A National Cross-Sectional Assessment of Emotional Labor and Compassion Fatigue Among Emergency Response Personnel in Turkey

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Methods A cross-sectional study was conducted between January and May 2024 among 405 EMS and UMKE personnel from Ankara, Konya, Kayseri, and Antalya provinces in Turkey. Data were collected using a three-part questionnaire: demographic form, the Compassion Fatigue Scale (revised by Adams et al.), and the Emotional Labour Scale (developed by Diefendorff et al.). Confirmatory factor analyses with bootstrap resampling (n = 10,000) assessed construct validity, and Cronbach’s alpha coefficients evaluated reliability. Group comparisons were performed using t-tests, ANOVA, Mann–Whitney U, and Kruskal–Wallis tests, with Bonferroni correction for multiple comparisons. Spearman’s correlation examined relationships between variables. Results Significant differences in compassion fatigue and its subdimensions were observed by age, gender, marital status, education level, working style, and professional title (p < 0.05). Emotional labour scores also varied significantly by age, gender, marital status, education level, and working style (p < 0.05). Positive correlations were found between compassion fatigue and emotional labour dimensions, suggesting a psychosocial interplay between these constructs in high-stress disaster contexts. Conclusion Findings highlight the psychosocial burden faced by emergency medical and disaster response personnel in Turkey’s disaster zones. Targeted mental health support, resilience-building interventions, and organisational strategies are essential to mitigate compassion fatigue and manage emotional labour demands in this population. Compassion fatigue emotional labour disaster response personnel Turkey 1. Introduction Disasters are unpredictable events that impose substantial physical, emotional, and psychological burdens on affected populations and responders alike. Emergency Medical Services (EMS) and National Medical Rescue Teams (UMKE) constitute the frontline workforce in Türkiye’s disaster management system, often being the first to witness and respond to mass trauma, injury, and loss of life. Such occupational exposure to repeated traumatic events increases vulnerability to psychosocial stressors, particularly compassion fatigue and heightened emotional labour demands, which in turn can negatively influence both mental health and quality of care [ 1 , 2 ]. Compassion fatigue—first described by Joinson (1992) [ 3 ] in nurses—refers to a form of secondary traumatic stress characterised by emotional, physical, and cognitive exhaustion stemming from prolonged exposure to others’ suffering [ 4 ]. It has been associated with decreased empathy, professional disengagement, and increased burnout risk [ 5 , 6 ]. Within the context of disaster response, repeated high-intensity exposure may amplify compassion fatigue risk, thereby compromising resilience and long-term occupational functioning [ 7 ]. Emotional labour, conceptualised by Hochschild (1983) [ 8 ], involves the regulation and expression of emotions to meet organisational and professional expectations. In healthcare, emotional labour requires providers to display empathy, compassion, and composure even under extreme stress [ 9 ]. While emotional labour can enhance patient satisfaction, sustained emotional regulation in high-pressure environments has been linked to stress, burnout, and mental health decline [ 10 ]. Although both constructs have been studied separately, the interplay between compassion fatigue and emotional labour in disaster contexts remains underexplored, particularly among frontline responders in low- and middle-income countries. Limited evidence from Türkiye suggests that EMS and UMKE personnel may face unique psychosocial risks due to prolonged deployments, insufficient recovery periods, and intense public expectations during large-scale disasters [ 11 , 12 ]. This study addresses this gap by examining the levels of compassion fatigue and emotional labour among EMS and UMKE personnel deployed to disaster zones in Türkiye, and by exploring the influence of sociodemographic and occupational factors. Understanding these relationships is critical for designing targeted interventions to protect the mental well-being and professional sustainability of disaster responders. 2. Materials and methods 2.1. Study design and setting This cross-sectional study was conducted between January and May 2024 among EMS and UMKE personnel in Türkiye. The research targeted four provinces—Ankara, Konya, Kayseri, and Antalya—selected due to their active deployment of EMS and UMKE teams to recent large-scale disaster zones. The study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines to ensure methodological transparency and the SAGER (Sex and Gender Equity in Research) guidelines to address gender considerations. 2.2. Participants and sampling The study population consisted of all EMS and UMKE personnel employed by the provincial ambulance service directorates and disaster health service units in the four selected provinces. Inclusion criteria were: (1) active duty in disaster response operations during the previous 12 months, (2) at least six months of work experience in current position, and (3) voluntary informed consent. Personnel on administrative leave or with incomplete questionnaire data were excluded. A total of 405 personnel participated, representing a high response rate from the eligible workforce. Participants included a range of professional titles (paramedics, emergency physicians, nurses, and support staff), working in both field and administrative capacities. 2.3. Ethical approval and consent Ethical approval was obtained from the Lokman Hekim University Scientific Research Ethics Committee (Approval No. 2023/200; 23 October 2023). Institutional permissions were granted by the hospital administrations. Participation was voluntary, and informed digital consent was obtained prior to data collection. No personally identifiable information was recorded. All procedures complied with the Declaration of Helsinki and relevant national research ethics regulations. All collected data were stored on password-protected computers accessible only to the research team. Identifiers were not recorded, and anonymized datasets will be securely retained for five years according to institutional data protection policy. 2.4. Instruments Demographic and occupational information form – Included age, gender, marital status, education level, years of service, working style (shift-based or fixed schedule), unit of work, and professional title. Compassion Fatigue Scale (Revised ) – Developed by Figley [4] and revised by Adams et al. [13], the scale measures compassion fatigue through subdimensions such as “secondary traumatic stress” and “occupational burnout”. Previous studies have demonstrated strong psychometric properties across healthcare settings [13, 14]. The scale comprises five-point Likert-type statements, ranging from 1 (never) to 5 (very often). Emotional Labour Scale – Developed by Diefendorff et al. [15], this 13-item scale measures “surface acting”, “deep acting”, and “genuine expression”. The Turkish adaptation has demonstrated good validity and reliability among healthcare workers [16]. The scale comprises five-point Likert-type statements, ranging from 1 (at no time) to 5 (at all times). 2.5. Data collection procedure For the administration of the data collection tool, consultations were conducted with the directors of the Provincial Ambulance Service Chief Physician’s Offices in Ankara, Konya, Kayseri, and Antalya, as designated by the respective Provincial Health Directorates and authorized to grant research approval. The directors were briefed on the study’s objectives and scope, and the survey link, developed via Google Forms, was disseminated to 112 EMS and UMKE personnel through these directors to ensure participation 2.6. Statistical analysis Data were analysed using SPSS version 29.0 and AMOS version 24.0. Descriptive statistics (frequency, percentage, mean, standard deviation, median, minimum, maximum) were computed for demographic and scale variables. Construct validity of both scales was examined via Confirmatory Factor Analysis (CFA) with 10,000 bootstrap resamples, and model fit was evaluated using fit indices (χ²/df, GFI, AGFI, NFI, RFI, RMR, SRMR) according to Hu and Bentler’s criteria [17]. Reliability was assessed using Cronbach’s alpha coefficients. Group differences were analysed using independent-samples t-tests or Mann–Whitney U tests for two-category variables, and one-way ANOVA or Kruskal–Wallis tests for three or more categories, with Bonferroni correction applied to post hoc comparisons. Relationships between continuous variables were assessed using Spearman’s rank correlation coefficients. A significance threshold of p < 0.05 (two-tailed) was applied. 