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Effects of empathy on the perspectives of respectful and disrespectful maternity care among nursing and midwifery students in China: A cross-sectional study

Nurse Educ Today. 2025 Mar;146:106559. doi: 10.1016/j.nedt.2024.106559. Epub 2024 Dec 24.

ABSTRACT

BACKGROUND: Empathy is a crucial attribute in healthcare, benefiting both professionals and patients. It also plays an important role in the midwife-woman relationship, contributing to the implementation of respectful maternity care. Witnessing acts of disrespect towards childbearing women in the clinical setting may impair students’ perceptions of respectful maternity care, as they may come to view disrespect as normative. However, empathy may moderate this effect among pre-registration nursing and midwifery students.

OBJECTIVES: To measure empathy levels and associated factors among pre-registration nursing and midwifery students, and the mediating role of empathy on perceptions of disrespectful and respectful maternity care.

DESIGN: A cross-sectional survey.

SETTINGS: Eight universities/colleges.

PARTICIPANTS: A total of 694 pre-registration nursing and midwifery students.

METHODS: Participants completed an online survey with questions from the Jefferson Scale of Empathy (Health Profession Students), Students’ Perceptions of Respectful Maternity Care and a list of items to measure exposure to disrespectful maternity care.

RESULTS: Students reported a mean empathy score of 103 out of 140. Factors such as female, Han ethnicity, fourth year of the program, midwifery major, and a hybrid mode of clinical practicum (online and in-person) were found to be associated with higher empathy levels. Empathy mediated the impact of witnessing disrespectful care on students’ perceptions of respectful maternity care.

CONCLUSION: Pre-registration education should consider the different needs of students based on their gender, ethnicity, and different stages of clinical training. Enabling clinical learning environments with empathetic role models may cultivate students’ empathy during their clinical training.

PMID:40059753 | DOI:10.1016/j.nedt.2024.106559

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