Association Between Empathy and Readiness to Deliver Psychological First Aid among Undergraduate Nursing Students in Iraq
Downloads
Objective: This study aimed to assess empathy levels and readiness to deliver psychological first aid among undergraduate nursing students in Iraq, and to examine the association between empathy and readiness to deliver psychological first aid.
Methods and Materials: A descriptive correlational study was conducted among 637 third- and fourth-year nursing students from six public universities across northern, central, and southern Iraq. Stratified multistage cluster sampling was used. Data were collected using a demographic questionnaire, the Jefferson Scale of Empathy–Health Professions Student Version (20–140), and a PFA self-assessment questionnaire (20–100). Descriptive statistics, Spearman’s rank correlation, and non-parametric tests (Mann–Whitney U and Kruskal–Wallis) were used. Significance was set at p < 0.05.
Findings: The mean age was 22 ± 2.5 years; 57.8% were female. Students’ mean empathy score was 94.09 ± 16.81, reflecting moderate empathy; 38.8% scored high, 55.7% moderate. The mean PFA readiness score was 79.45 ± 12.51, reflecting high readiness; 76.1% scored high. A significant positive correlation was observed between empathy and PFA readiness (r = .398, p < .001). Empathy differed significantly by university (p = .001) and monthly income (p = .042). PFA readiness differed by university (p = .004), academic year (p = .038), and academic achievement (p = .014).
Conclusion: Empathy is positively associated with readiness to provide PFA. Nursing education should integrate structured PFA training to strengthen students’ emotional competence and crisis-response preparedness.
Downloads
Abdown, S. N., & Hussein, H. A. (2022). Lifestyle behavior and mental health among nursing collegians at Baghdad University. International journal of health sciences, 6(S2), 15209-15216. https://doi.org/10.53730/ijhs.v6nS2.8853
Aslam, M. Z., Ajani, K., Zahid, W., Salim, Z., & Soomar, S. M. (2025). Academic motivation in undergraduate nursing students: An analytical cross-sectional study. JPMA. The Journal of the Pakistan Medical Association, 75(10), 1537-1542. https://doi.org/10.47391/JPMA.20628
Bas-Sarmiento, P., Fernández-Gutiérrez, M., Baena-Baños, M., Correro-Bermejo, A., Soler-Martins, P. S., & de la Torre-Moyano, S. (2020). Empathy training in health sciences: A systematic review. Nurse education in practice, 44, 102739. https://doi.org/10.1016/j.nepr.2020.102739
Bas-Sarmiento, P., Fernández-Gutiérrez, M., Díaz-Rodríguez, M., Carnicer-Fuentes, C., Castro-Yuste, C., García-Cabanillas, M. J., Gavira-Fernández, C., de los Ángeles Martelo-Baro, M., Paloma-Castro, O., & del Carmen Paublete-Herrera, M. (2019). Teaching empathy to nursing students: A randomised controlled trial. Nurse education today, 80, 40-51. https://doi.org/10.1016/j.nedt.2019.06.002
Cao, X., Wang, L., Wei, S., Li, J., & Gong, S. (2021). Prevalence and predictors for compassion fatigue and compassion satisfaction in nursing students during clinical placement. Nurse education in practice, 51, 102999. https://doi.org/10.1016/j.nepr.2021.102999
Cunico, L., Sartori, R., Marognolli, O., & Meneghini, A. M. (2012). Developing empathy in nursing students: a cohort longitudinal study. Journal of clinical nursing, 21(13-14), 2016-2025. https://doi.org/10.1111/j.1365-2702.2012.04105.x
