Document Type : Research articles


1 Nursing Department, Health Sciences Faculty, Bezmialem Vakif University ,Istanbul, Turkey

2 Nursing Department, Health Sciences Faculty Istanbul Medipol University, Istanbul, Turkey


Background: Nurses who are more self-compassionate may be better able to manage the stress and emotional challenges of working in an emergency hospital during a pandemic. They may be less likely to experience burnout or compassion fatigue and may be more resilient in the face of adversity. They will probably be more patient and understanding with their patients and colleagues, and more able to maintain a positive attitude and provide compassionate care.
Objectives: This study aims to determine the relationship between the self-compassion levels and patience levels of the nurses working in an emergency hospital and taking care of patients diagnosed with COVID-19.
Methods: This cross-sectional and correlational study was conducted between May and August 2021 on 171 nurses working in an emergency hospital in Istanbul and taking care of patients diagnosed with COVID-19. The data were collected using the researcher-made Nurse Information Form, the Self-Compassion Scale, and Patience Scale.
Results: The mean rank was found to be 78.03±12.03 for the Self-Compassion Scale and 37.97±6.34 for the Patience Scale. A weak positive significant correlation was identified between the nurses' mean rank of the Self-Compassion Scale and the mean rank of the Patience Scale (rho=0.393, P=0.000), interpersonal patience (rho=0.395), and short-term patience (rho=0.191) subscales, whereas a moderately positive significant correlation was detected between the mean rank of the Self-Compassion Scale and the mean rank of the long-term patience (rho=0.442) subscale.
Conclusion: It can be said that nurses' self-compassion and patience were at moderate levels, and as their self-compassion levels decreased, their patience levels reduced as well. Institutions should develop in-hospital social activities and policies that are supportive of nurses. Supporting nurses' self-compassion levels with evidence-based programs will also increase their patience levels.


  1. Occupational Safety and Health Administration. Coronavirus disease (COVID-19). Available from:
  2. Shen X, Zou X, Zhong X, Yan J, Li L. Psychological stress of ICU nurses in the time of COVID-19. Crit Care. 2020 May 6;24(1):200. doi: 10.1186/s13054-020-02926-2. PMID: 32375848; PMCID: PMC7202793.
  3. Çiçek B, Almalı V. COVID-19 pandemisi sürecinde kaygı öz-yeterlilik ve psikolojik iyi oluş arasındaki ilişki: özel sektör ve kamu çalışanları karşılaştırması. Journal of Turkish Studies . 2020 doi:10.7827/TurkishStudies.43492
  4. Saricam M. COVID-19-Related anxiety in nurses working on front lines in Turkey. Nurs Midwifery Stud 2020;9:178-81. DOI: 10.4103/nms.nms_40_20
  5. Salvagioni DAJ, Melanda FN, Mesas AE, Gonzalez AD, Gabani FL, Andrade SM. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies. PLoS One. 2017 Oct 4;12(10):e0185781. doi: 10.1371/journal.pone.0185781. PMID: 28977041; PMCID: PMC5627926.
  6. Stuntzner S, Hartley MT. Balancing self-compassion with self-advocacy: a new approach for persons with disabilities. Annals of Psychotherapy & Integrative Health, 2015; 12–28.
  7. Neff KD. The development and validation of a scale to measure self-compassion. Self and Identity 2003; 2(3):223-250.
  8. Marshall EJ, Brockman RN. The relationships between psychological flexibility, self-compassion, and emotional well-being. J Cogn Psychother. 2016;30(1):60-72. doi: 10.1891/0889-8391.30.1.60. Epub 2016 Jan 1. PMID: 32755906.
  9. Seligowski AV, Miron LR, Orcutt HK. Relations among self-compassion, PTSD symptoms, and psychological health in a trauma-exposed sample. Mindfulness 2015;6(5):1033-1041.
  10. Woodruff SC, Glass CR, Arnkoff, DB, Crowley KJ, Hindman RK, Hirschhorn EW. Comparing Self-Compassion, Mindfulness, and Psychological Inflexibility as Predictors of Psychological Health. Mindfulness 2014;5:410-421.
  11. Wasson RS, Barratt C, O'Brien WH. Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis. Mindfulness (N Y). 2020 Mar 5:1-21. doi: 10.1007/s12671-020-01342-5. Epub ahead of print. PMID: 32421083; PMCID: PMC7223423.
