{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:16:26Z","timestamp":1773137786487,"version":"3.50.1"},"posted":{"date-parts":[[2026,3,6]]},"group-title":"Occupational and Environmental Health","reference-count":30,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>Compassion fatigue is a well-documented hazard among healthcare and veterinary professionals, yet the psychological toll on informal caregivers of feral cat colonies, likely numbering several tens of thousands in Portugal, remains largely unexplored. This cross-sectional study examines internal and external factors associated with the secondary traumatic stress component of compassion fatigue among 172 informal caregivers in Portugal. Secondary traumatic stress refers to work-related secondary exposure to individuals who have experienced extremely stressful or traumatic events. Structured telephone interviews assessed sociodemographics, colony management, compassion satisfaction, resilience, spiritual well-being, and perceived social support. Univariate and multivariable linear regression identified predictors of secondary traumatic stress. Results indicate that 47% of participants experienced moderate secondary traumatic stress, and 10% reported high levels. Multivariable analysis revealed that caring for large colonies (more than 25 cats) and being unemployed were significantly associated with higher fatigue. Conversely, older age, higher perceived family support, and the resilience dimension of serenity served as protective factors. Interestingly, finding meaning in life was positively correlated with fatigue, suggesting that caregivers who perceive their role as central to their life purpose may become more emotionally invested, increasing vulnerability to distress when unable to help animals. Official colony registration and formal institutional support did not significantly alleviate fatigue. These findings highlight that institutional support alone is insufficient to mitigate fatigue among informal caregivers, who experience significant distress driven by both practical burdens and profound emotional involvement. The most frequently reported concern among caregivers was the inability to cover the costs of feeding and veterinary care for the cats. Interventions must address both external needs (e.g., support to cover veterinary and feeding expenses for the cats) and internal coping mechanisms. Implementing psychosocial support alongside trap-neuter-return programs may also improve caregiver well-being and foster sustainable urban feral cat management. This underscores a One Health perspective, demonstrating that animal health is closely interconnected with human well-being and environmental health.<\/jats:p>","DOI":"10.64898\/2026.03.05.26347725","type":"posted-content","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T19:40:21Z","timestamp":1772826021000},"source":"Crossref","is-referenced-by-count":0,"title":["Internal and External Protective Factors Associated with the Secondary Traumatic Stress Component of Compassion Fatigue, in Feral Cat Caregivers"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7109-1101","authenticated-orcid":false,"given":"Cristina","family":"Costa-Santos","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculdade de Medicina Universidade do Porto, Porto, Portugal"},{"name":"RISE-Health,, Faculdade de Medicina Universidade do Porto, Porto, Portugal"}]},{"given":"Rui","family":"Vidal","sequence":"additional","affiliation":[{"name":"Dire\u00e7\u00e3o Geral de Alimenta\u00e7\u00e3o e Veterin\u00e1ria (DGAV), Portugal"}]},{"given":"Sara","family":"Lisboa","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculdade de Medicina Universidade do Porto, Porto, Portugal"}]},{"given":"Paulo","family":"Vieira-de-Castro","sequence":"additional","affiliation":[{"name":"Independent Researcher, Porto, Portugal"}]},{"given":"Ana","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences (ECAV), University of Tr\u00e1sos-Montes and Alto Douro (UTAD), Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5160-7043","authenticated-orcid":false,"given":"Ivone","family":"Duarte","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences, Faculdade de Medicina Universidade do Porto, Porto, Portugal"},{"name":"RISE-Health,, Faculdade de Medicina Universidade do Porto, Porto, Portugal"}]}],"member":"54368","reference":[{"key":"2026030913000875000_2026.03.05.26347725v1.1","unstructured":"Stamm, B.H. (2010). The Concise ProQOL Manual, 2nd Ed. Pocatello, ID: ProQOL.org."