Epub 2019 Nov 13. According to Quenot et al. Although the last two studies addressed relevant issues, it may be difficult to identify changeable determinants in the work setting to prevent the consequences of emotional distress. A systematic search in the computerized databases of Embase, Medline OvidSP, Cinahl, Web-of-science, PsychINFO, PubMed publisher, Cochrane and Google Scholar has been performed. It has been associated with a ‘helper syndrome’ that results from continuous disappointing situations and leads to moral distress . Compassion fatigue reportedly affects 16% to 39% of registered nurses, with most reports coming from nurses working in areas like hospice, oncology, and emergency care. e0136955. This distancing behaviour was used as a coping mechanism, “You are going through the motions but there is some disconnect… (you're) not really feeling their suffering” (Austin et al., 2009, p. 204). Two studies reported the prevalence of compassion fatigue as 7.3% and 40%; five studies described the prevalence of secondary traumatic stress ranging from 0% to 38.5%. The emotional toll of the experience of continuous stress had a direct effect on deterioration of important intimate relationships and in caring (Austin et al., 2009; Perry et al., 2011). Subsequently, more agreement is needed to address the discrepancies in measurement issues, and to better investigate emotional distress with a large international quantitative observational multicenter study. All studies were set within an ICU, Critical Care Unit, Neonatology Intensive Care Unit or Pediatric Intensive Care Unit, and were applicable to healthcare professionals i.e. An increased knowledge about compassion fatigue helped, but attending workshops and continuing education opportunities were also useful (Perry et al., 2011). Noblit and Hare's (1988) meta‐ethnographic approach was used to guide the analysis. Metasynthesis offers a means of more fully illuminating compassion fatigue and further understanding of practices which might reduce its negative consequences. Three studies were conducted in Canada, five in the USA and one in Australia. reported a prevalence rate of 68.0% with BO defined as a high score on any BO symptom, and 45% for the emotional exhaustion subscale . One participant said, “…I had the ability to do more, withstand more, help more…more, more, more without help…it took its toll”. However, a study using the ProQOL in an academic hospital with 68 nurses in the United States did not find a severe risk for S/PTS . The restriction in language could also have caused an incomplete overview of the relevant studies.