This paper below is a translation of a paper originally published in Korean. The translated content may differ from the actual content of the paper or the author’s intent. Therefore, if you wish to cite this paper, please refer to the original text of the publication.
Korean Journal of Care Management vol.15, pp. 77-101 (2015)
Yoon, Kyeong-A**
Shim, Woo-Chan***
Kim, Ki-Soo****
* This paper partially utilizes research data on the improvement of working conditions for social workers from Daejeon Welfare Foundation in 2014.
** Corresponding author: Professor, Department of Social Welfare, Daejeon University (E-mail: kayoon@dju.kr)
*** Corresponding author: Professor, Department of Social Welfare, Daejeon University (E-mail: shimw@dju.kr)
**** Co-author: Researcher, Daejeon Welfare Foundation (E-mail: kks125400@dwf.kr)
Ⅰ. Introduction
Professional Quality of Life (ProQOL), a facet of quality of life in the domain of work, was introduced by Stamm (2002) as a concept particularly relevant to professionals such as social workers, nurses, and counselors. These professionals experience satisfaction in assisting individuals who have undergone traumatic events, but they may also experience secondary traumatic stress or burnout directly related to their interactions with clients (Stamm, 2010). Within Professional Quality of Life, positive experiences like satisfaction are conceptualized as compassion satisfaction, while negative experiences such as secondary traumatic stress and burnout are labeled as compassion fatigue.
The reason for exploring the professional quality of life among frontline practitioners in this study is the vulnerability of these professionals to various factors that can negatively impact their professional well-being. This vulnerability, in turn, has negative consequences for both the service recipients and providers and the organizations they work for. Unfortunately, governmental and institutional measures addressing these challenges are insufficient, and research in this area is limited.
Firstly, the vulnerability of professional quality of life among frontline practitioners in social welfare facilities is associated with the nature of their work. While these professionals derive satisfaction and fulfillment from their ability to empathize during interactions with clients, they also experience considerable stress. The stress arises from efforts to change the behavior or emotions of clients, which can be demanding and emotionally draining (Ohaeri, 2003). Moreover, providing care to individuals who have experienced serious trauma may lead to secondary psychological trauma as practitioners empathize with the trauma experienced by their clients, affecting both their personal and professional lives.
The vulnerability of professional quality of life among frontline practitioners is also linked to their work environment. Social welfare facility staff often work in situations characterized by excessive workload and inadequate resources (Seong & Kwon, 2013; Duffy et al., 2003). They frequently face aggression from clients, and their personal values and judgments are often involved in the social welfare tasks they perform (Kang & Cho, 2010). This involvement can lead to mental fatigue or burnout due to the nature of the work or the work environment, impacting both personal and professional aspects of their lives (Jacobson, 2012).
Despite the negative impact of the vulnerability of professional quality of life on service recipients, providers, and organizations, there is a lack of adequate government and institutional measures. According to a report by the National Human Rights Commission in 2013, the salaries of social workers are approximately 80% of the average wages of all wage laborers (around 2.43 million won, based on Statistics Korea). This low income is coupled with long working hours and a high risk of physical attacks, posing safety concerns at the workplace.
Considering the complex interplay of the nature of the work and the work environment on the professional quality of life among frontline practitioners, there is a need for essential government and institutional strategies to enhance their professional well-being. Addressing the vulnerability of professional quality of life among frontline practitioners is crucial not only for maintaining and improving service quality but also for preventing organizational challenges. This study aims to explore the professional quality of life of frontline practitioners (life guidance officers, care aides, nurses, and social workers) in social welfare facilities in Daejeon. Through this exploration, the study seeks to provide foundational data necessary for developing effective personnel management strategies.
Ⅱ. Theoretical Background
1. Trauma Experiences of Social Welfare Workers
Social welfare workers in the field are highly likely to encounter individuals who have experienced severe traumas such as falls, violence, and abuse during their work. According to DSM-5 (APA, 2014), trauma in Post-Traumatic Stress Disorder (PTSD) involves continuous exposure to specific information about personally experienced life-threatening events, deaths of close individuals, or deaths or near-death experiences of unfamiliar third parties. The social work field mainly encountering individuals experiencing trauma as defined by DSM-5 is likely to be correctional welfare. Case managers, social workers, and counselors working in correctional welfare settings are exposed to specific information related to physical and psychological trauma, such as assault, sexual harassment, violence, and murder, for prolonged periods when dealing with individuals who have committed criminal acts (Maiden, 2014). Mental health social workers also interact continuously with victims who have experienced trauma, such as suicide, physical violence, and sexual assault. Furthermore, professionals working with victims of neglect or abuse, such as domestic violence, sexual violence, child abuse, elder abuse, and school violence, are exposed to specific trauma-related information. Those continuously exposed to such specific trauma-related information are more likely to experience secondary trauma, leading to compassion fatigue (Devilly, Wright & Varker, 2009; Nolen, 2011).
