Cross-Validation of the Spanish HP-Version of the Jefferson Scale of Empathy Confirmed with Some Cross-Cultural Differences

Abstract

Context: Medical educators agree that empathy is essential for physicians' professionalism. The Health Professional Version of the Jefferson Scale of Empathy (JSE-HP) was developed in response to a need for a psychometrically sound instrument to measure empathy in the context of patient care. Although extensive support for its validity and reliability is available, the authors recognize the necessity to examine psychometrics of the JSE-HP in different socio-cultural contexts to assure the psychometric soundness of this instrument. The first aim of this study was to confirm its psychometric properties in the cross-cultural context of Spain and Latin American countries. The second aim was to measure the influence of social and cultural factors on the development of medical empathy in health practitioners.Methods: The original English version of the JSE-HP was translated into International Spanish using back-translation procedures. The Spanish version of the JSE-HP was administered to 896 physicians from Spain and 13 Latin American countries. Data were subjected to exploratory factor analysis using principal component analysis (PCA) with oblique rotation (promax) to allow for correlation among the resulting factors, followed by a second analysis, using confirmatory factor analysis (CFA). Two theoretical models, one based on the English JSE-HP and another on the first Spanish student version of the JSE (JSE-S), were tested. Demographic variables were compared using group comparisons.Results: A total of 715 (80%) surveys were returned fully completed. Cronbach's alpha coefficient of the JSE for the entire sample was 0.84. The psychometric properties of the Spanish JSE-HP matched those of the original English JSE-HP. However, the Spanish JSE-S model proved more appropriate than the original English model for the sample in this study. Group comparisons among physicians classified by gender, medical specialties, cultural and cross-cultural backgrounds yielded statistically significant differences (p < 0.001).Conclusions: The findings support the underlying factor structure of the Jefferson Scale of Empathy (JSE). The results reveal the importance of culture in the development of medical empathy. The cross-cultural differences described could open gates for further lines of medical education research.

Human Connections and Their Roles in the Occupational Well-being of Healthcare Professionals: A Study on Loneliness and Empathy

“…These values are higher than the recommendation of the American Educational Research Association of 0.70, confirming the adequate psychometric reliability of all instruments used in a Spanish clinical context. These findings are also slightly superior to those previously reported for empathy ( Hojat et al, 2002 ; Alcorta-Garza et al, 2016 ), loneliness ( DiTommaso et al, 2004 ; Yárnoz Yaben, 2008 ), and collateral effects ( Blanch et al, 2010 ).…”

“…To measure empathetic orientation in clinical encounters, the Jefferson Scale of Empathy (JSE; HP-Version) was used. The JSE includes 20 items that measure the empathetic behavior of physicians and other healthcare professionals in the context of patient care ( Hojat et al, 2002 ; Alcorta-Garza et al, 2016 ). The JSE is answered on a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree), with higher scores associated with more empathetic behavior in the context of patient care.…”

Professionalism and Occupational Well-Being: Similarities and Differences Among Latin American Health Professionals

“…The JSE includes 20 items that measure empathetic behavior of physicians and health professionals in the context of patients’ care (Hojat et al, 2002; Alcorta-Garza et al, 2016). The JSE is answered in a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree).…”

“…In fact, there are no big differences among Latin American countries in terms of medical and nursing educational curricula (Andrade, 1978) and in public health policies (Atun et al, 2015). This is reflected in findings reported in Latin American physicians in relation to medical empathy (Alcorta-Garza et al, 2016), or attitudes toward inter-professional collaboration and lifelong learning (San Martín et al, 2016). In relation to professional roles and inter-professional relationships, two studies reported a “hierarchical” model as dominant in Mexican institutions (Hojat et al, 2001, 2003).…”

Is empathy change in medical school geo‐socioculturally influenced?

“…Both the theory related to context specificity and empirical studies indicate that constructs such as empathy should be viewed as locally construed global constructs. Finding out whether changes in empathy in medical school follow a discernible pattern or trend, or are indiscriminate across geographical boundaries would provide useful evidence as to how context specificity influences empathy.…”