Archive page

Psychological Capital and Empathy Among Nurses in Psychiatric Care

Mare Silić Kirhmajer

1 2 3 Majda Grah

1 Psychiatric Clinic Sveti Ivan Zagreb, Croatia

2 University of Applied Health Sciences, Zagreb, Croatia

3 Faculty of Dental Medicine and Health Osijek,

Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

Article received: 02. 10. 2025.

Article accepted: 23. 01. 2026.

DOI: 10.24141/2/10/1/9

Author for correspondence:

Mare Silić Kirhmajer

Psychiatric Clinic Sveti Ivan Zagreb, Croatia E-mail: maresilickirhmajer@gmail.com

Keywords: empathy, health workforce, nurses, psychiatric nursing, work experience

Abstract

Introduction. Psychological capital is a construct within positive psychology that includes hope, self-efficacy, resilience, and optimism. Empathy is a complex neurobiological, psychological, and social phenomenon. In nursing, empathy is viewed as a

multidimensional, dynamic process that is co-created between nurse and patient, dependent on a trust- ing therapeutic relationship and directed toward the other while remaining self-aware.

Aim. The aim of the research was to examine the empathy and psychological capital of nurses and the relationship between empathy and psychological capital with length of service in the field of psychia- try and completed psychotherapy education.

Methods. A quantitative, nonexperimental study was conducted at the Psychiatric Clinic Sveti Ivan in Zagreb, Croatia. The shortened psychological capital questionnaire (PCQ 12), the Jefferson Scale of Empa- thy for Healthcare Professionals (JSE-HP), and the so- ciodemographic questionnaire were used to conduct the assessment among a sample of 67 psychiatric nurses.

Results. The study participants achieved a high level of psychological capital on average (M = 4.80, SD = 0.57) and moderate levels of empathy with rela- tively higher variability (M = 102.36, SD = 17.14). No statistically significant associations were identified between either psychological capital or empathy and years of psychiatric work experience or psychother- apy education.

Conclusion. The study found that psychiatric nurses demonstrated generally high levels of psychological capital and moderate levels of empathy. No statisti- cally significant associations were identified between these results and either length of work experience in psychiatry or completed psychotherapy education. Fu- ture research should explore additional personal and professional variables that may relate to psychological capital and empathy in this population.

Introduction

Organizations operate in environments characterized by constant change, making human capital a critical determinant of their success. In healthcare, human capital is embodied primarily in the knowledge, skills, and experience of healthcare professionals. The Na- tional Strategy of the Croatian Healthcare System 2020–2030 identifies improving population health and increasing the quality and accessibility of care as key priorities, both of which depend heavily on the competencies of the nursing workforce (1). Nurses represent the largest professional group in Croatia, comprising 32,765 individuals and 42.6% of all health- care employees (2). Given this central role, strategic investment in nurses is essential at institutional and policy levels. Understanding the psychological capaci- ties that enable nurses to function effectively—such as psychological capital and empathy—is therefore crucial for workforce planning, staff retention, and sustainable human resource development.

Positive psychology focuses on developing psycho- logical resources that enable individuals and organi- zations to function effectively (3). Within workplace settings, this approach is reflected in Positive Or- ganizational Behaviour (POB), which emphasizes hu- man strengths that can be measured, developed, and managed to enhance performance and well-being

(4). POB identifies four core psychological capaci- ties—hope, self-efficacy, resilience, and optimism— collectively termed psychological capital or HERO

(4). Hope is defined as a positive motivational state based on an interactively derived sense of success- ful agency and pathways (5), self-efficacy reflects an individual’s confidence in mobilizing motivation, cog- nitive resources and actions (6), resilience denotes the capacity to recover from challenges (7), and op- timism represents a positive attributional style (8). Psychological capital is conceptualized as a state-like and malleable resource, shaped by contextual and ex- periential factors and capable of increasing through professional development and targeted training (4).

