HOW TO MEASURE THE EMPATHY LEVEL OF UNDERGRADUATE NURSING STUDENTS? AN INTEGRATIVE REVIEW

Souza, Mirella Castelhano; Godoy, Simone de; Santos, Sara Soares dos; Trevizan, Maria Auxiliadora; Silveira, Renata Cristina de Campos Pereira; Mendes, Isabel Amélia Costa

doi:10.1590/1980-265X-TCE-2018-0017

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Brasil

Texto & Contexto - Enfermagem

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Sumário

LITERATURE REVIEW • Texto contexto - enferm. 28 • 2019 • https://doi.org/10.1590/1980-265X-TCE-2018-0017 copy

HOW TO MEASURE THE EMPATHY LEVEL OF UNDERGRADUATE NURSING STUDENTS? AN INTEGRATIVE REVIEW

¿COMO MENSURAR EL NIVEL DE EMPATIA DE ALUMNOS DE PREGRADO EN ENFERMERIA? REVISION INTEGRADORA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

analyze available evidence in the literature on the measuring of empathy levels in nursing undergraduates.

Method:

integrative literature review developed in the databases PubMed, Web of Science, CINAHL and LILACS in September 2017.

Results:

among the 40 primary studies analyzed, 21 questionnaires were identified to measure the empathy levels of nursing undergraduates.

Conclusion:

different tools exist that are considered reliable to analyze the empathy level among nursing undergraduates.

DESCRIPTORS
Nursing; Empathy; Students, nursing; Surveys and questionnaires; Nursing staff; Social Behavior

PICO	Descriptors
#1 P	“Students, nursing” OR “pupil nurses” OR “student, nursing” OR “pupil nurse” OR “nursing student” OR “nursing students”
#2 I	“Questionnaires and surveys” OR questionnaires OR questionnaire OR surveys OR Survey OR scale
#3 O	Empathy OR caring OR compassion AND “students, nursing” OR “pupil nurses” OR “student, nursing” OR “pupil nurse” OR “nursing”

