Empathy levels among nursing students: A comparative cross-sectional study

A study of latent profile analysis of empathic competence and factors influencing it in nursing interns: a multicenter cross-sectional study

Background

Empathy, as one of the fundamental principles of nursing professionalism, plays a pivotal role in the formation and advancement of the nursing team. Nursing interns, as a reserve force within the nursing team, are of significant importance in terms of their ability to empathize. This quality is not only directly related to the degree of harmony in the nurse-patient relationship and the enhancement of patient satisfaction, but also plays a pivotal role in the promotion of the quality of nursing services to a new level.

Aim

The objective of this study was to gain a deeper understanding of the current state of nursing interns' empathic abilities. To this end, we sought to examine empathic performance under different profile models and to identify the key factors influencing these profile models.

Methods

The study utilized 444 nursing interns from 11 tertiary general hospitals in Inner Mongolia as research subjects. The study employed a number of research tools, including demographic characteristics, the Jefferson Scale of Empathy, and the Professional Quality of Life Scale. A latent profile model of nursing interns' empathy ability was analyzed using Mplus 8.3. The test of variability of intergroup variables was performed using the chi-square test. Finally, the influencing factors of each profile model were analyzed by unordered multi-categorical logistic regression analysis.

Results

The overall level of empathy among nursing interns was found to be low, with 45% belonging to the humanistic care group, 43% exhibiting low empathy, and 12% demonstrating high empathy. The internship duration, empathy satisfaction, secondary traumatic stress, only child, place of birth, and satisfaction with nursing were identified as factors influencing the latent profiles of empathy in nursing interns (p < 0.05).

Conclusion

There is considerable heterogeneity in nursing interns' ability to empathize. Consequently, nursing educators and administrators should direct greater attention to interns with lower empathy and develop targeted intervention strategies based on the influences of the different underlying profiles.

Empathy in Nursing Students: A Scoping Review

Purpose: Empathy is essential for nursing students as they progress through their education. To date, few review studies explored empathy in nursing students. This review examined empathy in nursing students, including how to promote empathy, factors contributing to empathy, and the evaluation of empathy. Design: The eligible population included undergraduate nursing students. The concept of interest was empathy related to nursing students. The context was undergraduate nursing programs. Eligible studies included quantitative, qualitative, and mixed-method studies. The protocol was registered in Open Science Framework (OSF). Review Methods: Joanna Briggs Institute Reviewers' Manual guided this scoping review protocol. MEDLINE with Full text (EBSCO), Scopus, ScienceDirect (Elsevier), and PubMed were used for the electronic database search. The findings were analyzed with descriptive statistics and thematic analysis. Findings: A total of 94 articles were included for analysis. Three main themes emerged: (1) approaches to promoting empathy, (2) contributing factors to empathy, and (3) evaluation of empathy. Conclusions: Empathy is cultivated in nursing in numerous ways, highlighting the need to incorporate it into the nursing curriculum. There is also controversy regarding the relationship between empathy and individual characteristics. This finding highlights the need for more effective empathy-promoting educational training that considers these personal characteristics.

The role of evidence-based practice and empathy in shared decision-making attitudes among newly graduated nurses: A cross-sectional study

AIM

Examine the levels of variables and explore drivers associated with shared decision-making attitudes among newly graduated nurses.

DESIGN

This was a descriptive and cross-sectional study.

METHODS

From August 2022 to October 2022, a cross-section of 216 newly graduated nurses from four comprehensive A-level hospitals in northern China was recruited using convenience sampling. Newly graduated nurses are generally defined as nurses with a service period of six months to one year. Data were collected using an online questionnaire support platform, including the Nursing Shared Decision-Making Attitude scale, Jefferson scale of Empathy-Health profession students and the Health Sciences Evidence-Based Practice questionnaire. All data were analysed descriptively, and correlational analysis and hierarchical regression were used to make identical connections between variables.

RESULTS

Newly graduated nurses supported shared decision-making. Perceptions of shared decision-making were correlated with the experiences of empathy and evidence-based practice. Additionally, perspective-taking of empathy and beliefs, and the ability to search for and apply existing scientific findings of evidence-based practice had a significant impact on more positive attitudes.

CONCLUSION

The survey showed that acceptance of shared decision-making was positive among newly graduated nurses. Clinical nursing managers and teachers should pay attention to cultivating the evidence-based practice and empathy of newly graduated nurses to adopt an optimistic attitude towards shared decision-making in the long term.