Empathy is a multifaceted construct whose diverse definitions across philosophy, psychology, and neu- roscience contribute to considerable conceptual complexity (9). Within nursing practice, empathy is understood as a multidimensional, dynamic, and re-

lational concept composed of four interrelated ele- ments: (a) a co-creative practice involving both the empathizer and the empathee, (b) an experience that is fundamentally other-directed while main- taining connection with oneself, (c) a bi-directional, interactive interpersonal process requiring continu- ous attunement and responsivity, and (d) a relational quality that flourishes under conditions of openness, relatability, and trust (10).

Empathic medical care is associated with numerous benefits, including fewer medical errors and mal- practice claims, and higher retention of healthcare professionals (11). By using empathic skills, nurses obtain information about patients’ subjective health experiences, enabling them to tailor care to individ- ual needs, establish a constructive therapeutic rela- tionship, foster trust, and provide effective support in the recovery process (12, 13).

The existing literature shows mixed results on wheth- er empathy increases or decreases over time in the health professions trajectory (14, 15). Higher levels of empathy among healthcare workers have been found to be associated with higher educational levels, female gender, older age, and more years of work experience in the mental health field (16-19). However, health- care workers’ empathy towards patients decreases when confronted with violent and antisocial behaviour

(20). Current systematic reviews indicate that both psychotherapy training and other empathy-enhancing interventions can strengthen and sustain empathic behaviour, but further research is needed to identify which approaches produce durable changes (21-23). Specifically, group analysis education fosters altruism, empathy, cooperation and reflective functioning with- in therapeutic communities, contributing to positive professional and organizational change (24). Through experiential group learning, trainees develop their therapeutic role, strengthen professional identity, and refine their emotional and relational responses toward themselves, colleagues and patients (24, 25).

Because psychiatric nursing relies heavily on inter- personal attunement and emotional labour, empathy is a foundational competence in this specialty. In light of the relational nature of psychiatric nursing and the unclear effects of psychotherapy training on psychological capital and empathy, we hypothesized that (1) nurses with more years of psychiatric expe- rience would have higher psychological capital and empathy, and (2) nurses who completed psychother- apy education would score higher on both constructs.

Aim

The aim of the research was to examine the empa- thy and psychological capital of nurses and the rela- tionship between empathy and psychological capital with length of service in the field of psychiatry and completed psychotherapy education.

Methods Participants

The study sample consisted of nurses employed at the Psychiatric Clinic who voluntarily took part in the study, which was conducted between June 5 and July 7, 2023. In total, 67 nurses participated (N = 67; N_male = 20, N_female = 47), with a mean age of approximately 39 years (M = 38.78, SD = 11.41). Data on education level was missing for one participant. Among the remaining participants, the largest group had completed second- ary education (N = 30), followed by higher vocational education (N = 22) and university-level education (N

= 14). At that time, the Clinic employed 189 nurses in total, meaning that the participants in this study repre- sent 35% of the nursing workforce.

Instruments

Psychological Capital Questionnaire (PCQ-12)

Psychological capital was measured using the 12-item Psychological Capital Questionnaire (PCQ- 12), developed by Luthans et al. (2007) (26). The scale consists of four subscales: self-efficacy (3 items), hope (4 items), resilience (3 items), and opti- mism (2 items). Each item is rated on a 6-point Likert scale (1 = strongly disagree, 6 = strongly agree). Sub- scale scores are calculated as the mean of all items within each domain, and the total psychological capi- tal score is obtained as the mean of all 12 items, with higher scores indicating higher psychological capital. The Croatian version of the PCQ-12, used with per- mission of the validators, has demonstrated solid psy- chometric properties. Murgić et al. (2018) confirmed the expected four-factor structure and reported sat- isfactory construct validity and internal consistency

in a Croatian sample (Cronbach’s α: self-efficacy =

.77, hope = .73, resilience = .68, optimism = .63, total PsyCap = .87) (27). In the present study, Cronbach’s alpha for the total scale was .82, and reliability coef- ficients for the subscales were .83 for self-efficacy,

.78 for hope, .79 for resilience, and .66 for optimism, indicating acceptable internal consistency.