Local community workers also face a significant likelihood of encountering individuals who have experienced trauma. Social welfare offices, established simultaneously with the construction of permanent rental housing in the 1980s, have been responsible for case management, family function enhancement services, and community organization functions primarily for the impoverished and marginalized. Basic livelihood recipients, including the impoverished basic livelihood recipients, are also included in the target audience of disability welfare centers or senior welfare centers. Since basic livelihood recipients meet the criteria of having no obligation or ability of support from parents, children, or other support obligation holders, or having a family relationship with a support obligation holder severed due to refusal or disappearance, they are highly likely to have experienced trauma such as death through separation, divorce, or abandonment by family. Moreover, not only individuals themselves but also their neighbors often face health problems and are frequently exposed to instability and risks due to the nature of their jobs involving simple or daily labor (Jeong, Mi-Ae, 1996). Research on children who have experienced sexual abuse in traumatic incidents also indicated a high proportion of victims belonging to the lower strata in terms of economic status and a higher likelihood of residing in areas with frequent crime occurrences (Han, In-Young et al., 2008). Regardless of the field, individuals receiving social welfare services are continuously exposed to trauma events closely related to death caused by illness, accidents, or violence, making them highly likely to experience various stresses and pains.
2. Concept of Professional Quality of Life
Stamm (2002) developed the Professional Quality of Life Scale (ProQOL) by considering the satisfaction experienced by frontline providers who help individuals exposed to traumatic events but may also experience secondary traumatic stress or burnout due to direct contact with those individuals or the nature of their work environment. In this context, professional quality of life encompasses both positive and negative experiences that frontline providers encounter while working. The positive experience, satisfaction, is conceptualized as compassion satisfaction, while negative experiences such as secondary traumatic stress and burnout are conceptualized as compassion fatigue.
Specifically, many frontline providers feel a sense of accomplishment and experience positive emotions in the process of providing assistance, which serves as a driving force to continue their work (Radley & Figley, 2007). This positive experience is what is referred to as compassion satisfaction. Radly and Figley (2007) identify factors that can enhance compassion satisfaction, including positive emotions, optimistic tendencies, possession and utilization of social resources, health, and a harmonious life. On the other hand, compassion fatigue is a state of physical, psychological, and social withdrawal and dysfunction resulting from prolonged empathy with suffering individuals (Figley, 1995). Here, fatigue refers to exhaustion arising from emotional fluctuations (Fujioka, 2012). Compassion fatigue is further divided into burnout and secondary traumatic stress. Burnout is a state where individuals feel human doubts or frustration due to the absence of expected results or rewards despite performing their duties diligently (Freudenberger, 1974). Secondary traumatic stress is the stress experienced indirectly by frontline providers during the process of contact with individuals who have faced traumatic experiences or painful events. While burnout can be experienced even outside the field dealing with trauma, secondary traumatic stress refers to the negative impact when exposed to individuals who have faced severe events or traumatic incidents related to work (Figley, 2002).
3. Research Trends and Related Factors in the Quality of Professional Life
Research on the quality of professional life has been explored in various fields of social welfare, both domestically and internationally. In South Korea, initial attempts were made in the fields of social work, special education, and nursing. In the field of social work, Shin’s (2007) study on professionals working in child protection agencies was the first attempt. The results indicated a lower level of burnout than usual but lower compassion satisfaction and significantly higher levels of secondary traumatic stress, resulting in a generally low assessment of the quality of professional life. Factors influencing the quality of professional life were found to be marital status and years of service. Unmarried individuals had a higher risk of compassion fatigue, and longer service years were associated with lower compassion fatigue and higher compassion satisfaction. In nursing, several studies have been conducted, including those targeting oncology nurses, emergency room nurses, and nurses in general hospitals.
Kim et al.’s (2010) study on oncology nurses analyzed the relationships between the quality of professional life, job satisfaction, job stress, and general characteristics. Nurses in the group with higher age, higher education levels, and longer clinical experience showed higher job satisfaction and compassion satisfaction. A program to reduce compassion fatigue was suggested by implementing a care program for nurses in their 20s with less than three years of experience.
Kim and Choi’s (2012) study on emergency room nurses conducted cluster analysis based on three variables of the quality of professional life, revealing that over half of the participants belonged to a cluster with a low quality of professional life. Nurses in the low-quality cluster were younger, had less experience, were more likely to be single, and held lower positions compared to those in the high-quality cluster. This emphasized the urgent need for stress management or educational programs to enhance the quality of professional life for nurses at higher risk.
In other studies, factors such as age, religion, job position, and department were found to be related to compassion satisfaction and burnout among nurses (Jeon & Ha, 2012; Yum & Kim, 2012; Kim et al., 2014). It was highlighted that attention should be paid to the quality of professional life, especially for nurses in their 20s with less than three years of experience.
Research on the quality of professional life has extended beyond nursing to include various professionals working in hospitals and other healthcare settings. Studies in mental health fields, involving psychologists, social workers, and psychiatrists, explored factors like working hours and mindfulness in relation to compassion satisfaction and burnout (Rossi et al., 2012; Thomas et al., 2014). In the field of health and medicine, studies on physicians, nurses, social workers, and counselors have been conducted, considering factors such as workload, clinical experience, and organizational characteristics (Macchi et al., 2014; Smart et al., 2014). These studies indicate that the quality of professional life is influenced by diverse factors and is not limited to specific professions.