3. Results 3.1. Participant Characteristics A total of 405 participants were included, comprising EMS (n=343, 84.7%) and UMKE (n=62, 15.3%) personnel. The mean age was 32.43 years (SD = 11.08), with 51.6% female and 48.4% male participants. Most were married (70.4%), held an undergraduate degree (84.0%), and worked in 24 hours shifts schedules (82.5%). 90.6% of the participants were employed as emergency medical technicians or paramedics (Table 1.). Table 1. Sociodemographic and occupational characteristics of participants (n = 405) Variable n % Age 32,43±11,08 Gender Female 209 51,6 Male 196 48,4 Marital status Married 285 70,4 Single 120 29,6 Level of education High school 25 6,2 Bachelor’s 340 84,0 Postgraduate 40 9,9 Length of service 0-5 years 68 16,8 6-10 years 75 18,5 11-15 years 134 33,1 ≥ 16 year 128 31,6 Working type Day shift 46 11,4 Shift schedules 25 6,2 24 hours shifts 334 82,5 Institution UMKE 62 15,3 Emergency medical services 343 84,7 Title Nurse 27 6,7 Emergency medical technician 204 50,4 Paramedic 163 40,2 Midvife 11 2,7 3.2. Scale Validity and Reliability Confirmatory Factor Analysis indicated acceptable model fit for both scales: Compassion Fatigue Scale : χ2/df: 2,303; GFI: 0,988; AGFI: 0,984; NFI: 0,982; RFI: 0,978; RMR: 0,0633; SRMR: 0,053. The CFA results indicated that the model demonstrated acceptable fit indices. Factor loadings for the Secondary Trauma subscale ranged from 0.421 to 0.839, while those for the Occupational Burnout subscale ranged from 0.399 to 0.792. All items exhibited positive lower and upper bounds of the 95% confidence interval for factor loadings, and these were statistically significant (p < 0.05). Cronbach’s alpha coefficients were 0.752 for Secondary Trauma, 0.844 for Occupational Burnout, and 0.879 for the overall Compassion Fatigue Scale, confirming satisfactory reliability for both subscales and the overall instrument. Emotional Labour Scale : χ2/df: 2,381; GFI: 0,987; AGFI: 0,980; NFI: 0,978; RFI: 0,973; RMR: 0,063; SRMR: 0,049. The CFA results indicated that the model demonstrated acceptable fit indices. Factor loadings ranged from 0.683 to 0.808 for the Surface Acting subscale, from 0.741 to 0.838 for the Deep Acting subscale, and from 0.784 to 0.878 for the Genuine Emotions subscale. All items showed positive lower and upper bounds of the 95% confidence interval for factor loadings, and these were statistically significant (p < 0.05). Cronbach’s alpha coefficients indicated good internal consistency: Compassion Fatigue Scale : Cronbach’s alpha coefficients were 0.752 for Secondary Trauma, 0.844 for Occupational Burnout, and 0.879 for the overall Compassion Fatigue Scale, confirming satisfactory reliability for both subscales and the overall instrument. Emotional Labour Scale : Cronbach’s alpha coefficients were 0.885 for Surface Acting, 0.873 for Deep Acting, 0.864 for Genuine Emotions, and 0.756 for the overall Emotional Labor Scale, confirming satisfactory reliability for all subscales and the overall instrument. 3.3. Group Comparisons Statistically significant differences in compassion fatigue and its subdimensions based on participants’ demographic and occupational characteristics were as follows: Participants aged ≥39 years had lower scores in compassion fatigue (χ² = 6.400, p = 0.041) and occupational burnout (χ² = 10.999, p = 0.004) compared with younger age groups. Females reported significantly higher levels of secondary trauma than males (Z = −2.427, p = 0.015). Participants with a postgraduate degree had significantly higher levels of secondary trauma (χ² = 16.673, p < 0.001), occupational burnout (χ² = 20.217, p < 0.001), and overall compassion fatigue (χ² = 22.253, p < 0.001) compared with those with a high school education. Shift-based personnel demonstrated significantly lower levels of compassion fatigue (χ² = 10.792, p = 0.005), occupational burnout (χ² = 9.835, p = 0.007), and secondary trauma (χ² = 9.809, p = 0.007) compared with those working day shifts or 24-hour shifts. Emergency medical technicians and paramedics reported significantly higher occupational burnout scores than nurses and midwives (χ² = 11.719, p = 0.020). Statistically significant differences in emotional labour and its subdimensions were as follows: For the Genuine Emotions subscale, higher mean scores were observed among participants aged ≥39 years compared with younger groups (χ² = 9.885, p = 0.007), among females compared with males (Z = −2.533, p = 0.011), and among married participants compared with single participants (Z = −1.962, p = 0.049). Shift-based personnel reported significantly lower scores in the Surface Acting subscale (χ² = 8.158, p = 0.017) compared with those working day shifts or 24-hour shifts. 3.4. Correlation Analysis The findings of the Spearman’s correlation analysis conducted to examine the relationships between the Compassion Fatigue Scale and the Emotional Labour Scale are presented in Table 2. Table 2. Spearman’s correlation analysis findings Scales Secondary trauma Occupational burnout Compassion fatigue scale Surface acting r 0,317 0,410 0,409 p <0,001 <0,001 <0,001 Deep acting r 0,150 0,054 0,091 p 0,002 0,277 0,067 Genuine emotions r -0,096 -0,264 -0,221 p 0,054 <0,001 <0,001 Emotional labour scale r 0,280 0,251 0,282 p <0,001 <0,001 <0,001 Based on these findings: Secondary traumatic stress was positively correlated with surface acting (r = 0.317), deep acting (r = 0.150), and the total Emotional Labour Scale score (r = 0.280) (all p < 0.05). Occupational burnout was positively correlated with surface acting (r = 0.410) and the total Emotional Labour Scale score (r = 0.251), but negatively correlated with genuine emotions (r = –0.264) (all p < 0.05). The total Compassion Fatigue Scale score was positively correlated with surface acting (r = 0.409) and the total Emotional Labour Scale score (r = 0.282), and negatively correlated with genuine emotions (r = –0.221) (all p < 0.05). 3.5. Regression Analysis The results of the regression analysis conducted to examine the effects of the subdimensions of the Emotional Labour Scale on the Compassion Fatigue Scale score are presented in Table 3. In the regression model, the subdimensions of the Emotional Labour Scale were entered as independent variables, and the total score of the Compassion Fatigue Scale was entered as the dependent variable. Table 3. Regression analysis findings Model B SD β t p Intercept 21,415 2,674 8,008 <0,001 Surface acting 4,255 0,534 0,401 7,971 <0,001 Deep acting 0,264 0,430 0,029 0,613 0,540 Genuine emotions -0,565 0,532 -0,053 -1,063 0,288 R =0,429 R² =0,184 Adjusted R² =0,178 F =30,137 p = <0,001 The analysis revealed that: The subdimensions of the Emotional Labour Scale explained 17.8% of the variance in the Compassion Fatigue Scale score, and the model was statistically significant (F = 30.137, p < 0.001). Surface acting had a significant positive effect on the Compassion Fatigue Scale score (β = 0.401, p < 0.001). 4. Discussion This study examined compassion fatigue and emotional labour among EMS and UMKE personnel deployed to disaster zones in Türkiye, revealing significant associations between these constructs and various sociodemographic and occupational factors. The findings underscore the psychosocial vulnerability of frontline disaster responders and the need for targeted interventions to support their mental well-being. 4.1. Compassion fatigue in disaster responders The observed compassion fatigue levels, particularly in burnout and secondary traumatic stress dimensions, are consistent with prior research among healthcare and emergency personnel exposed to high-stress environments [ 5 , 6 ]. Interestingly, shift-based workers were found to have significantly lower compassion fatigue scores, a finding that does not align with existing evidence suggesting that irregular working hours and insufficient recovery time exacerbate fatigue and emotional exhaustion [ 10 ]. Female personnel reported higher secondary traumatic stress than males, a finding aligned with studies suggesting that women may experience greater emotional strain in caregiving roles due to gendered expectations and differences in emotional processing [ 2 , 7 , 18 , 19 , 20 ]. Higher levels of occupational burnout and compassion fatigue observed among younger participants were found to be associated with the professional challenges they face, potentially reflecting cumulative exposure to occupational stressors and increasing personal responsibilities [ 1 ]. The higher levels of secondary trauma, occupational burnout, and compassion fatigue observed among university and postgraduate degree holders compared with high school graduates were attributed to their greater responsibilities in the workplace, increased exposure to others’ traumatic experiences, and heavier workloads. These findings regarding educational level are consistent with results reported in the literature [ 21 , 22 , 23 ]. 