Introducing nursing practice to student nurses: How can we promote care compassion and empathy

Exploring levels of empathy and assertiveness in final year physiotherapy students during clinical placements

Empathy and assertiveness are two essential soft skills for any healthcare professional's competence and ethical development. It has been shown that empathy can be influenced throughout the training of a future healthcare professional, particularly during the clinical placement period. This research aims to assess fourth-year physiotherapy students' empathic and assertive development before and after clinical placement. A longitudinal observational study was conducted with fourth-year physiotherapy students during the academic year 2022/2023. A preliminary assessment of empathy and assertiveness levels was carried out before the start of the clinical placement and at the end of the placement using the Individual Reactivity Index to assess empathy and the Rathus Test to assess assertiveness. The results show a statistically significant difference (p ≤ 0.05) in both the empathy subscales of perspective-taking and empathic-concern between the pre- and postassessment, as well as an inverse correlation between the empathy subscale of personal distress and assertiveness. It is concluded that students show adequate results in empathy and assertiveness. However, there is some influence of clinical practice on the development of empathy, and future intervention studies need to be considered. Furthermore, students with higher levels of assertiveness have lower levels of personal distress, suggesting that assertiveness is closely related to empathy.

Evaluating the Effectiveness of Empathy-Based Education in Undergraduate Nursing: A Scoping Review

BACKGROUND

Empathy is an essential trait in nursing practice that improves the quality of patient care. Nursing curricula that incorporate empathy-based experiential learning (i.e., hands-on educational experiences and reflections designed to foster and develop emotional intelligence) promote students' self-awareness and confidence when providing care to patients. This scoping review examined studies that explored the effects of educational interventions on the development of empathy in undergraduate nursing students.

METHOD

Searches were conducted in MEDLINE using keywords related to nursing education and translated into CINAHL, EMBASE, and ERIC databases.

RESULTS

A total of 6,238 studies were identified. After duplicate and unrelated articles were excluded, 18 publications were considered for this review. Sixteen studies concluded empathy interventions were effective, five indicated the need for further research, and two implicated a need for standardization in empathy-evaluation tools.

CONCLUSION

This review endorses the effectiveness of educational interventions and supports their implementation to promote empathy in undergraduate nursing students. [J Nurs Educ. 2024;63(6):367-371.].

"Stereotype embodiment theory"-based intervention to reduce ageism in Japan: Integration with interventions to encourage life planning among younger people

To solve the problems related to the ageing society, effective strategies to reduce younger people's ageism towards older adults should be developed. Previous studies incorporated the content of stereotype embodiment theory (SET) into ageism reduction strategy, suggesting that younger participants' ageism eventually has undesirable impacts on their own future (i.e., SET intervention). In the SET intervention, participants read an explanatory text on several empirical findings related to SET. To enhance the versatility of this intervention, two experiments were conducted with younger participants in Japan. Study 1 examined concerns that arise in the practical application of the intervention. Results revealed that the SET intervention had few effects on fear of death and increased state self-esteem. In Study 2, the SET intervention was combined with interventions to encourage life planning, in which they freely described possible negative/positive events in their future. SET intervention reduced ageism, increased advocacy for policies to support older adults and increased emphasis on life planning and hope for the future. Many previous studies have shown that intergenerational contact-based interventions are effective in reducing ageism, and future research should be conducted in combination with the SET interventions.

Understanding the communication skills that support nurses to provide person-centred care

Communication is a process of sharing information and developing relationships through interaction. It is essential for nursing care, providing a basis for nurses to establish therapeutic relationships and trust with patients and their families. It is often assumed that nurses can intuitively communicate well; as a result, traditionally there has been a lack of formal training in this area. However, communication is a skill that can be developed and enhanced. This article explains the elements of communication and discusses the skills required by nurses to communicate effectively and provide compassionate, person-centred care. The author outlines two communication models to demonstrate how nurses can use these skills to deliver bad news and support people in distress.

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.

Understanding the Patient's Perspective on Nursing Excellence: Insights From Patient Experience Data

This performance improvement project leverages patient experience data to better understand patient preferences and values with respect to care from nurses. Through the analysis of both quantitative and qualitative data collected in patient experience surveys, the authors explore the concept of nursing excellence from the patient's perspective and discuss practical approaches, based on the Compassionate Connected Care model, to achieve desired improvement goals for nursing.