Internationally, research on the quality of professional life has been extensive, covering various professions and settings. In social work, studies mainly focused on child protection professionals, while in health and medicine, research included physicians, nurses, social workers, and counselors. The findings emphasized the importance of understanding the diverse factors influencing the quality of professional life across different occupations.
Ⅲ. Research Methodology
1. Participants and Data Collection Method
The study targeted 397 frontline practitioners (life counselors, care aides, nurses/nursing assistants, social workers) working in social welfare facilities in Daejeon. Data collection took place from October 1 to October 14, 2014. A stratified random sampling method was employed, dividing social welfare facilities into 20% strata based on facility type, target population type, and workforce size. A total of 125 facilities (45 residential and 80 service facilities) were randomly selected and surveys were sent by mail to all employees in the selected institutions. Respondents were instructed to answer based on their specific job roles.
2. Measurement Tools
To assess the quality of professional life among frontline practitioners in social welfare facilities, the ProQOL 5 (Korean version) was used. The questionnaire was modified to suit social welfare facility workers. It consisted of 30 items, with 10 items measuring compassion satisfaction and 20 items measuring compassion fatigue.
Specifically, compassion satisfaction was measured with 10 items, including statements like “I feel satisfied knowing that I am helping others,” and “I get energized from my work.” Burnout was assessed with 10 items, such as “I am less productive at work because I am tired from my work with those I serve” and “I feel tired from my work.” Secondary traumatic stress was measured with 10 items, including statements like “I am preoccupied with more than one person I serve,” and “I find it difficult to separate my personal life from my life as a social welfare worker.” Responses were on a scale from ‘Never’ (1 point) to ‘Very often’ (5 points). Higher scores indicated a higher level of compassion satisfaction or compassion fatigue. The Cronbach’s ⍺ for compassion satisfaction was 0.89, for burnout was 0.73, and for secondary traumatic stress was 0.78.
Demographic and work environment characteristics included gender, age, education level, work experience, facility type, social work qualification, employment type, shift work, workload, and income level. Work experience was measured as the total career experience in the social welfare field, and facility type was categorized into residential and service facilities. Workload was analyzed using a 10-point Likert scale, considering scores of 7 or above as indicative of excessive workload, and income level was assessed based on the average monthly income over the past three months.
3. Data Analysis
The survey results were analyzed using the SPSS 20.0 statistical software. To examine the characteristics of the study participants and all measured variables, frequency analysis and descriptive statistics were employed. For the classification and verification of differences in the characteristics of professional life quality, compassion satisfaction, burnout, and secondary traumatic stress scores were calculated according to Stamm’s (2010) manual. Scores were standardized into Z-scores with a mean of 50 and a standard deviation of 10. Subsequently, participants were categorized into subgroups based on the standardized scores: below 25% as the lower subgroup, between 25% and 75% as the middle subgroup, and above 75% as the upper subgroup.
To verify the differences in professional life quality based on demographic and work environment characteristics, t-tests, analysis of variance (ANOVA), and post hoc Scheffe tests were conducted.
Ⅳ. Research Results
In Table 1, we examined the demographic and work environment characteristics of frontline practitioners (life counselors, caregivers, nurses, social workers). Among them, life counselors worked with staff in facilities for children and people with disabilities, caregivers and nurses worked in facilities for the elderly, and social workers targeted team leaders or higher-ranking positions in facilities such as social welfare centers and local activity centers.
Demographic Characteristics:
- Overall, the female-to-male ratio was approximately 4:1.
- Gender differences were statistically significant, with over 90% of caregivers and nurses being female.
- The age distribution was highest in the 20-30 age group, with an average age of 41.01. Social workers had a notable presence in the 50s and above, likely due to the inclusion of social workers from home-based elderly welfare centers in this study.
- Educationally, 4-year university graduates constituted the majority (36.9%), with variations across professions.
Work Environment Characteristics:
- The average work experience in the social welfare field was 5 years, with over half having more than 5 years of experience.
- Employment types were predominantly regular (80%), but substantial variation existed, especially for caregivers and social workers.
- Shift work was common, particularly for life counselors (71.8%) and caregivers (55.7%).
Variables such as education level, work experience, employment type, and age showed statistically significant differences across different frontline practitioner groups. The detailed breakdown of these characteristics is presented in Table 1.