Jefferson Scale of Empathy – Health Professionals Version (JSE-HP)

Empathy was measured using the 20-item Jefferson Scale of Empathy – Health Professionals version (JSE- HP) by Hojat et al. (2002) (28). Items are rated on a 7-point Likert scale. After reverse-scoring negatively worded items, all responses are summed to yield a total score ranging from 20 to 140, with higher val- ues indicating greater empathy. Previous research reports internal consistency between α = .78 and .89

(28). The Cronbach’s alpha reliability coefficient for the empathy scale obtained in this study was .88, indicating good internal consistency reliability. The Croatian translation by Batrnek and Gašpert was used with permission of the coordinator at Thomas Jefferson University (29).

Sociodemographic Questionnaire

A brief sociodemographic questionnaire collected data on age, sex, education level, total years of work experience, years of psychiatric work experience, and completed psychotherapy education.

Procedure

Participants were recruited through an internal an- nouncement issued by the Nursing Department. Data were collected using paper-and-pencil ques- tionnaires. Participation was voluntary and anony- mous; written informed consent was obtained before completion. Questionnaires were returned in sealed envelopes. Ethical approval was granted by the Eth- ics Committee of the Psychiatric Clinic Sveti Ivan (01- 1878/23-2), and procedures adhered to the Declara- tion of Helsinki.

Statistics

Using the Shapiro–Wilk test to assess normality, a statistically significant deviation from normal distri- bution was identified for all examined variables ex- cept the empathy scale (see Table 1). However, the

skewness and kurtosis coefficients for all variables fell within the range of –1 to +1 (see Table 1), indicat- ing that the use of parametric statistical procedures should not be restricted (30). Descriptive statistics (frequencies, means, and standard deviations) were used to summarize the data. Pearson’s correlation co- efficient and the point-biserial correlation coefficient were used to test associations between the vari- ables. The use of correlations—including the point- biserial coefficient for dichotomous variables—was selected because the primary aim of the study was to examine relationships between variables, specifi- cally the presence, strength, and direction of these associations within a correlational research design. Although a t-test would yield the same p-value math- ematically, the correlational approach was conceptu- ally more appropriate for addressing the research questions. A significance level of 5% was applied when evaluating statistical results. The proportion of missing data for all items of the psychological capi- tal and empathy scales was below 5%; following the scoring guidelines, missing responses were replaced with the participant’s mean score on the remaining items of the corresponding scale, in line with the recommended scoring procedures. Data analysis was conducted using IBM SPSS Statistics 20.

Results

Descriptive statistics were calculated for all main va- riables (Table 1).

The average total number of years of work experi- ence among participants was approximately 18 years (M = 18.34, SD = 11.63), while the average number of years of work experience in the field of psychiatry was about 15 years (M = 14.96, SD = 11.15). Both variables showed very high variability, which is con- sistent with the observed range of work experience: from one to 45 years in total work experience, and from less than one year to 41 years in psychiatric work experience. Most participants had not complet- ed any form of psychotherapy training (N = 42). All participants who had received psychotherapy educa- tion completed training in the psychotherapeutic mo- dality of group analysis (N = 25).

Participants, on average, demonstrated high levels of psychological capital (M = 4.80, SD = 0.57) and mod- erate empathy, with somewhat greater variability (M

= 102.36, SD = 17.14).

To test the first and second hypotheses—whether nurses with more years of psychiatric work experi- ence would show higher psychological capital and empathy—Pearson’s correlation coefficient was used. The analysis revealed no statistically significant as-

sociations between years of psychiatric work experi- ence and psychological capital (r = .23, p = .063), nor between years of psychiatric work experience and empathy (r = .15, p = .226).

To test the third and fourth hypotheses—whether nurses who had completed psychotherapy education would score higher on psychological capital and em- pathy—the point-biserial correlation coefficient was applied. The results showed no statistically signifi- cant associations between psychotherapy education and psychological capital (rpb = –.21, p = .087), nor between psychotherapy education and empathy (rpb

= –.18, p = .138).

Discussion

In our sample, the mean psychological capital score was 4.80 (SD = 0.57), higher than the meta-analytic average for nurses (4.2) (31), though that meta-anal- ysis did not include European samples. Our result was comparable to Italian data for teachers and health- care professionals (4.6) (32). In Croatia, psychologi- cal capital across professions ranges from 3.8 among hospitality workers (33) to 4.85 among teachers and preschool educators (34,35), with healthcare pro- fessionals showing similar levels (4.72) (36). These comparisons suggest that care-and education-ori- ented professions, including nursing, tend to show

higher psychological capital, which is consistent with our findings.

