This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic.

A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm’s Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn’s test was then applied to determine whether groups differed from each other.

On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions.

Despite high compassion satisfaction, most surveyed health care providers from Ecuador’s public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.

Overweight and obesity are growing problems for primary care. Although effective weight management programs exist, these programs experience significant attrition, which limits effectiveness.

This study examined provider and staff perceptions of attrition from the Veterans Health Administration MOVE!® Weight Management Program as an initial step toward understanding attrition from primary care-based programs.

MOVE!® clinicians, primary care providers, and other staff members who interacted with patients about participating in MOVE!® (n=754) from Department of Veterans Affairs medical centers throughout the United States. Respondents were predominantly female (80.8%), Caucasian (79.2%), and trained as nurses (L.P.N., R.N., or N.P.; 50%).

Participants completed a web-mediated survey; items assessed agreement with personal and programmatic reasons for dropout, and allowed respondents to indicate the number one reason for dropout in an open-ended format. This survey was adapted from an existing tool designed to capture patient perceptions.

Respondents indicated that veterans experienced practical barriers to attendance (eg, transportation and scheduling difficulties) and desire for additions to the program (eg, a live exercise component). Low motivation was the primary factor identified by respondents as associated with dropout, particularly as noted by MOVE!® clinicians (versus other providers/staff; P<0.01).

These findings suggest that programmatic changes, such as adding additional meeting times or in-session exercise time, may be of benefit to MOVE!®. In addition, increasing the use of techniques such as Motivational Interviewing among providers who refer patients to MOVE!® may improve participant engagement in MOVE!® and other primary care-based weight management programs. Further research is needed to effectively identify those likely to withdraw from weight management programs before achieving their goals, and the reasons for withdrawal.