level of empathy with quality of life of health care professionals

BIOSTAT tests, t tests

1. Level of Empathy and its Association with Professional Quality of Life Of Nurses Working in a Public Hospital PROJECT EVALUATION BY DR AYESHA & DR SHAZIA

2. Purpose: To assess the level of empathy and ProQOL of nurses working in a public hospital in Rawalpindi and to explore the association between the level of empathy and the nurses’ professional quality of life. Objectives: 1. To measure the level of empathy among nurses working in a public hospital. 2. To assess the Professional Quality of Life ( ProQOL ) among nurses working in a public hospital. 3. To explore the association between the level of empathy and professional quality of life. 4. To assess the association of level of empathy and professional quality of life with the demographic variables.

3. RESEARCH QUESTIONS What is the level of Empathy among nurses working in a public hospital? What is the level of Professional Quality of Life ( ProQOL ) among nurses working in a public hospital? Is there any association between the level of empathy, professional quality of life and demographic variables? Is there any relationship between the level of empathy and professional quality of life?

4. Research Hypothesis H1: There is a significant association between the participants’ level of empathy and ProQOL . H0: There is no association between the participant’s level of empathy and ProQOL .

5. Research hypothesis Null and Alternate both have been stated. It is suggested that to have clarity only one hypothesis can be stated. Moreover there are 3 objectives but only one hypothesis have been stated It would have been better if objectives were presented as primary and secondary objectives.

6. Inclusion & Exclusion Criteria Can be improved by addressing the confounders in the study. Such as, subgroups workloads, Lack of awareness, departmental logistics. Exclusion criteria can be improved by excluding nurses who are medically compromised and taking antidepressants or any mental health problem.

7. Study design PI has stated that correlational design was used to determine the cause and effect relationship. To determine cause and effect relationship randomized controlled trial or case control study can also be used.

8. Settings & Sampling Can be multicenter for generalizability of results Understand the logistics of different departments. Sample can be done stratified sampling .

9. MethodOLOGY Study Design: Cross-sectional Analytical design was used to conduct the study. Study Setting: A tertiary care teaching hospital Duration of Study: May 2023 to July 2023 . Study Population: All the registered nurses working in a public hospital Sample Size: 200/ Recalculate Sampling: Random Sampling (Which type of random sampling)???

10. Data Collection tool Level of Empathy : Jefferson Scale of Empathy Health Professional (JSE HP) version measures nurses' empathy levels. 7 point Likert scale [scores range from 20-140. Cut-off values for scores are Low from 47 to 106, Medium from 107 to 121, and High from 122 to 140 ( Yuguero et al., 2017)] Professional Quality of life : 10 items for each subscale. Values range from 30-150, and cut-off values for sub-scales are Low from 22 or less, Medium from 23 to 41, and High from 42 or more for each scale ( Stamm , 2010)] Three-part self-reporting questionnaire consisting of socio-demographic data (age, gender, years of experience, marital status, number of kids, education, work department, number of jobs, etc.). 5 point Likert scale

11. Data Analysis Descriptive Statistics Continuous variables: Mean, standard deviation, median, interquartile range Categorical variables: Percentages, and frequencies Normality Test: Inferential Statistics: Spearman correlation was used to check the association between empathy and ProQOL Kruskal Wallis and Mann Whitney U test were used to look for significant differences in empathy, CS, and BO due to demographic variables like age, year of experience, workplace, workload, marital status, and education level. One-way ANOVA was used to check the association between STS and demographic variables.

12. Sample size: N= 131 Software: G power Test family : F tests Statistical Tests : Linear multiple regressions Effect size : 0.15 Alpha error : 0.05 Power : 85% Number of Predictors : 10

13. Demographic Variables

14. Characteristics Categories f (%) Age 20-29 Years 78 (39%) 30-39 Years* 109 (54.5%) 40-50 Years 13 (6.5%) Qualification Diploma* 110 (55%) Post RN 83 (41.5%) Bachelor of Science in Nursing 7 (3.5%) Workplace Medical ward 29 (14.5%) Surgical ward 27 (13.5%) ICU 35 (17.5%) Peads * 33 (16.5%) Gynecology* 27 (13.5%) ED 26 (13.0%) OT 23 (11.5%) Shift Day 31 (15.5%) Rotating* 169 (84.5%) Nurse-Patient Ratio 1-10 Patients* 51 (21.5%) 11-20 Patients 36 (18%) 21-30 Patients 54 (27%) 31-40 Patients 35 (17.5%) 41-50 Patients 24 (12%) Years of Experience 1-10 Years* 138 (69%) 11-20 Years 60 (30%) 21-30 Years 2 (1%) Marital Status Single 59 (29.5%) Married* 141 (70.5%) No of Kids 100 (50%) 1 28 (14.0) 2* 41 (20.5%) 3 25 (12.5%) 4 6 (3.0%) No of jobs 1* 196 (98%) 2 4 (2.0%) Demographic Information (n=200)