IMPACT

The survey addresses attitudes of shared decision-making among newly graduated nurses and determines whether empathy and evidence-based practice has an impact on it. The main finding is that newly graduated nurses have an optimistic outlook on the implementation of shared decision-making. This survey showed that empathy and evidence-based practice competencies are associated with shared decision-making attitudes among newly graduated nurses. The results of this survey have an impact on educational institutions and hospitals in the form of recommendations. Several training programmes on empathy and evidence-based practice can help adopt the shared decision-making attitudes of newly graduated nurses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Levels and predictors of empathy, self-awareness, and perceived stress among nursing students: a cross sectional study

BACKGROUND

High levels of empathy and self-awareness and low level of stress among nursing students are the core elements of improving patients' care and outcomes. The purpose of this study is to assess the levels, relationships, and predictors of empathy, self-awareness, and perceived stress in a sample of undergraduate Jordanian nursing students.

METHODS

A descriptive cross-sectional design was employed to collect data from 330 students using a web-based survey.

RESULTS

The total mean scores of empathy, self-awareness, and perceived stress were 75.75, 40.17, and 55.65, respectively. Students who are studying in public universities, with higher GPA, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of empathy. Students with lower income level, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of self-awareness. Female students, those who sleeping 6 h and less, did not get a balanced diet or perform exercise, studying in public universities, lower GPA, have intention to leave nursing, and did not satisfy with nursing; reported higher level of perceived stress.

CONCLUSIONS

Nursing students reported adequate empathy level, low self-awareness level, and moderate perceived stress level. Students who are satisfied and have no intention to leave nursing reported higher level of empathy, self-awareness, and perceived stress. It is necessary to conduct interventional programs that enhance students' well-being especially empathy and self-awareness, and reduce the level of their stress.

Resilience and empathy in pharmacy interns: Insights from a three-year cohort study

Background

Resilience and empathy are important attributes for healthcare professionals to navigate challenging work environments and providing patient-centred care. Knowledge about pharmacists' levels of resilience and empathy, particularly during the early stages of their careers, is limited.

Objectives

To explore pharmacy interns' levels of resilience and empathy using the Connor-Davidson-Resilience-Scale-25 (CD-RISC-25) and the Kiersma-Chen-Empathy-Scale (KCES), examine potential associations with demographic characteristics and ascertain what challenges interns' resilience and which support mechanisms they identify.

Methods

Hard copies of the surveys were distributed to three cohorts during face-to-face intern pharmacy workshops from 2020 to 2022. Additionally, a qualitative questionnaire explored interns' experiences while completing an accredited internship program during the COVID-19 pandemic. Data were analysed using descriptive and inferential statistics, open-ended questions were analysed through qualitative and quantitative content analysis.

Results

Among 134 completed surveys, most respondents were female, aged 18-22, and worked in hospitals. The CD-RISC-25 mean score was 66.6 (SD 11.7) and the KCES mean was 84.3 (SD 9.23) indicative of intermediate levels of resilience and empathy. Resilience and empathy scores did not significantly differ between the three cohorts (p-value > 0.05), and both were not consistently correlated with each other (p-value > 0.05). No significant associations were found between demographic characteristics and resilience scores. However, age and pre-internship employment history showed a statistically significant association with empathy scores (p-value < 0.05), with younger age groups and those who worked part-time during undergraduate studies demonstrating higher levels of empathy. Challenges undermining interns' resilience included the COVID-19 pandemic, internship requirements, and feelings of inadequacy and inexperience.

Conclusions

This study showed that resilience and empathy scores among interns were at what can be regarded as intermediate levels, largely unaffected by the COVID-19 pandemic or cohort demographics. It highlights professional aspects and strategies which are professionally sustaining and may assist interns in navigating challenges to their resilience and empathy.

The impact of theory of mind, stress and professional experience on empathy in Romanian community nurses-a cross-sectional study

BACKGROUND

High empathy levels in health professionals represent an important factor in patient satisfaction and compliance, reducing patient anxiety and pain, enhancing diagnostic and clinical results and strengthening patient empowerment. Our purpose was to determine empathy level and to identify which of the socioeconomic status (SES) and psychological factors were able to predict highest empathy levels in a Romanian sample of community nurses.

METHODS

Community nurses were invited in January-February 2023 to provide an answer to an online survey, using an advertisement in a professional network. 1580 participants voluntarily agreed to take part in this study, with a response rate of 85.8%. The survey included the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and socio-economic status items. A multivariate model for the prediction of belonging to the highest quartile of empathy as opposed to lowest quartile was constructed using SES and psychological variables as factors.