Effects of video-recorded role-play and guided reflection on nursing student empathy, caring behavior and competence: A two-group pretest-posttest study

AIM

The study examined the differences in nursing student empathy, caring behavior and competence between the experimental and control groups before and after educational intervention and to predict the factors affecting their core competencies.

BACKGROUND

Educating nursing students in empathy and caring behaviors before entering clinical practice is challenging.

DESIGN

We used a two-group pretest and post-test quasi-experimental design.

METHODS

First-year nursing students from medical schools in Taiwan participated in our study. Data were collected between March and May 2022. The learning method used with the intervention group was role-playing with videos and guided reflection. The control group was exposed to traditional curriculum. Empathy, caring behavior and competence were measured using the Jefferson Scale of Empathy- Healthcare Providers, the Caring Behaviors Scale and the Nursing Student Competence Scale.

RESULT

A total of 72 participants (40 in the experimental group and 32 in the control group) were included in the final statistical analysis. The response rate was 92%. Statistically significant differences in nursing student empathy, caring behavior and competence were observed between the experimental and control groups (p < .05). The η² effect levels were 0.083, 0.223 and 0.270. Higher caring behavior scores were significantly associated with higher nursing student competence scores (β = 0.81, 95% CI:0.66-0.97).

CONCLUSIONS

Education based on video role-play and guided reflection improved empathy, caring behavior and nursing competence in first-year nursing students.

Humanities-Based Educational Preparation and Empathy in Novice Nurses: Critical Thinking and Analytic Practice

ABSTRACT

Empathy has been associated with improved patient outcomes in practicing nurses, but empathy levels have been shown to decline in nursing students with increased clinical exposure. Integrating content from the humanities in the nursing classroom, not common in nursing education, supports professional empathy development and maintenance. Whether competencies gained from humanities-based liberal education courses support empathy in nursing students as they emerge into practice is not known. The purpose of this quantitative, nonexperimental, descriptive, pilot research was to explore the relationship between humanities-based liberal education and empathy in recently graduated, baccalaureate-prepared practicing nurses ( n = 40).

Mediating effect of workplace violence on the relationship between empathy and professional identity among nursing students

Background

Studies have reported that empathy had a positive effect on professional identity (PI) in nursing students. However, little was known about the mechanism underlying this relationship between empathy and professional identity in nursing students.

Objective

The purpose of this study was to analyze in depth the mediating effect of workplace violence (WVP) between empathy and professional identity in nursing students.

Methods

A total of 405 nursing students participated and were investigated using the Chinese version of the Jefferson Scale of Empathy-Health Professional (JSE-HP), the scale of professional identity about nursing students, and the workplace violence Incident Survey in this study. Hierarchical regression was used to analyze the mediating effect of workplace violence on the relationship between empathy and professional identity among nursing students.

Results

The score of nursing students' professional identity was 103.69 ± 17.79. Workplace violence had a significant negative correlation with empathy (r = -0.449, P < 0.001) and professional identity (r = -0.330, P < 0.001). Workplace violence accounted for 14.59% of the total mediating effect on the relationship between empathy and professional identity for nursing students.

Conclusions

In this study, the level of professional identity of nursing students was low. Workplace violence had a partially significantly mediating effect on the relationship between empathy and professional identity. Maybe, it was suggested that nursing students' professional identity might be improved and driven by a decrease in workplace violence. Targeted interventions at reducing nursing students' workplace violence should be developed and implemented. In addition, nursing managers and educators should be aware of the importance of empathy and improve professional identity in nursing students.

Ethical challenges of death faced by nursing undergraduates in clinical practice: A qualitative study

BACKGROUND

The characteristics of nursing work determine that nursing practice is inseparable from ethical considerations and decision-making. Nursing students have difficulty in dealing with death and it is necessary to explore the ethical challenges faced by nursing undergraduates in the process of clinical practice of nursing dead or dying patients.

OBJECTIVE

To explore the ethical challenges faced by undergraduate nursing students in nursing of dead or dying patients.

DESIGN

This study was conducted with a phenomenological approach in a qualitative design.

SETTINGS, PARTICIPANTS, METHODS

The purposive sample of the study consisted of 35 nursing undergraduates in their last year of education at the bachelor level in nursing who had experience of clinical practice. They voluntarily participated in the study. Data were collected through semi-structured interviews and analyzed using the Colaizzi analysis method.