  12. Erkin Ö, Şenuzun Aykar F. The effect of the yoga course on mindfulness and self-compassion among nursing students. Perspect Psychiatr Care. 2021 Apr;57(2):875-882. doi: 10.1111/ppc.12630. Epub 2020 Sep 28. PMID: 32989775.
  13. Deniz E, Gündüz M. Öz-Anlayışın Yordayıcıları Olarak Psikolojik Katılık ve Bilişsel Esneklik. Kalem Eğitim ve İnsan Bilimleri Dergisi 2021;11(1):75-94. doi: 10.23863/kalem.2021.183
  14. Allen AB, Leary MR. Self-Compassion, Stress, and Coping. Soc Personal Psychol Compass. 2010 Feb 1;4(2):107-118. doi: 10.1111/j.1751-9004.2009.00246.x. PMID: 20686629; PMCID: PMC2914331.
  15. Neff KD, Knox MC, Long P, Gregory K. Caring for others without losing yourself: An adaptation of the Mindful Self-Compassion Program for Healthcare Communities. J Clin Psychol. 2020 Sep;76(9):1543-1562. doi: 10.1002/jclp.23007. Epub 2020 Jul 6. PMID: 32627192.
  16. Kemper KJ, McClafferty H, Wilson PM, Serwint JR, Batra M, Mahan JD, Schubert CJ, Staples BB, Schwartz A; Pediatric Resident Burnout-Resilience Study Consortium. Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents? Acad Med. 2019 Jun;94(6):876-884. doi: 10.1097/ACM.0000000000002546. Erratum in: Acad Med. 2020 Mar;95(3):386. PMID: 30520809.
  17. Hiçdurmaz D, Aydın A. The relationship between self-compassion and multidimensional perfectionism levels and ınfluencing factors in nursing students. Journal of psychiatric nursing 2017;8(2):86-94. DOI: 10.14744/phd.2017.40469
  18. McVicar A, Pettit A, Knight-Davidson P, Shaw-Flach A. Promotion of professional quality of life through reducing fears of compassion and compassion fatigue: Application of the Compassionate Mind Model to Specialist Community Public Health Nurses (Health Visiting) training. J Clin Nurs. 2021 Jan;30(1-2):101-112. doi: 10.1111/jocn.15517. Epub 2020 Oct 27. PMID: 33010061.
  19. Rooeintan M, Khademi M, Toulabi T, Nabavi FH, Gorji M. Explaining Postdischarge Care Needs of Cancer Patients: A Qualitative Study. Indian J Palliat Care. 2019 Jan-Mar;25(1):110-118. doi: 10.4103/IJPC.IJPC_164_18. PMID: 30820112; PMCID: PMC6388595.
  20. Schnitker SA. An examination of patience and well-being. The Journal of Positive Psychology: Dedicated to furthering research and promoting good practice 2012;7(4).
  21. Doğan M. Karakter Gücü Olarak Sabır ve Psikolojik İyi Oluş İlişkisi. The Journal of Happiness and Well-Being. 2017;5(1):134-153.
  22. Achour M, Bensaid B, Nohr MR. An Islamic Perspective on Coping with Life Stressors. Applied Research Quality Life. 2016;11:663-685
  23. Stavrianea A, Kamenidou I. Generation Z and Religion in Times of Crisis. In: Kavoura A., Sakas D., Tomaras P. (eds) Strategic Innovative Marketing. Springer Proceedings in Business and Economics. Springer, Cham. 2017.
  24. Eliüşük Bülbül A, Arslan C. Investigation of patience tendency levels in terms of self-determination, self-compassion and personality features, Universal Journal of Educational Research. 2017;5(9):1632-1645. DOI: 10.13189/ujer.2017.050921
  25. Holm A, Dreyer P. Nurse-patient communication within the context of non-sedated mechanical ventilation: A hermeneutic-phenomenological study. Nurs Crit Care. 2018 Mar;23(2):88-94. doi: 10.1111/nicc.12297. Epub 2017 Jun 7. PMID: 28593721.
  26. Asmundson GJG, Taylor S. Coronaphobia: Fear and the 2019-nCoV outbreak. J Anxiety Disord. 2020 Mar;70:102196. doi: 10.1016/j.janxdis.2020.102196. Epub 2020 Feb 10. PMID: 32078967; PMCID: PMC7134790
  27. Uçar N, Aygin D, Uzun E. Yoğun bakım ünitelerinde çalışan hemşirelerin tükenmişlik ve iş doyumunun değerlendirilmesi. Online Türk Sağlık Bilimleri Dergisi. 2016;1(4):18-37.
