.

The intervention was delivered by two senior mental health professionals. One facilitator was a mental health nurse specialist with more than 25 years of clinical experience in mental health settings, holding degrees in psychology and health sciences and advanced training in brief systemic interventions and solution-focused therapy. The second facilitator was a licensed psychologist with more than 15 years of clinical experience and postgraduate training in general health psychology, dance movement therapy and body-oriented therapeutic approaches. Both facilitators had prior experience conducting group-based interventions aimed at emotional regulation and professional well-being in healthcare contexts.

Follow-up assessments were conducted immediately after completion of the intervention (T1) and six months after the end of the program (T2).

Assessment instruments

The following validated instruments were used:

• Compassion Fatigue Inventory - Scale for Healthcare Professionals (Spanish acronym: IDE-ESAPE): allows detecting clinical and subclinical profiles of compassion fatigue with high internal reliability (α > 0.85) [21].

• Professional Quality of Life Scale (ProQOL IV): This internationally used instrument assesses three dimensions: compassion fatigue (secondary traumatic stress), burnout, and compassion satisfaction. Previous studies have reported adequate internal consistency, with Cronbach’s alpha coefficients ranging from 0.75 to 0.88 across subscales. Cut-off points recommended in the ProQOL-IV manual were used to classify levels of risk [22].

• Subjective Traumatic Experiences Questionnaire (STEQ): this instrument was used exclusively during the preliminary screening phase (n = 148) to characterize the subjective emotional impact of prior traumatic experiences among the assessed healthcare professionals. The STEQ was not administered at T1 or T2, as its purpose was restricted to contextualizing the emotional burden of the sample prior to intervention selection rather than serving as a longitudinal outcome measure. Accordingly, STEQ data are reported solely in the preliminary phase results and are not included in the pre–post intervention analyses [23].

Sociodemographic and professional variables (age, sex, professional category, years of experience, and work unit) were collected using a structured self-administered questionnaire developed for this study (Additional File 1).

The combined use of ProQOL-IV and IDE-ESAPE allowed cross-validation of compassion fatigue-related constructs, as ProQOL evaluates professional quality of life dimensions while IDE-ESAPE provides specific empathy-related risk profiling.

Data analysis

IBM SPSS Statistics v.28 software was used for statistical analysis. Descriptive statistics (means, standard deviations, and frequencies) were calculated for sociodemographic and clinical variables. Normality of distribution was assessed using the Shapiro–Wilk test. Given the small sample size (n = 30) and non-normal distribution of several variables, nonparametric tests were applied. Changes between measurement points (T0, T1, T2) were analyzed using the Wilcoxon signed-rank test. The Mann–Whitney U test was used for between-group comparisons when appropriate. Spearman correlation coefficients were calculated to assess associations between variables. A significance level of p < 0.05 was established. Effect sizes (r) were calculated to evaluate the magnitude of changes.

A post-hoc power analysis was conducted using the normal approximation to the Wilcoxon signed-rank distribution, based on the observed Z-statistics reported in Table 5. For the primary comparisons (T0 vs. T1), achieved power ranged from 0.989 to 0.994, with effect sizes in the medium-to-large range according to Cohen’s conventions (r = 0.46–0.53) [24]. Power for the T1–T2 comparisons exceeded 0.99. A sensitivity analysis indicated that, with n = 30 and α = 0.05, the study had 80% power to detect effects of r ≥ 0.36; all observed effects exceeded this threshold. These analyses are post hoc and do not replace an a priori sample size calculation, which remains a limitation of the pilot design [25].

Table 5.

