Compassion Fatigue in General and Psychiatric Hospital Nurses: A Systematic Review of Patterns, Determinants, and Consequences

Background/Objectives: Compassion fatigue (CF), commonly discussed alongside burnout and secondary traumatic stress, is an important occupational concern in nursing. General and psychiatric hospital environments expose nurses to different combinations of organizational, emotional, and relational demands. This systematic review aimed to synthesize and compare the reported patterns, determinants, and consequences of compassion fatigue among nurses working in general and psychiatric hospital settings and to identify setting-specific factors relevant to nursing practice and workforce support. Methods: The review was conducted in accordance with PRISMA 2020. PubMed, CINAHL, PsycINFO, and Scopus were searched for peer-reviewed studies published from 2020 to 2025. Quantitative and qualitative hospital-based nursing studies reporting CF or closely related professional-quality-of-life constructs were eligible. Methodological quality was appraised using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively because of heterogeneity in study designs, instruments, and reporting formats. Results: Eighteen studies were included after screening 302 records identified in the database searches. Moderate-to-high CF-related burden was reported across both general and psychiatric settings, but direct prevalence comparisons were not appropriate because instruments, definitions, and thresholds differed substantially. General-hospital studies more often emphasized workload, high acuity, staffing pressures, sleep disruption, and acute trauma exposure, whereas psychiatric studies more often emphasized moral distress, aggression or workplace violence, stigma, and prolonged emotionally demanding therapeutic relationships. Across settings, CF was associated with poorer psychological and occupational well-being. Conclusions: The available evidence supports setting-sensitive prevention and workforce-support strategies but does not establish that one hospital setting has a uniformly higher prevalence of CF. More consistent definitions, measurement tools, and reporting thresholds are needed to enable reliable cross-setting comparisons.