RESULTS

The mean (SD) empathy level was 49.1 (6.7), with 74.7% of participants over the threshold of high empathy level. In the multivariate analysis, predictors of belonging to the highest quartile of TEQ, as opposed to the lowest quartile were: low self-perceived stress level (OR = 2.098, 95%CI 1.362-3.231), higher experience as a community nurse (OR = 1.561, 95%CI 1.120-2.175) and higher levels of the theory of mind (OR = 1.158, 95%CI 1.118-1.199), when controlling for gender, age, relationship status, presence of children in families, education, and income.

CONCLUSIONS

Training programs targeting to increase emotional competences, reduce levels of stress and encourage personnel retention have the potential to increase the quality of community nursing in Romania.

Attitudes toward Patient-Centred Care, Empathy, and Assertiveness among Students in Rehabilitation Areas: A Longitudinal Study

This study assessed attitudes toward patient-centred care, empathy, assertiveness, and subjective perception of communication skills and technical knowledge among Portuguese undergraduate students in healthcare. These students may develop rehabilitation activities with patients in their person-oriented or technique-oriented professions. Portuguese nursing and allied health students from two public higher education schools completed questionnaires in the first and third academic years: Patient-Practitioner Orientation Scale, Jefferson Scale of Physician Empathy, Scale for Interpersonal Behaviour, and a subjective perception of technical knowledge and communication skills. A total of 183 students completed the surveys. In the first year, students showed moderate to high scores on patient-centredness attitudes, empathy, and assertiveness and perceived themselves as having good communication skills. Students from person-oriented programmes significantly improved their Total and shared patient-centred attitudes in the third year compared with students attending technique-oriented professions. Significant differences in empathy were found between groups in the third year. Distress associated with assertive behaviours increased significantly across time in students from technique-oriented programmes compared with their peers in person-oriented programmes. The results suggest that the health profession's orientation and the programmes' specific curriculum might have a role in how some dimensions evolved in the two groups of students. The increasing assertiveness-related discomfort highlighted the importance of assessing and monitoring students' emotional wellbeing during their initial interactions with patients.

Experience of verbal violence among Chinese nursing students in clinical practice: a qualitative study

BACKGROUND

Workplace violence is prevalent in the nursing profession, and as a relatively junior link of the professional hierarchy, nursing students are not immune to it. Among these, verbal violence may have more serious consequences for the victims than physical violence, but the literature on verbal violence among nursing students in Chinese clinical settings is limited.

AIMS

To explore the verbal violence experience among Chinese nursing students in clinical practice, and the strategies used by nursing students to cope with violence.

DESIGN

A descriptive qualitative study.

METHODS

From January 2022 to June 2022, semi-structured interviews were conducted with 21 nursing students in clinical practice by purposive snowball sampling. Nvivo12 software and inductive content analysis were used for data analysis. This paper followed the COREQ (Consolidated criteria for Reporting Qualitative Research) guidance.

RESULTS

Through data analysis, three themes were defined:(1) Multiform verbal violence; (2) Hurting and impacting and (3) Struggling or Coping. The findings indicated that nursing students were subjected to multiple forms of verbal violence in clinical practice, not only from patients and caregivers, but also from peers such as clinical tutors and doctors, which not only harmed students' personal health and well-being, but may also contribute to the nursing industry's future loss of human resources. Seeking emotional support from others and forcing themselves to grow up were the most commonly used coping strategies.

CONCLUSION

Nursing educators and nursing managers need to pay attention to verbal violence in the clinical environment, and actively develop the ability of nursing students to deal with uncivilized behavior. Establishing relevant courses and training such as communication, resilience, and violence prevention, establishing a stricter clinical mentor appointment system, and teaching assessment system may be strategies to help nursing students better perform clinical practice.

Beyond scientific and technical training: Assessing the relevance of empathy and assertiveness in future physiotherapists: A cross-sectional study

Background and Aims

Empathy and assertiveness are two essential social skills for a health professional such as a physiotherapist and are necessary for developing moral thinking. Previous studies show that the development of empathy and other social skills improves as students progress in their studies. However, other authors show deterioration of empathy as students progress in their studies and acquire clinical experience. Training in soft skills, such as assertiveness, among health science students will have an impact on the quality of patient care. Effective communication, conflict resolution and the ability to work as part of a team are competencies that have been put to one side as a result of the recent COVID-19 pandemic and it is important to resume training students in soft skills. The objective of this study is to investigate to determine the empathic and assertive state of physiotherapy university students.

