Differential associations of compassion and affective empathy with compassion fatigue among nurses: a path analysis study

Compassionate concern and affective empathy may have different associations with the emotional demands of nursing. This study examined their associations with compassion fatigue in nurses. A cross-sectional correlational study included 234 nurses working in a tertiary hospital. Data were collected using the Compassion Scale–Short Form, Kiersma–Chen Empathy Scale and Compassion Fatigue Short Scale. Spearman correlations were evaluated with Benjamini–Hochberg adjustment, and two observed-variable path models were estimated using maximum likelihood. Compassion was inversely associated with total fatigue (β = −0.206, 95% CI − 0.374 to − 0.045). Affective empathy was positively associated with secondary traumatic stress (β = 0.186, 95% CI 0.016 to 0.347) and burnout (β = 0.211, 95% CI 0.054 to 0.365). Complete adjusted models explained 4.8%, 11.4% and 14.1% of outcome variance, respectively. Affective empathy reliability was low (α = 0.602). The small adjusted associations are compatible with different association patterns for compassion and affective empathy. Low explained variance, measurement limitations and the cross-sectional design preclude causal or intervention conclusions.