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Published in: Perspectives on Medical Education 6/2014

Open Access 01-12-2014 | Original Article

Measurement properties and confirmatory factor analysis of the Jefferson Scale of Empathy in Italian medical students

Authors: Paolo Leombruni, Mariangela Di Lillo, Marco Miniotti, Angelo Picardi, Guido Alessandri, Chiara Sica, Francesca Zizzi, Lorys Castelli, Riccardo Torta

Published in: Perspectives on Medical Education | Issue 6/2014

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Abstract

Medical educators agree that empathy is essential for physicians’ professionalism and most studies on the patient-physician relationship demonstrate that this attitude has a key role in improving clinical outcomes. Literature findings show conflicting views in defining and measuring empathy. Nevertheless, the Jefferson Scale of Empathy (JSE) is a psychometric tool now widely used. Therefore, the aim of this study was to examine psychometrics and confirm factor structure of the Italian version of the JSE in Italian medical students (JSE S-Version). During 2012, 257 second-year Italian medical students completed the JSE S-Version. Internal consistency and test-retest reliability were assessed. A confirmatory factor analysis was performed to test the factor structure. The Italian JSE S-Version showed an acceptable internal consistency (r = 0.76) and test-retest reliability (r = 0.72). Confirmatory factor analysis found that the factor structure proposed by the developers of the tool provides an acceptable data fit. In this sample, female medical students showed a higher mean empathy score than did males. The present study provides evidence confirming the structural validity and reliability for the Italian JSE S-Version. Further studies are needed to confirm these findings and to explore cross-cultural differences and their implications.
Literature
1.
go back to reference Hojat M. Empathy in patient care. Antecedents, development, measurement, and outcomes. New York: Springer; 2007. Hojat M. Empathy in patient care. Antecedents, development, measurement, and outcomes. New York: Springer; 2007.
2.
go back to reference Veloski J, Hojat M. Measuring specific elements of professionalism: empathy, teamwork, and lifelong learning. In: Stern DT, editor. Measuring medical professionalism. New York: Oxford University Press; 2006. Veloski J, Hojat M. Measuring specific elements of professionalism: empathy, teamwork, and lifelong learning. In: Stern DT, editor. Measuring medical professionalism. New York: Oxford University Press; 2006.
4.
go back to reference Rogers CR. A theory of therapy: personality and interpersonal relationships as developed in the client-centered framework. In: Koch S, editor. Psychology, a study of science: foundations of the person and the social context. New York: McGraw-Hill; 1959. Rogers CR. A theory of therapy: personality and interpersonal relationships as developed in the client-centered framework. In: Koch S, editor. Psychology, a study of science: foundations of the person and the social context. New York: McGraw-Hill; 1959.
5.
go back to reference Hojat M, Mangione S, Nasca TJ, Gonnella JS. Empathy scores in medical school and ratings of empathic behavior three years later. J Soc Psychol. 2005;145(6):663–72.PubMedCrossRef Hojat M, Mangione S, Nasca TJ, Gonnella JS. Empathy scores in medical school and ratings of empathic behavior three years later. J Soc Psychol. 2005;145(6):663–72.PubMedCrossRef
7.
go back to reference Neumann M, Bensing J, Mercer S, Ernstmann N, Ommen O, Pfaff H. Analyzing the ‘nature’ and ‘specific effectiveness’ of clinician empathy: a theoretical overview and contribution towards a theory-based research agenda. Patient Educ Couns. 2009;74(3):339–46.PubMedCrossRef Neumann M, Bensing J, Mercer S, Ernstmann N, Ommen O, Pfaff H. Analyzing the ‘nature’ and ‘specific effectiveness’ of clinician empathy: a theoretical overview and contribution towards a theory-based research agenda. Patient Educ Couns. 2009;74(3):339–46.PubMedCrossRef