RESULTS

Through analysis of interviews, four themes were identified: (1) Distant death is coming-inadequate preparation; (2) Making decisions between the needs of different positions-difficult balance; (3) Experience a patient's death up close-irresistible resistance; (4) Providing bereavement care after a patient's death-insurmountable obstacle.

CONCLUSION

This study shows that nursing undergraduates face ethical challenges in the process of caring for dead or dying patients and the early identification of these ethical challenges is of great significance. University and hospital leaders should pay attention to the ethic and death education of nursing undergraduates so as to help nursing students prepare for clinical practice.

The relationship between nursing students' professional attitudes and caring behaviors: A cross-sectional study

PURPOSE

This study aimed to determine the relationship between nursing students' professional attitudes and caring behaviors.

DESIGN AND METHODS

The research is a cross-sectional, descriptive, and correlational study. The study was conducted with 202 nursing students. The participation rate was 95%.

FINDINGS

The total Instrument of Professional Attitude for Student Nurses mean score was 106.708 ± 20.24 and the Caring Behaviors Inventory-24 mean score of the nursing students was 5.23 ± 0.88. A positive weak correlation was found between total Instrument of Professional Attitude for Student Nurses scores and sub-dimension scores, and Caring Behaviors Inventory-24 total scores of nursing students (p < .05).

PRACTICE IMPLICATIONS

The present study has demonstrated that the professional attitudes of students positively affect caring behaviors.

Effectiveness of an online short compassion strengths course on nursing students compassion: A mixed methods non-randomised pilot study

BACKGROUND

Although student nurses are expected to demonstrate and show understanding of compassion in their learning and practice, literature suggests that this is not always the case. To address this, nursing students need to be introduced to the value and behaviours of compassion during their education.

OBJECTIVES

To evaluate the effectiveness of an online course to help nursing students develop their strengths and further validate the Bolton Compassion Strengths Indicators.

DESIGN

A pre-and post-mixed methods non-randomised pilot study.

SETTING

A university in the north west of England.

PARTICIPANTS

A sample of first year undergraduate nursing students (67), in two groups, with 33 in the online control and 34 in the on-site group.

METHODS

Both groups took part in the Short Compassion Strengths Course (SCSC). The online group took the course in their own time over a 3-week period, while the on-site group completed the course during their time at University. In both groups baseline assessments were carried out using the Bolton Compassion Strengths Indicator (BCSI). Post-test data were collected 3 weeks after in the online group and immediately after in the on-site group, for the BCSI and reflective accounts. Data were analysed using ANOVA in SPSS27.

RESULTS

The online group did not complete the course but filled out the questionnaires. The on-site group had significantly higher scores on all indicators but self-care and engagement.

CONCLUSIONS

The SCSC is an effective course for teaching and developing compassion strengths when delivered on-site. This paper adds further validity for the BCSI.

Burnout, Self-Efficacy, and Resilience in Haitian Nurses: A Cross-Sectional Study

Purpose of Study: Though nursing burnout is a global problem, research on nurse burnout in Haiti is scarce. In a context of multiple personal, social, and environmental challenges, this study assessed burnout and associated factors among Haitian nurses. Design of Study: A multi-site cross-sectional study. Methods: A survey in French and Haitian Creole was conducted in five Haitian hospitals using forward and back translated scales measuring burnout (emotional exhaustion [EE], depersonalization [DP], personal accomplishment [PA]), self-efficacy, nursing work environment, resilience, and demographics. Findings: Haitian nurses (N = 179) self-reported moderate EE (M = 21, SD = 11.18), low DP (Mdn = 2.0, range = 29), and high personal accomplishment (Mdn = 41.0, range = 33). General self-efficacy (M = 32.31, SD = 4.27) and resilience (M = 26.68, SD = 5.86) were high. Dissatisfaction with salary, autonomy, and staffing were evident. Conclusions: It is noteworthy that burnout was lower than expected given the scarce resource, difficult socio-politico-economic environment. High levels of self-efficacy and resilience likely mitigated a higher level of burnout. Adaptation enables these nurses to manage their critical conditions and practice holistic nursing, which may inspire hope among nurses in similar contexts.

Compassionate practice in a hospital setting. Experiences of patients and health professionals: A narrative inquiry

AIM

To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting.

