Repeated exposure to trauma narratives and professional quality of life in palliative and end-of-life healthcare providers

Objectives This study examined how repeated exposure to trauma narratives influences professional quality of life, including burnout, secondary traumatic stress (STS), and compassion satisfaction (CS), among end-of-life healthcare providers. The moderating roles of resilience and both organizational and personal support were also tested. Methods A cross-sectional online survey was completed by 507 healthcare providers working in hospice, oncology, or other end-of-life settings. Participants completed validated self-report measures assessing exposure to trauma narratives (Vicarious Trauma Scale [VTS]), professional quality of life (ProQOL-5), resilience (STARS-6), organizational support (SPOS), and social support (MSPSS). Hierarchical regression and moderation analyses were conducted to evaluate main and interaction effects. Results Greater exposure to trauma narratives was significantly associated with higher burnout (β =.37, p <.001) and STS (β =.42, p <.001), and with lower CS (β = −.13, p =.004). Higher resilience and organizational support predicted greater CS and lower burnout and STS. A significant VTS × resilience interaction indicated that resilience buffered the association between exposure to trauma narratives and STS (β = −.10, p =.009). Conclusions Repeated exposure to trauma narratives is a meaningful occupational stressor for end-of-life clinicians. Resilience and organizational support appear to protect against the negative impact of trauma exposure and promote CS, highlighting key multilevel targets for trauma-informed workforce interventions. Significance of results This study addresses a critical gap by clarifying how repeated trauma narratives specifically influence burnout, Secondary Traumatic Stress (STS), and Compassion Satisfaction (CS) within the unique context of end-of-life care. The results provide a nuanced framework for understanding how clinicians maintain empathic presence despite chronic emotional demands. Furthermore, by identifying specific resilience factors and support systems that buffer against psychological distress, these findings offer actionable insights for developing targeted interventions to mitigate long-term professional harm.