Comparison of ProQOL-IV subscales

Subscale	Time	Mean	SD	Statistic (Z)	P value
Fatigue	T0 T1 T2	28.6 15.4 7.9	7.5 8.5 2.5	Z = − 4.25 Z = − 4.79	< 0.001 < 0.001
Burnout	T0 T1 T2	32.2 21.1 17.8	5.6 5.1 3.5	Z = − 4.49 Z = − 4.79	< 0.001 < 0.001
Satisfaction	T0 T1 T2	27.4 43.7 47.4	13.1 3.8 2.2	Z = − 4.25 Z = − 4.78	< 0.001 < 0.001

Note. Differences between time points were analysed using the Wilcoxon signed-rank test for paired samples. For each subscale, the first Z-value and corresponding p-value refer to the comparison between baseline (T0) and immediately post-intervention (T1), whereas the second Z-value and p-value refer to the comparison between immediately post-intervention (T1) and six-month follow-up (T2)

Results

Preliminary phase

An initial evaluation using the ProQOL-IV and IDE-ESAPE questionnaires was carried out on a total of 148 health professionals (81.1% women), belonging to CHUNSC services that attended patients with COVID-19. The distribution by professional category was as follows: 68 nurses (45.9%), 71 nursing assistants (48.0%) and 9 physicians (6.1%). The mean age of the participants was 40.1 ± 9.5 years, with a mean work experience of 11.7 ± 7.2 years. Detailed descriptive statistics can be found in Table 1.

Table 1.

Sociodemographic statistics of the preliminary phase. (n = 148)

Variable	Category	n (%) / Mean ± SD
Sex	Female Male	120 (81.1) 28 (18.9)
Age		40.1 ± 9.5
Years of experience		11.7 ± 7.2
Marital status	Single Married Separated Widowed In a relationship	56 (37.8) 44 (29.7) 15 (10.1) 3 (2.0) 30 (20.3)
Lives alone	Yes No	41 (27.7) 107 (72.3)
Dependents	Yes No	77 (52) 71 (48)
Professional category	Physician Nurse Nursing assisstant	9 (6.1) 68 (45.9) 71 (48)
Workplace	Emergency Department Inpatient Ward Intensive Care Unit/Operating Room Other	40 (27) 67 (45.3) 11 (7.4) 26 (17.6)

In this preliminary assessment, 61.3% of the participants presented elevated levels of compassion fatigue, and 52.3% were classified in the high burnout risk category, according to the ProQOL-IV scale. In the IDE-ESAPE, the empathic profiles identified were: profile 2 (empathic functioning without risk, 0.8%), profile 3 (risk of compassion fatigue, 60.0%) and profile 4 (compassion fatigue, 39.2%) (see Tables 2 and 3).

Table 2.

Results of the ProQOL-IV questionnaire in the preliminary phase (n = 148)

Subscale	Category	n (%)
Compassion fatigue	No compassion fatigue Compassion fatigue	55 (38.7) 87 (61.3)
Burnout	Low risk Moderate risk High risk	25 (17.1) 80 (54.1) 41 (27.7)
Compassion satisfaction	Low satisfaction Medium satisfaction High satisfaction	63 (42.9) 39 (26.5) 45 (30.6)

Note: The cut-off points to classify the subscales were:

Compassion fatigue: ≥17 points

Burnout: ≤ 18 Low; 19–26 Moderate; >27 High

Compassion satisfaction: ≤ 33 Low; 33–41 Medium; ≥42 High

Table 3.

Results of the Empathic Fatigue Inventory (IDE-ESAPE) in the preliminary phase (n = 148)

Dimension	Level	n (%)
Professional involvement	Low Medium	102 (71.8) 40 (28.2)
Self-care	Low Medium	94 (70.1) 40 (29.9)
Vulnerability	Low Medium	109 (77.9) 31 (22.1)
IDE Diagnosis (ESAPE Profile)	Profile 1: No risk Profile 2: Normal without risk Profile 3: Normal with risk Profile 4: With compassion fatigue	0 (0) 1 (0.8) 78 (60.0) 51 (39.2)

As part of the preliminary screening, the STEQ was administered to characterize the emotional burden of the initial cohort (n = 148). This instrument was employed solely for descriptive and screening purposes in this phase and was not re-administered during the intervention or follow-up assessments. Results indicated that 32.6% of participants reported difficulties in asking for help “frequently or always”, whilst 21.1% reported feeling unable to connect with others with the same frequency. Additionally, 42.1% reported feeling emotionally drained at work “frequently”, and 42.2% reported feeling “sometimes or quite often” that they had no reason to live. Likewise, 22.5% reported having no initiative to carry out activities and 69.4% reported feeling completely alone at some point. Finally, 42.1% reported having experienced traumatic situations in the past. These findings underscore the pre-existing emotional vulnerability of the cohort from which intervention participants were subsequently drawn.

