Byrne, Matthew

AbstractRegistered nurses increasingly work in remote care and digital interaction roles, offering flexibility and expansion of their scope of practice. These roles may expose nurses to digital compassion fatigue, a phenomenon proposed to be characterized by the negative psychological and emotional impact of caring for patients remotely through the use of technology.The first objective of this work is to propose the phenomenon of “digital compassion fatigue” as a potentially further evolved and differentiated form of “compassion fatigue.” The second objective is to produce a comparative analysis of attributes, antecedents, and consequences through literature reviews.An evolutionary concept analysis approach was selected as a guide for exploring, discussing, and defining the new concept of digital compassion fatigue. Concept analysis was selected given the need for a framework that accounts for the dynamic nature of technology and practice. The process of conducting a concept analysis includes consideration of diverse and multidisciplinary perspectives. As a result, those in caring, educational, and/or support service roles (e.g., social work, counseling, and teaching) for which distance suffering and technostress could feasibly be present were also included in the literature searches and reviews. Health care-specific studies often included nurses in the sample but may not have differentiated their specific insights or data points in the results.The concept analysis explored the attributes, antecedents, and consequences of digital compassion fatigue, differentiating it from its evolutionary parent, compassion fatigue. Key antecedents included technostress, distant suffering, and the unique challenges of delivering care remotely. A major confounding variable was the COVID-19 pandemic, which may have heightened or introduced new technology-related stressors or highlighted the existence of digital compassion fatigue.Further defining and understanding digital compassion fatigue is crucial for developing effective strategies to support nurses who may experience it or who are at risk.

Parkinson’s disease (PD) is thought to be caused by a combination of genetic and environmental factors. Bacterial or viral infection has been proposed as a potential risk factor, and there is supporting although not entirely consistent epidemiologic and basic science evidence to support its role. Encephalitis caused by influenza has included parkinsonian features. Epidemiological evidence is most compelling for an association between PD and hepatitis C virus. Infection with Helicobacter pylori may be associated not only with PD risk but also response to levodopa. Rapidly evolving knowledge regarding the role of the microbiome also suggests a role of resident bacteria in PD risk. Biological plausibility for the role for infectious agents is supported by the known neurotropic effects of specific viruses, particular vulnerability of the substantia nigra and even the promotion of aggregation of alpha-synuclein. A common feature of implicated viruses appears to be production of high levels of cytokines and chemokines that can cross the blood-brain barrier leading to microglial activation and inflammation and ultimately neuronal cell death. Based on multiple avenues of evidence it appears likely that specific bacterial and particularly viral infections may increase vulnerability to PD. The implications of this for PD prevention requires attention and may be most relevant once preventive treatments for at-risk populations are developed.