高年级护生的临床共情、人格特质与心理韧性：一项横断面二次分析

摘要(中文译文)

临床共情是护理教育的核心胜任力，在概念上与以人为中心的护理照护相关。然而，关于高年级护理学生的临床共情如何与人格特质和心理韧性等倾向性特征相关联，现有证据有限。本研究旨在探讨三年级和四年级护理学生临床共情、大五人格特质与心理韧性之间的横断面关联。本研究采用描述性横断面二次分析，使用现有调查数据库。最终分析样本包括来自西班牙一所护理学校的66名三年级和四年级护理学生。临床共情采用杰斐逊共情量表评估，心理韧性采用6条目简明心理韧性量表评估，人格特质采用大五人格量表-44评估。生活满意度、学业投入和一般自我效能感作为次要心理社会变量纳入。研究进行了描述性分析、相关性分析、组间比较和探索性多元线性回归。宜人性较高与临床共情总分较高（ρ = 0.390， = 0.001）和观点采择较高（ρ = 0.440， < 0.001）相关。尽责性较高也与临床共情总分较高（ρ = 0.480， < 0.001）、观点采择较高（ρ = 0.432， < 0.001）和关怀照护较高（ρ = 0.324， = 0.008）相关。在探索性多变量横断面模型中，宜人性和尽责性与临床共情总分独立相关，而心理韧性则无独立关联。涉及“站在患者角度”分量表的研究结果应谨慎解读，因为其内部一致性较低。在这一高年级护理学生的探索性样本中，自我报告的临床共情主要与宜人性和尽责性相关。这些研究结果应被解读为基于自我报告数据的横断面关联，不应被视为因果效应、伦理行为或以人为中心照护实践的证据。需要进一步的纵向和多中心研究，以检验这些关联是否稳定，以及它们是否与可观察的教育或临床结局相关。

Abstract

Clinical empathy is a core competency in nursing education and is conceptually relevant to person-centered nursing care. However, limited evidence is available on how clinical empathy in advanced nursing students is associated with dispositional characteristics such as personality traits and resilience. This study aimed to examine cross-sectional associations between clinical empathy, Big Five personality traits, and resilience in third- and fourth-year nursing students. A descriptive, cross-sectional secondary analysis was conducted using an existing survey database. The final analytic sample comprised 66 third- and fourth-year nursing students from a nursing school in Spain. Clinical empathy was assessed with the Jefferson Scale of Empathy, resilience with the 6-item Brief Resilience Scale, and personality traits with the Big Five Inventory-44. Life satisfaction, academic engagement, and general self-efficacy were included as secondary psychosocial variables. Descriptive analyses, correlation analyses, group comparisons, and exploratory multiple linear regression were performed. Higher agreeableness was associated with higher total clinical empathy (ρ = 0.390, = 0.001) and perspective-taking (ρ = 0.440, < 0.001). Higher conscientiousness was also associated with higher total clinical empathy (ρ = 0.480, < 0.001), perspective-taking (ρ = 0.432, < 0.001), and compassionate care (ρ = 0.324, = 0.008). In the exploratory multivariable cross-sectional model, agreeableness and conscientiousness were independently associated with total clinical empathy, whereas resilience was not. Findings involving the Standing in the Patient's Shoes subscale should be interpreted cautiously because of its low internal consistency. In this exploratory sample of advanced nursing students, self-reported clinical empathy was associated mainly with agreeableness and conscientiousness. These findings should be interpreted as cross-sectional associations based on self-report data and should not be taken as evidence of causal effects, ethical behavior, or person-centered care practices. Further longitudinal and multicenter studies are needed to examine whether these associations are stable and whether they relate to observable educational or clinical outcomes.

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