},{"key":"2026030913000875000_2026.03.05.26347725v1.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2012.05985.x"},{"key":"2026030913000875000_2026.03.05.26347725v1.3","unstructured":"Figley CR . Compassion fatigue as secondary traumatic stress disorder: An overview. In: Figley CR , editor. Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatised. New York: Routledge; 1995. p. 1\u201320."},{"key":"2026030913000875000_2026.03.05.26347725v1.4","doi-asserted-by":"crossref","unstructured":"Klimecki O , Singer T. Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and social neuroscience. In: Oakley B , Knafo A , Madhavan G , Wilson DS , editors. Pathological altruism. Oxford: Oxford University Press; 2012. p. 368\u2013383.","DOI":"10.1093\/acprof:oso\/9780199738571.003.0253"},{"key":"2026030913000875000_2026.03.05.26347725v1.5","doi-asserted-by":"publisher","DOI":"10.1093\/scan\/nst060"},{"key":"2026030913000875000_2026.03.05.26347725v1.6","doi-asserted-by":"crossref","first-page":"103973","DOI":"10.1016\/j.ijnurstu.2021.103973","article-title":"The prevalence of compassion satisfaction and compassion fatigue among nurses: A systematic review and meta-analysis","volume":"120","year":"2021","journal-title":"Int J Nurs Stud"},{"issue":"2","key":"2026030913000875000_2026.03.05.26347725v1.7","doi-asserted-by":"crossref","first-page":"e70023","DOI":"10.1111\/inr.70023","article-title":"Interventions to Reduce Compassion Fatigue in Nursing: A Systematic Review and Meta-Analysis of Controlled Studies","volume":"72","year":"2025","journal-title":"Int Nurs Rev"},{"issue":"11","key":"2026030913000875000_2026.03.05.26347725v1.8","doi-asserted-by":"crossref","first-page":"e1975","DOI":"10.1002\/vetr.1975","article-title":"Veterinarians\u2019 experiences of treating cases of animal abuse: An online questionnaire study","volume":"191","year":"2022","journal-title":"Vet Rec"},{"issue":"7","key":"2026030913000875000_2026.03.05.26347725v1.9","doi-asserted-by":"crossref","first-page":"739","DOI":"10.2460\/javma.247.7.739","article-title":"Taking stock and making strides toward wellness in the veterinary workplace","volume":"247","year":"2015","journal-title":"J Am Vet Med Assoc"},{"issue":"5","key":"2026030913000875000_2026.03.05.26347725v1.10","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2460\/javma.245.5.513","article-title":"The role of veterinary team effectiveness in job satisfaction and burnout in companion animal veterinary clinics","volume":"245","year":"2014","journal-title":"J Am Vet Med Assoc"},{"issue":"10","key":"2026030913000875000_2026.03.05.26347725v1.11","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1002\/vetr.77","article-title":"Is veterinary work more than satisfying? A critical review of the literature","volume":"188","year":"2021","journal-title":"Vet Rec"},{"issue":"2","key":"2026030913000875000_2026.03.05.26347725v1.12","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1080\/13811118.2024.2363223","article-title":"Suicide Risk in Veterinary Professionals in Portugal: Prevalence of Psychological Symptoms, Burnout, and Compassion Fatigue","volume":"29","year":"2025","journal-title":"Arch Suicide Res"},{"issue":"5","key":"2026030913000875000_2026.03.05.26347725v1.13","doi-asserted-by":"crossref","first-page":"3489","DOI":"10.1007\/s11259-024-10510-0","article-title":"Life satisfaction, psychological distress, compassion satisfaction and resilience: when the pleasure of helping others protects veterinary staff from emotional suffering","volume":"48","year":"2024","journal-title":"Vet Res Commun"},{"key":"2026030913000875000_2026.03.05.26347725v1.14","doi-asserted-by":"publisher","DOI":"10.1126\/science.1139518"},{"key":"2026030913000875000_2026.03.05.26347725v1.15","doi-asserted-by":"crossref","unstructured":"Ferreira JP , Leit\u00e3o I , Santos-Reis M , Revilla E. Human-Related Factors Regulate the Spatial Ecology of Domestic Cats in Sensitive Areas for Conservation. PLoS ONE. 2011; 6(10).","DOI":"10.1371\/journal.pone.0025970"},{"key":"2026030913000875000_2026.03.05.26347725v1.16","unstructured":"Azevedo A , Peste F , Linck P , Carvalho J , Crawshaw D , Ferreira E , et al. Censo Nacional de Animais Errantes - 2023. Relat\u00f3rio final. Departamento de Biologia & CESAM, Universidade de Aveiro, Aveiro; 2023."