IMPACT OF COMPASSION FATIGUE ON SURGEON'S PERFORMANCE AND PATIENT OUTCOMES: A CASE STUDY OF RESIDENT DOCTORS IN FMC UMUAHIA.

1.1 Background to the Study Globally, healthcare systems are increasingly confronting a hidden but pervasive crisis: the emotional and psychological toll borne by health professionals. In contemporary medical practice, surgeons—particularly resident doctors—play an indispensable role in emergency response, complex surgical interventions, and continuous patient care. This crisis is epitomized in the phenomenon of compassion fatigue—a condition marked by emotional exhaustion, diminished empathy, and a reduced sense of accomplishment, particularly among caregivers repeatedly exposed to patient trauma and suffering (Joinson, 1992; Figley, 2002). In surgical practice, where quick, accurate decisions and emotional composure are non-negotiable, compassion fatigue has been identified as a silent threat to both professional performance and patient safety (West et al., 2018). Compassion fatigue, a concept initially articulated by Figley (1995), refers to the profound emotional and physical erosion that occurs when healthcare professionals are unable to refuel and regenerate, typically resulting from continuous exposure to patients’ trauma and suffering. In surgical contexts, this condition is often characterized by diminished empathy, emotional exhaustion, and detachment, which can impair both cognitive and technical aspects of care delivery (Joinson, 1992; Hooper et al., 2010). Surgeon performance, on the other hand, encompasses not only technical proficiency in operative procedures but also clinical judgment, communication, and responsiveness to patient needs. As defined by Yule et al. (2006), surgical performance includes a surgeon's ability to make accurate intraoperative decisions, maintain focus under stress, and adhere to safety protocols, all of which may be negatively influenced by psychological stressors like compassion fatigue. The experience of compassion fatigue has become more pronounced in low- and middle-income countries such as Nigeria, where under-resourced hospitals, overwhelming patient loads, long working hours, and emotional strain contribute to psychological burnout. Resident doctors, particularly in federal medical centres like FMC Umuahia, often shoulder disproportionate burdens with limited institutional support. Surgeons who suffer from compassion fatigue may demonstrate impaired decision-making, lowered concentration, delayed reaction time, and increased surgical errors, all of which compromise the quality of patient outcomes (Rupert et al., 2021; Nwosu et al., 2023). Moreover, this phenomenon is frequently under-recognized and poorly managed within Nigeria’s healthcare infrastructure, leading to cyclical burnout and workforce attrition. 1.2 Statement of the Problem In recent years, global health discourses have expanded to address not just the physical competence of surgeons, but their psychological and emotional well-being as crucial determinants of healthcare delivery quality. While research in developed countries has extensively examined compassion fatigue among nurses, palliative care workers, and emergency responders (Hooper et al., 2010), less empirical attention has been paid to its manifestation among surgeons, especially in the Nigerian context. Hence, understanding how compassion fatigue affects resident surgeons' clinical efficacy and patient outcomes is essential for shaping institutional interventions, human resource policies, and support mechanisms. Despite rising awareness about physician well-being, the psychological toll on resident surgeons in Nigerian tertiary hospitals remains inadequately studied. At FMC Umuahia, resident doctors frequently manage high-risk surgeries under intense pressure with limited rest, minimal psychosocial support, and growing expectations from patients and superiors. In such demanding settings, compassion fatigue may manifest in subtle but harmful ways: diminished empathy, mental fatigue, clinical detachment, and procedural mistakes. These symptoms, if unchecked, may compromise patient safety, increase postoperative complications, and reduce the overall quality of surgical outcomes (Adewuyi et al., 2022). Furthermore, many hospitals lack structured programs to assess, monitor, or mitigate compassion fatigue among their surgical workforce. While emotional resilience and competence are often expected of surgeons, institutional recognition of their emotional limits remains low. This creates a dangerous mismatch between clinical demands and psychological resources, often resulting in long-term professional dissatisfaction, high turnover, and diminished healthcare quality (Ugochukwu & Olajide, 2021). Against this backdrop, this study seeks to explore the relationship between compassion fatigue, the performance of surgical resident doctors, and patient outcomes at FMC Umuahia, thereby filling a critical gap in Nigeria’s healthcare research and policy dialogue. 1.3 Objectives of the Study The major objective of this study is to assess the impact of compassion fatigue on the performance of surgical resident doctors and its implications for patient outcomes in FMC Umuahia. The specific objectives are to: 1. Examine the prevalence of compassion fatigue among surgical resident doctors in FMC Umuahia. 2. Analyze the effect of compassion fatigue on clinical decision-making and technical performance in surgery. 3. Evaluate the relationship between compassion fatigue and surgical patient outcomes (e.g., recovery rate, complication incidence). 4. Explore coping strategies adopted by resident surgeons to manage compassion fatigue. 5. Propose institutional interventions for minimizing compassion fatigue and enhancing surgical care quality. 1.4 Research Questions 1. What is the prevalence of compassion fatigue among resident surgeons in FMC Umuahia? 2. How does compassion fatigue influence the clinical performance of resident surgeons? 3. What is the relationship between compassion fatigue and patient outcomes in surgery? 4. What coping mechanisms are currently used by resident surgeons in managing compassion fatigue? 5. What institutional strategies can reduce compassion fatigue and improve patient care quality? 1.5 Research Hypotheses H₀₁: There is no significant relationship between compassion fatigue and the clinical performance of surgical resident doctors. H₀₂: Compassion fatigue does not significantly affect patient outcomes in surgery. 1.6 Significance of the Study This study offers practical relevance to healthcare policymakers, hospital administrators, and medical educators by empirically highlighting how emotional and psychological stressors affect surgical performance and patient care. It underscores the need for mental health screening, professional support systems, and resilience-building programs for resident doctors. For academic purposes, the study contributes to growing literature on occupational stress in healthcare, particularly in under-studied contexts like Nigeria. The findings will also serve as a reference point for future research on physician wellness, quality assurance, and healthcare delivery reform. 1.7 Scope of the Study The study is limited to resident doctors in the surgical department of FMC Umuahia. It focuses on their experiences with compassion fatigue, its impact on their technical and interpersonal performance, and implications for surgical patient outcomes. The study does not include consultants, interns, or non-surgical medical personnel. 1.8 Operational Definition of Terms • Compassion Fatigue: A condition characterized by emotional exhaustion and reduced capacity to empathize, resulting from prolonged exposure to patients’ suffering. • Resident Doctors: Medical doctors undergoing postgraduate surgical training and responsible for patient care under supervision. • Patient Outcomes: Clinical results including recovery speed, complication rate, and patient satisfaction following surgical procedures. • Surgical Performance: Technical execution, decision-making, and interpersonal communication skills demonstrated during surgery.