4.2. Emotional labour in disaster responders In the present study, genuine emotional expression was found to be higher among older participants, females, and married individuals, suggesting that life experience, gender-related socialisation patterns, and interpersonal responsibilities may influence the authenticity of emotional display in disaster response contexts. These findings align with prior research indicating that demographic characteristics can shape emotional regulation strategies and the propensity for genuine expression in high-stress occupational settings [ 9 , 24 ]. Interestingly, shift-based personnel reported significantly lower surface acting scores compared with those working fixed day or 24-hour shifts, potentially reflecting differences in job demands, team dynamics, or adaptation to rotating schedules. This contrasts with literature linking irregular working hours to higher emotional strain [ 10 ] and warrants further investigation to clarify contextual and organisational factors driving these patterns. 4.3. Emotional labour and ıts ınterplay with compassion fatigue The positive correlation between compassion fatigue and emotional labour indicates that the demands of emotional regulation may amplify the psychological toll of disaster work. Surface acting, in particular, was moderately correlated with both secondary traumatic stress and occupational burnout. This aligns with findings that surface acting is more emotionally taxing than deep acting or genuine expression, as it requires suppression of authentic feelings and sustained emotional dissonance [ 9 , 10 ]. Interestingly, compassion fatigue was negatively correlated with genuine emotions but positively correlated with surface acting and emotional labor, suggesting that authenticity in emotional display may serve as a protective factor against compassion fatigue. This supports the notion that interventions aimed at enhancing authentic emotional engagement, rather than promoting constant emotional suppression, could foster resilience [ 24 ]. 4.4. Contextualising findings in the disaster response setting Disaster settings pose unique psychosocial risks compared to routine emergency care. Extended deployments, exposure to mass casualties, and the moral weight of decision-making under resource constraints can intensify both compassion fatigue and emotional labour demands [ 25 ]. In Türkiye, EMS and UMKE personnel are often redeployed to multiple disasters within short timeframes, compounding these stressors [ 12 ]. The significant role of working style, years of service, and professional title in predicting outcomes highlights the need for differentiated support strategies. For example, shift-based paramedics with long service histories may benefit from structured debriefings, shorter deployment rotations, and tailored mental health interventions. Limitations This study has several limitations that should be considered when interpreting the findings. First, the cross-sectional design precludes causal inferences between compassion fatigue, emotional labour, and sociodemographic or occupational variables. Second, data were collected through self-reported questionnaires, which may be subject to social desirability and recall biases. Third, the study was limited to EMS and UMKE personnel from four provinces in Türkiye; therefore, the findings may not be generalisable to other regions, countries, or non-emergency healthcare workers. Fourth, potential confounders such as prior mental health history, coping styles, and organisational support were not assessed and could influence the observed associations. Finally, while validated instruments were used, cultural nuances in the expression of emotional labour and compassion fatigue may not be fully captured by these scales. 5. Conclusions This study provides empirical evidence that compassion fatigue and emotional labour are interrelated occupational challenges for EMS and UMKE personnel responding to disasters in Türkiye. Specific sociodemographic (e.g., gender, age) and occupational factors (e.g., working style, years of service, professional title) appear to influence these outcomes, highlighting subgroups that may require targeted mental health interventions. Strengthening psychosocial support systems for personnel and implementing regular training and rehabilitation programs are essential to safeguarding the well-being of disaster responders. Leadership commitment is critical, and managers should adopt policies aimed at improving working conditions and fostering a supportive organisational climate. Key measures include limiting deployment durations, expanding access to psychological support services, and enhancing intra-team communication. Personnel deployed to disaster zones should have guaranteed access to psychological counselling both during and after assignments, which is vital for protecting emotional health and preventing burnout, particularly following traumatic events. Better regulation of deployment schedules and increased rest intervals are equally important to maintaining physical and emotional health. For prolonged disaster operations, rotation systems should be implemented to ensure opportunities for recovery and renewal. Training programs focusing on emotional resilience and stress management should be provided to personnel, as such initiatives can raise awareness about emotional labour, promote adaptive coping strategies, and reduce emotional exhaustion. Importantly, overcoming compassion fatigue requires action not only at the individual level but also at the organisational level. For critical response teams such as EMS and UMKE, strengthening intra-team communication and collaboration is essential. Managers should actively monitor staff’s emotional well-being and ensure timely access to professional mental health services when needed. In conclusion, this study demonstrates that the emotional labour and compassion fatigue experienced by EMS and UMKE personnel deployed to disaster zones have profound implications for their professional lives. Developing and implementing preventive strategies is imperative to avoid long-term negative outcomes. Organisational-level interventions will not only enhance staff satisfaction but also contribute to more efficient, sustainable, and high-quality disaster management services. Declarations Ethical approval This study was conducted in accordance with the Declaration of Helsinki and received ethical approval form the Lokman Hekim University Scientific Research Ethics Committee ((Approval No. 2023/200; 23 October 2023). Consent to participate All participants provided informed consent prior to participation in the research. Consent to publication Yes. Clinical trial number Not applicable. Funding No funds were received for this study. Author Contribution MK was the principal investigator and was responsible for the study concept, design, data collection, and overall project supervision. TKT contributed to the research design, supported the data analysis process, and assisted in the interpretation of results. IS was responsible for drafting the manuscript, editing the text, and implementing revisions based on critical feedback. All authors read and approved the final version of the manuscript. Data Availability This study is derived from a master's thesis completed in the Department of Health Management at Lokman Hekim University Institute of Health Sciences. The author confirms that all data generated or analyzed in that thesis are included in this published article. Furthermore, primary and secondary sources and data supporting the findings of this study were publicly available at the time the article was submitted. References Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. https://doi.org/10.3390/ijerph13060618 Baughan, P., Abbot, S., & Jelley, C. (2022). Addressing compassion fatigue in healthcare: A systematic review. 