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Empathy Among Physicians and Nurses in Japan: A Nationwide Cross-sectional Study

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Abstract

Background

Empathy with patients improves clinical outcomes. Although previous studies have shown no significant differences in empathy levels between physicians and nurses, investigations have not considered differences in cultural backgrounds and related factors of healthcare providers at the individual level.

Objective

This study compares empathy between physicians and nurses in Japan and identifies relevant factors that contribute to these differences.

Design

A cross-sectional survey design was used in the study. The online survey was conducted using the Nikkei Medical Online website.

Participants

A total of 5441 physicians and 965 nurses in Japan who were registered as members of Nikkei Medical Online were included.

Main Measures

Empathy was measured by the Jefferson Scale of Empathy (JSE).

Key Results

Cronbach’s α was 0.89. The mean JSE score for Japanese physicians was significantly lower at 100.05 (SD = 15.75) than the mean score of 110.63 (SD = 12.25) for nurses (p<0.001). In related factors, higher age (increasing by one year) (+0.29; 95% CI 0.25 to 0.32; p<0.001), self-identified female gender (+5.45; 95% CI 4.40 to 6.49; p<0.001), having children (+1.20; 95% CI 0.30 to 2.10; p=0.009), and working at a hospital with 20–99 beds (+1.73; 95% CI 0.03 to 3.43; p=0.046) were significantly associated with higher scores, whereas those whose mother is a physician (−6.65; 95% CI −8.82 to −4.47; p<0.001) and father is a nurse (−9.53; 95% CI −16.54 to −2.52; p=0.008) or co-medical professional (−3.85; 95% CI −5.49 to −2.21; p<0.001) were significantly associated with lower scores.

Conclusions

Physicians had significantly lower scores on the JSE than nurses in Japan. Higher age, self-identified female gender, having children, working at a small hospital, having a mother who is a physician, and having a father who is a nurse or co-medical professional were factors associated with the level of empathy.

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Data Availability:

Data supporting the findings of this study are available from the General Medicine Center of Shimane University Hospital (e-mail: shimanegp@gmail.com).

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Acknowledgements:

We would like to thank all those who assisted us in completing this study. In particular, we appreciate the generous cooperation of the Nikkei Medical Online staff. We also thank the members of the Shimane University Center for General Medicine for their support in conducting this study.

Funding

This work was supported by the National Academic Research Grant Fund (JSPS KAKENHI: 20H03913). The sponsor of the study had no role in the study design, data collection, analysis, or manuscript preparation.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Shimane University, Shimane, Japan

    Tomoe Otsuka MD, RN & Yasuhisa Nakano MD

  2. General Medicine Center, Shimane University Hospital, 89-1, Enya-cho, Izumoshi, Shimane, 693-8501, Japan

    Kota Sakaguchi MD, MBA, Takeshi Endo MD, Seiji Odagawa MD, Yoshihiko Shiraishi MD & Takashi Watari MD, MHQS, PhD

  3. Medicine Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Nathan Houchens MD & Takashi Watari MD, MHQS, PhD

  4. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA

    Nathan Houchens MD & Takashi Watari MD, MHQS, PhD

  5. Nikkei BP Nikkei Medical Editorial Department, Tokyo, Japan

    Daisaku Yamasaki BA & Mamoru Miwa MMS

  6. Muribushi Okinawa Project for Teaching Hospitals, Okinawa, Japan

    Yasuharu Tokuda MD, MPH

  7. Diversity and Inclusion Center, Okayama University, Okayama, Japan

    Hitomi Kataoka MD, PhD

Authors
  1. Tomoe Otsuka MD, RN
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Contributions

T.W. served as the principal investigator of the entire study. T.O., Y.N., D.Y., M.M., and T.W. collaborated on designing the study, formulating the main conceptual ideas, and outlining the proof. Data collection through a web survey was conducted by T.O., T.W., K.S., Y.S., T.Y., M.M., D.Y., and H.K. The gathered data was subsequently analyzed and visualized by T.O., S.K., Y.S., T.E., S.O., H.K., and T.W. The results were interpreted by T.O., K.S., T.E., S.O., and T.W. The manuscript was authored by T.O. and T.W. with the assistance of the others. N.H., H.K., Y.S., Y.T., and T.W. provided supervision for this study. The manuscript underwent revisions by T.O., T.W., Y.T., N.H., and H.K. All authors discussed the results and provided feedback on the manuscript.

Corresponding author

Correspondence to Takashi Watari MD, MHQS, PhD.

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The authors declare no conflict of interest. All authors have reviewed and agreed to the content of the manuscript, and there are no financial interests to declare.

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Key Points

Question: What are the differences in levels of empathy between physicians and nurses in Japan and the factors influencing them?

Findings: In this cross-sectional study that included 6406 participants, the mean Jefferson Scale of Empathy (JSE) score for Japanese physicians was significantly lower than that for nurses. In terms of related factors, higher age, self-identified female gender, having children, and working at a small hospital were significantly associated with higher scores, whereas those whose mother is a physician and father is a nurse had significantly lower scores.

Meaning

Higher age, self-identified female gender, having children, working at a small hospital, having a mother who is a physician, and having a father who is a nurse were factors associated with the level of empathy.

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Otsuka, T., Sakaguchi, K., Houchens, N. et al. Empathy Among Physicians and Nurses in Japan: A Nationwide Cross-sectional Study. J GEN INTERN MED 39, 960–968 (2024). https://doi.org/10.1007/s11606-024-08620-1

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