Dal Santo, L., Pohl, S., Saiani, L., & Battistelli, A. (2014). Empathy in the emotional interactions with patients. Is it positive for nurses too? Journal of Nursing Education and Practice, 4(2), 74. https://doi.org/10.5430/jnep.v4n2p74
Derksen, F., Bensing, J., & Lagro-Janssen, A. (2012). Effectiveness of empathy in general practice: a systematic review. The British Journal of General Practice, 63(606), e76. https://doi.org/10.3399/bjgp13X660814
Derksen, F., Hartman, T. C. O., van Dijk, A., Plouvier, A., Bensing, J., & Lagro-Janssen, A. (2017). Consequences of the presence and absence of empathy during consultations in primary care: A focus group study with patients. Patient education and counseling, 100(5), 987-993. https://doi.org/10.1016/j.pec.2016.12.003
Doyle, K., Hungerford, C., & Cruickshank, M. (2014). Reviewing tribunal cases and nurse behaviour: Putting empathy back into nurse education with Bloom's taxonomy. Nurse education today, 34(7), 1069-1073. https://doi.org/10.1016/j.nedt.2014.02.004
Dulay, M. C. B., Domingo, J. E. A., Domingo, K. F. R., Domondon, H. O. F., Dumangon, L., Duran, R., & Sevilla, G. (2018). An exploratory study of factors influencing student nurses’ empathy. J Health Educ Res Dev, 6(2), 2-7. 10.4172/2380-5439.1000259
Edoho Samson-Akpan, P., Lee, Y., Baqer Al-Jubouri, M., Rose Cayaban, A., & John, M. E. (2022). Compassion competence among nursing students from different cultures: A multinational study. Journal of Nursing Education, 61(6), 289-295. https://doi.org/10.3928/01484834-20220404-13
Findley, P. A., Halpern, J., Rodriguez, R., & Vermeulen, K. (2016). Psychological first aid: A tool for mitigating conflict in the Middle East. In Mental health and addiction care in the Middle East (pp. 155-170). Springer. https://doi.org/10.1007/978-3-319-41556-7_10
Gebbie, K. M., & Turnock, B. J. (2006). The public health workforce, 2006: new challenges. Health Affairs, 25(4), 923-933. https://doi.org/10.1377/hlthaff.25.4.923
Ghazwani, S., Alshowkan, A., & AlSalah, N. (2023). A study of empathy levels among nursing interns: a cross-sectional study. BMC nursing, 22(1), 226. https://doi.org/10.1186/s12912-023-01381-y
Hamaideh, S. H., Abuhammad, S., Khait, A. A., Al-Modallal, H., Hamdan-Mansour, A. M., Masa’deh, R., & Alrjoub, S. (2024). Levels and predictors of empathy, self-awareness, and perceived stress among nursing students: a cross sectional study. BMC nursing, 23(1), 131. https://doi.org/10.1186/s12912-024-01774-7
Hassan, A. F., Majeed, H. M., & Jasim, A. H. (2020). Assessment of undergraduate critical care nursing students’‘knowledge and attitudes toward caring of dying patients in colleges of nursing at Baghdad University. Indian Journal of Forensic Medicine & Toxicology, 14(3), 1142-1146. https://www.researchgate.net/profile/Haider-Majeed-2/publication/348415364_Assessment_of_Undergraduate_Critical_Care_Nursing_Students'_'_Knowledge_and_Attitudes_toward_Caring_of_Dying_Patients_In_Colleges_of_Nursing_at_Baghdad_University/links/5ffda1c045851553a03a6cd5/Assessment-of-Undergraduate-Critical-Care-Nursing-Students-Knowledge-and-Attitudes-toward-Caring-of-Dying-Patients-In-Colleges-of-Nursing-at-Baghdad-University.pdf
Hassan, G., Ventevogel, P., Jefee-Bahloul, H., Barkil-Oteo, A., & Kirmayer, L. J. (2016). Mental health and psychosocial well-being of Syrians affected by armed conflict. Epidemiology and psychiatric sciences, 25(2), 129-141. https://doi.org/10.1017/S2045796016000044