  28. Khanjarian F, Sadat-Hoseini AS. Lived experiences of nurses providing altruistic care to patients with COVID-19. Nurs Outlook. 2021 Sep-Oct;69(5):767-779. doi: 10.1016/j.outlook.2021.03.021. Epub 2021 May 7. PMID: 34656272; PMCID: PMC8103141.
  29. Xu T, Wang Y, Wang R, Lamb KV, Ren D, Dai G, Wang L, Yue P. Predictors of caring ability and its dimensions among nurses in China: A cross-sectional study. Scand J Caring Sci. 2021 Dec;35(4):1226-1239. doi: 10.1111/scs.12941. Epub 2020 Dec 7. PMID: 33615516.
  30. Heffernan M, Quinn Griffin MT, Sister Rita McNulty, Fitzpatrick JJ. Self-compassion and emotional intelligence in nurses. Int J Nurs Pract. 2010 Aug;16(4):366-73. doi: 10.1111/j.1440-172X.2010.01853.x. PMID: 20649668
  31. Neff KD. Self-Compassion. In M. R. Leary & R. H. Hoyle (Eds.), Handbook of Individual Differences in Social Behavior. 2009: 561-573. New York: Guilford Press
  32. Pettit A, Stephen R, Nettleton R. Developing a compassionate resilience: A Health Visiting Framework Guide for Employers. Managers and Team Leaders. A report for the Institute for Health Visiting. Health Education England and the Department of Health.2015.
  33. Neff KD. Self-Compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity. 2003;2:85-102.
  34. Deniz ME, Kesici Ş, Sümer AS. The validity and reliability of the Turkish version of the Self-Compassion Scale. Social Behavior and Personality: An International Journal. 2008;36(9):1151–1160.
  35. Doğan M, Gülmez Ç. Sabır Ölçeğinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması. Atatürk Üniversitesi İlahiyat Fakültesi Dergisi. 2014;0(42):263-280.
  36. Santos JLGD, Balsanelli AP, Freitas EO, Menegon FHA, Carneiro IA, Lazzari DD, Menezes JAL, Erdmann AL, Camponogara S. Work environment of hospital nurses during the COVID-19 pandemic in Brazil. Int Nurs Rev. 2021 Jun;68(2):228-237. doi: 10.1111/inr.12662. Epub 2021 Feb 15. PMID: 33586794; PMCID: PMC8014554.
  37. Jin YH, Huang Q, Wang YY, Zeng XT, Luo LS, Pan ZY, Yuan YF, Chen ZM, Cheng ZS, Huang X, Wang N, Li BH, Zi H, Zhao MJ, Ma LL, Deng T, Wang Y, Wang XH. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey. Mil Med Res. 2020 May 11;7(1):24. doi: 10.1186/s40779-020-00254-8. PMID: 32393381; PMCID: PMC7211983.
  38. Danielis M, Palese A, Terzoni S, Destrebecq ALL. Come sono cambiati gli ospedali, le Terapie Intensive, l’assistenza al malato critico in tempi di Covid-19? Risultati di una indagine esplorativa in alcuni contesti europei [How hospitals, Intensive Care Units and nursing care of critically ill patients have changed during the Covid-19 outbreak? Results from an exploratory research in some European countries]. Assist Inferm Ric. 2020 Jul-Sep;39(3):130-138. Italian. doi: 10.1702/3454.34430. PMID: 33077982.
  39. Havaei F, Ma A, Staempfli S, MacPhee M. Nurses' Workplace Conditions Impacting Their Mental Health during COVID-19: A Cross-Sectional Survey Study. Healthcare (Basel). 2021 Jan 16;9(1):84. doi: 10.3390/healthcare9010084. PMID: 33467080; PMCID: PMC7830057.
  40. Labrague LJ, De Los Santos JAA. COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag. 2020 Oct;28(7):1653-1661. doi: 10.1111/jonm.13121. Epub 2020 Aug 21. PMID: 32770780; PMCID: PMC7436313.
  41. Aggar C, Samios C, Penman O, Whiteing N, Massey D, Rafferty R, Bowen K, Stephens A. The impact of COVID-19 pandemic-related stress experienced by Australian nurses. Int J Ment Health Nurs. 2022 Feb;31(1):91-103. doi: 10.1111/inm.12938. Epub 2021 Oct 11. PMID: 34636134; PMCID: PMC8653281.