8.
go back to reference Hemmendinger JM, Stoddart SD, Lilford RJ. A systematic review of tests of empathy in medicine. BMC Med Educ. 2007;25:7–24. Hemmendinger JM, Stoddart SD, Lilford RJ. A systematic review of tests of empathy in medicine. BMC Med Educ. 2007;25:7–24.
9.
go back to reference Pedersen R. Empirical research on empathy in medicine—a critical review. Patient Educ Couns. 2009;76(3):307–22.PubMedCrossRef Pedersen R. Empirical research on empathy in medicine—a critical review. Patient Educ Couns. 2009;76(3):307–22.PubMedCrossRef
10.
go back to reference Hojat M, Mangione S, Nasca TJ, et al. The Jefferson Scale of Physician Empathy: development and preliminary psychometric data. Educ Psychol Meas. 2001;61:349–65.CrossRef Hojat M, Mangione S, Nasca TJ, et al. The Jefferson Scale of Physician Empathy: development and preliminary psychometric data. Educ Psychol Meas. 2001;61:349–65.CrossRef
11.
go back to reference Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, Magee M. Physician empathy: definition, component, measurement and relationship to gender and specialty. Am J Psychiatry. 2002;159(9):1563–9.PubMedCrossRef Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, Magee M. Physician empathy: definition, component, measurement and relationship to gender and specialty. Am J Psychiatry. 2002;159(9):1563–9.PubMedCrossRef
13.
go back to reference Hojat M, Gonnella JS, Maxwell K. Jefferson Scales of Empathy (JSE). Professional manual and user’s guide. Philadelphia: Jefferson Medical College; 2009. Hojat M, Gonnella JS, Maxwell K. Jefferson Scales of Empathy (JSE). Professional manual and user’s guide. Philadelphia: Jefferson Medical College; 2009.
14.
go back to reference Di Lillo M, Cicchetti A, Lo Scalzo A, Taroni F, Hojat M. The Jefferson Scale of Physician Empathy: preliminary psychometrics and group comparisons in Italian psysicians. Acad Med. 2009;84(9):1198–202.PubMedCrossRef Di Lillo M, Cicchetti A, Lo Scalzo A, Taroni F, Hojat M. The Jefferson Scale of Physician Empathy: preliminary psychometrics and group comparisons in Italian psysicians. Acad Med. 2009;84(9):1198–202.PubMedCrossRef
15.
go back to reference Neumann M, Edelhäuser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86(8):996–1009.PubMedCrossRef Neumann M, Edelhäuser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86(8):996–1009.PubMedCrossRef
16.
go back to reference Muthén LK, Muthén BO. Mplus user’s guide. Los Angeles: Muthén & Muthén; 2006. Muthén LK, Muthén BO. Mplus user’s guide. Los Angeles: Muthén & Muthén; 2006.
17.
go back to reference Shariat SV, Habibi M. Empathy in Iranian medical students: measurement model of the Jefferson Scale of Empathy. Med Teach. 2013;35(1):e913–8.PubMedCrossRef Shariat SV, Habibi M. Empathy in Iranian medical students: measurement model of the Jefferson Scale of Empathy. Med Teach. 2013;35(1):e913–8.PubMedCrossRef
18.
go back to reference Satorra A, Bentler PM. Scaling corrections for Chi square statistics in covariance structure analysis. In: Proceeding of the business and economics sections. Alexandria: American Statistical Association (ASA); 1988. Satorra A, Bentler PM. Scaling corrections for Chi square statistics in covariance structure analysis. In: Proceeding of the business and economics sections. Alexandria: American Statistical Association (ASA); 1988.
19.
go back to reference Brown MW, Cudeck R. Alternative ways of assessing model fit. In: Bollen KA, Long JS, editors. Testing structural equation models. Newbury Park: Sage; 1993. Brown MW, Cudeck R. Alternative ways of assessing model fit. In: Bollen KA, Long JS, editors. Testing structural equation models. Newbury Park: Sage; 1993.
