Professional Quality of Life and Occupational Stress Among Nurses in Pediatric Palliative and Related Pediatric Care Settings: A Cross-Sectional Study in Croatia

Abstract

Highlights What are the main findings? Participants reported high levels of compassion satisfaction, while burnout and secondary traumatic stress were present at low-to-moderate levels. Better organizational conditions, emotional support from colleagues, and access to professional education were associated with more favorable indicators of professional quality of life. What are the implications of the main findings? Strengthening organizational and peer support structures may help promote more favorable professional quality-of-life outcomes among nurses working in emotionally demanding pediatric settings. Continuous education and targeted professional development programs should be integrated into pediatric palliative care services to support nurses’ well-being and sustain high-quality patient care. Abstract Background/Objectives: Pediatric palliative care is a highly demanding field requiring nurses to maintain professional competence and emotional resilience. Continuous exposure to suffering, dying, and death may increase the risk of psychological distress among healthcare workers. The objective of this study was to examine compassion satisfaction, burnout, and secondary traumatic stress among nurses working in pediatric palliative and related pediatric care settings in Split-Dalmatia County, Croatia, and to explore organizational and emotional factors associated with their professional quality of life. Methods: A descriptive cross-sectional study was conducted involving 36 female nurses employed in a pediatric hospice, pediatric hemato-oncology department, and neonatology department. Data were collected using the Professional Quality of Life (ProQOL) questionnaire and a custom questionnaire assessing organizational, educational, and emotional challenges. Results: Participants reported high levels of compassion satisfaction (M = 4.55, SD = 0.45), moderate levels of secondary traumatic stress (M = 3.02, SD = 0.68), and relatively low levels of burnout (M = 2.34, SD = 0.65). A significant negative correlation was found between compassion satisfaction and burnout (ρ = −0.542; p < 0.001). Favorable organizational conditions, including sufficient time for rest (ρ = −0.567; p < 0.001) and emotional support from colleagues (ρ = −0.414; p = 0.012), were significantly associated with lower burnout levels. Although 63.9% of nurses lacked formal psychological support in the workplace, communication with families of terminally ill children remained a major emotional burden (M = 4.25, SD = 1.13) and was positively associated with secondary traumatic stress (ρ = 0.460; p = 0.005). Conclusions: Despite the substantial emotional demands of pediatric palliative and terminal care, nurses reported high compassion satisfaction alongside moderate secondary traumatic stress and relatively low burnout. The findings suggest that organizational conditions, collegial support, and access to formal psychological support may represent relevant targets for strategies aimed at sustaining nurses’ professional quality of life.