BACKGROUND

Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients.

DESIGN

Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ).

METHODS

Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework.

RESULTS

Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering.

CONCLUSION

Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting.

IMPACT

Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice.

Improving nursing students' perspective taking, perceptions of humanness, and attitudes toward older adults

Whereas prior work has examined the role of nursing courses in improving empathic skills and reducing dehumanization of older adults, little research has explored how perspective taking and perceptions of humanness of older adults acquired through nursing curricula predict attitudes toward this age group. Nursing students (N = 43) completed surveys at the beginning (Time 1) and end of gerontological coursework (Time 2). Perspective taking and perceived human nature and human uniqueness of older adults increased from Time 1 to Time 2. Perceived human nature of older adults was associated with more positive attitudes at the end of the semester, compared to the beginning. Improved perceptions of the human nature of older adults also predicted lower ageism at the end of the semester. Strategies for improving perspective taking and perceptions of humanness of older adults in nursing courses are discussed.

A journey through roses and thorns: becoming a physician by learning from patients with life-threatening illnesses. A qualitative study with international medical students

The medical students' well-being may be threatened by various stressors associated with providing care to different kinds of patients. This study aims to explore students' clinical experiences with patients who suffer from life-threatening illnesses, focusing on potential risk and protective factors. Audio-recorded and face-to-face interviews were conducted and transcribed verbatim. The "Interpretive Description" approach was used to analyse data. Overall, ten medical students with a mean age of 28 years old were interviewed. Well-being promoting factors were the following: therapeutic relationships, work-life balance, social support and communication, perception of improvement in knowledge and availability of advanced directives. Whilst factors that may reduce well-being included death exposure, managing emotions, communication difficulties, internal conflicts and disagreements, lack of knowledge and subjective concerns. These findings shed light on facets that are inherent parts of clinical experience with patients suffering from a life-threatening illness and that may turn in risk or protective factors for the medical students. Understanding the students' subjective experiences may aid in the improvement of the current educational programs, as well as in the development of tailored supportive and preventative interventions to promote well-being and professional competencies among this kind of students.

Psychometric properties of the Jefferson Empathy Scale in four nursing student faculties

OBJECTIVE

To evaluate the psychometric properties of the Jefferson Medical Empathy Scale, Spanish version (JSE-S), its factorial structure, reliability, and the presence of invariance between genders in the behavior of empathy levels among Chilean nursing students.

METHOD

Instrumental research design. The JSE-S was applied to 1,320 nursing students. A confirmatory factor analysis was used. An invariance study between genders was carried out. Descriptive statistics were estimated. Between genders, Student's T distribution was applied alongside a homoscedasticity analysis. The level of significance was α ≤ 0.05.

RESULTS

The confirmatory factor analysis determined the existence of three dimensions in the matrix. The statistical results of the invariance tests were significant, and allowed comparison between genders. Differences were found between mean empathy values, as well as in some of its dimensions between genders.

CONCLUSION

The factor structure of empathy data and its dimensions is in correspondence with the underlying three-dimensional model. There are differences in empathy levels and their dimensions between genders, with the exception of the compassionate care dimension, which was distributed similarly. Women were more empathetic than men.

What should be included in web-based simulation for new nurses?

PURPOSE

The purpose of this study was to investigate newly graduated nurses' educational needs for web-based simulation (WBS) education.

METHODS

A cross-sectional descriptive study was conducted with 132 registered nurses, regardless of their career length, working at a hospital in Korea. Data accrued through a self-reported questionnaire asking nurses about their educational needs. Data were analyzed using descriptive statistics, independent t-test ANOVA, and Scheffe test.

RESULTS

Almost all (96.2%) participants said that new nurses need simulation training, and 90.2% of participants said WBS is necessary. The highest ranked category was fundamental nursing knowledge, followed by fundamental nursing technique. Among 81 items of nursing education needs, top ranked items were cardiopulmonary resuscitation, care of artificial airways, oxygen therapy, and mechanical ventilation, which were mostly in the fundamental-nursing-techniques category. Educational needs significantly differed depending on participants' clinical experience (F = 5.37; p = .006), hospital types (t = -3.48; p = .001), and past experiences as a preceptor (t = 2.71; p = .008). Participants with 4 to 6 years of clinical experience, working in a hospital with more than 300 beds, and with experience as a preceptor, answered that new nurses have high educational needs WBS.

