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

Pet attachment and prosocial attitude toward humans: the mediating role of empathy to animals

Attachment relationships are widely recognized as influential in increasing prosocial tendencies, with existing literature indicating that human attachment can increase empathetic processes, thereby potentially facilitating prosocial behavior. Given that pets frequently fulfill the criteria for attachment figures, this study investigates whether the observed associations among human attachment, empathy, and prosocial attitudes extend to human-animal interactions (HAI). This study examines the relationship between pet attachment, animal empathy, and prosocial attitudes toward humans. The study hypothesizes that animal empathy mediates the association between pet attachment and prosocial attitudes. A cross-sectional survey was administered to 343 Filipino participants, predominantly consisting of single female young adults with college education backgrounds. Participants completed a battery of assessments including the Contemporary Companion Animal Bonding Scale (CCABS), the Animal Empathy Scale (AES), and the Prosocialness Scale for Adults (PSA). Aligned with our hypothesis, our study reveals that animal empathy plays a significant mediating role in the relationship between pet attachment and attitudes toward humans. We found that stronger pet attachment correlates positively with heightened animal empathy, subsequently leading to elevated levels of prosocial attitudes. Our findings prompt discussions on implications for understanding human-animal relationships and suggest avenues for future research exploration.

The influence of socio-cognitive mindfulness, moral sensitivity and dementia communication behaviors on dementia nursing performance of nurses in long-term care hospitals: a cross-sectional study

BACKGROUND

By incorporating socio-cognitive mindfulness which has been under-examined in the nursing field, this study investigated the relationships between socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance of nurses in long-term care hospitals. This study also examined the factors influencing nurses' dementia nursing performance.

METHODS

A cross-sectional study was conducted with 209 nurses from long-term care hospitals in Korea. Data were collected between August 1 and August 31, 2022. Participants completed the questionnaire assessing their socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance. Pearson's correlation and hierarchical multiple regression analysis were performed for data analysis.

RESULTS

Dementia nursing performance of the nurses in long-term care hospitals was positively related to their socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors. Furthermore, nurses' dementia communication behaviors, moral sensitivity, and total clinical career, in that order, were found to be the factors influencing their dementia nursing performance.

CONCLUSION

The findings indicate that the higher socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors, the higher dementia nursing performance, and that higher dementia nursing performance is associated with better dementia communication behaviors, greater moral sensitivity, and more extensive clinical experiences. This study provides a foundation for developing effective interventions to enhance dementia nursing performance in the future. To improve dementia nursing performance of nurses in long-term care hospitals, it is necessary to improve dementia communication behaviors and moral sensitivity, and prepare multilateral countermeasures to maintain nurses' clinical careers.

Seeing it my way: A perspective taking intervention alleviates psychological distress in caregivers of autistic children

Cognitively empathic caregivers are able to take the perspective of their autistic child(ren) without experiencing vicarious distressing emotions, and typically report lower psychological distress. Taking the perspective of the autistic child might, through fostering cognitive empathy, might relieve caregivers' psychological distress. Here we explored whether autism perspective taking videos developed by the National Autistic Society (NAS), intended to raise public awareness about autism, might be effective, packaged as an intervention, for increasing caregivers' cognitive empathy and reducing their psychological distress. A sample of 24 caregivers of autistic children completed questionnaires capturing psychological distress and cognitive empathy at baseline. For three consecutive days, for two-three minutes per day, caregivers watched perspective taking videos. Follow up assessments were collected 7, 14, and 21 days post intervention. Psychological distress was lower after seven days, and stayed lower 14 and 21 days post intervention compared with baseline. Cognitive empathy was higher after 14 days, and remained higher 21 days post intervention compared with baseline. Taking the perspective of the autistic child, achieved here with publically available NAS videos, seems to be effective for increasing caregivers' cognitive empathy and reducing their psychological distress for up to three weeks. Future research might use more rigorous methodologies, incorporating control groups and larger samples, to explore moderators of intervention efficacy.

