Does self-esteem mediate the relationship between empathy and anxiety in nurses working in intensive care units?: A cross-sectional study

Empathy is considered as an essential element in nursing care and the essence of all nurse-patient interactions, which can be affected by stressful work environments such as Intensive Care Units (ICUs). High self-esteem enables nurses to establish healthy interpersonal relationships with patients and cope more effectively with stressful situations. This study was conducted with the aim of determining the role of self-esteem and anxiety on the empathy of nurses working in ICUs.

This study is a cross-sectional research. The research population included nurses working in the adult inpatient wards of hospitals affiliated to Ilam University of Medical Sciences in 2023. Accordingly, 217 nurses were selected using the Karjisi and Morgan table in a convenience manner. Data were collected using the Demographic information questionnaire, Spielberger's anxiety, Rosenberg's Self-esteem Questionnaire, and Jefferson's Empathy questionnaire. The collected data were analysed using descriptive and inferential statistics.

The mean empathy, anxiety, and self-esteem of nurses were 92.38 ± 15.17, 65.66 ± 20.64, and 20.46 ± 5.49, respectively. A positive and significant relationship was observed between empathy and self-esteem (P < 0.01), and a negative and significant relationship was observed between empathy and anxiety, as well as self-esteem and anxiety (P < 0.01). The results of the Bootstrap and Sobel test showed that self-esteem plays a role in the relationship between empathy and anxiety in nurses working in ICUs. Actually, the higher the self-esteem of nurses, the less anxiety they experience and the more empathy they show in caring for special ward patients.

According to the findings of the present study, it can be stated that a significant relationship exists between self-esteem, anxiety and empathy. In addition, self-esteem plays a role in the relationship between empathy and anxiety. Therefore, it is necessary to develop and use programs that increase self-esteem in order to manage anxiety and strengthen empathy skills in the stressful conditions of the ICU.