(Unit: Individuals, %)
| Category | Response | Total | Life Facility | Caregivers | Nurses | Social Workers | χ^2 |
| Gender | Male | 84 (21.2) | 34 (29.3) | 7 (7.9) | 1 (3.6) | 42 (25.6) | 21.19*** |
| Female | 313 (78.8) | 80 (70.7) | 82 (92.1) | 27 (96.4) | 122 (74.4) | ||
| Age | 20-30s | 192 (49.4) | 52 (45.2) | 9 (10.7) | 10 (37.0) | 121 (74.2) | 147.99*** |
| 40s | 76 (19.5) | 29 (25.2) | 9 (10.7) | 9 (33.3) | 29 (17.8) | ||
| 50s | 91 (23.4) | 27 (23.5) | 46 (54.8) | 7 (25.9) | 11 (6.7) | ||
| 60s and above | 30 (7.7) | 7 (6.1) | 20 (23.8) | 1 (3.7) | 2 (1.2) | ||
| M±SD (years) | 41.01±12.31 | 41.39±11.68 | 52.99±9.39 | 44.52±8.1 | 33.98±9.19 | ||
| Education Level | High School | 101 (25.4) | 34 (29.3) | 59 (66.3) | 6 (21.4) | 2 (1.2) | 187.12*** |
| Associate’s Degree | 122 (30.7) | 49 (42.2) | 22 (24.7) | 14 (50.0) | 37 (22.4) | ||
| Bachelor’s Degree | 147 (36.9) | 30 (25.9) | 3 (3.4) | 8 (28.6) | 106 (64.2) | ||
| Graduate Degree | 28 (7.0) | 3 (2.6) | 5 (5.6) | – | 20 (12.1) | ||
| Work Experience | Less than 3 years | 112 (28.2) | 23 (19.8) | 17 (19.1) | 5 (17.9) | 67 (40.9) | 29.82*** |
| 3-5 years | 86 (21.7) | 24 (20.7) | 21 (23.6) | 3 (10.7) | 38 (23.2) | ||
| 5 years or more | 199 (50.1) | 69 (59.5) | 51 (57.3) | 20 (71.4) | 59 (36.0) | ||
| M±SD (months) | 59.06±49.85 | 77.19±56.88 | 47.46±32.54 | 89.50±87.03 | 46.72±35.60 | ||
| Employment Type | Regular | 312 (78.8) | 111 (95.7) | 69 (77.5) | 23 (85.2) | 109 (66.5) | 35.48*** |
| Irregular | 84 (21.2) | 5 (4.3) | 20 (22.5) | 4 (14.8) | 55 (33.5) | ||
| Shift Work | No Shift | 231 (64.9) | 29 (28.2) | 35 (44.3) | 22 (91.7) | 145 (96.7) | 149.73*** |
| Shift (2,3 rotations) | 125 (35.1) | 74 (71.8) | 44 (55.7) | 2 (8.3) | 5 (3.3) | ||
| Workload | Not Excessive | 174 (43.8) | 54 (46.6) | 44 (50.0) | 12 (42.9) | 64 (38.8) | 3.424 |
| Excessive | 223 (56.2) | 62 (53.4) | 44 (50.0) | 16 (57.1) | 101 (61.2) | ||
| Income Level | ≤1,300,000 won | 105 (26.4) | 10 (8.6) | 45 (50.6) | 7 (25.0) | 43 (26.1) | 108.00*** |
| 1,301,000-1,600,000 won | 112 (28.1) | 21 (18.1) | 36 (40.4) | 8 (28.6) | 47 (28.5) | ||
| 1,601,000-2,000,000 won | 105 (26.4) | 41 (35.3) | 3 (3.4) | 4 (14.3) | 57 (34.5) | ||
| ≥2,001,000 won | 76 (19.1) | 44 (37.9) | 5 (5.6) | 9 (32.1) | 18 (10.9) | ||
| M±SD (thousand won) | 173.72±66.91 | 206.57±74.98 | 141.59±45.38 | 197.19±82.26 | 164.41±56.70 |
* p<.05, ** p<.01, *** p<.001
Note: Significant differences were observed in gender, age, education level, work experience, employment type, shift work, and income level across different frontline practitioner groups. Detailed breakdowns are presented in the table.
2. Level of Professional Quality of Life
The examination of the professional quality of life among frontline workers revealed intriguing findings, as depicted in Table 2 and Figure 1. Stamm (2010) independently evaluates three sub-concepts of professional quality of life, standardizing them into Z-scores with an average of 50 and a variance of 10. These Z-scores are categorized into subgroups: below 25% as a lower group, between 25% and 75% as a middle group, and above 75% as an upper group.
Analyzing these categories, it was observed that 17.5% were in the upper group for compassion satisfaction, while 80.0% and 82.5% were in the middle-to-high range for burnout and secondary traumatic stress, respectively. Among frontline workers, nurses/nursing assistants had the highest proportion (35.7%) in the upper group for compassion satisfaction. As shown in Table 1, nurses/nursing assistants, with generally higher work experience and an older age group (excluding care workers who are predominantly in their 50s), were more likely to be in the upper group for compassion satisfaction. Previous studies have indicated a positive correlation between work experience and compassion satisfaction or identified work experience as a factor that enhances compassion satisfaction (McKim & Smith-Adcock, 2014; Thomson et al., 2014).
However, other professions did not reach a proportion of 20% in the upper group. Among those working in care facilities, only 11.5% of care workers were in the upper group. Burnout rates were relatively consistent across professions, ranging from 77.6% for life counselors to 82.7% for nurses/nursing assistants. Similarly, rates of secondary traumatic stress ranged from 81.0% for life counselors to 89.3% for nurses/nursing assistants.