CONCLUSIONS

WBS for new nurses should include fundamental nursing knowledge and techniques that can apply to clinical practice immediately after learning. Also, emergency nursing care should be included to prioritize adequately and cope with emergency situations. The use of WBS will help new nurses learn and adapt to the clinical setting, which can assist nurses in providing optimal care to patients with confidence.

Designing a Virtual Reality Game for Promoting Empathy Toward Patients With Chronic Pain: Feasibility and Usability Study

Background

Many researchers have been evaluating how digital media may impact the emotional and perspective taking aspects of empathy in both clinical and nonclinical settings. Despite the growing interest in using virtual reality (VR) and VR games to motivate empathy, few studies have focused on empathy for people who live with chronic pain.

Objective

Chronic pain affects, by conservative estimates, 1 in 5 people in industrialized countries. Despite this prevalence, public awareness of chronic pain was remarkably low until the recent opioid crisis; as a result, stigma remains a problem frequently faced by people who live with this condition. To address this, the VR game AS IF was developed to increase nonpatients’ empathy toward the growing number of people who live with long-term chronic pain. On the basis of our prior work, we overhauled our approach, designed and built a VR prototype and evaluated it, and offered design suggestions for future research.

Methods

We introduced the design features of the VR game AS IF and described the study we devised to evaluate its effectiveness. We adopted a mixed methods approach and compared the empathy-related outcomes in both pre- and posttesting. A total of 19 participants were recruited.

Results

The findings of this study suggest that the VR game was effective in improving implicit and explicit empathy as well as its emotional and perspective taking aspects. More specifically, for the Empathy Scale, the total pretest scores (mean 47.33, SD 4.24) and posttest scores (mean 59.22, SD 4.33) did not reach statistical significance (P=.08). However, we did find differences in the subscales. The kindness subscale showed a statistically significant increase in the posttest score (mean 15.61, SD 2.85) compared with the pretest score (mean 17.06, SD 2.65;P=.001). For the Willingness to Help Scale, a significant increase was observed from a t test analysis (P<.001) of scores before (mean 7.17, SD 2.28) and after (mean 8.33, SD 2.03) the gameplay. The effect size for this analysis was large (d=−1.063).

Conclusions

The contributions of this research are as follows: AS IF provides a promising approach for designing VR games to motivate people’s empathy toward patients with chronic pain, the study evaluates the potential effectiveness of such a VR approach, and the general design suggestions devised from this study could shed light on future VR game systems.

Final-year student nurses' experiences of caring for patients

BACKGROUND

Shortage of nurses in South African hospitals has affected the nurse-patient ratio, thus prompting nurses to be focussed on completing nursing-related duties with less or no caring for the patient. Caring involves having a therapeutic relationship with the patients, and it can be challenging and demanding for final-year student nurses who are still novices in the nursing profession.

OBJECTIVES

To explore and describe the experiences of caring for patients amongst final-year student nurses in order to develop and provide recommendations to facilitate caring.

METHOD

A qualitative, descriptive and contextual design was used. Data collection was done through eight in-depth individual interviews. Giorgi's five-step method of data analysis was used, along with an independent coder. Measures to ensure trustworthiness and ethical principles were applied throughout the research.

RESULTS

Four themes with 12 subthemes emerged from the data: therapeutic relationship with patients as an integral part of caring, teamwork - team spirit makes caring easy, continuous caring that promotes quality and safe nursing, as well as satisfaction amongst staff and patients, and various barriers that contributed to lack of caring in the unit.

CONCLUSION

The majority of student nurses had positive experiences of caring, which included therapeutic relationships between nurses and the patients, teamwork and team spirit that fostered safe and quality nursing care, rendered effortlessly. Barriers to caring were also highlighted as negative experiences.

Effectiveness of empathy clinical education for children's nursing students: A quasi-experimental study

BACKGROUND

Empathy is a central competence for nursing students in delivering compassionate care. Empathy training might improve the communication skills in children's nursing students.

OBJECTIVES

To evaluate the effectiveness of the Knowledge, Simulation, and Sharing training programme on empathy skills among children's nursing students.

DESIGN

A controlled pre-post intervention study with a quasi-experimental design.

SETTING

Tertiary children's hospital in China.

PARTICIPANTS

Children's nursing students (n = 250) in clinical internship.