  42. Kavaklı M, Ak M, Uğuz F, Türkmen O. The mediating role of self-compassion in the relationship between perceived COVID-19 threat and death anxiety. J Clin Psy. 2020; 23(1): 15-23
  43. Hollis-Walker L, Colosimo K. Mindfulness, self-compassion, and happiness in non-meditators: A theoretical and empirical examination. Personality and Individual Differences. 2011;50:222-227.
  44. Shapira LB, Mongrain M. The benefits of self-compassion and optimism exercises for individuals vulnerable to depression. The Journal of Positive Psychology. 2010;5:377-389.
  45. Smeets E, Neff K, Alberts H, Peters M. Meeting suffering with kindness: effects of a brief self-compassion intervention for female college students. J Clin Psychol. 2014 Sep;70(9):794-807. doi: 10.1002/jclp.22076. Epub 2014 Apr 1. PMID: 24691680.
  46. Gellerstedt L, Moquist A, Roos A, Karin B, Craftman ÅG. Newly graduated nurses' experiences of a trainee programme regarding the introduction process and leadership in a hospital setting-A qualitative interview study. J Clin Nurs. 2019 May;28(9-10):1685-1694. doi: 10.1111/jocn.14733. Epub 2019 Jan 29. PMID: 30552783.
  47. Lau BH, Chan CL, Ng SM. Self-Compassion Buffers the Adverse Mental Health Impacts of COVID-19-Related Threats: Results From a Cross-Sectional Survey at the First Peak of Hong Kong's Outbreak. Front Psychiatry. 2020 Nov 5;11:585270. doi: 10.3389/fpsyt.2020.585270. PMID: 33250793; PMCID: PMC7674650.
  48. Tangünü, S. (2020). Hemşirelerin sabır ve tükenmişlik düzeylerinin belirlenmesi, hemşirelerin sabır ve tükenmişlik düzeylerinin belirlenmesi. Gazi Üniversitesi Sağlık Bilimleri Enstitüsü Hemşirelik Anabilim Dalı. 2020, Yüksek Lisans Tezi.
  49. Süzen, H. Hemşirelerin profesyonel değerleri ile merhamet ve sabır düzeyleri arasındaki ilişki. Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Anabilim Dalı. 2020,Yüksek lisans Tezi.
  50. Kim J, Kim S. Nurses' Adaptations in Caring for COVID-19 Patients: A Grounded Theory Study. Int J Environ Res Public Health. 2021 Sep 27;18(19):10141. doi: 10.3390/ijerph181910141. PMID: 34639445; PMCID: PMC8507730.
  51. Aydın T, Ağaçdiken S. Covid-19 Pandemi Sürecinde Hemşirelerde Meslektaş Dayanışması ve Tükenmişlik Durumu. JoSHES. 2021; 6(1): 11-22.
  52. Alharbi J, Jackson D, Usher K. The potential for COVID-19 to contribute to compassion fatigue in critical care nurses. J Clin Nurs. 2020 Aug;29(15-16):2762-2764. doi: 10.1111/jocn.15314. Epub 2020 May 18. PMID: 32344460; PMCID: PMC7267232.
  53. Çakır Ö, Tanğ Y. Türkiyede Sağlık Çalışanlarında Tükenmişlik Sendromu: Bi̇r Meta Anali̇z Çalışması. ISGUC The Journal of Industrial Relations & Human Resources 2018; 20(4): 39-59.
  54. Ozsoylu S, Akyıldız B, Dursun, A. Burnout levels and affecting factors in nurses working in a university hospital. J Pediatr Emerg Intensive Care Med 2017;4:104-109. DOI: 10.4274/cayd.05925
  55. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, Xia L, Liu Z, Yang J, Yang BX. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study. Lancet Glob Health. 2020 Jun;8(6):e790-e798. doi: 10.1016/S2214-109X(20)30204-7. Epub 2020 Apr 29. PMID: 32573443; PMCID: PMC7190296.
  56. Turale S, Meechamnan C, Kunaviktikul W. Challenging times: ethics, nursing and the COVID-19 pandemic. Int Nurs Rev. 2020 Jun;67(2):164-167. doi: 10.1111/inr.12598. PMID: 32578249; PMCID: PMC7361611.
  57. Gebreheat G, Teame H. Ethical Challenges of Nurses in COVID-19 Pandemic: Integrative Review. J Multidiscip Healthc. 2021 May 6;14:1029-1035. doi: 10.2147/JMDH.S308758. PMID: 33986597; PMCID: PMC8110276.