The Relationship Between Caregiver Burden and the Role of Religious Beliefs, Hope, and Compassion Fatigue Among Intensive Care Unit Nurses: A Cross-sectional Study

Abstract

Background: Intensive care unit (ICU) nurses are exposed to high levels of occupational and psychological stress, which can lead to a decline in the quality of nursing care and impose numerous consequences on their personal well-being. Despite this, the role of psychological and emotional variables in this context has been less investigated. Objectives: This study aimed to examine the relationship between caregiver burden and religious beliefs, hope, and compassion fatigue among ICU nurses. Methods: In this descriptive cross-sectional analytical study, 175 nurses working in the ICU wards of hospitals affiliated with Ahvaz University of Medical Sciences in 2024 were selected using convenience sampling. Data were collected through self-report questionnaires, including a demographic information form, the Zarit Burden Interview (ZBI), the Allport-Ross Religious Beliefs Scale, the Snyder Hope Scale, and the Compassion Fatigue Questionnaire. The questionnaires were administered through in-person visits to the research setting. Data analysis was conducted using Pearson's correlation, independent t-tests, and multivariable linear regression models in SPSS software version 22. Results: The mean age of the participants was 33.59 ± 6.32 years, and the mean duration of work experience was 9.81 ± 5.91 years. The majority of the participants were female 128 (73.1%), single 93 (53.1%), and worked rotating shifts 144 (82.3%). The levels of hope 163 (93.1%) and religious beliefs 147 (84%) were rated above average in most participants, while caregiver burden was reported at a moderate level in 149 (85.1%) of the participants. The mean compassion fatigue score was 106.46 ± 13.99. Independent t-test analysis showed no significant differences between psychological and demographic variables (P > 0.005). Correlational analysis revealed a positive relationship between compassion fatigue and caregiver burden (R = 0.554, P < 0.001), and negative relationships between caregiver burden and hope (R = -0.242, P < 0.001), as well as religious beliefs (R = -0.454, P < 0.001). In the regression analysis, religious beliefs (β = -0.888, P < 0.001), compassion fatigue (β = 0.593, P < 0.001), and hope (β = -0.213, P = 0.011) significantly predicted caregiver burden, with religious beliefs having the strongest inverse effect. Conclusions: The findings indicated that psychological and spiritual factors — particularly religious beliefs, hope, and compassion fatigue — play a decisive role in predicting the caregiver burden among ICU nurses. These factors may serve as protective resources against chronic stress and occupational burnout, making them appropriate targets for clinical and organizational interventions such as promoting spirituality, managing compassion fatigue, and enhancing hope.