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Cite Share Download PDF Status: Published Journal Publication published 10 Apr, 2026 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Revision requested 21 Jan, 2026 Reviews received at journal 16 Jan, 2026 Reviews received at journal 16 Jan, 2026 Reviewers agreed at journal 09 Jan, 2026 Reviewers agreed at journal 07 Jan, 2026 Reviewers agreed at journal 06 Jan, 2026 Reviewers invited by journal 06 Jan, 2026 Editor invited by journal 18 Dec, 2025 Editor assigned by journal 18 Dec, 2025 Submission checks completed at journal 16 Dec, 2025 First submitted to journal 16 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8337784","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":571088738,"identity":"3dd83ea1-7980-4981-9b23-ca08e9a66ac7","order_by":0,"name":"Tugba Kursun Taskan","email":"","orcid":"","institution":"Ministry of Health, General Directorate of Emergency Health Services","correspondingAuthor":false,"prefix":"","firstName":"Tugba","middleName":"Kursun","lastName":"Taskan","suffix":""},{"id":571088739,"identity":"cc6f2173-e685-43a0-9a99-6520290be71d","order_by":1,"name":"Mevlut Karadag","email":"data:image/png;base64,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","orcid":"","institution":"Lokman Hekim University","correspondingAuthor":true,"prefix":"","firstName":"Mevlut","middleName":"","lastName":"Karadag","suffix":""},{"id":571088740,"identity":"6f6735b0-1c3a-4bc1-b48b-72807555e125","order_by":2,"name":"Ismet Sahin","email":"","orcid":"","institution":"Lokman Hekim University","correspondingAuthor":false,"prefix":"","firstName":"Ismet","middleName":"","lastName":"Sahin","suffix":""}],"badges":[],"createdAt":"2025-12-11 14:38:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8337784/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8337784/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-026-01865-7","type":"published","date":"2026-04-10T15:58:10+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":99812423,"identity":"92d2f4cb-99fa-42e0-b305-03477786e2ee","added_by":"auto","created_at":"2026-01-08 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14:37:24","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":94052,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8337784/v1/69a4ed936ce081c3546c7982.html"},{"id":106809200,"identity":"bb30d8d5-468f-42ad-bd70-9a21698cabae","added_by":"auto","created_at":"2026-04-13 16:08:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":951151,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8337784/v1/ae2f1bc1-bf46-4eba-85b0-7d61ec1a45ee.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A National Cross-Sectional Assessment of Emotional Labor and Compassion Fatigue Among Emergency Response Personnel in Turkey","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eDisasters are unpredictable events that impose substantial physical, emotional, and psychological burdens on affected populations and responders alike. Emergency Medical Services (EMS) and National Medical Rescue Teams (UMKE) constitute the frontline workforce in T\u0026uuml;rkiye\u0026rsquo;s disaster management system, often being the first to witness and respond to mass trauma, injury, and loss of life. Such occupational exposure to repeated traumatic events increases vulnerability to psychosocial stressors, particularly compassion fatigue and heightened emotional labour demands, which in turn can negatively influence both mental health and quality of care [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCompassion fatigue\u0026mdash;first described by Joinson (1992) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] in nurses\u0026mdash;refers to a form of secondary traumatic stress characterised by emotional, physical, and cognitive exhaustion stemming from prolonged exposure to others\u0026rsquo; suffering [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. It has been associated with decreased empathy, professional disengagement, and increased burnout risk [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Within the context of disaster response, repeated high-intensity exposure may amplify compassion fatigue risk, thereby compromising resilience and long-term occupational functioning [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEmotional labour, conceptualised by Hochschild (1983) [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], involves the regulation and expression of emotions to meet organisational and professional expectations. In healthcare, emotional labour requires providers to display empathy, compassion, and composure even under extreme stress [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. While emotional labour can enhance patient satisfaction, sustained emotional regulation in high-pressure environments has been linked to stress, burnout, and mental health decline [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough both constructs have been studied separately, the interplay between compassion fatigue and emotional labour in disaster contexts remains underexplored, particularly among frontline responders in low- and middle-income countries. Limited evidence from T\u0026uuml;rkiye suggests that EMS and UMKE personnel may face unique psychosocial risks due to prolonged deployments, insufficient recovery periods, and intense public expectations during large-scale disasters [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThis study addresses this gap by examining the levels of compassion fatigue and emotional labour among EMS and UMKE personnel deployed to disaster zones in T\u0026uuml;rkiye, and by exploring the influence of sociodemographic and occupational factors. Understanding these relationships is critical for designing targeted interventions to protect the mental well-being and professional sustainability of disaster responders.\u003c/p\u003e"},{"header":"2. Materials and methods","content":"\u003cp\u003e\u003cstrong\u003e2.1. Study design and setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional study was conducted between January and May 2024 among EMS and UMKE personnel in T\u0026uuml;rkiye. The research targeted four provinces\u0026mdash;Ankara, Konya, Kayseri, and Antalya\u0026mdash;selected due to their active deployment of EMS and UMKE teams to recent large-scale disaster zones.\u003c/p\u003e\n\u003cp\u003eThe study followed the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines to ensure methodological transparency and the SAGER (Sex and Gender Equity in Research) guidelines to address gender considerations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2. Participants and sampling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population consisted of all EMS and UMKE personnel employed by the provincial ambulance service directorates and disaster health service units in the four selected provinces. Inclusion criteria were: (1) active duty in disaster response operations during the previous 12 months, (2) at least six months of work experience in current position, and (3) voluntary informed consent. Personnel on administrative leave or with incomplete questionnaire data were excluded.\u003c/p\u003e\n\u003cp\u003eA total of 405 personnel participated, representing a high response rate from the eligible workforce. Participants included a range of professional titles (paramedics, emergency physicians, nurses, and support staff), working in both field and administrative capacities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3. Ethical approval and consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Lokman Hekim University Scientific Research Ethics Committee (Approval No. 2023/200; 23 October 2023). Institutional permissions were granted by the hospital administrations. Participation was voluntary, and informed digital consent was obtained prior to data collection. No personally identifiable information was recorded. All procedures complied with the Declaration of Helsinki and relevant national research ethics regulations. All collected data were stored on password-protected computers accessible only to the research team. Identifiers were not recorded, and anonymized datasets will be securely retained for five years according to institutional data protection policy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4. Instruments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eDemographic and occupational information form \u0026ndash;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eIncluded age, gender, marital status, education level, years of service, working style (shift-based or fixed schedule), unit of work, and professional title.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompassion Fatigue Scale (Revised\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e) \u0026ndash;\u0026nbsp;\u003c/strong\u003eDeveloped by Figley [4] and revised by Adams et al. [13], the scale measures compassion fatigue through subdimensions such as \u0026ldquo;secondary traumatic stress\u0026rdquo; and \u0026ldquo;occupational burnout\u0026rdquo;. Previous studies have demonstrated strong psychometric properties across healthcare settings [13, 14]. The scale comprises five-point Likert-type statements, ranging from 1 (never) to 5 (very often).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEmotional Labour Scale\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u0026ndash;\u0026nbsp;\u003c/strong\u003eDeveloped by Diefendorff et al. [15], this 13-item scale measures \u0026ldquo;surface acting\u0026rdquo;, \u0026ldquo;deep acting\u0026rdquo;, and \u0026ldquo;genuine expression\u0026rdquo;. The Turkish adaptation has demonstrated good validity and reliability among healthcare workers [16]. The scale comprises five-point Likert-type statements, ranging from 1 (at no time) to 5 (at all times).