Intervention phase

In the intervention phase, 30 participants with high levels of emotional exhaustion were chosen in the initial assessment. Sociodemographic and professional characteristics of participants are summarized in Table 4. The intervention was completed in its entirety by the sample (100%), with no losses (see Fig. 1).

Table 4.

Sociodemographic and professional characteristics of participants (n = 30)

Variable	Category	n (%) / Mean ± SD
Sex	Female Male	24 (80.0) 6 (20.0)
Age (years)		40.5 ± 8.8
Years of professional experience		13.6 ± 8.0
Marital status	Single/divorced/widowed Married/with partner	16 (53.3) 14 (46.7)
Living alone	Yes No	10 (33.3) 20 (66.7)
Dependents	Yes No	15 (50.0) 15 (50.0)
Professional category	Physician Nurse Nursing assistant (TCAE)	3 (10.0) 12 (40.0) 15 (50.0)
Workplace	Inpatient Ward Emergency Department Intensive Care Unit/Operating Room Other	16 (53.3) 8 (26.7) 3 (10.0) 3 (10.0)

Fig. 1.

Flow diagram of the study sample

Subsequently, a statistically significant improvement was evidenced in the mean scores obtained in the ProQOL-IV and IDE-ESAPE questionnaires, both immediately after the intervention (T1) and at the six-month follow-up assessment (T2).

A progressive reduction in compassion fatigue and burnout scores was observed across the study period, together with a marked increase in compassion satisfaction following the intervention, which was maintained at six months. Statistically significant differences were observed for the T0–T1 and T1–T2 comparisons (p < 0.001). Detailed descriptive and inferential statistics are reported in Table 5; Fig. 2.

Fig. 2.

Evolution of ProQOL-IV scores at the three study time points

Analysis of correlations between ProQOL-IV subscales revealed strong and statistically significant associations at baseline (T0), highlighting the inverse relationship between burnout and compassion satisfaction (ρ= -0.83). After intervention (T1), a positive association between compassion fatigue and burnout remained (ρ = 0.70), along with an emerging negative correlation between fatigue and satisfaction (ρ= -0.45). At the six-month assessment (T2), the correlations attenuated, but remained moderate, suggesting a stable evolution of the therapeutic effect (see Table 6).

Table 6.

Correlations between ProQOL-IV subscales

Time	Variable 1	Variable 2	ρ (Spearman)	P value
T0	Fatigue Fatigue Burnout	Burnout Satisfaction Satisfaction	0.68 −0.56 −0.83	< 0.001 0.0012 < 0.001
T1	Fatigue Fatigue Burnout	Burnout Satisfaction Satisfaction	0.70 −0.45 −0.50	< 0.001 0.0121 0.0048
T2	Fatigue Fatigue Burnout	Burnout Satisfaction Satisfaction	0.41 −0.34 −0.16	0.0251 0.0697 0.3988

Note. Spearman correlation coefficients (ρ) were used due to the ordinal nature of the data, the small sample size, and the presence of non-normal distributions. All reported correlations are two-tailed. Correlations with P < 0.05 were considered significant

Regarding the IDE-ESAPE, the percentage of participants classified under profile 4 (compassion fatigue) decreased from 63.3% at baseline to 36.7% immediately after the intervention (P value < 0.05), and to 0% at six months (P value < 0.001). Meanwhile, the proportion of professionals classified under profile 3 (empathic functioning with risk of compassion fatigue) increased from 36.7% at T0 to 63.3% at T1, reaching 100% at T2.