Although our hypothesis that nurses with more years of psychiatric experience would show higher overall psychological capital was not supported, one noteworthy exception emerged: years of psychiatric experience were significantly associated with high- er levels of optimism, although the correlation was small. This partly aligns with studies reporting higher PsyCap among psychiatric nurses with longer service (37–40), but the weak effect in our sample suggests that only specific components of PsyCap—not the construct as a whole—may be sensitive to accumulat- ed clinical experience. Given that psychological capi- tal is considered a state-like, developable resource, it is plausible that workplace conditions, professional role, and organizational stability may influence Psy- Cap trajectories more strongly than tenure alone.

A similar pattern was observed for psychotherapy education. Overall PsyCap did not differ significantly between nurses with and without psychotherapy training, a small but significant correlation emerged for the self-efficacy subscale, indicating that nurses who completed psychotherapy education reported slightly higher self-efficacy. To our knowledge, no previous studies have examined whether psycho- therapy education increases PsyCap among nurses or other healthcare professionals. Given that psy- chotherapy training includes processes theoretically aligned with PsyCap development, our hypothesis in this area remained exploratory rather than empiri- cally grounded.

In our sample, the average empathy score measured by the JSE-HP was 102.36 (SD = 17.14), indicating a moderate level of empathy. This score is lower than those typically reported in JSPE results among phy- sicians and nurses, where averages range from 110 to 113 (41), and lower than the median of 121 (IQR 111–128) reported among Croatian nurses (42).

Research examining the association between work experience and empathy in nursing is mixed. Some studies report that empathy increases with profes- sional experience, including findings among oncol- ogy nurses and among mental health nurses with both general and specialized experience (43,44). In contrast, other studies have found no association (45), while several report decreases in empathy over time, particularly among nurses who remain on the same unit and may experience cumulative emotional strain (46). Beyond experience itself, contextual and organizational factors also influence empathy levels. For example, mental health staff in France reported generally high empathy scores, with slightly lower values among psychiatric nurses (20). Ghaedi et al.

(47) similarly showed that high workload and stress

reduce empathic capacity across clinical settings, al- though psychiatric nurses tended to exhibit higher empathy compared with nurses in intensive care or emergency departments. Together, these findings suggest that empathy is shaped by a combination of experience, work environment, and emotional demands rather than by tenure alone. Studies ex- amining the perceived importance of psychothera- pists’ empathy consistently show that clients’ sub- jective experience of being understood strongly predicts long-term therapeutic success (48–50). It is important to highlight that nurses reporting higher compassion fatigue also report higher burnout, and empathic engagement appears to play a significant mediating role in this relationship, effectively ampli- fying the impact of compassion fatigue on burnout (51, 52). Collectively, the literature indicates that empathy is not a linear function of tenure but a dy- namic construct influenced by interpersonal stress- ors, organizational climate, workload, and emotional demands. Taken together, these findings help ex- plain why our hypothesis—that empathy would be higher among nurses with more years of psychiatric experience and among those with psychotherapy education—was not supported.

Broader factors may also have influenced our results, particularly given the heterogeneity of our sample:

we did not distinguish between nurses actively en- gaged in psychotherapeutic work and those who had completed psychotherapy training but were not practicing, and many nurses’ psychotherapeutic skills may be overshadowed by task-focused clinical du- ties. Another limitation is that empathy and psycho- logical capital may be constrained by organizational conditions, such as staffing ratios, patient acuity, or burnout levels, which were not measured. The rela- tively small sample size further reduces statistical power and may have limited our ability to detect meaningful associations. The single-site design al- so restricts the interpretability and generalizability of the findings. In this context, the absence of sig- nificant associations in our study likely reflects the complex interplay of systemic and methodological factors rather than the absence of meaningful rela- tionships in principle.

Conclusion

This study examined whether psychological capital and empathy among psychiatric nurses were associ- ated with years of psychiatric work experience and psychotherapy education. Psychological capital was generally high and empathy moderate, but neither showed statistically significant associations with the examined variables. Empathy appears to be a dynamic, context-sensitive construct rather than a linear outcome of tenure. Further research in broader settings is needed to clarify which individual and or- ganizational factors contribute to these capacities in psychiatric nursing.