Combining the evaluation of the three sub-concepts, Stamm (2010) suggested that the most desirable group comprises those with high compassion satisfaction and low burnout and secondary traumatic stress. The least desirable group is characterized by high burnout and secondary traumatic stress and low compassion satisfaction, indicating not only job burnout but also fear of indirect exposure to trauma. Accordingly, in this study, only 12.7% (50 individuals) fell into the most desirable group, while 5.6% (22 individuals) were in the least desirable group, and a substantial 28.1% (111 individuals) were in the group at the highest risk for burnout.
| (Unit: %) | |||||||
| Overall | Life Facilities | Utilization Facilities | |||||
| Life Counselor | Care Worker | Nurse/Nursing Assistant | Social Worker | ||||
| Compassion Satisfaction | Lower (≤ 44 points) | 27.8 | 25 | 36.8 | 17.9 | 26.8 | |
| Middle (45-56 points) | 54.7 | 56.9 | 51.7 | 46.4 | 56.1 | ||
| Upper (≥ 57 points) | 17.5 | 18.1 | 11.5 | 35.7 | 17.1 | ||
| Overall (Cases) | 100.0(395) | 100.0(116) | 100.0(87) | 100.0(28) | 100.0(164) | ||
| Compassion Fatigue | Burnout | Lower (≤ 43 points) | 20 | 22.4 | 17.2 | 17.9 | 20.1 |
| Middle (44-55 points) | 49.6 | 45.7 | 56.3 | 46.4 | 49.4 | ||
| Upper (≥ 56 points) | 30.4 | 31.9 | 26.4 | 35.7 | 30.5 | ||
| Overall (Cases) | 100.0(395) | 100.0(116) | 100.0(87) | 100.0(28) | 100.0(164) | ||
| Secondary Traumatic Stress | Lower (≤ 42 points) | 17.5 | 19 | 17.2 | 10.7 | 17.7 | |
| Middle (43-55 points) | 58.2 | 52.6 | 56.3 | 67.9 | 61.6 | ||
| Upper (≥ 56 points) | 24.3 | 28.4 | 26.4 | 21.4 | 20.7 | ||
| Overall (Cases) | 100.0(395) | 100.0(116) | 100.0(87) | 100.0(28) | 100.0(164) | ||
[Table 2] Level of Professional Quality of Life for Social Workers
3. Difference in Professional Quality of Life
In Table 3, we examined the differences in the professional quality of life among frontline practitioners based on their demographic and work environment characteristics. We categorized life guidance counselors and social workers as social welfare occupations, while care workers (요양보호사) and nurses (간호사/간호조무사) were considered non-social welfare occupations. We also differentiated between those with no shift work and those working in 2-3 shifts for the analysis.
The results indicated statistically significant differences in age and workload. Although women tended to have higher levels of compassion satisfaction and secondary traumatic stress compared to men, the differences were not statistically significant. Regarding age, those in their 40s reported the highest level of compassion satisfaction at 52.13 points, while those in their 20s and 30s had the lowest at 48.25 points, showing a statistically significant difference between the two groups. Burnout was highest among those in their 20s and 30s, with a statistically significant difference compared to other age groups. Similarly, secondary traumatic stress was highest among those in their 20s, though not statistically significantly different from other age groups.
In terms of education, those with a high school diploma exhibited the lowest compassion satisfaction, but also the lowest burnout and secondary traumatic stress. On the other hand, those with a graduate degree showed the highest levels of both compassion satisfaction and secondary traumatic stress.
It is noteworthy that among individuals in their 20s and 30s, compassion satisfaction was low, and burnout was high. Despite a somewhat elevated burnout, the risk can be mitigated if compassion satisfaction is concurrently high. However, for individuals in their 20s and 30s, both burnout and compassion satisfaction were low, indicating vulnerability in their professional quality of life.