At T2, all participants were classified as Profile 3, with none classified as profile 1 (optimal functioning, without risk of EBS) or profile 2 (empathic functioning without risk). Regarding the ESAPE factors, statistically significant changes were observed in factor 2: self-care, with a mean score of 2.6 ± 0.32 at T0, reduced to 2.1 ± 0.34 at T1 (Z= -4.149), and to 1.86 ± 0.16 at T2 (Z= -4.711; p < 0.001).

Discussion

The findings of this pilot study suggest that a structured secondary prevention intervention may be useful in reducing compassion fatigue and burnout and in enhancing compassion satisfaction among healthcare professionals. The statistically significant reductions in compassion fatigue and burnout, together with the increase in compassion satisfaction, indicate a favorable pattern of change in both the short and medium term. These results are consistent with systematic reviews and meta-analyses supporting the effectiveness of mindfulness-based and emotional self-care interventions in nurses and other healthcare workers, as well as with studies conducted during the COVID-19 context [14, 15, 17, 18].

The observed changes are also consistent with conceptual models of compassion fatigue and secondary traumatic stress, which describe these phenomena as consequences of sustained empathic engagement with suffering in the absence of adequate coping and organizational support [1–3]. In this study, the intervention was associated with a progressive improvement in empathic functioning as assessed with the IDE-ESAPE profile, suggesting that structured, early, and multidimensional approaches may help mitigate the emotional impact of prolonged occupational exposure. This interpretation is further supported by recent conceptual work emphasizing the dynamic and multidimensional nature of compassion fatigue in clinical nurses [6].

A particularly relevant finding was that, at the six-month follow-up (T2), all participants (100%) were classified as Profile 3, while none reached Profiles 1 or 2. Clinically, this pattern suggests partial but incomplete recovery: participants no longer met criteria compatible with established compassion fatigue (Profile 4), but they continued to show a level of empathic functioning associated with residual risk. The transition from Profile 4 to Profile 3 is therefore clinically meaningful, as it reflects movement from manifest compassion fatigue to a subclinical vulnerability state. However, the absence of Profile 1 or 2 classifications at T2 indicates that the intervention may have reduced symptom severity without fully restoring low-risk or optimal empathic functioning. This interpretation is consistent with the literature showing that compassion fatigue is prevalent, persistent, and shaped by cumulative occupational exposure, particularly in emotionally demanding healthcare settings [2, 12, 13, 19, 20]. In professionals exposed to the acute phase of the COVID-19 pandemic, such residual vulnerability is also plausible given the prolonged and repeated exposure to distress, uncertainty, and moral strain [9–11, 15, 26]. Taken together, these findings suggest that longer, repeated, or booster interventions, ideally combined with organizational-level measures, may be necessary to facilitate progression toward lower-risk profiles. Future studies should examine whether sustained or cyclical intervention models can promote transitions beyond Profile 3 and whether this trajectory is moderated by factors such as baseline resilience, perceived social support, or organizational culture.

The intervention combined cognitive-behavioral strategies, mindfulness techniques, and resilience-oriented components, all of which have empirical support in healthcare settings with high emotional burden [16–18]. Their integration may have promoted emotional regulation, self-awareness, and adaptive coping, thereby contributing to the observed improvements in professional quality of life and empathic response. From an institutional perspective, interventions of this type may offer benefits beyond individual well-being, including reductions in absenteeism, turnover, and adverse consequences associated with burnout and emotional exhaustion [5, 9, 10, 27]. In line with previous authors, these findings support the need for a broader and more systemic approach to compassion fatigue, one that addresses not only individual symptoms but also the organizational conditions that perpetuate chronic stress [9, 11]. Protecting the mental health of healthcare professionals is therefore both an ethical obligation and a strategic requirement for resilient health systems.