Methods

A descriptive cross-sectional study of physiotherapy university students was conducted in the 2022/2023 academic year. The Interpersonal Reactivity Index (IRI) scales for empathy and the Rathus test for assertiveness (RAS) were used as study tools. Finally, 127 students participated in the study, 52.91% of the total population of physiotherapy students. The questionnaire was available for 4 weeks in November and December 2022.

Results

The empathetic and assertive development of the students was found to be acceptable. Significant differences were also observed according to the gender variable in the students, with female students presenting better results (p = 0.01). Students who are working or have clinical experience in other professions score lower on the empathy personal distress subscale (p < 0.001).

Conclusion

Future research should be considered to help improve clinical and professional expertise in physiotherapy students about empathic and assertive development. The findings provide new evidence on the levels of empathy and assertiveness in physiotherapy students.

A study of empathy levels among nursing interns: a cross-sectional study

BACKGROUND

Empathy is one of the therapeutic communication techniques used to help the client feel better. However, there are a few studies have investigated level of empathy among enrollers at nursing colleges. The aim was to examine the level of self-reported empathy among nursing interns.

METHODS

The study was a descriptive, cross-sectional in nature. A total of 135 nursing interns fill in the Interpersonal Reactivity Index from August to October 2022. Data was analyzed through the SPSS program. An independent -sample t-test and one way- ANOVA was used to explore differences in the degree of empathy with respect to academic and sociodemographic factors.

RESULTS

The results of this study showed that nursing interns showed a mean level of empathy of 67.46 (SD = 18.86). This result indicated that the nursing interns have moderate levels of empathy overall. There was statistical significant difference in the mean level of subscales of perspective-taking and empathic concern between males and females. Additionally, nursing interns who are less than 23 years old scored high in the subscale of perspective-taking. Married nursing interns and who preferred nursing as a profession scored higher in the subscale of empathic concern than unmarried ones and who did not preferred nursing as a profession.

CONCLUSION

Perspective taking incresed with younger male nursing interns, this reflects high cognitive flexibility with younger age nursing interns. Morover, the empathic concern incresed with male married nuring interns who preferred nursing as a profession. This implies that they should engage in continuous reflection and educational activities as part of their clinical training as nursing interns in order to improve their empathic attitudes.

Effects of weight bias training on student nurse empathy: A quasiexperimental study

AIM

This study aimed to identify the efficacy of weight bias training on the empathy skills of student nurses when working with a person with obesity.

BACKGROUND

Weight bias with nurses harboring negative attitudes towards patients with obesity results in inferior care and patients' reluctance to seek medical care. Empathy is a communication skill used in nursing to build trust and rapport with patients to provide optimal patient-centered care.

METHODS

This study used a quasi-experimental design with 121 undergraduate nursing students in their first semester of the nursing program. The students completed learning activities on weight bias, including reading an article on weight bias, watching a video showing an individual with obesity's experiences in the healthcare setting and participating in a group discussion and reflection on the article and video. In addition, students completed the Jefferson Scale of Empathy-Health Professions Students' version before and after the learning activities. Following the learning activities, students participated in a simulation activity with a standardized patient wearing an obesity suit. The standardized patient completed the Jefferson Scale of Patient Perceptions of Nurse Empathy to rate the patient's perception of the nursing student's level of empathy based on their interactions in the simulation scenario.

RESULTS

A comparison of the scores on the Jefferson Scale of Empathy-HPS showed there was not a significant difference in the scores before learning activities (M = 15.45, SD = 12.7) and post-learning activities (M = 15.94, SD = 11.5); t(120) = 0.476, p = .635. Data analysis identified significant changes in empathy scores on the Jefferson Scale of Empathy-HPS in the accelerated second-degree cohort with differences in scores before learning activities (M = 113.7, SD = 10.5) and post-learning activities (M = 116.5, SD = 13.4); t(50) = 2.02, p = .049. The traditional cohort did not have a significant change in empathy scores. Empathy scores and the patient's perception of empathy scores showed no relationship. Most (79 %) of the patient's perception of empathy scores was moderate. Student comments in this study support the findings that some nursing students harbor weight bias towards individuals with obesity.

CONCLUSION

There is a need to identify learning activities that eliminate weight bias in the nursing student population and result in the student's ability to demonstrate appropriate communication skills and nursing behaviors in a nondiscriminatory manner to the patient with obesity. To improve empathy behaviors, students should practice communication skills throughout the nursing curriculum.