METHODS

A Knowledge, Simulation, and Sharing (KSS) module related to empathy learning was developed and tested during a 10-month period in 2017. Nursing students were divided into an experimental group (n = 125) and control group (n = 125). Both groups received the standard internship programme. The experimental group received the KSS training. Outcome measures were: Jefferson Scale of Empathy-Health Professions Student, Clinical Communication Competence Scale and Professional Identity Scale.

RESULTS

At the end of the internship the experimental groups had significantly higher empathy scores than the control group (114.57 versus 110.36; p = .016). The communication skills improved significantly in the experimental group after the training; experimental group mean 90.22 versus control group mean 87.41 (p = .042). The professional identity scores were significantly higher in the experimental group at the end of the internship compared to the control group (mean 116.43 versus 107.68; p < .001). Subgroup analysis revealed only significant differences on professional identity outcomes between experimental and control groups on diploma level (mean 115.78 versus 107.72; p < .001); and bachelor's level (mean 120.05 versus 108.00; p < .016).

CONCLUSION

The KSS training can enhance empathy and communication skills and the professional identity in children's nursing students. Further long-term effectiveness of the training needs to be tested, ideally with reported outcomes measures of children and parents.

Compassionate love, burnout and professional commitment in nurses

AIMS

To determine the effects of compassionate love on burnout and professional commitment in nurses.

BACKGROUND

Compassionate love as 'other-centred' love is referred to as altruistic love, unconditional love and unreciprocated love. Compassionate love has an important role among nurses in moderating burnout and increasing professional commitment.

METHODS

One-hundred ninety-four nurses working at two public hospitals in Turkey completed four self-report instruments: socio-demographics, the Compassionate Love Scale, the Burnout Measure-Short Version and the Nursing Professional Commitment Scale.

RESULTS

A statistically significant inverse relationship was found between Compassionate Love Scale and Burnout Measure-Short Version scores, while Compassionate Love Scale scores were significantly and positively associated with Nursing Professional Commitment Scale scores. Participants with children had higher Compassionate Love Scale scores while those participating in the arts had lower Burnout Measure-Short Version scores. Nurses with intensive care experience had higher Nursing Professional Commitment Scale scores.

CONCLUSION

There is a positive relationship between compassionate love and professional commitment, a negative relationship between compassionate love and burnout. Further research is needed to test compassionate love interventions.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers may use the results of this study in encouraging and rewarding acts of compassionate love towards colleagues and patients.

The mediating role of cognitive and affective empathy in the relationship of mindfulness with engagement in nursing

BACKGROUND

The work of health professionals is characterized by a high demand for psychological and emotional resources and high levels of stress. Therefore, the promotion of commitment and job well-being through strategies such as increased mindfulness, is important among nursing workers. Although mindfulness has shown positive effects in the health field, few studies have explored the mechanisms and processes underlying these results. We investigated the mediating role of empathy (cognitive/affective) in the effect of mindfulness on the dimensions of engagement in nursing professionals.

METHODS

Sample was comprised of 1268 Spanish nurses between 22 and 62 years old, that completed the Utrecht Labor Engagement Scale and the adapted versions of Mindful Attention Awareness Scale and Basic Empathy Scale. The relationship between variables to be included in the regression analyses, bivariate correlations were carried out, and the descriptive statistics of these variables were also found. To estimate the mediation model was used, in this case for multiple mediation effects.

RESULTS

Mindfulness is found to affect the Vigor and Dedication factors of engagement through cognitive empathy. While for the Absorption factor, the affective component of empathy also exerts a mediating role, although weaker than cognitive empathy. Cognitive empathy, as an individual factor, was shown to have a mediating effect between mindfulness and the factors of engagement in healthcare workers.

CONCLUSIONS

The level of mindfulness influences engagement of nursing professionals positively, and this result is mediated mainly by cognitive empathy. Both mindfulness and empathy are modifiable individual factors, so their intervention by designing and implementing specific programs, can increase the commitment and wellbeing of professionals generating benefits to workers and to their patients.