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5. Data collection procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the administration of the data collection tool, consultations were conducted with the directors of the Provincial Ambulance Service Chief Physician\u0026rsquo;s Offices in Ankara, Konya, Kayseri, and Antalya, as designated by the respective Provincial Health Directorates and authorized to grant research approval. The directors were briefed on the study\u0026rsquo;s objectives and scope, and the survey link, developed via Google Forms, was disseminated to 112 EMS and UMKE personnel through these directors to ensure participation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6. Statistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analysed using SPSS version 29.0 and AMOS version 24.0. Descriptive statistics (frequency, percentage, mean, standard deviation, median, minimum, maximum) were computed for demographic and scale variables. Construct validity of both scales was examined via Confirmatory Factor Analysis (CFA) with 10,000 bootstrap resamples, and model fit was evaluated using fit indices (\u0026chi;\u0026sup2;/df, GFI, AGFI, NFI, RFI, RMR, SRMR) according to Hu and Bentler\u0026rsquo;s criteria [17]. Reliability was assessed using Cronbach\u0026rsquo;s alpha coefficients. Group differences were analysed using independent-samples t-tests or Mann\u0026ndash;Whitney U tests for two-category variables, and one-way ANOVA or Kruskal\u0026ndash;Wallis tests for three or more categories, with Bonferroni correction applied to post hoc comparisons. Relationships between continuous variables were assessed using Spearman\u0026rsquo;s rank correlation coefficients. A significance threshold of p \u0026lt; 0.05 (two-tailed) was applied.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1. Participant Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 405 participants were included, comprising EMS (n=343, 84.7%) and UMKE (n=62, 15.3%) personnel. The mean age was 32.43 years (SD = 11.08), with 51.6% female and 48.4% male participants. Most were married (70.4%), held an undergraduate degree (84.0%), and worked in 24 hours shifts schedules (82.5%). 90.6% of the participants were employed as emergency medical technicians or paramedics (Table 1.).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eSociodemographic and occupational characteristics of participants (n = 405)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"68%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 70px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 70px;\"\u003e\n \u003cp\u003e32,43\u0026plusmn;11,08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e51,6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e196\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e48,4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e70,4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e29,6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 29px;\"\u003e\n \u003cp\u003eLevel of education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e6,2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e84,0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003ePostgraduate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e9,9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 29px;\"\u003e\n \u003cp\u003eLength of service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e0-5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e16,8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e6-10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e18,5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e11-15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e33,1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026ge; 16 year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e31,6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 29px;\"\u003e\n \u003cp\u003eWorking type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eDay shift\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e11,4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eShift schedules\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e6,2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e24 hours shifts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e82,5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 29px;\"\u003e\n \u003cp\u003eInstitution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eUMKE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e15,3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eEmergency medical services\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e343\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13px;\"\u003e\n \u003cp\u003e84,7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 29px;\"\u003e\n \u003cp\u003eTitle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eNurse\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e6,7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eEmergency medical technician\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e50,4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eParamedic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e40,2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003eMidvife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e2,7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e3.2. Scale Validity and Reliability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConfirmatory Factor Analysis indicated acceptable model fit for both scales:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eCompassion Fatigue Scale\u003c/em\u003e\u003c/strong\u003e: \u0026chi;2/df: 2,303; GFI: 0,988; AGFI: 0,984; NFI: 0,982; RFI: 0,978; RMR: 0,0633; SRMR: 0,053.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe CFA results indicated that the model demonstrated acceptable fit indices. Factor loadings for the Secondary Trauma subscale ranged from 0.421 to 0.839, while those for the Occupational Burnout subscale ranged from 0.399 to 0.792. All items exhibited positive lower and upper bounds of the 95% confidence interval for factor loadings, and these were statistically significant (p \u0026lt; 0.05). Cronbach\u0026rsquo;s alpha coefficients were 0.752 for Secondary Trauma, 0.844 for Occupational Burnout, and 0.879 for the overall Compassion Fatigue Scale, confirming satisfactory reliability for both subscales and the overall instrument.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eEmotional Labour Scale\u003c/em\u003e\u003c/strong\u003e: \u0026chi;2/df: 2,381; GFI: 0,987; AGFI: 0,980; NFI: 0,978; RFI: 0,973; RMR: 0,063; SRMR: 0,049.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe CFA results indicated that the model demonstrated acceptable fit indices. Factor loadings ranged from 0.683 to 0.808 for the Surface Acting subscale, from 0.741 to 0.838 for the Deep Acting subscale, and from 0.784 to 0.878 for the Genuine Emotions subscale. All items showed positive lower and upper bounds of the 95% confidence interval for factor loadings, and these were statistically significant (p \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eCronbach\u0026rsquo;s alpha coefficients indicated good internal consistency:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eCompassion Fatigue Scale\u003c/em\u003e:\u003c/strong\u003e Cronbach\u0026rsquo;s alpha coefficients were 0.752 for Secondary Trauma, 0.844 for Occupational Burnout, and 0.879 for the overall Compassion Fatigue Scale, confirming satisfactory reliability for both subscales and the overall instrument.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003e\u003cem\u003eEmotional Labour Scale\u003c/em\u003e:\u003c/strong\u003e Cronbach\u0026rsquo;s alpha coefficients were 0.885 for Surface Acting, 0.873 for Deep Acting, 0.864 for Genuine Emotions, and 0.756 for the overall Emotional Labor Scale, confirming satisfactory reliability for all subscales and the overall instrument.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e3.3. Group Comparisons\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistically significant differences in compassion fatigue and its subdimensions based on participants\u0026rsquo; demographic and occupational characteristics were as follows:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eParticipants aged \u0026ge;39 years had lower scores in compassion fatigue (\u0026chi;\u0026sup2; = 6.400, p = 0.041) and occupational burnout (\u0026chi;\u0026sup2; = 10.999, p = 0.004) compared with younger age groups.\u003c/li\u003e\n \u003cli\u003eFemales reported significantly higher levels of secondary trauma than males (Z = \u0026minus;2.427, p = 0.015).\u003c/li\u003e\n \u003cli\u003eParticipants with a postgraduate degree had significantly higher levels of secondary trauma (\u0026chi;\u0026sup2; = 16.673, p \u0026lt; 0.001), occupational burnout (\u0026chi;\u0026sup2; = 20.217, p \u0026lt; 0.001), and overall compassion fatigue (\u0026chi;\u0026sup2; = 22.253, p \u0026lt; 0.001) compared with those with a high school education.