Authors	Country	Study design	Questionnaire/purpose	Evidence level
Ferri, et al.1616. Ferri P, Rovesti S, Panzera N, Marcheselli L, Bari A, Di Lorenzo R. Empathic attitudes among nursing students: a preliminary study. Acta Biomed. 2017 July [cited 2018 Apr 6];88(Suppl 3):22-30. Available from: Available from: https://dx.doi.org/10.23750/abm.v88i3-S.6610 https://dx.doi.org/10.23750/abm.v88i3-S....	The Netherlands	Retrospective cohort	BEES*/ measure empathy	VI
Gallagher, et al.1717. Gallagher P, Moriarty H, Huthwaite M, Lim B. Challenging some assumptions about empathy. Clin Teach. 2017 Dec [cited 2018 Apr 6];14(6):437-40. Available from: Available from: https://dx.doi.org/10.1111/tct.12607 https://dx.doi.org/10.1111/tct.12607...	New Zealand	Prospective cohort	JSPE†/measure empathy	VI
Anaya, et al.1818. Anaya MM, Amador LT, Martínez FG. Factores relacionados con la empatía en estudiantes de Enfermería de la Universidad de Cartagena. Enferm Clin. [Internet]. 2016 Sept-Oct [cited 2018 Apr 6];26(5):282-9. Available from: Available from: https://dx.doi.org/10.1016/j.enfcli.2016.06.004 https://dx.doi.org/10.1016/j.enfcli.2016...	Colombia	Retrospective cohort	JSPE†/measure empathy	VI
Petrucci, et al.1919. Petrucci C, La Cerra C, Aloisio F, Montanari P, Lancia L. Empathy in health professional students: A comparative cross-sectional study. Nurs Educ Today. 2016 June [cited 2018 Apr 6];41:1-5. Available from: Available from: https://dx.doi.org/10.1016/j.nedt.2016.03.022 https://dx.doi.org/10.1016/j.nedt.2016.0...	Italy	Retrospective cohort	JSE-HPS‡/measure empathy	VI
Ward2020. Ward J. The Empathy Enigma: Does It Still Exist? Comparison of Empathy Using Students and Standardized Actors. Nurse Educ [Internet]. 2016 May-June [cited 2018 May 30];41(3):134-8. Available from: Available from: https://doi.org/10.1097/NNE.0000000000000236 https://doi.org/10.1097/NNE.000000000000...	United States	Prospective cohort	JSE-HPS‡/measure empathy	VI
Choi, et al.2121. Choi H, Hwang B, Kim S, Ko H, Kim S, Kim C. Clinical education in psychiatric mental health nursing: Overcoming current challenges. Nurse Educ Today. 2016 Apr [cited 2018 Apr 6];39:109-15. Available from: Available from: https://dx.doi.org/10.1016/j.nedt.2016.01.021 https://dx.doi.org/10.1016/j.nedt.2016.0...	Korea	Prospective cohort	Empathy Construct Rating Scale/measure empathy	IV
Chen, et al.2222. Chen AN, Kiersma ME, Yehle KS, Plake KS. Impact of the Geriatric Medication Game on nursing students' empathy and attitudes toward older adults. Nurse Educa Today. 2015 Jan [cited 2018 Apr 6];35(1):38-43. Available from: Available from: https://dx.doi.org/10.1016/j.nedt.2014.05.005 https://dx.doi.org/10.1016/j.nedt.2014.0...	United States	Prospective cohort	KCES§ e JSE-HPS‡/measure empathy	VI
Everson, et al.2323. Everson N, Levett-Jones T, Lapkin S, Pitt V, Van Der Riet P, Rossiter R, et al. Measuring the impact of a 3D simulation experience on nursing students’ cultural empathy using a modiﬁed version of the Kiersma-Chen Empathy Scale. J Clin Nurs [Internet]. 2015 Oct [cited 2018 Apr 6];24(19-20):2849-58. Available from: Available from: https://dx.doi.org/10.1111/jocn.12893 https://dx.doi.org/10.1111/jocn.12893...	Australia	Prospective cohort	Modiﬁed KCES‡/measure empathy	VI
Ferri, et al.2424. Ferri P, Guerra E, Marcheselli L, Cunico L, Di Lorenzo RD. Empathy and burnout: an analytic cross-sectional study among nurses and nursing students. Act Biomed. 2015 Sept [cited 2018 May 30];86(Suppl 2):104-15. Available from: Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/4792/3529 https://mattioli1885journals.com/index.p...	Italy	Retrospective cohort	BEES*/measure empathy	VI
Fleming, et al.2525. Fleming BD, Thomas SE, Burnham WS, Charles LT, Shaw D. Improving Ethnocultural Empathy in Healthcare Students through a targeted intervention. J Cult Divers. 2015 [cited 2018 Apr 6];22(2):59-64. Available from: Available from: https://www.ncbi.nlm.nih.gov/pubmed/26245011 https://www.ncbi.nlm.nih.gov/pubmed/2624...	United States	Prospective cohort	Scale of Ethnocultural Empathy /measure empathy	VI
Montanari, et al.2626. Montanari P, Petrucci C, Russo S, Murray I, Dimonte V, Lancia L. Psychometric properties of the Jefferson Scale of Empathy-Health Professional Student's version: An Italian validation study with nursing students. Nurs Health Sci. 2015 Dec [cited 2018 Apr 6];17(4):483-91. Available from: Available from: https://dx.doi.org/10.1111/nhs.12221 https://dx.doi.org/10.1111/nhs.12221...	Italy	Retrospective cohort	JSE-HPS‡/scale validation	VI