| N | Compassion Satisfaction | Compassion Fatigue | ||||||||||||
| Burnout | Secondary Traumatic Stress | |||||||||||||
| M | SD | t/F | Scheffe Test | M | SD | t/F | Post-hoc Test | M | SD | t/F | Scheffe Test | |||
| Gender | Male | 84 | 47.66 | 8.83 | -1.85 | 50.92 | 10.12 | 0.37 | 48.41 | 8.69 | -1.63 | |||
| Female | 313 | 49.65 | 8.72 | 50.48 | 9.46 | 50.33 | 9.77 | |||||||
| Age | 20-30s | 192 | 48.25 | 8.42 | 4.24** | a<b | 53.07 | 9.47 | 9.63*** | a> b,c,d | 50.88 | 8.47 | 1.26 | |
| 40s | 76 | 52.13 | 9.09 | 47.83 | 9.85 | 49.1 | 8.46 | |||||||
| 50s | 91 | 48.53 | 8.85 | 48.83 | 9.18 | 49.55 | 11.58 | |||||||
| 60s+ | 30 | 51.17 | 9.16 | 46.38 | 8.47 | 48.08 | 10.15 | |||||||
| Education | High School | 101 | 48.74 | 7.71 | 1.4 | 48.72 | 9.08 | 1.65 | 49.31 | 11.38 | 0.32 | |||
| College | 120 | 49.54 | 9.38 | 51.23 | 10.07 | 49.98 | 9.66 | |||||||
| University | 147 | 48.87 | 8.59 | 51.2 | 9.66 | 49.97 | 8.69 | |||||||
| Grad School | 27 | 52.41 | 11.16 | 50.03 | 10 | 51.26 | 5.87 | |||||||
| Work Exp. | < 3 years | 110 | 47.64 | 9.08 | 2.75 | 50.91 | 10.27 | 0.202 | 48.34 | 9.73 | 2.19 | |||
| 3-5 years | 86 | 50.22 | 7.67 | 50.02 | 9.33 | 50.99 | 9.79 | |||||||
| 5+ years | 198 | 49.8 | 9.12 | 50.5 | 9.59 | 50.29 | 9.35 | |||||||
| Facility Type | Living Facility | 213 | 49.12 | 8.91 | -0.19 | 50.39 | 9.63 | -0.43 | 49.98 | 9.93 | 0.21 | |||
| Service Facility | 177 | 49.29 | 8.62 | 50.81 | 9.66 | 49.77 | 9.19 | |||||||
| Social Welfare Role | Social Welfare | 280 | 49.56 | 8.41 | 0.96 | 50.56 | 9.62 | 0.21 | 49.88 | 8.86 | -0.02 | |||
| Non-Social Welfare | 115 | 48.62 | 9.79 | 50.33 | 9.91 | 49.91 | 11.14 | |||||||
| Employment Type | Regular | 312 | 49.48 | 8.6 | 0.72 | 50.92 | 9.49 | 1.74 | 50.33 | 9.38 | 1.83 | |||
| Irregular | 84 | 48.69 | 9.83 | 48.83 | 10.39 | 48.16 | 10.19 | |||||||
| Shift Work | No Shift | 230 | 49.48 | 8.87 | -0.59 | 50.78 | 9.9 | -0.55 | 49.86 | 8.99 | 0.48 | |||
| 2-3 Shifts | 124 | 48.92 | 8.49 | 50.22 | 8.72 | 50.41 | 10.71 | |||||||
| Workload | Not Excessive | 171 | 49.54 | 8.57 | 0.65 | 47.89 | 9.35 | -4.86*** | 48.91 | 9.38 | -1.73 | |||
| Excessive | 223 | 48.96 | 8.88 | 52.55 | 9.47 | 50.59 | 9.65 | |||||||
| Income Level | ≤ 1.3 million | 103 | 48.54 | 8.78 | 0.45 | 49.35 | 9.76 | 0.77 | 49.05 | 10.92 | 0.51 | |||
| 1.31-1.6 million | 112 | 49.53 | 8.67 | 51.2 | 9.37 | 50.59 | 9.2 | |||||||
| 1.61-2 million | 104 | 49.22 | 8.67 | 50.45 | 9.77 | 49.71 | 8.91 | |||||||
| ≥ 2.01 million | 76 | 50.04 | 9.23 | 51.09 | 10.02 | 50.27 | 9.11 | |||||||
| ** p<.01, *** p<.001 | ||||||||||||||
In terms of work experience, compassion satisfaction and secondary traumatic stress were lowest in those with less than 3 years of experience, but there were no statistically significant differences across different work experience levels. Facility type and social welfare role did not show significant differences in the quality of professional life, with average scores for compassion satisfaction, burnout, and secondary traumatic stress falling within the moderate range around 50 points.
Regarding employment type, regular employment showed higher levels of compassion satisfaction and lower compassion fatigue compared to irregular employment, although these differences were not statistically significant. Shift work and workload did not result in significant differences in the quality of professional life. However, excessive workload was associated with higher burnout, showing statistical significance.
Income level displayed some variations, with the group earning 201 million won or more per month reporting the highest compassion satisfaction. Meanwhile, those earning between 131-160 million won per month exhibited the highest levels of burnout and secondary traumatic stress, although these differences were not statistically significant.
In summary, while certain factors such as workload and income level demonstrated some impact on the quality of professional life, variations in work experience, facility type, social welfare role, employment type, shift work, and age did not lead to statistically significant differences in compassion satisfaction, burnout, or secondary traumatic stress among professionals in this study.
4. Factors Influencing the Quality of Professional Life
In this study, three regression analyses were conducted to examine the factors influencing the quality of professional life among frontline practitioners. The independent variables included personal and work environment characteristics, while the dependent variable was the quality of professional life. The individual factors and their relationship with the quality of professional life were identified through an analysis of differences in the quality of professional life based on demographic and work environment characteristics, as presented in Table 4.
