Prevalence and determinants of compassion fatigue among nurses in a district hospital in Bangladesh

BACKGROUND: Compassion fatigue is an occupational hazard among nurses that arises from prolonged exposure to patient suffering and to work-related stress. In resource-limited healthcare settings, such as public district hospitals in Bangladesh, high patient loads, staffing shortages, and limited organizational support may increase nurses' vulnerability to CF. However, evidence from district-level hospitals in low- and middle-income countries is limited. METHODS: A cross-sectional study was conducted between January and June 2025 among nurses working at a 250-bedded district hospital in Bangladesh. Using stratified random sampling, 380 nurses from the medicine, surgery, pediatrics, and intensive care/emergency units were recruited. Compassion fatigue was assessed using the Professional Quality of Life Scale (ProQOL-5). Descriptive statistics were used to estimate the prevalence. Chi-square tests and multivariate logistic regression were performed to identify the demographic and occupational predictors of high compassion fatigue. RESULTS: Overall, 44.2% of nurses reported high compassion fatigue, and 37.6% reported moderate levels. The highest prevalence was observed among nurses working in intensive care/emergency units (52%). Multivariate analysis identified lack of organizational support (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6-4.1), more than 10 years of service (OR 2.3, 95% CI 1.4-3.8), and intensive care/emergency assignment (OR 1.9, 95% CI 1.2-2.9) as significant predictors of high compassion fatigue scores. Subscale analyses indicated higher burnout and secondary traumatic stress among nurses working in high-acuity departments. CONCLUSIONS: Compassion fatigue is highly prevalent among nurses in a resource-limited district hospital in Bangladesh, particularly among those working in high-acuity settings and those reporting insufficient organizational support. These findings highlight the need for targeted organizational strategies, including improved support systems, workload management, and mental health interventions, to promote nurses' well-being and sustain quality patient care in similar healthcare contexts.