20.
go back to reference Hu L, Bentler PM. Fit indices in covariance structure modelling: sensitivity to under-parameterized model misspecification. Psychol Methods. 1998;4(3):424–53.CrossRef Hu L, Bentler PM. Fit indices in covariance structure modelling: sensitivity to under-parameterized model misspecification. Psychol Methods. 1998;4(3):424–53.CrossRef
21.
22.
go back to reference Yu CY. Evaluating cut-off criteria of model fit indices for latent variable models with binary and continuous outcomes [Doctoral dissertation]. Los Angeles: University of California; 2002. Yu CY. Evaluating cut-off criteria of model fit indices for latent variable models with binary and continuous outcomes [Doctoral dissertation]. Los Angeles: University of California; 2002.
23.
go back to reference Satorra A, Bentler PM. A scaled difference Chi square test statistic for moment structure analysis. Psychometrika. 2001;66(4):507–14.CrossRef Satorra A, Bentler PM. A scaled difference Chi square test statistic for moment structure analysis. Psychometrika. 2001;66(4):507–14.CrossRef
24.
go back to reference Austin EJ, Evans P, Goldwater R, Potter V. A preliminary study of emotional intelligence, empathy and exam performance in first year medical students. Pers Individ Dif. 2005;39(5):1395–405.CrossRef Austin EJ, Evans P, Goldwater R, Potter V. A preliminary study of emotional intelligence, empathy and exam performance in first year medical students. Pers Individ Dif. 2005;39(5):1395–405.CrossRef
25.
go back to reference Kataoka HU, Koide N, Ochi K, Hojat M, Gonnella JS. Measurement of empathy among Japanese medical students: psychometrics and score differences by gender and level of medical education. Acad Med. 2009;84(9):1192–7.PubMedCrossRef Kataoka HU, Koide N, Ochi K, Hojat M, Gonnella JS. Measurement of empathy among Japanese medical students: psychometrics and score differences by gender and level of medical education. Acad Med. 2009;84(9):1192–7.PubMedCrossRef
26.
go back to reference Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91.PubMedCrossRef Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91.PubMedCrossRef
27.
go back to reference Shariat SV, Keikhavani A. Empathy in residents of clinical specialties of Iran University of Medical Sciences. Iran J Psychiatry Clin Psychol. 2010;16:248–56. Shariat SV, Keikhavani A. Empathy in residents of clinical specialties of Iran University of Medical Sciences. Iran J Psychiatry Clin Psychol. 2010;16:248–56.
28.
go back to reference Shariat SV, Eshtad E, Ansari S. Empathy and its correlates in Iranian physicians: a preliminary psychometric study of the Jefferson Scale of Physician Empathy. Med Teach. 2010;32(10):417–21.CrossRef Shariat SV, Eshtad E, Ansari S. Empathy and its correlates in Iranian physicians: a preliminary psychometric study of the Jefferson Scale of Physician Empathy. Med Teach. 2010;32(10):417–21.CrossRef
29.
go back to reference Hojat M, Gonnella JS, Mangione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ. 2002;36(6):522–7.PubMedCrossRef Hojat M, Gonnella JS, Mangione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ. 2002;36(6):522–7.PubMedCrossRef
Metadata
Title
Measurement properties and confirmatory factor analysis of the Jefferson Scale of Empathy in Italian medical students
Authors
Paolo Leombruni
Mariangela Di Lillo
Marco Miniotti
Angelo Picardi
Guido Alessandri
Chiara Sica
Francesca Zizzi
Lorys Castelli
Riccardo Torta
Publication date
01-12-2014
Publisher
Bohn Stafleu van Loghum
Published in
Perspectives on Medical Education / Issue 6/2014
Print ISSN: 2212-2761
Electronic ISSN: 2212-277X
DOI
https://doi.org/10.1007/s40037-014-0137-9

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