15. RQ1: What is the Level of empathy Data Collection Tool : Jefferson Empathy scale for Health Professional Score Range : 20-140. Higher the score more is the level of empathy. Cut off Values Low level of empathy: 47- 106 Medium Level of empathy: 107-121 High Level of Empathy: 122-140

16. Overall Empathy scores Mean : 90.5 + 12.5 Standard Error : 0.88 Median: 92.00 Skewness: -.589 Kurtosis : .342

17. Test of normality Level of empathy Data is not normally distributed

18. Interpretation The mean of level of empathy score is 90.59 with standard deviation of 12.55 standard error of 0.8876 (90.59 + 12.55) with 95 % CI. Median 92.00 . Skewness and kurtosis is -.589 and 1.596 For normality testing Kolmogorov –Smirnov test p value is 0.000 which is lesser than 0.05 so assumption is not met and data is not normally distributed.

19. Level of empathy ( Categorical variable)

20. Rq2: Association of level of empathy with Demographic Variables: Non parametric test : Kruscal Willis Test, Mann whitney test ( Marital status, no of jobs, work shift) JUSTIFICATION : Distribution is non-parametric Demographic Variables are displayed in proportion and percentages Data is been divided into categories

21. Association Between Empathy and Demographic Variables Empathy Variables Categories N (%) Median (IQR) P-value Age 20-29 years 78 (39%) 93 (12.50) 0.183 30-39 years 109 (54.5%) 92 (15) 40-50 years 13 (6.5%) 87 (17) Workplace Medical Wards 29 (14.5%) 88 (10.50) 0.283 Surgical Wards 27 (13.5%) 90 (16) ICU 35 (17.5%) 92 (11) Paeds 33 (16.5%) 94 (15) Gynaecology 27 (13.5%) 92 (21) ER 26 (13%) 93 (24.50) OT 23 (11.5%) 89 (10) Experience 1-10 years 139 (69.5%) 92 (15) 0.99 11-20 years 61 (30.5%) 90 (13.50) Qualification Diploma 110 (55%) 92 (15) 0.97 Post RN 83 (41.5%) 91 (14) BScN 7 (3.5%) 93 (9) Marital Status Married 141 (70.5%) 92 (16) 0.414 Single 59 (29.5%) 92 (13) No of kids 0 kids 100 (50%) 92 (15.75) 0.913 1 kid 28 (14%) 91 (16.25) 2 kids 41 (20.5%) 89 (13) 3 kids 25 (12.5%) 90 (14) 4 kids 6 (3%) 96.5 (19.25) Duty shift Day shift 31 (15.5%) 89 (14) 0.491 Rotating shift 169 (84.5%) 92 (14.50) Nurse: Patient 10-Jan 55 (27.5%) 89 (10) 0.508 20-Nov 36 (18%) 93.50 (10.75) 21-30 52 (26%) 92 (17.50) 31-40 33 (1.5%0 93 (17.50) 41-50 24 (12%) 86.50 (18.50) No of Jobs One job 196 (98%) 92 (14.75) 0.733 Two jobs 4 (2%) 91 (8.25) No significant association between empathy and demographic variable was found. P>0.05

22. AGE

23. Workplace /departments

24. Work experience

25. Marital STATUS

26. Number of kids

27. Number of jobs

28. WORKSHIFT

29. rq : What is the level of PRO- QOL? Mean : 100 + 12.5 Standard Error : 0.88 Median: 101 Skewness: -.600 Kurtosis : 1.168

30. nORMALITY OF pro- qol Data is not. Normally distributed

31. nORMALITY OF pro- qol outliers

32. Association Between PR0-QOL and Demographic Variables PRO-QOL Variables Categories N (%) Median (IQR) P-value Age 20-29 years 78 (39%) 32.50 (8) 0.139 30-39 years 109 (54.5%) 33 (5.50) 40-50 years 13 (6.5%) 29 (7.50) Workplace Medical Wards 29 (14.5%) 33 (7) 0.888 Surgical Wards 27 (13.5%) 33 (5) ICU 35 (17.5%) 32 (6) Paeds 33 (16.5%) 33 (7.50) Gynaecology 27 (13.5%) 33 (9) ER 26 (13%) 32.50 (7.75) OT 23 (11.5%) 31 (6) Experience 1-10 years 139 (69.5%) 32 (7) 0.961 11-20 years 61 (30.5%) 33 (5.75) Qualification Diploma Generic 110 (55%) 32 (7) 0.694 Post RN 83 (41.5%) 33 (6) 0.006* Generic BScN 7 (3.5%) 32 (7) 0.43 Marital Status Married 141 (70.5%) 32 (6) 0.754 Single 59 (29.5%) 33 (8) No of kids 0 kids 100 (50%) 29 (8) 0.73 1 kid 28 (14%) 32.50 (7.75) 2 kids 41 (20.5%) 29 (6.50) 3 kids 25 (12.5%) 28 (6) 4 kids 6 (3%) 31.50 (13) Duty shift Day shift 31 (15.5%) 32 (5) 0.331 Rotating shift 169 (84.5%) 33 (6.50) Nurse: Patient 10-Jan 55 (27.5%) 32 (6) 0.743 20-Nov 36 (18%) 32.50 (6.75) 21-30 52 (26%) 33 (7.50) 31-40 33 (1.5%0 32 (8) 41-50 24 (12%) 33 (9) No of Jobs One job 196 (98%) 32.50 (6) 0.897 Two jobs 4 (2%) 33.50 (6.25) Significant difference in PRO-QOL the group of nurses who have POST RN qualification. p = 0.006

