Compassion, Burnout and Self-Care in NHS Staff Delivering ... 1.2 Literature Review Method The literature

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    Compassion, Burnout and Self-Care

    in NHS Staff Delivering Psychological

    Interventions

    Lisa Jayne Walker

    A thesis submitted in partial fulfilment of the requirements of

    the University of East London for the degree of Professional

    Doctorate in Clinical Psychology

    Submitted May 2017 (Revised August 2017)

    Word Count: 23,015

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    TABLE OF CONTENTS

    TABLE OF CONTENTS ....................................................................................... 2

    LIST OF TABLES ................................................................................................. 8

    LIST OF FIGURES ............................................................................................... 9

    ABSTRACT ........................................................................................................ 10

    Background ..................................................................................................... 10

    Aim .................................................................................................................. 10

    Method ............................................................................................................ 10

    Results ............................................................................................................ 10

    Conclusions ..................................................................................................... 11

    Implications ..................................................................................................... 11

    ACKNOWLEDGEMENTS .................................................................................. 12

    1 INTRODUCTION ......................................................................................... 13

    1.1 Overview ................................................................................................ 13

    1.2 Literature Review Method ...................................................................... 13

    1.3 Defining Compassion ............................................................................. 15

    1.4 Compassion for Others .......................................................................... 15

    1.4.1 Limitations of the Construct of Compassion for Others ................... 16

    1.5 The Compassionate Mind Approach ...................................................... 17

    1.5.1 Threat System ................................................................................. 19

    1.5.2 Drive System ................................................................................... 20

    1.5.3 Soothing System ............................................................................. 20

    1.5.4 Development and Interaction of the Affect Regulation Systems ...... 20

    1.5.5 Limitations of the Compassionate Mind Approach .......................... 21

    1.6 Compassion in the NHS......................................................................... 22

    1.7 Measuring Compassionate Care ........................................................... 23

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    1.8 A Model of Compassionate Care ........................................................... 24

    1.8.1 Clinical Factors Influencing Compassionate Care ........................... 25

    1.8.2 Environmental and Institutional Factors Influencing Compassionate

    Care ........................................................................................................ 26

    1.9 Defining Burnout .................................................................................... 26

    1.9.1 Emotional Exhaustion ...................................................................... 27

    1.9.2 Depersonalisation............................................................................ 27

    1.9.3 Reduced Personal Accomplishment ................................................ 27

    1.10 Measuring Burnout ............................................................................. 28

    1.11 A Model of Burnout ............................................................................. 28

    1.12 Factors Influencing Burnout ................................................................ 29

    1.13 Prevalence of Burnout ........................................................................ 31

    1.14 Consequences of Burnout .................................................................. 32

    1.14.1 The Impact of Burnout on Compassionate Care .......................... 32

    1.14.2 The Impact of Burnout on Staff .................................................... 33

    1.14.3 Preventing Burnout through Self-Care ......................................... 33

    1.15 Defining Self-Care .............................................................................. 34

    1.16 Measuring Self-Care ........................................................................... 35

    1.17 Models of Self-Care ............................................................................ 36

    1.18 Benefits of Self-Care .......................................................................... 38

    1.19 Defining Self-Compassion .................................................................. 40

    1.20 Self-Compassion and Burnout ............................................................ 40

    1.21 Compassion for Oneself and Others .................................................. 41

    1.22 Compassion, Burnout and Self-Care .................................................. 43

    1.23 Summary of Key Studies .................................................................... 44

    1.24 Aims of the Current Study................................................................... 48

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    1.25 Research Questions and Hypotheses ................................................ 49

    2 METHOD ..................................................................................................... 50

    2.1 Epistemology ......................................................................................... 50

    2.2 Design .................................................................................................... 51

    2.3 Measures ............................................................................................... 53

    2.3.1 Burnout ............................................................................................ 53

    2.3.2 Self-Compassion ............................................................................. 54

    2.3.3 Compassion for Others ................................................................... 55

    2.3.4 Self-Care ......................................................................................... 56

    2.4 Procedure .............................................................................................. 56

    2.4.1 Ethical Approval .............................................................................. 56

    2.4.2 Pilot ................................................................................................. 57

    2.4.3 Sampling ......................................................................................... 58

    2.4.4 Power Calculation ........................................................................... 58

    2.5 Refining the Hypotheses ........................................................................ 59

    2.5.1 Research Question 1. Factors Associated with Burnout in NHS Staff

    Delivering Psychological Interventions ........................................................ 59

    2.5.2 Research Question 2. Factors Associated with Compassion for

    Others in NHS Staff Delivering Psychological Interventions ........................ 59

    3 RESULTS .................................................................................................... 60

    3.1 Overview of the Data Analysis ............................................................... 60

    3.1.1 Data Checking and Cleaning ........................................................... 60

    3.2 Participants ............................................................................................ 61

    3.2.1 Occupational Information ................................................................ 61

    3.2.2 Demographic Information ................................................................ 62

    3.3 Descriptive Statistics .............................................................................. 63

    3.3.1 Burnout ............................................................................................ 64

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    3.3.2 Self-Compassion ............................................................................. 64

    3.3.3 Compassion for Others ................................................................... 65

    3.3.4 Self-Care Satisfaction ...................................................................... 65

    3.4 Correlation Analysis ............................................................................... 65

    3.5 Research Question 1. Factors Associated with Burnout in NHS Staff

    Delivering Psychological Interventions ............................................................ 66

    3.5.1 Hypothesis 1.1 ....................................................................