Validity and Reliability of the Jefferson Scale of Empathy, Nursing Student Version R in a Sample of Iranian Oncology Nurses

Abstract

Background: Empathy is essential in the process of nurse-patient relationships in oncology wards. The lack of a rigorous tool to measure empathy in oncology nurses makes the research difficult. Objectives: Modifying a Persian translation of the Jefferson scale of empathy to create an Iranian version of the Jefferson scale of empathy-nursing student version R (JSE-NS version R), and to determine its validity and reliability in oncology nurses of Tehran Universities of Medical Sciences. Methods: This is a methodological study with cross-sectional design, conducted in 2015. The translation and modification process was conducted according to the World Health Organization guidelines and an Iranian version of the scale was created. Different types of validity, including face and content validity together with construct and convergent validity were assessed. Construct validity was evaluated in a convenience sample of oncology nurses (n = 181) through confirmatory (CFA) and exploratory factor analysis (EFA). By correlation assessment between the total score of the JSE-NS version R and the subscales of the interpersonal reactivity index (IRI), convergent validity was tested. Reliability was ascertained by assessing the internal consistency and stability of the scale. The data were analyzed using SPSS-13 and LISREL 8.8. Results: Face and content validity of the scale was confirmed by an expert panel. The initial CFA did not show a three-factor structure of empathy, thus an EFA was run and a four-factor model with a grand factor was extracted. Subsequently, the results of the final CFA confirmed acceptable goodness of fit indices for the four-factor structure of empathy, and the scale explained 63% of variances in the data. Convergent validity showed a significant correlation between the total score of the scale and most subscales of the IRI (P < 0.001). Cronbach's alpha value (0.86) and the ICC level (0.90) showed satisfactory results in oncology nurses. Conclusions: The Iranian version of the Jefferson scale of empathy-NS version R is a psychometrically sound instrument, implying that it is suitable for measurement of empathy in oncology nurses.

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

“…Despite these differences in subscales, from a theoretical point of view, empathy should be considered a system with three elements: CC, PA and Wips. Therefore, empathy is based on the interaction among these elements, an existence characterized mainly by active, positive correlation, and any alteration of their natural relationship (for example, the decrease or absence of positive correlation of an element, such as Wips in our case), may alter the system itself; consequently it cannot function as before or change into another type of system (1,(25)(26) . In others words, empathy is a dialectical synthesis of cognitive (PA and Wips) and affective (CC) attributes.…”

“…This is a significant challenge, as it implies profound changes in structure of teaching curricula and its own dynamics right up to the level of empathic teacher training. Many researchers have analyzed studies of interventions for developing empathy in nursing students, concluding that in general, the effect of these interventions on levels of empathy was small to moderate (25)(26)34) .…”

Changes in the Level of Nursing Students’ Empathy During Four Years Education

“…JSE-NS version R has three factors; "perspective taking" (10 items), "compassionate care" (8 items), and "standing in patient's shoes" (2 items). To calculate the total score, 10 items must be reversed (1,3,(6)(7)(8)(11)(12)(13)(14)(15). The validity and reliability of the Persian version of the JSE-NS version R are confirmed in a previous study (12).…”

“…However, in the psychometrics study of the Persian version of this scale, four factors were identified, i.e., "perspective taking", "compassionate care", "standing in patient's shoes", and "metacognitive" (12). The total score ranges from 20 to 140.…”

Exploring oncology nurses’ perception of the consequences of clinical empathy in patients and nurses: a qualitative study

“…One of the strengths of this study is the selection of participants based on the level of empathy from the findings of a previous research [47]. Due to the qualitative data analysis, the generalization of the findings should be done with caution.…”