The Mediating Effect of Empathy between Mindfulness and Self-Leadership in Female University Students: A Cross-Sectional Study

(1) Background: Acknowledging scant research on integrating mindfulness, empathy, and self-leadership among female university students, this study aimed to investigate the relationships among these three variables, as well as the mediating effect of empathy. (2) Methods: A cross-sectional design was employed with 127 female sophomores in a mindfulness-based liberal arts class at K Women's University in South Korea. Participants completed a self-reported questionnaire measuring levels of mindfulness, empathy, and self-leadership. Data were analyzed with descriptive statistics and correlations between the variables using the SPSS 28 program. The Jamovi 2.2.5 program was used to analyze the mediating effect of empathy. (3) Results: The levels of mindfulness, empathy, and self-leadership were higher than in previous studies. Mindfulness was positively related to empathy (r = 0.407, p < 0.001) and self-leadership (r = 0.635, p < 0.001); empathy was also positively associated with self-leadership (r = 0.635, p < 0.001). Furthermore, empathy mediated the relationship between mindfulness and self-leadership (β = 0.187, p < 0.001). (4) Conclusions: The findings indicate that mindfulness is helpful in improving university students' self-leadership by reinforcing their empathy, and that an integrated training program of mindfulness and empathy could produce positive effects on promoting self-leadership. The findings can be utilized as a basis for developing programs to improve mindfulness and empathy, eventually improving students' self-leadership.

Mediating effects of emotion regulation between socio-cognitive mindfulness and empathy in nurses: a cross-sectional study

Background

Acknowledging the under-examined research of socio-cognitive mindfulness and Gross’s emotion regulation strategies in nursing, this study investigated the relationships between socio-cognitive mindfulness, emotion regulation (i.e., reappraisal and suppression), and empathy among nurses. It also explored the mediating effects of emotion regulation.

Methods

A cross-sectional quantitative study was conducted in a sample of 245 nurses from two university hospitals in South Korea. Convenience sampling was used to collect data between August 3 and September 29, 2020. Participants completed the questionnaire measuring their socio-cognitive mindfulness, emotion regulation, and empathy. Structural equation modeling and path analysis were conducted for data analysis.

Results

Socio-cognitive mindfulness positively influenced emotion regulation of reappraisal (β = 0.404, p < 0.01) and empathy (β = 0.402, p < 0.01), but negatively influenced emotion regulation of suppression (β = −0.149, p < 0.05). Reappraisal positively influenced empathy (β = 0.341, p < 0.01), whereas suppression negatively influenced empathy (β = −0.127, p < 0.05). Importantly, emotion regulation of reappraisal mediated the association between socio-cognitive mindfulness and empathy (a X b = 0.107, p < 0.01).

Conclusion

The findings indicate that socio-cognitive mindfulness is effective in improving empathy among nurses by enhancing reappraisal. This study can provide a foundation for developing socio-cognitive mindfulness or emotion regulation programs to improve empathy among nurses, which would ultimately lead to better nursing performance by increasing patient satisfaction.

A scoping review and evaluation of instruments used to measure resilience among post-secondary students

As mental health problems continue to increase among post-secondary populations, the need to develop effective initiatives designed to bolster students’ resilience has increasingly been identified as a priority. Therefore, access to valid tools with which to measure the efficacy of these interventions is imperative. To date, a comprehensive assessment of existing instruments used to evaluate the construct of resilience among post-secondary student populations has not been conducted. The purpose of this study was to fill this gap by conducting a scoping review of literature detailing the use of resilience instruments and evaluating their quality based on suitability for use in the post-secondary setting and associated psychometric evidence. We identified a total of 78 records published between 2010 and 2022, extracting a total of 12 instruments. Using detailed criteria frameworks, each instrument was assessed in terms of suitability and quality of associated psychometric evidence for validity and reliability. The results of our study suggest that many of the instruments currently being used to assess resilience among post-secondary students may not be appropriate. The majority of the instruments included in our review were developed for use among general adult populations and not specifically designed for use in the post-secondary setting. Most instruments did not assess resilience in a comprehensive, holistic matter that addressed the ability to bounce back from adversity by drawing upon psychological, social, cultural, and environmental resources, as defined by recent research. Further, no instruments included in our review had published evidence in support of a complete psychometric analysis. The results of our evaluation suggest that the Connor-Davidson Resilience Scale (CD-RISC) is the most suitable instrument for measuring resilience among post-secondary populations due to its suitability, comprehensive assessment of the construct of resilience, and demonstrably strong psychometric properties for both the 25- and 10-item versions of the tool.

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There is a need for access to valid and appropriate tools with which to measure post-secondary students’ resilience.

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We identified a total of 12 instruments evaluating resilience among post-secondary student populations.

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The majority of the instruments were not designed for use in the post-secondary setting and were not comprehensive· We recommend the CD-RISC as the most suitable.

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We recommend the CD-RISC as the most suitable instrument for measuring resilience among post-secondary students.