Before each regression analysis, multicollinearity was assessed by examining the variance inflation factor (VIF) between the included variables. Generally, if the VIF values for all variables in the analysis are 5 or higher, multicollinearity may be present. In this study, the VIF values for each regression analysis model ranged from 1.091 to 2.105, indicating a low risk of multicollinearity.
| Empathic Satisfaction | Empathic Fatigue | |||||
| Burnout | Secondary Traumatic Stress | |||||
| Variable | B(S.E.) | β | B(S.E.) | β | B(S.E.) | β |
| Constant | 46.89 (4.31) | 50.17 (4.61) | 48.61 (4.76) | |||
| Gender (1 = Male) | -2.41 (1.27) | -0.123 | -0.74 (1.36) | -0.03 | -1.97(1.40) | -0.09 |
| Age | 0.03 (0.06) | 0.037 | -0.27 (0.06) | -.35** | -0.14 (0.06) | -.18* |
| Education Level | 1.45 (0.79) | 0.155 | -0.36 (0.84) | -0.03 | .19(.87) | 0.02 |
| Years of Experience | -0.00 (0.02) | -0.007 | 0.02 (0.02) | 0.06 | 0.01 (0.02) | 0.04 |
| Facility Type | -1.08 (1.45) | -0.065 | -0.65 (1.55) | -0.03 | -.81(1.60) | -0.04 |
| Occupation (1 = Social Service) | 0.15 (1.62) | 0.008 | -2.37 (1.73) | -0.11 | -.31(1.79) | -0.02 |
| Employment Status (1 = Regular) | 1.12 (1.29) | 0.055 | 2.03 (1.37) | 0.09 | 1.35(1.42) | 0.06 |
| Shift Work (1 = Non-Shift) | -0.26 (1.36) | -0.014 | -1.19 (1.45) | -0.06 | -2.30(1.50) | -0.12 |
| Workload | -0.66 (0.36) | -0.116 | 2.05 (0.39) | .31*** | 1.11(.40) | .17** |
| Salary | 0.02 (0.01) | 0.139* | -0.01 (0.01) | -0.06 | -.00(.01) | -0.02 |
| R-squared | 0.053 | 0.177 | 0.067 | |||
| F | 1.857 | 5.694*** | 1.903** | |||
| Variance Inflation Factor Range | 1.121-2.103 | 1.121-2.105 | 1.091-2.105 | |||
| p < .05 **p < .01 **p < .001 | ||||||
As shown in Table 4, the independent variables in the model to predict the quality of professional life in terms of empathy satisfaction explained 5% of the total variance of empathy satisfaction, but the coefficient of determination was weak (F=1.857, p>.05).
Next, the independent variables in the model to predict the quality of professional life in terms of burnout explained 18% of the total variance of burnout. In this model, age (β=-.35, p<.001) and workload (β=.31, p<.001) were statistically significant. In other words, burnout was found to be higher as age decreased and workload was perceived to be heavier.
Finally, the independent variables in the model to predict the quality of professional life in terms of secondary traumatic stress explained 7% of the total variance of secondary traumatic stress. In this model as well, age (β=-.18, p<.05) and workload (β=.17, p<.01) were statistically significant. In other words, secondary traumatic stress was found to be higher as age decreased and workload was perceived to be heavier.
V. Conclusion
In this study, we explored the level of professional quality of life among frontline social welfare facility practitioners using Stamm’s (2002) Professional Quality of Life Scale. The focus extended beyond negative emotions such as burnout and secondary traumatic stress, which can arise from continuous interactions with individuals in distress, to include the integrated measurement of positive emotions, specifically compassion satisfaction.
Key findings regarding the level of professional quality of life are as follows. Overall, the participants in this study reported low levels of compassion satisfaction, while burnout and secondary traumatic stress were notably high. Only 17.5% of the group experienced high levels of compassion satisfaction, while 80.0% and 82.5% reported moderate to high levels of burnout and secondary traumatic stress, respectively.
Comparing these results with a study by Jeon and Ha (2012) analyzing the professional quality of life among emergency room nurses, the group with high compassion satisfaction in that study was 19.7%, slightly higher than our participants. However, the proportions for burnout and secondary traumatic stress were lower at 76.4% and 73.2%, respectively. Another study by Kim et al. (2010) focusing on oncology nurses found a 14.8% rate of high professional quality of life, with burnout and secondary traumatic stress reported at 75.3% and 77.6%, respectively, aligning closely with our results.
According to Stamm (2010), the work environment is a crucial factor influencing professional quality of life, varying based on the occupational field and working conditions of the study participants. Therefore, it is challenging to directly compare our results with studies involving professionals in different working environments. However, for frontline practitioners in social welfare facilities, similar challenges and issues related to emotional exhaustion (compassion fatigue) are consistently present due to prolonged empathetic engagement with individuals facing difficulties (Nolen, 2011). Consequently, high levels of compassion fatigue are generally presumed, as observed in our study.
