Confirmatory factor analysis and exploratory structural equation modeling of the factor structure of the Questionnaire of Cognitive and Affective Empathy (QCAE)

Measuring dispositional empathy in South African children

OBJECTIVE

Empathy is a key factor to examine in development, because of its predictive associations with both aggression and successful prosocial behaviour. However, established measures of empathy for Low-to-Middle Income Countries, including South Africa, are lacking. In children, parent-report measures are key. However, a local study examining empathy and aggression (Malcolm-Smith et al., 2015) found poor psychometric performance for a widely used parent-report measure of dispositional empathy, the Griffith Empathy Measure (GEM). We thus investigated which of two questionnaires measuring dispositional cognitive and affective empathy perform better in this context.

METHOD

We contrasted internal consistency reliability of a simplified version of the GEM (SGEM; n = 160) and a parent-report version of the Questionnaire of Cognitive and Affective Empathy (QCAE; n = 440) in a low-mid socio-economic status sample. Convergence between the measures and factor structure were also assessed.

RESULTS

The parent-report version of the QCAE performed well as a measure of child dispositional cognitive and affective empathy, with good reliability (overall α = 0.90 vs. SGEM α = .63), and confirmatory factor analysis supporting the two-factor structure. The SGEM's reliability and failure to correlate with QCAE indicated poor psychometric performance.

CONCLUSION

This is the first psychometric evaluation of the QCAE as a parent-report measure, and our results indicate that it should prove useful for future assessments of dispositional empathy in children across a variety of contexts.

Exploring medical students' perceptions of empathy after cinemeducation based on Vygotsky's theory

BACKGROUND

Medical students' empathy toward patients with Alzheimer's is rarely found in formal medical curricula. Based on Vygotsky's theory, watching films and reflection can be considered as effective methods to improve empathy. The present study aimed to explore medical students' perceptions of empathy toward patients with Alzheimer after participating in an educational program by using interactive video based on Vygotsky's theory.

METHODS

This qualitative study was conducted at Tehran University of Medical Sciences in 2022. The population included all 40 medical students. Firstly, the Still Alice movie which is about the feelings of a professor who was diagnosed with Alzheimer's disease was shown to the students. Secondly, the students reflected on their experiences of watching the movie. Thirdly, a session was held for group discussion on the subject of the movie, the patient's feelings, the doctor's attitude, the social environment surrounding the patient shown in the movie, and the necessity of empathy toward patients with Alzheimer's disease. The reflection papers were analyzed using the conventional qualitative content analysis method.

RESULTS

After analyzing 216 codes from 38 reflection papers, four categories, including communication with a patient with Alzheimer's, understanding the patient with Alzheimer's as a whole, medical science development, and the student's individual ideology, were extracted.

CONCLUSION

Reflection and group discussion after watching movie by providing opportunities for social interaction about personal interpretations will lead to active role in enhancing empathy. Based on the perceptions of the medical students, they gained a perspective to consider the patient as a whole and pay attention to establishing a proper relationship with the patient.

Exploratory structural equation modeling: a streamlined step by step approach using the R Project software

Confirmatory Factor Analysis (CFA) has been a popular yet limited approach to assessing latent factor structures. Despite items rarely loading exclusively on one latent factor in multifactorial scales, CFA assumes all indicators/items should load uniquely on their allocated latent dimensions. To address this weakness, Exploratory Structural Equation Modeling (ESEM) combines exploratory factor analyses (EFA) and CFA procedures, allowing cross-loadings to occur when assessing hypothesized models. Although such advantages have enhanced ESEM popularity, its adoption is often limited by software rigidity and complex coding difficulties. To address these obstacles, the current tutorial presents a streamlined, step-by-step approach using the open-source software R while providing both R and Mplus ESEM syntax. The tutorial demonstrates the sequence of the ESEM stages by examining the frequently debated Strengths and Difficulties Questionnaire (SDQ) factor structure, using openly accessible data from the Longitudinal Study of Australian Children (LSAC). As ESEM may allow a better understanding of the complex associations in multidimensional scales, this tutorial may optimize the epidemiological and clinical assessment of common yet multifaceted psychiatric presentations.

Turkish adaptation of the nursing student academic resilience inventory: A validity and reliability study

BACKGROUND

Due to the stressful nature of nursing education, it is stated that academic resilience is an important skill for students. However, there is no measurement tool to determine nursing students' academic resilience in our country.

OBJECTIVES

This study was conducted to adapt the nursing student academic resilience inventory to Turkish and determine its validity and reliability.

DESIGN

A descriptive, cross-sectional, and methodological design was used.

SETTING

The study was conducted with nursing students between May 2022 and June 2022.

PARTICIPANTS

The study included 250 s, third, and fourth-year nursing students.

METHODS

The data were collected using a personal information form, the nursing student academic resilience inventory and the resilience scale for nurses.

RESULTS

The inventory showed a 6-factor structure, namely optimism, communication, self-esteem/evaluation, self-awareness, trustworthiness, and self-regulation and consisted of 24 items. In confirmatory factor analysis, all factor loads were found to be >0.30. The fit indexes of the inventory were χ2/df = 2.294, GFI = 0.848, IFI = 0.853, CFI = 0.850, RMSEA = 0.072, and SRMR = 0.067. Cronbach's alpha of the total inventory was 0.887.

CONCLUSIONS

The Turkish version of the nursing student academic resilience inventory was shown to be a valid and reliable measurement tool.

Dissociating cognitive and affective empathy across psychopathy dimensions: The role of interoception and alexithymia

This study examined the associations between psychopathy dimensions (triarchic phenotypes and classical factors), empathy domains (cognitive and affective), and interoception (interoceptive attention and accuracy) while accounting for the putative role of alexithymia. A community sample (n = 515) completed an online survey encompassing: Triarchic Psychopathy Measure (boldness, meanness, disinhibition); Levenson Self-Report Psychopathy Scale (primary and secondary psychopathy); Body Perception Questionnaire (interoceptive attention); Interoceptive Accuracy Scale; Toronto Alexithymia Scale. Hierarchical linear regression models were implemented for hypothesis-driven analyses examining the associations between psychopathy, empathy, and interoception while controlling for sex, age, and alexithymia. Exploratory path models were employed to investigate alexithymia and/or cognitive empathy as mediators between interoception and psychopathy. Our results largely confirmed the postulated empathy profiles across psychopathy dimensions, as meanness and primary psychopathy displayed a broad empathy impairment, while disinhibition and secondary psychopathy were only associated with diminished cognitive empathy. Importantly, boldness displayed a unique pattern (enhanced cognitive empathy and reduced affective empathy), further reinforcing its importance within the constellation of psychopathy traits. Contrary to our hypotheses, self-perceived interoceptive attention and accuracy were not associated with either psychopathy dimension after controlling for alexithymia. However, interoceptive accuracy and alexithymia were associated with cognitive empathy, while alexithymia was also positively related to all psychopathy dimensions (as expected), despite the unexpected strong and negative association with boldness. Exploratory analyses suggested significant indirect effects (mediation) between interoceptive accuracy and psychopathy via alexithymia and/or cognitive empathy. These mediating effects must be interpreted with caution and future studies should be designed to formally test this model.

Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale

Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.