How perceived school culture relates to work engagement among primary and secondary school teachers? Roles of affective empathy and job tenure

Evidence suggests that perceived school culture is the most powerful predictor of teachers' work performance. However, studies to date have paid little attention to the potential mechanisms behind this association. On the basis of the job demands-resources (JD-R) model, the present study explored the mediating role of affective empathy and the moderating role of job tenure in the association between perceived school culture and teachers' work engagement. 647 primary and secondary school teachers completed questionnaires measuring perceived school culture, affective empathy, and work engagement. After gender and educational level were included as covariates, the results showed that perceived school culture positively correlated with teachers' work engagement, and more importantly, this association was partially mediated by affective empathy. In addition, job tenure significantly moderated the direct association between perceived school culture and work engagement. Specifically, there was a stronger association between perceived school culture and work engagement for teachers with shorter job tenure than those with longer job tenure. The findings suggested the direct effect of perceived school culture on work engagement, and the indirect effect of perceived school culture on work engagement through the mediating role of affective empathy. These findings enrich our understanding of how perceived school culture associates with work engagement, and highlight the moderating role of job tenure in the direct association between perceived school culture and work engagement.

The Turkish validity and reliability of the Kiersma-Chen empathy scale

PURPOSE

This study aimed to establish the Turkish validity and reliability of the Kiersma-Chen empathy scale (KCES) and determine its psychometric properties.

DESIGN AND METHODS

This methodological study was carried out with 227 nursing students between April and May 2019.

FINDINGS

The Cronbach's alpha coefficient of the total scale is 0.854, the test-retest coefficient was high for the total scale (r = 0.989), and total-item correlations ranged between 0.398 and 0.712.

PRACTICE IMPLICATIONS

The KCES-TR is a valid and reliable scale to measure empathy in nursing students.

Mindfulness, empathy and moral sensitivity in nurses: a structural equation modeling analysis

Background

Ethical issues may pose challenges to nurses; moral sensitivity can help them to overcome these challenges. Identifying variables related to moral sensitivity can help in planning to increase nurses’ moral sensitivity. This study aimed to investigate the relationship among mindfulness, empathy, and moral sensitivity in a sample of nurses.

Methods

In the present study, a cross-sectional design utilizing Structural Equation Modeling (SEM) was conducted. The nurses in a private hospital in Yazd, Iran, were invited to participate in the study (n=162) using simple random sampling. In order to gather the data, the Freiburg’s mindfulness inventory, moral sensitivity questionnaire, and revised Jefferson’s empathy scale were used. The hypothesized model was analyzed by SEM.

Results

The results show that Mindfulness (β=0.41, t=5.53, p<0.01) and empathy (β=0.52, t=6.77, p<0.01) had a significant direct effect on moral sensitivity. However, mindfulness had an indirect effect on nurses’ moral sensitivity via empathy improvement (z= 6.25, p<.01).

Conclusion

Empathy played a significant mediating role in the relationship between mindfulness and moral sensitivity, so mindfulness-based interventions with an emphasis on empathy may provide an opportunity to increase moral sensitivity in nurses.

Pregnant women's coping strategies, participation roles and social support in the online community during the COVID-19

Pregnant women are experiencing enormous physical changes and suffering pregnancy-related losses, which may lead to depression symptoms during pregnancy. Given that the onslaught of COVID-19 had exacerbated pregnant women's anxiety because of disruptions in antenatal care and concerns regarding safe delivery, it is worth exploring how they obtain social support to cope with stress during COVID-19. Although many works have explored the impact of coping resources that people have on coping strategies, few studies have been done on the relationship between people's coping strategies and their acquisition of coping resources such as social support. To fill this gap, based on the stress and coping theory (SCT) and social penetration theory (SPT), this study investigates the impacts of pregnant women's different coping strategies on the acquisition of social support and the moderating role of the adverse impacts of COVID-19 and their online participation roles (support providers vs. support seekers) using the data of 814 pregnant women's online behavior from a parenting community in China1. Our study indicates that both women's superficial level disclosure and personal level disclosure positively affect online social support received. Moreover, self-disclosure about the adverse impacts of COVID-19 negatively moderates the relationship between personal level disclosure and social support received. Participation role positively moderates the relationship between personal level disclosure and social support received, but negatively moderates the relationship between superficial level disclosure and social support received. This paper makes theoretical contributions to the literature of SCT, SPT and the literature about social support in online communities.

Effectiveness of mindfulness‐based interventions on psychological well‐being, burnout and post‐traumatic stress disorder among nurses: A systematic review and meta‐analysis

AIMS AND OBJECTIVES

The aim of this study was to investigate the effectiveness of mindfulness-based interventions on psychological well-being, burnout and post-traumatic stress disorder symptoms among working registered nurses.

