Mapping global evidence on compassion fatigue among healthcare workers during COVID-19: insights and implications for future preparedness – a scoping review

Abstract

Background: Compassion fatigue (CF) is a critical occupational hazard for healthcare workers (HCWs), intensified by the COVID-19 pandemic, with implications for well-being, retention, and quality of care. We aimed to map the global evidence on CF prevalence, risk factors, effects, interventions, and research gaps among HCWs during the COVID-19 pandemic. Methods: A scoping review of 56 studies from 21 countries (2020-2025) was conducted following PRISMA-ScR guidelines. Seven databases were searched, and findings were synthesised narratively with attention to occupational, demographic, and systemic determinants of CF. Results: Compassion fatigue prevalence ranged from 20 to 87%. It was most pronounced among nurses, women, frontline staff, early-career professionals, and those in under-resourced or rural settings. Key risk factors included high workload, long shifts, repeated exposure to death, moral distress, and limited organisational support. Symptoms encompassed emotional exhaustion, depersonalisation, diminished empathy, and co-occurring anxiety, depression, or secondary traumatic stress. Interventions (resilience and peer-support programmes, self-compassion training, motivational messaging, and mobile psychoeducation) showed small-to-moderate benefits but were limited by methodological heterogeneity and scarce robust evaluation. Temporally, CF peaked during early pandemic surges and persisted among frontline staff and in resource-constrained or long-COVID contexts. Conclusions: Compassion fatigue is a multifactorial, context-dependent hazard disproportionately affecting vulnerable HCWs. Effective mitigation requires longitudinal research, inclusive global representation, and multi-level strategies linking individual resilience with organisational reform and policy action to safeguard HCW well-being in current and future crises.