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Emotional Preparedness Mediates the Relationship Between Empathy and Depersonalization Among Oncology Nurses: A Cross-Sectional Study

Shannastaniar Aisya Adif orcid scopus  -  Department of Nursing, Faculty of Medicine, Universitas Negeri Malang, Indonesia
*Huan-Fang Lee orcid  -  Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
Chung-Ying Lin orcid  -  Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan
Bayu Fandhi Achmad orcid  -  Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia
Miaofen Yen orcid  -  Department of Nursing, College of Medicine, National Cheng Kung University, Taiwan
Mohammad Adreng Pamungkas orcid  -  Sekolah Tinggi Ilmu Kesehatan (STIKes) Wira Medika Bali, Indonesia
Open Access Copyright (c) 2025 by the Authors, Published by Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Depersonalization is a key dimension of burnout that threatens the well-being of nurses and patient care, especially in oncology settings where exposure to suffering is frequent. Empathy typically protects against depersonalization; however, its effect may weaken in emotionally demanding environments. Emotional preparedness may help sustain empathy and prevent depersonalization. However, evidence on how emotional preparedness explains the relationship between empathy and depersonalization remains limited.

Purpose: This study examined whether emotional preparedness mediates the relationship between empathy and depersonalization among oncology nurses in Indonesia.

Methods: A cross-sectional survey using convenience sampling was conducted with 116 oncology nurses at a national cancer hospital in Jakarta, Indonesia. Empathy, emotional preparedness, and depersonalization were measured using the Jefferson Scale of Empathy (JSE), the Expanded Nursing Stress Scale (ENSS), and the Maslach Burnout Inventory (MBI). Data were analyzed using Pearson correlation, multiple linear regression, and mediation analysis with Hayes’ PROCESS Macro (Model 4).

Results: Emotional preparedness and empathy were both negatively correlated with depersonalization (r = −0.28, p < .01; r = −0.54, p < .01, respectively). Empathy significantly predicted depersonalization (β = −0.21, SE = 0.02, p < .001), and mediation testing demonstrated that emotional preparedness fully mediated this relationship (β = −0.08, SE = 0.06, 95% CI [−0.14, −0.02]).

Conclusion: Emotional preparedness fully mediates the association between empathy and depersonalization among oncology nurses. Strengthening emotional preparedness through structured training and psychosocial support may help preserve empathy, reduce depersonalization, and enhance both nurse well-being and the quality of patient care.
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Keywords: Burnout; cross-sectional studies; depersonalization; empathy; mediation analysis

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