Empathy, psychometrics, cut-off points in nursing students from Latin America

Víctor P. Díaz-Narváez, Aracelis Calzadilla-Núñez, Alejandro Reyes-Reyes, Gloria Lastre Amell, Herminia Castellón-Montenegro, Irma Andrade Valles, Shirley Fernández-Aragón, Elizabeth Fajardo-Ramos, Karina Santander Díaz, Pilar Torres-Martínez, Gina Muñoz Gámbaro, Juana Borja González, Claudia Arispe-Alburqueque

Research output: Contribution to journalArticlepeer-review


Background: Currently, there are no cut-off points for levels of empathy, making it difficult to assess the change experienced in its development or as a result of its intervention. It is an unsolved problem. Introduction: Empathy is a cognitive-affective attribute that enables nursing staff to maintain a professional relationship that entails various benefits for the patient. Its strengthening and development during university education is desirable. Empathy studies in Latin American nursing students are based on the direct scores obtained on an empathy test, based on which the variable is described and groups are compared. Statistical comparisons are not enough to discriminate substantive changes since two statistical values can show differences without implying that the post-intervention levels may correspond to a higher category in relation to those of pre-intervention or that two compared groups are qualitatively different. The above applies to empathic behaviour and is valid for students and professionals of health. This study aimed to establish cut-off points that allow defining ordinal categories in empathy. Methods: In this multicenter and cross-sectional study, 3712 students from 11 Latin American nursing schools participated. The Jefferson Empathy Scale (JES) was applied; the psychometric properties were confirmed by Factor Analysis Confirmatory and Invariance. Results: The JSE empathy scale is a measure with adequate reliability and construct validity. Examined cut-offs determined a structure of five empathy intervals that allowed them to be classified as empathy values in very high, high, medium, low and very low. Discussion: The sequence of statistical tests carried out allowed us to determine ranges of categorical values in the empathy levels of groups of students. However, the determined categories may constitute a specific characteristic of them. It is not possible to extrapolate these results to regions other than those of Latin America. Conclusion: The estimated rankings allow comparing levels of empathy between groups of nursing students and the real effect of empathic interventions. Implications for nursing: To contribute with strategies to evaluate changes in the empathic skills of nursing students, resulting in a well-valued skill in health services. Implications for nursing policy: The cut-off points define evaluative categories (very low, low, medium, high and very high) that allow objective classification of levels of empathy achieved after (for example) an empathic intervention. This allows assessment of substantive changes experienced by nursing students (and professionals).

Original languageEnglish
JournalInternational Nursing Review
Publication statusAccepted/In press - 2022


  • cut-off points
  • empathy
  • factor analysis
  • Latin América
  • nursing students
  • psychometrics

ASJC Scopus subject areas

  • Nursing(all)


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