Empathy ability of nursing students: A systematic review and meta-analysis

BACKGROUND

Empathy is an ability that nursing students need in clinical practice, there is no available data to assess nursing students' empathy ability level . The main purpose of this study is to synthesize the evidence relating to the empathy ability in nursing students to systematically evaluate the empathy ability level among nursing students.

METHODS

Adhering to the preferred reporting items for Systematic Reviews and Meta-analyses guidelines, we searched PubMed, Cochrane, Web of Science, Scopus, ScienceDirect, Wiley Library, Embase, CNKI, Wanfang, and China biomedical literature service system ten databases to collect cross-sectional studies on nursing students' empathy ability. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies.

RESULTS

A total of 19 cross-sectional studies were included. The sample comprised 5407 nursing students. Meta-analysis showed that females have a higher empathy ability than males, and the empathy ability of rural students is higher than that of provincial students.

CONCLUSIONS

The findings suggest that the empathy ability among nursing students worldwide is higher, but there needs further improvement. This result makes nursing educators pay more attention to the cultivation of the nursing students' empathy ability; improving the empathy level is beneficial in improving the standards of health care and patients' quality of life.

Compassionate communication levels of nursing students: Predictive role of empathic skills and nursing communication course

PURPOSE

This study aims to determine the compassionate communication levels of nursing students and the predictive roles of empathic skills and nursing communication courses.

DESIGN AND METHODS

This descriptive study was conducted with 430 nursing students and data were analyzed using a descriptive information form, Compassionate Communication Scale (CCS), and Empathic Skill Scale (ESS).

FINDINGS

A positive relationship was found between the students' ESS and CCS scores (r = .23 p = 0.001). Empathic skills (β = 0.43, p = 0.001), predicted compassionate communication (β = 0.23, p = 0.001), compassionate conversation (β = 0.43, p = 0.001), and compassionate touch (β = 0.18, p = 0.001).

PRACTICE IMPLICATIONS

Skills of compassion and empathy positively affect each other; therefore, it is important to adopt strategies that strengthen the empathic skills of nursing students during academic education and to include empathy and compassion in the curriculum.

The role of spiritual intelligence in predicting the empathy levels of nurses with COVID-19 patients

AIM

Given the prolongation of the newly emerging COVID-19 pandemic and the significance of caring for the patients by nursing staff, investigating and planning for the different psychological dimensions of this group is of paramount importance. Hence, this study investigated the role of spiritual intelligence in predicting nurses' empathizing with COVID-19 patients.

METHODS

This descriptive-correlation study was conducted in 2021 on nurses caring for COVID-19 patients in three public hospitals. The researchers used two standard questionnaires, including the Jefferson Scale of Empathy (JSE) and Spiritual Intelligence (SI), for data collection. The collected data were analyzed in SPSS16 using descriptive statistics and the following: The Mann-Whitney U test, Kruskal-Wallis test, Regression, chi-square test, and Pearson and Spearman correlations.

RESULTS

The statistical population consisted of 338 nurses with an average age of 34 and ten years of work experience. There was a significant positive relationship between the empathy scores and spiritual intelligence scores of the nurses caring for COVID-19 patients (P < 0.05). It was also concluded from the regression analysis that, spiritual intelligence affect empathy. Mean score of empathy was higher in hospitals where more nursing staff had MSc degrees. There was a significant difference between the empathy scores of the three hospitals (P < 0.05).

CONCLUSION

The results indicated that there is a positive relationship between empathy and spiritual intelligence. Therefor improving spiritual intelligence is the appropriate strategy to ameliorate empathy during the COVID19 pandemic. At the same time, study indicated attention to the issue of nurses' mental health. Hence, it was suggested to incorporate these issues in the training programs and national/international decisions.

Telephone nurses' perceived stress, self-efficacy and empathy in their work with frequent callers

Aim

To examine telephone nurses' perceived stress, self‐efficacy and empathy in their work with answering calls from frequent callers.

Design

The study is a quantitative questionnaire survey study with a comparative design.

Methods

Telephone nurses (N = 199) answered a survey containing three instruments: Perceived Stress Scale, General Self‐Efficacy Scale and Jefferson's Scale of Empathy. Correlation analysis, multiple regression analysis and analysis of variance were performed to test the research questions.

Results

Significant negative correlations were found between stress involving calls from FCs and self‐efficacy (r = −.238), and significant negative correlations between stress involving calls from frequent callers and empathy (r = −.185). It was further revealed that telephone nurses who had worked less than 30 years scored higher on Jefferson's Scale of empathy than those who had worked more than 30 years, F(1, 183) = 4.98, η² = 0.027.