\u003c/li\u003e\n \u003cli\u003eShift-based personnel demonstrated significantly lower levels of compassion fatigue (\u0026chi;\u0026sup2; = 10.792, p = 0.005), occupational burnout (\u0026chi;\u0026sup2; = 9.835, p = 0.007), and secondary trauma (\u0026chi;\u0026sup2; = 9.809, p = 0.007) compared with those working day shifts or 24-hour shifts.\u003c/li\u003e\n \u003cli\u003eEmergency medical technicians and paramedics reported significantly higher occupational burnout scores than nurses and midwives (\u0026chi;\u0026sup2; = 11.719, p = 0.020).\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eStatistically significant differences in emotional labour and its subdimensions were as follows:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eFor the Genuine Emotions subscale, higher mean scores were observed among participants aged \u0026ge;39 years compared with younger groups (\u0026chi;\u0026sup2; = 9.885, p = 0.007), among females compared with males (Z = \u0026minus;2.533, p = 0.011), and among married participants compared with single participants (Z = \u0026minus;1.962, p = 0.049).\u003c/li\u003e\n \u003cli\u003eShift-based personnel reported significantly lower scores in the Surface Acting subscale (\u0026chi;\u0026sup2; = 8.158, p = 0.017) compared with those working day shifts or 24-hour shifts.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e3.4. Correlation Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of the Spearman\u0026rsquo;s correlation analysis conducted to examine the relationships between the Compassion Fatigue Scale and the Emotional Labour Scale are presented in Table 2.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eSpearman\u0026rsquo;s correlation analysis findings\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"68%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 41px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eScales\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary trauma\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 19px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupational burnout\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompassion fatigue scale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 33px;\"\u003e\n \u003cp\u003eSurface acting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0,317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,410\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,409\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 33px;\"\u003e\n \u003cp\u003eDeep acting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0,150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,091\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0,002\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,277\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 33px;\"\u003e\n \u003cp\u003eGenuine emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e-0,096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e-0,264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e-0,221\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0,054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 33px;\"\u003e\n \u003cp\u003eEmotional labour scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003er\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e0,280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e0,282\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eBased on these findings:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eSecondary traumatic stress was positively correlated with surface acting (r = 0.317), deep acting (r = 0.150), and the total Emotional Labour Scale score (r = 0.280) (all p \u0026lt; 0.05).\u003c/li\u003e\n \u003cli\u003eOccupational burnout was positively correlated with surface acting (r = 0.410) and the total Emotional Labour Scale score (r = 0.251), but negatively correlated with genuine emotions (r = \u0026ndash;0.264) (all p \u0026lt; 0.05).\u003c/li\u003e\n \u003cli\u003eThe total Compassion Fatigue Scale score was positively correlated with surface acting (r = 0.409) and the total Emotional Labour Scale score (r = 0.282), and negatively correlated with genuine emotions (r = \u0026ndash;0.221) (all p \u0026lt; 0.05).\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e3.5. Regression Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of the regression analysis conducted to examine the effects of the subdimensions of the Emotional Labour Scale on the Compassion Fatigue Scale score are presented in Table 3. In the regression model, the subdimensions of the Emotional Labour Scale were entered as independent variables, and the total score of the Compassion Fatigue Scale was entered as the dependent variable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eRegression analysis findings\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"63%\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eModel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026beta;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e21,415\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e2,674\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e8,008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u0026lt;0,001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eSurface acting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e4,255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,534\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,401\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e7,971\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eDeep acting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,264\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,029\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e0,613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0,540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 29px;\"\u003e\n \u003cp\u003eGenuine emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e-0,565\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e0,532\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14px;\"\u003e\n \u003cp\u003e-0,053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 12px;\"\u003e\n \u003cp\u003e-1,063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 13px;\"\u003e\n \u003cp\u003e0,288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e=0,429 \u0026nbsp; \u003cstrong\u003eR\u0026sup2;\u003c/strong\u003e=0,184 \u0026nbsp; \u003cstrong\u003eAdjusted R\u0026sup2;\u003c/strong\u003e=0,178 \u0026nbsp; \u003cstrong\u003eF\u003c/strong\u003e=30,137 \u0026nbsp; \u003cstrong\u003ep\u003c/strong\u003e=\u003cstrong\u003e\u0026lt;0,001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe analysis revealed that:\u003c/p\u003e\n\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eThe subdimensions of the Emotional Labour Scale explained 17.8% of the variance in the Compassion Fatigue Scale score, and the model was statistically significant (F = 30.137, p \u0026lt; 0.001).\u003c/li\u003e\n \u003cli\u003eSurface acting had a significant positive effect on the Compassion Fatigue Scale score (\u0026beta; = 0.401, p \u0026lt; 0.001).\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study examined compassion fatigue and emotional labour among EMS and UMKE personnel deployed to disaster zones in T\u0026uuml;rkiye, revealing significant associations between these constructs and various sociodemographic and occupational factors. The findings underscore the psychosocial vulnerability of frontline disaster responders and the need for targeted interventions to support their mental well-being.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.1. Compassion fatigue in disaster responders\u003c/h2\u003e \u003cp\u003eThe observed compassion fatigue levels, particularly in burnout and secondary traumatic stress dimensions, are consistent with prior research among healthcare and emergency personnel exposed to high-stress environments [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Interestingly, shift-based workers were found to have significantly lower compassion fatigue scores, a finding that does not align with existing evidence suggesting that irregular working hours and insufficient recovery time exacerbate fatigue and emotional exhaustion [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eFemale personnel reported higher secondary traumatic stress than males, a finding aligned with studies suggesting that women may experience greater emotional strain in caregiving roles due to gendered expectations and differences in emotional processing [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eHigher levels of occupational burnout and compassion fatigue observed among younger participants were found to be associated with the professional challenges they face, potentially reflecting cumulative exposure to occupational stressors and increasing personal responsibilities [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe higher