33. Association Between BO and Demographic Variables BO Variables Categories N (%) Median (IQR) P-value Age 20-29 years 78 (39%) 32.50 (8) 0.217 30-39 years 109 (54.5%) 33 (5.50) 40-50 years 13 (6.5%) 29 (7.50) Workplace Medical Wards 29 (14.5%) 33 (7) 0.987 Surgical Wards 27 (13.5%) 33 (5) ICU 35 (17.5%) 32 (6) Paeds 33 (16.5%) 33 (7.50) Gynaecology 27 (13.5%) 33 (9) ER 26 (13%) 32.50 (7.75) OT 23 (11.5%) 31 (6) Experience 1-10 years 139 (69.5%) 32 (7) 0.517 11-20 years 61 (30.5%) 33 (5.75) Qualification Diploma 110 (55%) 32 (7) 0.065 Post RN 83 (41.5%) 33 (6) BScN 7 (3.5%) 32 (7) Marital Status Married 141 (70.5%) 32 (6) 0.125 Single 59 (29.5%) 33 (8) No of kids 0 kids 100 (50%) 29 (8) 0.698 1 kid 28 (14%) 32.50 (7.75) 2 kids 41 (20.5%) 29 (6.50) 3 kids 25 (12.5%) 28 (6) 4 kids 6 (3%) 31.50 (13) Duty shift Day shift 31 (15.5%) 32 (5) 0.911 Rotating shift 169 (84.5%) 33 (6.50) Nurse: Patient 10-Jan 55 (27.5%) 32 (6) 0.933 20-Nov 36 (18%) 32.50 (6.75) 21-30 52 (26%) 33 (7.50) 31-40 33 (1.5%0 32 (8) 41-50 24 (12%) 33 (9) No of Jobs One job 196 (98%) 32.50 (6) 0.967 Two jobs 4 (2%) 33.50 (6.25)

34. Association Between STS and Demographic Variables STS Variables Categories N (%) Median (IQR) P-value Age 20-29 years 78 (39%) 29 (10) 0.193 30-39 years 109 (54.5%) 29 (7.50) 40-50 years 13 (6.5%) 26 (7.50) Workplace Medical Wards 29 (14.5%) 30 (10.50) 0.505 Surgical Wards 27 (13.5%) 30 (7) ICU 35 (17.5%) 28 (7) Paeds 33 (16.5%) 29 (8.50) Gynaecology 27 (13.5%) 28 (9) ER 26 (13%) 28.50 (7) OT 23 (11.5%) 28 (9) Experience 1-10 years 139 (69.5%) 30 (8) 0.246 11-20 years 61 (30.5%) 28 (7) Qualification Diploma 110 (55%) 28 (7) 0.246 Post RN 83 (41.5%) 30 (10) BScN 7 (3.5%) 30 (6) Marital Status Married 141 (70.5%) 29 (8) 0.794 Single 59 (29.5%) 29 (7) No of kids 0 kids 100 (50%) 29 (8) 0.336 1 kid 28 (14%) 32.5 (7.75) 2 kids 41 (20.5%) 29 (6.50) 3 kids 25 (12.5%) 28 (6) 4 kids 6 (3%) 31.50 (13.0) Duty shift Day shift 31 (15.5%) 28 (9) 0.862 Rotating shift 169 (84.5%) 29 (7.50) Nurse: Patient 1-10 55 (27.5%) 28 (7) 0.732 11-20 36 (18%) 29 (7.50) 21-30 52 (26%) 28 (9) 31-40 33 (1.5%0 29 (8.50) 41-50 24 (12%) 30 (5.75) No of Jobs One job 196 (98%) 29 (8.75) 0.437 Two jobs 4 (2%) 26 (6)

35. RQ4: What is the correlation of Empathy & Pro QoL Bivariate Analysis Spearman Correlation was used.