BACKGROUND

Nurses account for nearly half of the global healthcare workforce and are considered significant contributors in multi-disciplinary healthcare teams. Yet, nurses face high levels of psychological distress, leading to burnout and post-traumatic stress disorder. Mindfulness-based training is a strategy that has been introduced to foster a state of awareness of present physical, emotional and cognitive experiences to regulate behaviour.

DESIGN

This systematic review of randomised controlled trials was designed according to PRISMA guidelines. Eligible studies were screened and extracted. Methodological quality was evaluated by two researchers, independently. RevMan 5.4 was used to conduct the meta-analysis.

RESULTS

Fourteen studies including a total of 1077 nurses were included, of which only eleven were included in the meta-analysis as the remaining had missing or incomplete data. Meta-analysis revealed that MBI was more effective than passive comparators in reducing psychological distress, stress, depression and burnout-personal accomplishment. When compared to active comparators, MBI was also found to be more effective in reducing psychological distress and was as effective in reducing stress, anxiety, depression and burnout. Evidence on the effects of MBIs on PTSD was scarce.

CONCLUSION

Mindfulness-based interventions can effectively reduce psychological distress, stress, depression and some dimensions of burnout. However, evidence remains scarce in the literature. There is a need for more methodologically sound research on mindfulness-based training among nurses.

RELEVANCE FOR CLINICAL PRACTICE

An important aspect that relates to the success of mindfulness-based interventions is the continued and dedicated individual practice of the skills taught during mindfulness training amidst demanding clinical work environments. Therefore, relevant support for nurses must be accounted for in the planning, design and implementation of future mindfulness-based interventions.

Basic Empathy Scale: A Systematic Review and Reliability Generalization Meta-Analysis

The Basic Empathy Scale (BES) has been internationally used to measure empathy. A systematic review including 74 articles that implement the instrument since its development in 2006 was carried out. Moreover, an evidence validity analysis and a reliability generalization meta-analysis were performed to examine if the scale presented the appropriate values to justify its application. Results from the systematic review showed that the use of the BES is increasing, although the research areas in which it is being implemented are currently being broadened. The validity analyses indicated that both the type of factor analysis and reliability are reported in validation studies much more than the consequences of testing are. Regarding the meta-analysis results, the mean of Cronbach's α for cognitive empathy was 0.81 (95% CI: 0.77-0.85), with high levels of heterogeneity (I2 = 98.81%). Regarding affective empathy, the mean of Cronbach's α was 0.81 (95% CI: 0.76-0.84), with high levels of heterogeneity. It was concluded that BES is appropriate to be used in general population groups, although not recommended for clinical diagnosis; and there is a moderate to high heterogeneity in the mean of Cronbach's α. The practical implications of the results in mean estimation and heterogeneity are discussed.

Effects of Patient Portal Use on Patient Satisfaction: Survey and Partial Least Squares Analysis

Background

With digital delivery of health care services gaining prominence, patient portals have become a mainstay of many health care organizations. Despite the importance of patient portals, inconclusive data exist regarding the effect of patient portal use on patient satisfaction.

Objective

The aim of this study is to understand the relationship between the postadoptive use of patient portals and patient satisfaction outcomes.

Methods

Postadoptive use of patient portals has a positive relationship with the 3 dimensions of patient satisfaction, mediated by gratification, health self-awareness, and health perceptions. A total of 504 valid patient portal user responses were collected, and partial least squares analysis was performed to analyze the data.

Results

Patient satisfaction was captured using three dimensions: care team interaction, atmosphere, and instruction effectiveness. The results show that postadoptive use of patient portals has a positive influence on all 3 dimensions of patient satisfaction through the mediating variables of gratification, health self-awareness, and health perceptions. Specifically, postadoptive use had significant positive influence on gratification, health self-awareness, and health perceptions. Each of the 3 patient perceptions had significant positive influence on all 3 dimensions of patient satisfaction: care team interaction, atmosphere, and instruction effectiveness. Specifically, our model explained 31.8% of the care team interaction, 40.6% of the atmosphere, and 39.1% of the instruction effectiveness.

Conclusions

Our model shows that patient portal use can influence patient satisfaction through the mediating effects of gratification, health self-awareness, and health perception. Patient satisfaction is an important outcome for health care organizations. Therefore, by promoting effective patient portal use and fostering patient perceptions, health care organizations can improve patient satisfaction.