Penprase, et al.2727. Penprase B, Oakley B, Ternes R, Driscoll D. Do higher dispositions for empathy predispose males toward careers in nursing? A descriptive correlational design. Nurs Forum. 2015 Jan-Mar [cited 2018 May 30];50(1):1-8. Available from: Available from: https://dx.doi.org/10.1111/nuf.12058 https://dx.doi.org/10.1111/nuf.12058...	United States	Retrospective cohort	Empathy Quotient e Systemizing Quotien /measure empathy	VI
Özakgül, et al.2828. Özakgül AA, Şendir M, Atav AS, Kızıltan B. Attitudes towards HIV/AIDS patients and empathic tendencies: A study of Turkish undergraduate nursing students. Nurse Educ Today. 2014 June [cited 2018 Apr 6];34(6):929-33. Available from: Available from: https://dx.doi.org/10.1016/j.nedt.2013.10.018 https://dx.doi.org/10.1016/j.nedt.2013.1...	Turkey	Retrospective cohort	Scale of Empathic Tendency /measure empathy	IV
Williams, et al.2929. Williams B, Brown T, McKenna L, Boyle M, Palermo C, Nestel D, et al. Empathy levels among health professional students: a cross-sectional study at two universities in Australia. Adv Med Educ Pract. 2014 May [cited 2018 Apr 6];5:107-13. Available from: Available from: https://dx.doi.org/10.2147/AMEP.S57569 https://dx.doi.org/10.2147/AMEP.S57569...	Australia	Retrospective cohort	JSE-HPS‡/measure empathy	VI
Hsiao, et al.3030. Hsiao CY, Tsai YF, Kao YC. Psychometric properties of a Chinese version of the Jefferson Scale of Empathy-Health Profession Students. J Psychiatric Mental Health Nurs. 2013 Dec [cited 2018 Apr 6];20(10):866-73. Available from: Available from: https://dx.doi.org/10.1111/jpm.12024 https://dx.doi.org/10.1111/jpm.12024...	China	Retrospective cohort	JSE-HPS‡/ analyze psychometric properties	VI
Kiersma et al.3131. Kiersma ME, Chen AM, Yehle KS, Plake KS. Validation of an empathy scale in pharmacy and nursing students. Am J Pharm Educ 2013 June [cited 2018 May 30];77(5):94. Available from: Available from: https://dx.doi.org/10.5688/ajpe77594 https://dx.doi.org/10.5688/ajpe77594 ...	United States	Retrospective cohort	KCES§/scale validation	VI
Kim, et al.3232. Kim SC, Burke L, Sloan C, Barnett S. Attitudes toward teen mothers among nursing students and psychometric evaluation of Positivity Toward Teen Mothers scale. Nurse Educ Today. 2013 Sept [cited 2018 Apr 6];33(9):986-91. Available from: Available from: https://dx.doi.org/10.1016/j.nedt.2012.10.014 https://dx.doi.org/10.1016/j.nedt.2012.1...	United States	Retrospective cohort	Empathy Quotient -Short/measure empathy	VI
Taylor e Mamier.3333. Taylor EJ, Mamier I. Nurse Responses to Patient Expressions of Spiritual Distress. Holist Nurs Pract. 2013 July-Aug [cited 2018 Apr 6];27(4):217-224. Available from: Available from: https://dx.doi.org/10.1097/HNP.0b013e318294e50a https://dx.doi.org/10.1097/HNP.0b013e318...	United States	Prospective cohort	Empathic Response Scale/measure empathy	IV
Penprase, et al.3434. Penprase B, Oakley B, Ternes R, Driscoll D. Empathy as a Determining Factor for Nursing Career Selection. J Nurs Educ. 2013 Apr [cited 2018 Apr 6];52(4):192-7. Available from: Available from: https://dx.doi.org/10.3928/01484834-20130314-02 https://dx.doi.org/10.3928/01484834-2013...	United States	Retrospective cohort	Empathy Quotient e Systemizing Quotient/ measure empathy	VI
Cunico, et al.3535. Cunico L, Sartori R, Marognolli O, Meneghini AM. Developing empathy in nursing students: a cohort longitudinal study. J Clin Nurs. 2012 July [cited 2018 May 30];21:(13-14):2016-25. Available from: Available from: https://dx.doi.org/10.1111/j.1365-2702.2012.04105.x https://dx.doi.org/10.1111/j.1365-2702.2...	Italy	Prospective cohort	BEES*/measure empathy	IV
McKenna, et al.3636. McKenna L, Boyle M, Brown T, Williams B, Molloy A, Lewis B, et al. Levels of empathy in undergraduate nursing students. Int J Nurs Pract. 2012 June [cited 2018 Apr 6];18(3):246-51. Available from: Available from: https://dx.doi.org/10.1111/j.1440-172X.2012.02035.x https://dx.doi.org/10.1111/j.1440-172X.2...	Australia	Retrospective cohort	JSPE†/measure empathy	VI
