Nursing students' empathy in response to biological and psychosocial attributions of depression: A vignette-based cross-cultural study

Abstract

Background: Empathy is vital for quality nursing care in acute mental health settings. Although different explanations of mental illnesses shape mental health clinicians' empathy towards people with mental illnesses, it is unclear how such findings translate to the culturally diverse nursing context.

Aim: The study investigated nursing students' empathy towards people with depression and their perceived clinical utility of biological and psychosocial explanations of depression in Australia and Singapore, focusing on two factors of cultural difference: relational mobility and cultural tightness.

Design: We used a cross-sectional research design with a repeated-measures component.

Participants: The sample included 211 nursing students from Australia and Singapore. Participants were predominantly female (81 %), with ages ranging from 18 to 57 years (M = 26.51, SD = 7.61).

Methods: Participants completed a vignette-based online questionnaire containing measures of empathy, perceived clinical utility, relational mobility, and cultural tightness.

Results: Nursing students' empathy in response to the biological and psychosocial explanations of depression differed in Australia (biological: M = 2.96, SD = 0.89, 95 % CI [2.80, 3.13]; psychosocial: M = 3.56, SD = 0.91, [3.39, 3.73]) but not in Singapore (biological: M = 3.05, SD = 0.91, [2.87, 3.23]; psychosocial: M = 3.25, SD = 0.93, [3.06, 3.43]). Relational mobility mediated cross-cultural variances in empathy, b = -0.16, SE = 0.06, 95 % CI [-0.29, -0.05], and perceptions of clinical utility, b = -0.08, SE = 0.05, [-0.20, -0.00], when depression was explained psychosocially.

Conclusions: Nursing students' empathy and perceived clinical utility of explanations of depression are shaped differently across cultures in part due to relational mobility and cultural tightness. As such, embedding cultural awareness education in nursing curricula to address any culturally rooted biases towards people with mental illnesses may present a promising avenue to optimise nursing students' empathy towards people with mental illnesses.

Keywords: Attributions; Biological explanations; Cross-cultural; Empathy; Mental health; Mental health nursing; Mental illnesses; Nursing education; Nursing students.