Relationship between emotional intelligence and job well-being in Chinese clinical nurses: multiple mediating effects of empathy and communication satisfaction

BACKGROUND

Nursing work is associated with great pressure, and nurses are often overwhelmed. Therefore, correct emotional regulation is essential to improve nurses' job well-being and promote better engagement in nursing work. The purpose of this study was to establish a structural model to estimate the impact of Chinese clinical nurses' emotional intelligence on job well-being, using multiple intermediaries to explain the internal mechanisms underlying the relationship.

METHODS

This was a cross-sectional study of 1475 registered nurses from a Chinese hospital who provided responses to emotional intelligence, empathy, communication satisfaction, and job well-being scales. Path analysis using a multiple mediation model was performed using AMOS 23.0.

RESULTS

Among all clinical nurses who participated in the survey, 1475 (98.33 %) completed the questionnaire. The nurses' job well-being score was 83.61 ± 12.63. There was a significant positive correlation between job well-being and communication satisfaction, emotional intelligence, and empathy ability (r = 0.346-0.570, P < 0.001). Empathy and communication satisfaction partially mediated the relationship between emotional intelligence and job well-being, with effect sizes of 0.047 and 0.227, respectively. The chain mediating effect of empathy and communication satisfaction had a value of 0.045.

CONCLUSIONS

It is recommended that hospital managers take actions to improve nurses' emotional intelligence level, and conduct professional psychological training to improve nurses' empathy and communication satisfaction, and ultimately improve their job well-being.

A training course on interpersonal relationships using role play in a Master of Mental Health Care programme - The students' experiences

OBJECTIVES

To study how Master Students of Mental Health Care experienced role play as an educational method that strengthened their relational competence.

DESIGN

The study was qualitative with an exploratory descriptive design.

SETTINGS

Relational competence training course during the Master of Mental Health Care programme INFORMANTS: Master students in a Mental Health Care programme METHODS: Data from open-ended questions were analysed using qualitative content analysis based on Graneheim and Lundman.

RESULTS

The following three categories were identified: A deeper understanding of self and others, Different positions and situations provide comprehensive understanding and Engagement strengthens relational competence.

CONCLUSIONS

The study demonstrated that extensive use of role play, in which the students took on the roles of patient, healthcare professional and observer, combined with theoretical preparations and reflections seemed to elicit some of the humanistic values and attitudes central for strengthening relational competence.

Nurse with smile: Does it make difference in patients' healing?

Smiling is a highly significant component of nurses' caring behavior. Nurses have to deal with too many people at workplace and interpersonal relation building is the key secret for quality work and also enhances job satisfaction. A genuine smile given by a nurse can do wonders as it conveys acceptance, builds trust and establishes inter-personal relationship. It also helps nurses to feel better and avoid anxiety or stress burnout in clinical situation. This paper of ours highlights the importance of nurses' smile in patients' recovery and important research literature to support smiling culture among health-care professionals.

Evaluation of empathy among undergraduate nursing students: a three-year longitudinal study

BACKGROUND AND AIM

An empathic approach is considered fundamental in order to ensure the identification of patient needs and to provide the appropriate care, although the studies on the development of empathic attitude during nursing course reported conflicting results. Different empathic tendencies have been observed in the two genders: many studies showed greater empathy in females.

METHODS

To assess empathy level of students enrolled in the academic year 2015/16 at an Italian University nursing course, the Balanced Emotional Empathy Scale (BEES) was administered at the start of Year 1 (n=118), at the mid-point of Year 2 (n=99) and at the end of Year 3 (n=67). Data were statistically analyzed.

RESULTS

Cronbach's values were satisfactory (0.87 at Year 1, 0.89 at Year 2, 0.79 at Year 3), confirming the good internal reliability of BEES. The nursing students obtained a total BEES mean ± SD score of 37.0 ± 19.5 at Year 1, 33.5 ± 22.6 at Year 2 and 35.4 ± 16 at Year 3, without any statistically significant difference among the three years. The BEES mean scores reported by males were lower in comparison with females during the three years of the course, although, at the end of the third year, males showed a significant increase at the "Emotional spread responsiveness" dimension of the scale.

CONCLUSIONS

The study suggests that empathy can be maintained at good levels during the nursing education especially if nursing teaching and internship are focused on this topic, acting up the innate aptitude of each student.