Ouzouni e Nakakis.3737. Ouzouni C, Nakakis K. An exploratory study of student nurses’ empathy. Health Science Journal [Internet]. 2012 July-Sept [cited 2018 Apr 6];6(3):534-52. Available from: Available from: http://knakakis.advancednursing.teiste.gr/wp-content/uploads/2014/01/11.pdf http://knakakis.advancednursing.teiste.g...	Greece	Retrospective cohort	JSPE-R^\|\| /measure empathy	VI
Ozcan, et al.3838. Ozcan CT, Oflaz F, Bakir B. The effect of a structured empathy course on the students of a medical and a nursing school. Int Nurs Rev. 2012 Dec [cited 2018 Apr 6];59(4):532-8. Available from: Available from: https://dx.doi.org/10.1111/j.1466-7657.2012.01019.x https://dx.doi.org/10.1111/j.1466-7657.2...	Turkey	Prospective cohort	ECSS¶ e ETS**/measure empathy	VI
Ward, et al.3939. Ward J, Cody J, Schaal H, Hojat M. The empathy enigma: an empirical study of decline in empathy among undergraduate nursing students. J Prof Nurs. 2012 Jan-Feb [cited 2018 Apr 6];28(1):34-40. Available from: Available from: https://dx.doi.org/10.1016/j.profnurs.2011.10.007 https://dx.doi.org/10.1016/j.profnurs.20...	United States	Retrospective cohort	JSPE-R^\|\|/measure empathy	VI
Wilson, et al.4040. Wilson SE, Prescott J, Becket G. Empathy Levels in First- and Third-Year Students in Health and Non-Health Disciplines. Am J Pharm Educ. 2012 Mar [cited 2018 May 30];76(2):24. Available from: Available from: https://dx.doi.org/10.5688/ajpe76224 https://dx.doi.org/10.5688/ajpe76224...	England	Retrospective cohort	JSPE†/measure empathy	VI
Briggs, et al.4141. Briggs C, Fox L, Abell C. The influence of film on the empathy ratings of nursing students. International Journal for Human Caring. 2012 [cited 2018 Apr 6];16(2):59-63. Available from: Available from: http://connection.ebscohost.com/c/articles/83243794/influence-film-empathy-ratings-nursing-students http://connection.ebscohost.com/c/articl...	United States	Prospective cohort	JSE-HPS‡/measure empathy	VI
Fields, et al.4242. Fields S, Mahan P, Tillman P, Harris J, Maxwell K, Hojat M. Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: Health provider-student version. J Interprof Care. 2011 July [cited 2018 Apr 6];25(4):287-93. Available from: Available from: https://dx.doi.org/10.3109/13561820.2011.566648 https://dx.doi.org/10.3109/13561820.2011...	United States	Retrospective cohort	JSE-HPS‡/ analyze psychometric properties	VI
McKenna, et al.4343. McKenna L, Boyle M, Brown T, Williams B, Molloy A, Lewis B, et al. Levels of empathy in undergraduate midwifery students: an Australian cross-sectional study. Women Birth. 2011 June [cited 2018 Apr 6];24(2):80-4. Available from: Available from: https://dx.doi.org/10.1016/j.wombi.2011.02.003 https://dx.doi.org/10.1016/j.wombi.2011....	Australia	Retrospective cohort	JSE-HPS‡/measure empathy	VI
McMillan e Shannon4444. McMillan LR, Shannon DM. Psychometric Analysis of the JSPE Nursing Student Version R: Comparison of Senior BSN Students and Medical Students Attitudes toward Empathy in Patient Care. ISRN Nurs. 2011 May [cited 2018 Apr 20];2011:726063. Available from: Available from: https://dx.doi.org/10.5402/2011/726063 https://dx.doi.org/10.5402/2011/726063...	United States	Retrospective cohort	JSPE-R^\|\|/ analyze psychometric properties	VI
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Ward, et al.4747. Ward J, Schaal M, Sullivan J, Bowen M, Erdmann J, Hojat M. Reliability and validity of the Jefferson Scale of Empathy in undergraduate nursing students. J Nurs Meas. 2009 [cited 2018 Apr 20];17(1):73-88. Available from: Available from: https://dx.doi.org/10.1891/1061-3749.17.1.73 https://dx.doi.org/10.1891/1061-3749.17....	United States	Retrospective cohort	JSPE†/ analyze reliability and validity	VI
Adriaansen, et al.4848. Adriaansen M, Van Achterberg TV, Borm G. The Usefulness of the Staff-Patient Interaction Response Scale for Palliative Care Nursing for measuring the empathetic capacity of nursing students. J Prof Nurs. 2008 Sept-Oct [cited 2018 Apr 6];24(5):315-23. Available from: Available from: https://dx.doi.org/10.1016/j.profnurs.2007.10.003 https://dx.doi.org/10.1016/j.profnurs.20...	The Netherlands	Retrospective cohort	Staff-Patient Interaction Response Scale for Palliative Care Nursing / analyze reliability and validity	VI
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[1] CORRESPONDENCE AUTHOR:
Isabel Amélia Costa Mendes. iamendes@usp.br