levels of secondary trauma, occupational burnout, and compassion fatigue observed among university and postgraduate degree holders compared with high school graduates were attributed to their greater responsibilities in the workplace, increased exposure to others\u0026rsquo; traumatic experiences, and heavier workloads. These findings regarding educational level are consistent with results reported in the literature [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.2. Emotional labour in disaster responders\u003c/h2\u003e \u003cp\u003e In the present study, genuine emotional expression was found to be higher among older participants, females, and married individuals, suggesting that life experience, gender-related socialisation patterns, and interpersonal responsibilities may influence the authenticity of emotional display in disaster response contexts. These findings align with prior research indicating that demographic characteristics can shape emotional regulation strategies and the propensity for genuine expression in high-stress occupational settings [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInterestingly, shift-based personnel reported significantly lower surface acting scores compared with those working fixed day or 24-hour shifts, potentially reflecting differences in job demands, team dynamics, or adaptation to rotating schedules. This contrasts with literature linking irregular working hours to higher emotional strain [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] and warrants further investigation to clarify contextual and organisational factors driving these patterns.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e4.3. Emotional labour and ıts ınterplay with compassion fatigue\u003c/h2\u003e \u003cp\u003eThe positive correlation between compassion fatigue and emotional labour indicates that the demands of emotional regulation may amplify the psychological toll of disaster work. Surface acting, in particular, was moderately correlated with both secondary traumatic stress and occupational burnout. This aligns with findings that surface acting is more emotionally taxing than deep acting or genuine expression, as it requires suppression of authentic feelings and sustained emotional dissonance [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInterestingly, compassion fatigue was negatively correlated with genuine emotions but positively correlated with surface acting and emotional labor, suggesting that authenticity in emotional display may serve as a protective factor against compassion fatigue. This supports the notion that interventions aimed at enhancing authentic emotional engagement, rather than promoting constant emotional suppression, could foster resilience [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e4.4. Contextualising findings in the disaster response setting\u003c/h2\u003e \u003cp\u003eDisaster settings pose unique psychosocial risks compared to routine emergency care. Extended deployments, exposure to mass casualties, and the moral weight of decision-making under resource constraints can intensify both compassion fatigue and emotional labour demands [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In T\u0026uuml;rkiye, EMS and UMKE personnel are often redeployed to multiple disasters within short timeframes, compounding these stressors [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe significant role of working style, years of service, and professional title in predicting outcomes highlights the need for differentiated support strategies. For example, shift-based paramedics with long service histories may benefit from structured debriefings, shorter deployment rotations, and tailored mental health interventions.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study has several limitations that should be considered when interpreting the findings. First, the cross-sectional design precludes causal inferences between compassion fatigue, emotional labour, and sociodemographic or occupational variables. Second, data were collected through self-reported questionnaires, which may be subject to social desirability and recall biases. Third, the study was limited to EMS and UMKE personnel from four provinces in T\u0026uuml;rkiye; therefore, the findings may not be generalisable to other regions, countries, or non-emergency healthcare workers. Fourth, potential confounders such as prior mental health history, coping styles, and organisational support were not assessed and could influence the observed associations. Finally, while validated instruments were used, cultural nuances in the expression of emotional labour and compassion fatigue may not be fully captured by these scales.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study provides empirical evidence that compassion fatigue and emotional labour are interrelated occupational challenges for EMS and UMKE personnel responding to disasters in T\u0026uuml;rkiye. Specific sociodemographic (e.g., gender, age) and occupational factors (e.g., working style, years of service, professional title) appear to influence these outcomes, highlighting subgroups that may require targeted mental health interventions.\u003c/p\u003e \u003cp\u003eStrengthening psychosocial support systems for personnel and implementing regular training and rehabilitation programs are essential to safeguarding the well-being of disaster responders. Leadership commitment is critical, and managers should adopt policies aimed at improving working conditions and fostering a supportive organisational climate.\u003c/p\u003e \u003cp\u003eKey measures include limiting deployment durations, expanding access to psychological support services, and enhancing intra-team communication. Personnel deployed to disaster zones should have guaranteed access to psychological counselling both during and after assignments, which is vital for protecting emotional health and preventing burnout, particularly following traumatic events. Better regulation of deployment schedules and increased rest intervals are equally important to maintaining physical and emotional health. For prolonged disaster operations, rotation systems should be implemented to ensure opportunities for recovery and renewal.\u003c/p\u003e \u003cp\u003eTraining programs focusing on emotional resilience and stress management should be provided to personnel, as such initiatives can raise awareness about emotional labour, promote adaptive coping strategies, and reduce emotional exhaustion. Importantly, overcoming compassion fatigue requires action not only at the individual level but also at the organisational level. For critical response teams such as EMS and UMKE, strengthening intra-team communication and collaboration is essential. Managers should actively monitor staff\u0026rsquo;s emotional well-being and ensure timely access to professional mental health services when needed.\u003c/p\u003e \u003cp\u003eIn conclusion, this study demonstrates that the emotional labour and compassion fatigue experienced by EMS and UMKE personnel deployed to disaster zones have profound implications for their professional lives. Developing and implementing preventive strategies is imperative to avoid long-term negative outcomes. Organisational-level interventions will not only enhance staff satisfaction but also contribute to more efficient, sustainable, and high-quality disaster management services.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical approval\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and received ethical approval form the Lokman Hekim University Scientific Research Ethics Committee ((Approval No. 2023/200; 23 October 2023).\u003c/p\u003e\n\u003ch2\u003eConsent to participate\u003c/h2\u003e\n\u003cp\u003eAll participants provided informed consent prior to participation in the research.\u003c/p\u003e\n\u003ch2\u003eConsent to publication\u003c/h2\u003e\n\u003cp\u003eYes.\u003c/p\u003e\n\u003ch2\u003eClinical trial number\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eNo funds were received for this study.\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eMK was the principal investigator and was responsible for the study concept, design, data collection, and overall project supervision. TKT contributed to the research design, supported the data analysis process, and assisted in the interpretation of results. IS was responsible for drafting the manuscript, editing the text, and implementing revisions based on critical feedback. All authors read and approved the final version of the manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThis study is derived from a master\u0026apos;s thesis completed in the Department of Health Management at Lokman Hekim University Institute of Health Sciences. The author confirms that all data generated or analyzed in that thesis are included in this published article. Furthermore, primary and secondary sources and data supporting the findings of this study were publicly available at the time the article was submitted.