},{"issue":"17","key":"2026030913000875000_2026.03.05.26347725v1.17","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.3390\/ani14172478","article-title":"Evaluation of Population Management Based on Trap\u2013Neuter\u2013 Return and Trap\u2013Neuter\u2013Adoption Practices in a Free-Roaming Cat Colony in the Federal District, Brazil","volume":"14","year":"2024","journal-title":"Animals"},{"issue":"10","key":"2026030913000875000_2026.03.05.26347725v1.18","doi-asserted-by":"crossref","first-page":"768","DOI":"10.3390\/ani9100768","article-title":"Back to school: An updated evaluation of the effectiveness of a long-term trap-neuter-return program on a university\u2019s free-roaming cat population","volume":"9","year":"2019","journal-title":"Animals"},{"key":"2026030913000875000_2026.03.05.26347725v1.19","unstructured":"One Health High-Level Expert Panel (OHHLEP). (2022). One Health definition and principles"},{"key":"2026030913000875000_2026.03.05.26347725v1.20","unstructured":"Ramalho-Santos, J. (2023). Integra\u00e7\u00e3o disciplinar e governan\u00e7a: O conceito de \u201cOne Health\u201d nos seus labirintos. In J. Ramalho-Santos & S. Horta (Coords.), One Health: Um planeta, uma sa\u00fade, uma \u00e9tica (Cole\u00e7\u00e3o Bio\u00e9tica). Lisboa: Conselho Nacional de \u00c9tica para as Ci\u00eancias da Vida."},{"key":"2026030913000875000_2026.03.05.26347725v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.prevetmed.2010.07.003"},{"key":"2026030913000875000_2026.03.05.26347725v1.22","doi-asserted-by":"crossref","unstructured":"Deep C , Leal I. Adapta\u00e7\u00e3o da \u201cthe resilience scale\u201d para a popula\u00e7\u00e3o adulta portuguesa. Psicol USP. 2012;23(2).","DOI":"10.1590\/S0103-65642012005000008"},{"key":"2026030913000875000_2026.03.05.26347725v1.23","first-page":"285","article-title":"Vers\u00e3o Portuguesa do Question\u00e1rio de Bem-Estar Espiritual (SWBQ): An\u00e1lise confirmat\u00f3ria da sua estrutura factorial","volume":"10","year":"2009","journal-title":"Psicol Sa\u00fade Doen\u00e7as"},{"key":"2026030913000875000_2026.03.05.26347725v1.24","unstructured":"Stamm BH . The ProQOL Manual: The Professional Quality of Life Scale: Compassion Satisfaction, Burnout & Compassion Fatigue\/Secondary Trauma Scales. Baltimore: Sidran Press; 2005."},{"key":"2026030913000875000_2026.03.05.26347725v1.25","unstructured":"Carvalho P. Estudo da fadiga por compaix\u00e3o nos cuidados paliativos em Portugal: Tradu\u00e7\u00e3o e adapta\u00e7\u00e3o cultural da Escala Professional Quality of Life-5 [Master\u2019s thesis]. Porto: Universidade Cat\u00f3lica Portuguesa; 2011."},{"issue":"XXXV","key":"2026030913000875000_2026.03.05.26347725v1.26","first-page":"529","article-title":"Professional quality of life in nurses: Contribution for the validation of the Portuguese version of the Professional Quality of Life Scale-5 (ProQOL-5)","volume":"4","year":"2017","journal-title":"An\u00e1lise Psicol\u00f3gica"},{"key":"2026030913000875000_2026.03.05.26347725v1.27","doi-asserted-by":"publisher","DOI":"10.1016\/S0191-8869(03)00045-X"},{"issue":"2","key":"2026030913000875000_2026.03.05.26347725v1.28","first-page":"165","article-title":"Development and psychometric evaluation of the Resilience Scale","volume":"1","year":"1993","journal-title":"J Nurs Meas"},{"key":"2026030913000875000_2026.03.05.26347725v1.29","doi-asserted-by":"publisher","DOI":"10.1207\/s15327752jpa5201_2"},{"key":"2026030913000875000_2026.03.05.26347725v1.30","doi-asserted-by":"crossref","unstructured":"Carvalho P. Caracter\u00edsticas psicom\u00e9tricas da vers\u00e3o portuguesa da Escala Multidimensional de Suporte Social Percebido (Multidimensional Scale of Perceived Social Support - MSPSS). Psychologica. 2011.","DOI":"10.14195\/1647-8606_54_13"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.64898\/2026.03.05.26347725","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:00:23Z","timestamp":1773086423000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.64898\/2026.03.05.26347725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":30,"URL":"https:\/\/doi.org\/10.64898\/2026.03.05.26347725","relation":{},"subject":[],"published":{"date-parts":[[2026,3,6]]},"subtype":"preprint"}}