Validation to the Spanish of the Jefferson empathy scale health professions students version and its psychometric properties in nursing students

The ability to empathize with patients has a positive effect on health outcomes and quality of care. This study aimed to evaluate the psychometric characteristics of the Spanish version of the Jefferson Scale of Empathy-Health Profession Student version (JSE-HPS) in a sample of 422 nursing students and to compare their factorial structure with that of the original scale. In this study, the Cronbach α value was 0.828. These analyses showed that the scale has a factorial structure with three dimensions and all the items loaded adequately (>0.36) except for item 18 (0.266). The main factor, ̔Perspective taking̕ grouped 10 items; the second factor, ̔Compassionate care̕, grouped 6 items, and the third factor, ̔Standing in the patient's shoes̕, grouped 3 items; 42.2% of the variance was explained. The results of the confirmatory factor analysis suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic capacity of nursing students.

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

AIM

Empathy is a crucial component of the nurse-patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes.

DESIGN

The design was a comparative cross-sectional study.

METHODS

A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy.

RESULTS

Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least.

Addressing the psychosocial needs of patients: Challenges for nursing students

PURPOSE

To evaluate the ability of nursing students to determine the psychosocial needs of patients and identify the needs and problems encountered by nursing students.

DESIGN AND METHODS

This study is a mixed method research. The nursing care plans of 40 nursing students that provided care to 129 patients with chronic medical diseases were examined retrospectively. Individual interviews were also conducted with five nursing students and six academicians.

FINDINGS

It was determined that nursing students defined an average of 15.77 ± 11.55 physiological and an average of 3.05 ± 2.28 psychosocial nursing diagnoses for 129 patients. Data analysis of individual interviews revealed two main themes: (1) identifying psychosocial diagnoses: teaching difficulties and (2) identifying psychosocial diagnoses: learning difficulties.

PRACTICE IMPLICATIONS

This can facilitate the learning process of each student to include physiological and a psychosocial care focus in their nursing care through discussions and evaluation with their mentors and instructors.

Proposing a policy framework for nursing education for fostering compassion in nursing students: A critical review

AIMS

To propose a policy framework for nursing education to foster compassion in nursing students.

DESIGN

A critical review.

DATA SOURCES

Literature was searched in CINAHL, PubMed, Science Direct and Google Scholar and sources published from January 2008 - April 2018 were reviewed.

REVIEW METHODS

We screened abstracts and full-texts using specific inclusion criteria, developed summary tables for data extraction and synthesized data logically to develop the framework.

RESULTS

Twenty-nine sources were reviewed. Recognizing, accepting, and alleviating patients' suffering are direct indicators of compassionate care. Three policy directions were identified: ensure the nursing curriculum has an appropriate balance of teaching-learning strategies that target learning in the affective domain, directly promote the use of reflection and the development of reflective thinking in students as an approach to enhance excellence in clinical practice and integrate information and assess students' understanding and expression of compassion throughout the nursing curriculum.

CONCLUSION

Compassion is expressed when nurses authentically work to understand patients' suffering and become sensitive to their experiences. Future research should focus on developing strategies that align with the affective domain and use reflection to optimize nursing students' experiential learning.

IMPACT

Policies are needed for cultivating a compassionate care culture and for fostering students' compassion, but no guidelines exist for nursing institutions. Targeting the affective learning domain, facilitating reflection, and integrating compassionate care indicators in clinical learning experiences can be useful. Therefore, nursing institutions can use these findings to integrate and measure compassionate care in clinical and educational curricula to foster students' compassion.

Does narrative medicine education improve nursing students' empathic abilities and academic achievement? A randomised controlled trial

Objective

To determine the effectiveness of a narrative medicine educational intervention on the empathic abilities and academic achievement of Chinese nursing students.

Methods

A cluster randomised controlled trial was conducted between January 2015 and July 2017. Six class clusters (two controls, four interventions) comprising 180 nursing students were included in this trial. After pre-tests to obtain baseline measurements, two control classes (Group 1) attended regular medical education courses, two intervention classes (Group 2) received theoretical narrative medicine education for 1 term, and two intervention classes (Group 3) received narrative medicine education that integrated theory with practice for 2 terms. The empathic ability and academic achievement of the groups were compared, and longitudinal changes in empathic ability were measured.

Results

Students in Group 3 showed higher empathic ability and academic achievement than students in Group 1. Empathic ability was measured at six time points and showed between-group differences. The empathy scores of students in Group 3 increased abruptly after the two-term intervention.

Conclusions

Narrative medicine education that combines theory with practice is an effective strategy for improving nursing students’ empathic ability and academic achievement.