Further analysis of professional quality of life differences among the study participants revealed age-related variations in compassion satisfaction, and burnout was associated with both age and work burden. While comparing our study with others is challenging due to the focus on frontline practitioners in social welfare facilities, age and work burden emerged as factors related to professional quality of life. Consistent with previous studies (Kim et al., 2010; Kim & Choi, 2012; Jeon & Ha, 2012; Yum & Kim, 2012; Kim et al., 2014; Jeon & Sung, 2014; Thomson et al., 2014; Salloum et al., 2015), age appeared to be a factor influencing professional quality of life in our study. However, Severn et al. (2012) presented contradictory results, suggesting that consistent findings across studies are not guaranteed. Future research should explore the relationship between age and professional quality of life further.
Work burden was also identified as a factor related to professional quality of life. In the study by Macchi et al. (2014), higher perceived workload was associated with lower levels of professional quality of life. Increased workload may lead to additional exposure to trauma for clients, resulting in an elevated risk of secondary traumatic stress and, consequently, burnout (Sprang et al., 2007).
Lastly, we examined the main results related to factors influencing professional quality of life through demographic and work environment characteristics. The study aimed to understand the relationship between individual factors and professional quality of life by analyzing differences in professional quality of life based on demographic and work environment characteristics. The analysis revealed that age and work burden were significant factors influencing burnout and secondary traumatic stress, indicating higher levels of both among younger participants and those experiencing greater work burden.
In conclusion, this study contributes to the understanding of professional quality of life among frontline social welfare facility practitioners by applying well-established demographic and work environment characteristics. While challenging to directly compare with previous studies focused on different occupational fields, our findings align with existing research. However, future research should consider Stamm’s (2010) recommendation to include not only the personal and working environments of frontline professionals but also the environment of caring for service recipients (Yoon & Shim, 2015). Additionally, a more refined construction of variables related to professional quality of life could enhance our understanding and potentially increase the explanatory power of regression models.
Based on these results, practical, policy-oriented, and educational strategies for enhancing the professional quality of life of frontline social welfare facility practitioners can be explored.
1. Practical Aspect
Stamm (2010) suggested that when burnout and secondary traumatic stress are high, and compassion satisfaction is low, treatment may be necessary if depression becomes severe. However, in cases where these issues are not severe, enhancing the efficiency of job skills through additional training at a personal level is recommended. Simultaneously, organizational efforts, such as adjustments in job assignments to bring about changes in the work environment, should be emphasized. Particularly for frontline practitioners in their 20s to 30s, who have recently entered social welfare organizations and need to adapt to multiple roles and tasks, the importance of early support for effective performance of various roles is highlighted. To address this, mentorship programs or supervision for job adaptation need to be strengthened.
2. Policy Aspect
Regarding changes in the work environment of social welfare facilities, government-level measures should be devised. In this study, one out of three participants was identified as belonging to the high-risk group for burnout, and approximately one out of three was indicated to have a high risk of burnout in the future. While the optimal solution would be to supplement the insufficient workforce in social welfare facilities to resolve these issues, if substantial workforce reinforcement within a short timeframe is challenging, alternative strategies to alleviate the workload for frontline practitioners through personnel support should be explored. The increasing demand for maternity leave and parental leave has led to the attention of substitute workforce support policies for stable institutional settlement (Kim & Oh, 2013). The Ministry of Employment and Labor established the Substitute Work Bank, a comprehensive substitute workforce support center, which began pilot operations in Seoul’s Guro-gu on April 4, 2014 (Asia Economy, 2014). The Substitute Work Bank identifies private-sector demand for substitute workers in advance, recruits a workforce pool that meets this demand, and promptly fills vacancies when demand arises. A similar approach reflecting diverse needs based on the situation of each social welfare facility seems necessary, considering variations in workload depending on the facility’s situation and the need for personnel at certain times.
3. Educational Aspect
Enhancing self-management training is necessary in university and continuing education programs. Practitioners in social welfare facilities who directly provide services to vulnerable populations always face emotional and psychological risks, yet self-management to prepare for such risks has been overlooked in the field of social welfare practice and education (Dunkley & Whelan, 2006; Figley, 2002). To systematically educate self-management methods for preventing compassion fatigue, these topics should be included in the curriculum of university social work majors and, importantly, incorporated into the continuing education and professional training courses for social welfare facility practitioners. Additionally, various educational institutions responsible for job training in social work should include programs that lower burnout and secondary traumatic stress while enhancing compassion satisfaction in their training content. Programs like the Accelerated Program for Compassion Fatigue (ARP), developed by Gentry et al. (1997), which aims to achieve ten objectives over five sessions (symptom identification, recognition of compassion fatigue triggers, identification of available resources, review of personal and professional experiences, mastery of excitement reduction techniques, learning emotional suppression techniques, agreement to enrich life, resolution of factors preventing efficiency, conflict resolution plan, implementation of supportive aftercare), are needed. This study goes beyond previous research by not only focusing on negative emotions, such as burnout, secondary traumatic stress, or compassion fatigue, which social welfare practitioners may experience while engaging with clients in distress but also integrating the examination of positive emotions, specifically compassion satisfaction. However, since this study targeted social welfare facility practitioners in Daejeon, generalizing the results nationwide, considering regional differences in urban characteristics and work environments, is challenging.
Uthando Nethemba 