Predictive Model of Altruistic Behaviors in Nurses Based on Empathy Considering the Mediating Role of Self-Compassion
Keywords:
Self, compassion, Empathy, Prosocial, NursesAbstract
Introduction and Aim: Altruistic behaviors among nurses can play an important role in improving professional interactions, supporting patients, and enhancing the quality of care, while empathy and self-compassion are among the key psychological constructs associated with such behaviors. This study aimed to develop and test a predictive model of altruistic behaviors in nurses based on empathy, considering the mediating role of self-compassion.
Methodology: This descriptive-correlational study was conducted among nurses working in hospitals in Tehran. A total of 330 nurses were recruited through non-random voluntary sampling, of whom 316 provided analyzable data. Participants completed the Mehrabian and Epstein Empathy Scale, Neff Self-Compassion Scale, and Ahmadi Altruistic Behavior Questionnaire. Data were analyzed using SPSS and AMOS through structural equation modeling with maximum likelihood estimation.
Findings: The structural model demonstrated acceptable fit indices (χ²/df=2.78, GFI=0.904, AGFI=0.867, CFI=0.910, and RMSEA=0.075). Empathy had a significant positive effect on self-compassion (β=0.370, P=0.001), while self-compassion significantly and positively predicted altruistic behaviors (β=0.540, P=0.001). The direct effect of empathy on altruistic behaviors was significant (β=0.416, P=0.001), and its indirect effect through self-compassion was also significant (β=0.203, P=0.001). The total effect of empathy on altruistic behaviors was β=0.616, and empathy together with self-compassion explained 63% of the variance in altruistic behaviors.
Conclusion: Empathy was associated with nurses’ altruistic behaviors both directly and indirectly through self-compassion, indicating that self-compassion constitutes an important mediating mechanism in this relationship. Accordingly, interventions aimed at strengthening empathy while fostering self-compassion may provide an effective basis for promoting supportive and altruistic behaviors among nurses.
Downloads
References
Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, compassion, and self-compassion among health care professionals: What's new? A systematic review. Frontiers in psychology, 11, 1683. https://doi.org/10.3389/fpsyg.2020.01683
Decety, J. (2020). Empathy in medicine: What it is, and how much we really need it. The American Journal of Medicine, 133(5), 561-566. https://doi.org/10.1016/j.amjmed.2019.12.012
Decety, J., Bartal, I. B. A., Uzefovsky, F., & Knafo-Noam, A. (2016). Empathy as a driver of prosocial behaviour: Highly conserved neurobehavioural mechanisms across species. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1686), 20150077. https://doi.org/10.1098/rstb.2015.0077
Delgado, N., Delgado, J., Betancort, M., Bonache, H., & Harris, L. T. (2023). What is the link between different components of empathy and burnout in healthcare professionals? A systematic review and meta-analysis. Psychology research and behavior management, 447-463. https://doi.org/10.2147/PRBM.S384247
Dovidio, J. F., Piliavin, J. A., Schroeder, D. A., & Penner, L. A. (2017). The social psychology of prosocial behavior. Psychology Press. https://doi.org/10.4324/9781315085241
Feather, J., McGillis Hall, L., Trbovich, P., & Baker, G. R. (2018). An integrative review of nurses' prosocial behaviours contributing to work environment optimization, organizational performance and quality of care. Journal of nursing management, 26(7), 769-781. https://doi.org/10.1111/jonm.12600
Frank, T. (2021). The benefits of knowing and caring about oneself: The role of self-insight and self-compassion in identity and well-being University of Northern British Columbia].
Friedman, P. (2018). Healing from anxiety, depression, trauma using forgiveness, self-compassion, and energy psychology while tracking change over time Part 2: Therapeutic Interventions. Society for the Advancement of Psychotherapy.
Gilbert, P. (2014). The origins and nature of compassion focused therapy. British Journal of Clinical Psychology, 53(1), 6-41. https://doi.org/10.1111/bjc.12043
Hart, R. (2024). Prosocial behaviors at work: Key concepts, measures, interventions, antecedents, and outcomes. Behavioral Sciences, 14(1), 78. https://doi.org/10.3390/bs14010078
Hu, Y., Zhang, T., Shi, H. F., & Fan, C. Y. (2023). Empathy and bystander helping behavior in cyberbullying among adolescents: The mediating role of internet moral judgment and the moderating role of internet self-efficacy. Frontiers in psychology, 14, 1196571. https://doi.org/10.3389/fpsyg.2023.1196571
Igartua, J. J., & Hayes, A. F. (2021). Mediation, moderation, and conditional process analysis: Concepts, computations, and some common confusions. The Spanish journal of psychology, 24, e49. https://doi.org/10.1017/SJP.2021.46
Kim, Y., & Jang, S. J. (2019). Nurses' organizational communication satisfaction, emotional labor, and prosocial service behavior: A cross-sectional study. Nursing & Health Sciences, 21(2), 223-230. https://doi.org/10.1111/nhs.12586
Krieger, T., Altenstein, D., Baettig, I., Doerig, N., & Holtforth, M. G. (2013). Self-compassion in depression: Associations with depressive symptoms, rumination, and avoidance in depressed outpatients. Behavior therapy, 44(3), 501-513. https://doi.org/10.1016/j.beth.2013.04.004