Mindfulness Promotes Online Prosocial Behavior via Cognitive Empathy

Mindfulness plays an important role in promoting prosocial behavior and well-being. With the spread of Internet usage, people's online prosocial behavior (OPB) has garnered great attention. Based on the link between online and offline behaviors, we predict that mindfulness can also facilitate OPB. We examined the association of mindfulness and OPB and the mediating effect of empathy. A total of 674 Chinese undergraduate students completed self-report measures of these constructs. The results showed that different dimensions of mindfulness predicted empathy, which in turn predicted OPB. Perspective taking was the main mediator in the mindfulness-OPB link. Mindfulness improves receptiveness to others' needs and feelings, thereby enhancing the willingness to help them, even in none-face-to-face situations.

The influence of psychosocial factors on the intention to incorporate complementary and integrative medicine into psychiatric clinical practices

Complementary and integrative medicine (CIM) can be of great support to individuals suffering from psychiatric conditions; however, it is still rarely incorporated into clinical practice.

OBJECTIVE

To examine the influences of psychosocial and sociodemographic factors on health-care professionals' intention to use CIM in their psychiatric clinical practice.

METHOD

One-hundred-and-five participants completed a questionnaire developed from an adapted version of Triandis' Theory of Interpersonal Behavior (TIB). Intentions to use CIM (yes or no) were analyzed using logistic regression models.

RESULTS

The multivariate model retained three main factors: affect, perceived social norms, and conditions facilitating CIM. These predicted health-care professionals' intention to use CIM with an AUC = 94.7%.

RESULTS

underlined that positive affective attitudes towards CIM, feeling that CIM was congruent with professional and institutional goals, and having sufficient skills in CIM were essential to ensuring that health-care professionals would integrate CIM into their clinical practice.

Effect of Anxiety on Empathy: An Observational Study Among Nurses

Empathy, defined as an emotional ability to put oneself in the place of others, read their state of mind, and think how they are feeling, is an essential pillar of nursing care. On the other hand, anxiety is a frequent emotion that can be generated in stressful work environments, like nurses developing their activity. The aim of the present study is to explore the value of empathy and anxiety personal traits in staff nurses. The sample was comprised of 197 staff nurses from tertiary level hospitals from Madrid, Spain, where 79.2% were women and 20.8% were men in the present study. The instrument used for analysis was the Spanish adaptation of the 16PF5 questionnaire. The results showed the following measurements to warmth (5.58), lively (5.25), socially bold (5.6), privacy (5.82), open to change (5.62), self-reliance (6.12), and anxiety (6.38). Furthermore, anxiety affects positively to warmth (t: 2.66; p > 0.0001) and lively (t = 2.36; p < 0.05), but in a negative way to social bold (t = −3.17; p < 0.001) or open to change (t = −5.81; p < 0.0001). However, it was not seen to have any effect over privacy (t = 1.96; p = 0.052) and self-reliance (t = 1.19; p = 0.234). Finally, it is recommended that healthcare professionals reinforce their personal competencies to strengthen their skills to manage anxiety and improve their empathy competencies.

The effect of a one-time 15-minute guided meditation (Isha Kriya) on stress and mood disturbances among operating room professionals: a prospective interventional pilot study

Background: Operating room professionals are exposed to high levels of stress and burnout. Besides affecting the individual, it can compromise patient safety and quality of care as well. Meditation practice is getting recognized for its ability to improve wellness among various populations, including healthcare providers.

Methods: Baseline stress levels of perioperative healthcare providers were measured via an online survey using a Perceived Stress Scale (PSS) questionnaire. An in-person meditation workshop was demonstrated during surgical grand rounds and an international anesthesia conference using a 15-minute guided Isha Kriya meditation. The participants were then surveyed for mood changes before and after meditation using a Profile of Mood States (POMS) questionnaire. 

Results: Surgeons and anesthesiologists were found to have higher median (interquartile range) Perceived Stress Scores as compared to nurses respectively (17 [12, 20] and 17 [12, 21] vs 14 [9, 19]; P = 0.01). Total mood disturbances were found to be significantly reduced after meditation in both the surgical grand rounds (pre-meditation median [IQR] 99 [85, 112] vs 87 [80, 93] post-meditation; P < 0.0001) and anesthesia conference cohorts (pre-meditation 92 [86, 106] vs 87 [81, 92] post-meditation; P < 0.0001).

Conclusions: Isha Kriya, a guided meditation, is easy to learn and takes less than 15 minutes to complete. This meditation technique improves mood changes and negative emotions among operating room professionals and could be used as a potential tool for improving wellness.