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCocker, F., \u0026amp; Joss, N. (2016). 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Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses. Journal of Nursing Scholarship, 47(2), 186\u0026ndash;194. https://doi.org/10.1111/jnu.12122\u003c/li\u003e\n\u003cli\u003eZhang, L., Xu, Y., \u0026amp; Zhang, J. (2023). Compassion fatigue in emergency healthcare workers: A systematic review and meta-analysis. International Emergency Nursing, 66, 101226. https://doi.org/10.1016/j.ienj.2022.101226\u003c/li\u003e\n\u003cli\u003eLi, Y., Cao, F., Cao, D., \u0026amp; Liu, J. (2022). Compassion fatigue in frontline healthcare workers during COVID-19: A systematic review and meta-analysis. Journal of Psychiatric Research, 149, 89\u0026ndash;99. https://doi.org/10.1016/j.jpsychires.2022.03.033\u003c/li\u003e\n\u003cli\u003eHochschild, A. R. (1983). The managed heart: Commercialization of human feeling. University of California Press.\u003c/li\u003e\n\u003cli\u003eMann, S. (2021). The effects of emotional labour on employee work outcomes. Work, Employment and Society, 35(1), 154\u0026ndash;171. https://doi.org/10.1177/0950017020929166\u003c/li\u003e\n\u003cli\u003eYoon, S. L., Kim, J. H. (2020). Job-related stress, emotional labour, and depressive symptoms among Korean nurses. Journal of Nursing Management, 28(3), 540\u0026ndash;548. https://doi.org/10.1111/jonm.12957\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;zdemir, H., Aksu, A., \u0026amp; Erbil, N. (2023). Emotional labour and burnout among emergency medical technicians in T\u0026uuml;rkiye: The mediating role of resilience. Australasian Emergency Care, 26(4), 345\u0026ndash;352. https://doi.org/10.1016/j.auec.2023.06.005\u003c/li\u003e\n\u003cli\u003eTopkara, T., Yıldız, M., \u0026amp; Kaya, E. (2024). Mental health challenges among UMKE personnel after earthquake response: A cross-sectional study. Prehospital and Disaster Medicine, 39(1), 45\u0026ndash;53. https://doi.org/10.1017/S1049023X23001148\u003c/li\u003e\n\u003cli\u003eAdams, R. E., Boscarino, J. A., \u0026amp; Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103\u0026ndash;108. https://doi.org/10.1037/0002-9432.76.1.103\u003c/li\u003e\n\u003cli\u003eStamm, B. H. (2010). The concise ProQOL manual. Pocatello, ID: ProQOL.org. \u003c/li\u003e\n\u003cli\u003eDiefendorff, J. M., Croyle, M. H., \u0026amp; Gosserand, R. H. (2005). The dimensionality and antecedents of emotional labour strategies. Journal of Vocational Behavior, 66(2), 339\u0026ndash;357. https://doi.org/10.1016/j.jvb.2004.02.001\u003c/li\u003e\n\u003cli\u003eBasım, H. N., \u0026amp; Beğenirbaş, M. (2012). The role of resilience in the relationship between emotional labour and burnout in nurses. Journal of Psychiatry and Neurological Sciences, 25(3), 194\u0026ndash;202. https://doi.org/10.5350/DAJPN2012250302\u003c/li\u003e\n\u003cli\u003eHu, L., \u0026amp; Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1\u0026ndash;55. https://doi.org/10.1080/10705519909540118\u003c/li\u003e\n\u003cli\u003eUrnek, S. (2023). Merhamet Yorgunluğu ve Duygusal Emek İlişkisi. Sağlık ve Hemşirelik Y\u0026ouml;netimi Dergisi, 10(3):358-367. https://doi.org/10.54304/SHYD.2023.34392\u003c/li\u003e\n\u003cli\u003ePolat, F. (2017). Merhamet Yorgunluğu D\u0026uuml;zeyinin \u0026Ccedil;alışma Yaşam Kalitesi ile İlişkisi: Sağlık Profesyonelleri \u0026Ouml;rneği. S\u0026uuml;leyman Demirel \u0026Uuml;niversitesi Sosyal Bilimler Enstit\u0026uuml;s\u0026uuml; Dergisi, 26: 291 \u0026ndash; 312.\u003c/li\u003e\n\u003cli\u003e\u0026Ouml;zen, Y.M., Y\u0026uuml;celer, A. (2019). 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Merhametin Sağlık Hizmetlerindeki Yeri ve \u0026Ouml;nemi. Sinop \u0026Uuml;niversitesi Sosyal Bilimler Dergisi, 2(1), s: 181-204.\u003c/li\u003e\n\u003cli\u003eSinclair, S., Raffin-Bouchal, S., Venturato, L., Mijovic-Kondejewski, J., \u0026amp; Smith-MacDonald, L. (2017). Compassion fatigue: A meta-narrative review of the healthcare literature. International Journal of Nursing Studies, 69, 9\u0026ndash;24. https://doi.org/10.1016/j.ijnurstu.2017.01.003\u003c/li\u003e\n\u003cli\u003eShih, F. J., Turale, S., Lin, Y. S., Gau, M. L., Kao, C. C., Yang, C. Y., ... \u0026amp; Liao, Y. M. (2022). Surviving a tsunami: Perspectives of frontline nurses and emergency personnel in disaster preparedness and response. International Journal of Nursing Studies, 126, 104151. https://doi.org/10.1016/j.ijnurstu.2021.104151\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Compassion fatigue, emotional labour, disaster response personnel, Turkey","lastPublishedDoi":"10.21203/rs.3.rs-8337784/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8337784/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eObjective\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThis aimed to examine the levels of emotional labour and compassion fatigue among 112 Emergency Medical Services (EMS) and National Medical Rescue Team (UMKE) personnel deployed in disaster zones, and to explore their associations with sociodemographic and occupational factors.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA cross-sectional study was conducted between January and May 2024 among 405 EMS and UMKE personnel from Ankara, Konya, Kayseri, and Antalya provinces in Turkey. Data were collected using a three-part questionnaire: demographic form, the Compassion Fatigue Scale (revised by Adams et al.), and the Emotional Labour Scale (developed by Diefendorff et al.). Confirmatory factor analyses with bootstrap resampling (n\u0026thinsp;=\u0026thinsp;10,000) assessed construct validity, and Cronbach\u0026rsquo;s alpha coefficients evaluated reliability. Group comparisons were performed using t-tests, ANOVA, Mann\u0026ndash;Whitney U, and Kruskal\u0026ndash;Wallis tests, with Bonferroni correction for multiple comparisons. Spearman\u0026rsquo;s correlation examined relationships between variables.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eSignificant differences in compassion fatigue and its subdimensions were observed by age, gender, marital status, education level, working style, and professional title (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Emotional labour scores also varied significantly by age, gender, marital status, education level, and working style (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Positive correlations were found between compassion fatigue and emotional labour dimensions, suggesting a psychosocial interplay between these constructs in high-stress disaster contexts.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003eFindings highlight the psychosocial burden faced by emergency medical and disaster response personnel in Turkey\u0026rsquo;s disaster zones. Targeted mental health support, resilience-building interventions, and organisational strategies are essential to mitigate compassion fatigue and manage emotional labour demands in this population.\u003c/p\u003e","manuscriptTitle":"A National Cross-Sectional Assessment of Emotional Labor and Compassion Fatigue Among Emergency Response Personnel in Turkey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-08 13:55:29","doi":"10.21203/rs.3.rs-8337784/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-21T17:49:59+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-16T22:14:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-16T12:49:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"59751898966689196691245898494577273641","date":"2026-01-09T07:41:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"7421019141789200020968430190655839939","date":"2026-01-07T21:18:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"20906511170099512386796583328069752742","date":"2026-01-06T14:20:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-06T14:15:51+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-18T18:19:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-18T05:41:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-16T11:22:55+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-12-16T10:41:56+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ddc77331-54e8-46c5-86b3-09419335caa1","owner":[],"postedDate":"January 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-13T16:04:24+00:00","versionOfRecord":{"articleIdentity":"rs-8337784","link":"https://doi.org/10.1186/s12982-026-01865-7","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2026-04-10 15:58:10","publishedOnDateReadable":"April 10th, 2026"},"versionCreatedAt":"2026-01-08 13:55:29","video":"","vorDoi":"10.1186/s12982-026-01865-7","vorDoiUrl":"https://doi.org/10.1186/s12982-026-01865-7","workflowStages":[]},"version":"v1","identity":"rs-8337784","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8337784","identity":"rs-8337784","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}