Li, X., Chang, H., Zhang, Q., Yang, J., Liu, R., & Song, Y. (2021). Relationship between emotional intelligence and job well-being in Chinese clinical nurses: Multiple mediating effects of empathy and communication satisfaction. BMC Nursing, 20, 1-10. https://doi.org/10.1186/s12912-021-00658-4
Liu, A., Wang, W., Wu, X., & Xu, B. (2023). Empathy and self-compassion mediate the relationships between parental attachment, prosocial behavior, and antisocial behavior among adolescents after the Jiuzhaigou earthquake. https://doi.org/10.21203/rs.3.rs-2627633/v1
Liu, X., Li, J., & Chen, X. (2025). Does compassion for oneself extend to prosocial behavior for others? Examining the relationship between self-compassion and prosocial behavior using multilevel meta-analysis. Personality and individual differences, 237, 113047. https://doi.org/10.1016/j.paid.2025.113047
Marshall, S. L., Ciarrochi, J., Parker, P. D., & Sahdra, B. K. (2020). Is self-compassion selfish? The development of self-compassion, empathy, and prosocial behavior in adolescence. Journal of Research on Adolescence, 30, 472-484. https://doi.org/10.1111/jora.12492
Martí-Vilar, M., Tortosa, A. C., Sales-Galán, A., & Corradi, G. (2022). Resilience and prosocial behaviour in Spanish care professionals of dependent persons. Health & Social Care in the Community, 30(6), e6613-e6621. https://doi.org/10.1111/hsc.14110
Morelli, S. A., Rameson, L. T., & Lieberman, M. D. (2014). The neural components of empathy: Predicting daily prosocial behavior. Social Cognitive and Affective Neuroscience, 9(1), 39-47. https://doi.org/10.1093/scan/nss088
Moreno-Jiménez, J. E., Demerouti, E., Blanco-Donoso, L. M., Chico-Fernández, M., Iglesias-Bouzas, M. I., & Garrosa, E. (2023). Passionate healthcare workers in demanding intensive care units: Its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion. Current Psychology, 42(33), 29387-29402. https://doi.org/10.1007/s12144-022-03986-z
Neff, K. D. (2016). The self-compassion scale is a valid and theoretically coherent measure of self-compassion. Mindfulness, 7, 264-274. https://doi.org/10.1007/s12671-015-0479-3
Neff, K. D., & Germer, C. K. (2013). A pilot study and randomized controlled trial of the mindful self-compassion program. Journal of Clinical Psychology, 69(1), 28-44. https://doi.org/10.1002/jclp.21923
Nembhard, I. M., David, G., Ezzeddine, I., Betts, D., & Radin, J. (2023). A systematic review of research on empathy in health care. Health Services Research, 58(2), 250-263. https://doi.org/10.1111/1475-6773.14016
Paga, B. A., & Amir, Y. (2025). The effects of self-compassion and social responsibility on promoting prosocial behavior among university students. Psikologi Prima, 8(1), 1-12. https://doi.org/10.34012/psychoprima.v8i1.6753
Pérez-Fuentes, M. D. C., Herrera-Peco, I., Molero Jurado, M. D. M., Oropesa Ruiz, N. F., Ayuso-Murillo, D., & Gázquez Linares, J. J. (2020). A cross-sectional study of empathy and emotion management: Key to a work environment for humanized care in nursing. Frontiers in psychology, 11, 706. https://doi.org/10.3389/fpsyg.2020.00706
Raab, K. (2014). Mindfulness, self-compassion, and empathy among health care professionals: A review of the literature. Journal of Health Care Chaplaincy, 20(3), 95-108. https://doi.org/10.1080/08854726.2014.913876
Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA, 323(21), 2133-2134. https://doi.org/10.1001/jama.2020.5893
Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-compassion, stress, and coping in the context of chronic illness. Self and identity, 14(3), 334-347. https://doi.org/10.1080/15298868.2014.996249
Spaulding, S. (2024). Motivating empathy. Mind & Language, 39(2), 220-236. https://doi.org/10.1111/mila.12469
Su, J. J., Masika, G. M., Paguio, J. T., & Redding, S. R. (2020). Defining compassionate nursing care. Nursing Ethics, 27(2), 480-493. https://doi.org/10.1177/0969733019851546
Suazo, I., Pérez-Fuentes, M. D. C., Molero Jurado, M. D. M., Martos Martínez, Á., Simón Márquez, M. D. M., Barragán Martín, A. B., & Gázquez Linares, J. J. (2020). Moral sensitivity, empathy and prosocial behavior: Implications for humanization of nursing care. International journal of environmental research and public health, 17(23), 8914. https://doi.org/10.3390/ijerph17238914
Wahyuni, R. (2019). Empathy as a predictor of prosocial behavior of nurses in the special region of Yogyakarta 3rd International Conference on Current Issues in Education (ICCIE 2018), https://doi.org/10.2991/iccie-18.2019.76 https://doi.org/10.2991/iccie-18.2019.76
Yang, Y., Kong, X., Guo, Z., & Kou, Y. (2021). Can self-compassion promote gratitude and prosocial behavior in adolescents? A 3-year longitudinal study from China. Mindfulness, 12, 1377-1386. https://doi.org/10.1007/s12671-021-01605-9
Zessin, U., Dickhäuser, O., & Garbade, S. (2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340-364. https://doi.org/10.1111/aphw.12051
Zhang, Y., Wang, C., Pan, W., Zheng, J., Gao, J., Huang, X., & Zhu, C. (2020). Stress, burnout, and coping strategies of frontline nurses during the COVID-19 epidemic in Wuhan and Shanghai, China. Frontiers in Psychiatry, 11, 565520. https://doi.org/10.3389/fpsyt.2020.565520
Downloads
Publication Timeline
- Submitted
- Revised
- Accepted
Issue
Section
License
Copyright (c) 2025 Hoda Monhaser (Author); Simin Bashardoust; Malek Mirhashemi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