Several limitations should be considered when interpreting these findings. First, the quasi-experimental design without a control group prevents firm causal inference. Regression to the mean represents a plausible alternative explanation, since participants were selected because they initially scored at the upper end of the compassion fatigue and burnout distributions; some reduction could therefore reflect statistical regression rather than a true intervention effect [28]. In addition, the study was conducted during the transition from the acute to the post-acute phase of the COVID-19 pandemic in Spain (March-November 2022), when reduced workload, improved resource availability, and lower perceived threat may have contributed to natural recovery in psychological well-being independently of the intervention. Without a concurrent comparison group exposed to the same contextual changes, intervention-specific effects cannot be fully disentangled from temporal improvement. The Hawthorne effect must also be considered, as participants were aware of being observed and may have reported improvement partly in response to the attention, support, and cohesion associated with participation. Likewise, the group format may have introduced non-specific therapeutic factors, such as peer validation, shared experience, and regular contact with facilitators, which could have contributed to the observed changes. Accordingly, the results should be interpreted as preliminary evidence of potential effectiveness rather than definitive proof of efficacy.

Second, external validity is limited by the small sample size, single-centre design, convenience sampling, and self-selection. The study was conducted in one hospital, and institutional culture, management practices, and pandemic response conditions may differ substantially across settings, thereby limiting ecological generalizability. Moreover, the initial pool of professionals was drawn from voluntarily participating units, and the final sample consisted of individuals who agreed to attend sessions outside working hours. This may have introduced a self-selection bias toward professionals who were more motivated, more psychologically minded, or more receptive to emotional support interventions, potentially inflating the magnitude of the observed effects. In addition, all outcomes were based on self-report measures, which may be influenced by social desirability or response bias, despite the use of validated instruments [21–23]. At the same time, the 100% retention rate over six months is a relevant strength, as it supports the acceptability and feasibility of the programme in this clinical context.

Future research should replicate these findings using a multicentre cluster-randomized controlled design involving hospitals of different sizes and locations, with unit-level randomization to reduce contamination. Sample size should be determined a priori on the basis of the effect sizes observed in this pilot study and adjusted for the intra-cluster correlation coefficient to ensure adequate statistical power [24, 25]. Replication studies should include standardized outcome measures such as the ProQOL-IV and IDE-ESAPE, incorporate process evaluation indicators, and extend follow-up to at least 12 months. Such designs would allow more robust conclusions regarding both intervention efficacy and generalizability.

Conclusion

This pilot study suggests that a structured secondary prevention program may contribute to reducing compassion fatigue and burnout while improving compassion satisfaction among healthcare professionals exposed to high emotional demand. The sustained improvements observed at six-month follow-up indicate the potential usefulness of this type of intervention as part of institutional strategies to support professional well-being.

Although the quasi-experimental design and limited sample size prevent definitive causal conclusions, the findings provide preliminary evidence supporting the feasibility and acceptability of structured psychosocial interventions in healthcare settings. Future controlled studies with larger samples and longer follow-up periods are warranted to confirm these results and to further explore their impact on organizational and clinical outcomes.

Supplementary Information

Below is the link to the electronic supplementary material.

Abbreviations

CHUNSC

Hospital Universitario Nuestra Señora de Candelaria

IDE-ESAPE

Inventario de Distrés Empático – Escala de Agotamiento por Empatía

ProQOL-IV

Professional Quality of Life Scale, version IV

STEQ

Subjective Traumatic Experiences Questionnaire

T0/T1/T2

Baseline/post-intervention/six-month follow-up

Author contributions

Rodríguez García, MA and Rodríguez de Miguel, C conceived and designed the study. Rodriguez Garcia, MA collected the data. Rodriguez de Miguel, C managed the project. Reyes Quesada, JG performed the statistical analysis and modeling, and drafted the manuscript. Rey Luque, O supervised the evaluation and revision of the manuscript.

Funding

This study was financed by the Fundación Canaria Instituto de Investigación Sanitaria de Canarias (Code ENF22/18).

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee for Research with Medicines (CEIm) of the University Hospital Complex of the Canary Islands (CHUNSC_2022_60). All participants signed informed consent.

Consent for publication

Not applicable. This manuscript does not contain any identifying images or other personal or clinical details of participants that compromise anonymity.

Competing interests

The authors declare no competing interests.