Jawad, O. M., & Mohammed, Q. Q. (2022). Assessment the Level of Psychological Resilience among Senior Undergraduate Nursing Students. https://www.researchgate.net/profile/Osama-Maki/publication/372781223_Open_Access_Clinical_Schizophrenia_Related_Psychoses_Assessment_the_Level_of_Psychological_Resilience_among_Senior_Undergraduate_Nursing_Students/links/64c80d1bb8336a7b3cf8bb60/Open-Access-Clinical-Schizophrenia-Related-Psychoses-Assessment-the-Level-of-Psychological-Resilience-among-Senior-Undergraduate-Nursing-Students.pdf
Kılıç, N., & Şimşek, N. (2019). The effects of psychological first aid training on disaster preparedness perception and self-efficacy. Nurse education today, 83, 104203. https://doi.org/10.1016/j.nedt.2019.104203
McCabe, C. (2004). Nurse–patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing, 13(1), 41-49. https://doi.org/10.1111/j.1365-2702.2004.00817.x
Mesk, Z., Alqaissi, N., Amro, A., Abdul Manaf, R., Farajalla, F., Abu Rmaileh, S., … Alzareer, A. (2025). Academic Stress and Its Effect on the Psychological, Emotional, and Behavioral Health of Nursing Students. International Journal of Body, Mind and Culture, 12(7), 147–156. https://doi.org/10.61838/ijbmc.v12i7.917
Nazir, M., Alhareky, M., Alqahtani, A., Alsulaimi, L., Alotaibi, R., Yousef, N., Abushal, F., & Alhumaid, J. (2021). Measuring Empathy among Dental Students and Interns: A Cross‐Sectional Study from Dammam, Saudi Arabia. International Journal of Dentistry, 2021(1), 5584423. https://doi.org/10.1155/2021/5584423
Noori, A. K. M. (2025). Effectiveness of Health Protection Attitudes in Disease Prevention Among Nursing Students in Baghdad. International Journal of Body, Mind & Culture, 12(1). https://doi.org/10.61838/ijbmc.v12i1.775
Nusbaum, K. E., Wenzel, J. G., & Everly, G. S. (2007). Psychological first aid and veterinarians in rural communities undergoing livestock depopulation. Journal of the American Veterinary Medical Association, 231(5), 692-694. https://doi.org/10.2460/javma.231.5.692
Raja, H., & Sajit, K. (2018). Self-esteem and its relationship with the age, gender and academic achievement among the students of the south Iraq colleges of nursing. Iraqi National Journal of Nursing Specialties, 31(2), 139-148. https://doi.org/10.58897/injns.v31i2.314
Saddik, B. (2018). Evaluation of Personal Digital Assistant Acceptance in Nursing Education. Iraqi National Journal of Nursing Specialties, 31(1), 93-100. https://doi.org/10.58897/injns.v31i1.295
Schoultz, M., McGrogan, C., Beattie, M., Macaden, L., Carolan, C., & Dickens, G. L. (2022). Uptake and effects of psychological first aid training for healthcare workers’ wellbeing in nursing homes: A UK national survey. Plos one, 17(11), e0277062. https://doi.org/10.58897/injns.v31i1.295
Ward, J., Schaal, M., Sullivan, J., Bowen, M. E., Erdmann, J. B., & Hojat, M. (2009). Reliability and validity of the Jefferson Scale of Empathy in undergraduate nursing students. Journal of Nursing Measurement, 17(1), 73-88. https://doi.org/10.1891/1061-3749.17.1.73
Xu, Y., Liang, Y., Ye, H., & Xu, Y. (2023). Literature review of the research on nursing students’ professional self-concept. Medical Education Online, 28(1), 2153396. https://doi.org/10.1080/10872981.2022.2153396
Younis, M. S. (2025). Mental health services in Iraq. In Mental Health Care in the Middle East (pp. 71-108). Springer. https://doi.org/10.1080/10872981.2022.2153396
Copyright (c) 2026 International Journal of Body, Mind and Culture
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