Author contributions

Conceptualization and methodology (MSK, MG); data curation and formal analysis (MSK, MG); investigation and project administration (MSK); and writing – origi- nal draft and review & editing (MSK, MG). All authors have approved the final manuscript.

Acknowledgements

The authors thank Eleonora Soldo, Master of Psy- chology, for statistical analysis support.

Conflict of Interest Statement

The authors declare no conflict of interest.

Declaration of Generative AI in Writing

During preparation, the authors used ChatGPT 5.1 for language enhancement.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not- for-profit sectors.

References

1. Džakula A, Vočanec D, Banadinović M, Vajagić M, Lonča- rek K, Lukačević Lovrenčić I, et al. Croatia: health system review. Health Syst Transit. 2021;23(2):1-146.

2. Hrvatski zavod za javno zdravstvo; Stevanović R, Capak K, Benjak T, editors. Hrvatski zdravstveno-statistički ljetopis za 2023. godinu. Zagreb: HZJZ; 2025. Available at: https://www.hzjz.hr/wp-content/uploads/2025/06/ HZsLJ_2023._g._2025.06.20..pdf Croatian

3. Plaza Leutar M. Pozitivna psihologija – od ishodišta do prakse u školi u dijalogu s pedagogijom i logoterapi- jom. Acta Iadertina. 2021;18(2):285-308. https://doi. org/10.15291/ai.3608 Croatian

4. Luthans F, Youssef-Morgan CM. Psychological capital: an evidence-based positive approach. Management Depar- tment Faculty Publications. 2017;4(17):1-28. https:// doi.org/10.1146/annurev-orgpsych-032516-113324

5. Snyder CR, Rand KL, Sigmon DR. Hope theory: a member of the positive psychology family. In: Snyder CR, Lopez SJ, editors. Handbook of Positive Psychology. New York: Oxford University Press; 2002.

6. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215. https://doi.org/10.1037/0033-295X.84.2.191

7. King DD, Newman A, Luthans F. Not if, but when, we need resilience in the workplace. J Organ Behav. 2016;37(5):782-6. https://doi.org/10.1002/job.2063

8. Seligman MEP. Positive health. Appl Psychol Health Well-Being. 2008;57(1):3-18. https://doi.org/10.1111/ j.1464-0597.2008.00351.x

9. Hoffman ML. Empathy and moral development. Cam- bridge: Cambridge University Press; 2000. https://doi. org/10.1017/CBO9780511805851

10. van Dijke J, van Nistelrooij I, Bos P, Duyndam J. Towards a relational conceptualization of empathy. Nurs Philos. 2020;21:e12297. https://doi.org/10.1111/nup.12297

11. Riess H, Kelley JM, Bailey RW, Dunn EJ, Phillips M. Empathy training for resident physicians: a randomized controlled trial of a neuroscience-informed curriculum. J Gen Intern Med. 2012;27(10):1280-6. https://doi.org/10.1007/ s11606-012-2063-z

12. Priest H. Uvod u psihološku njegu u sestrinstvu i zdravstve- nim strukama. Jastrebarsko: Naklada Slap; 2014. Croatian.

13. Wangel AM, Persson K, Duerlund S, Fhager J, Mårdhed E, Sjögran L, et al. The core elements of psychiatric and mental health nursing. Issues Ment Health Nurs. 2024;45(4):399-408. https://doi.org/10.1080/016128

    40.2024.2305934

14. Gohri J, Kalra S, Hegde S. Factors influencing empathy le- vel among healthcare professionals: a systematic review and meta-analysis. J Educ Health Promot. 2025;14:389. https://doi.org/10.4103/jehp.jehp_1647_24

15. Ghaedi F, Ashouri E, Soheili M, Sahragerd M. Nurses’ em- pathy in different wards: a cross-sectional study. Iran J Nurs Midwifery Res. 2020;25(2):117-21. https://doi. org/10.4103/ijnmr.IJNMR_84_19

16. Bogiatzaki V, Frengidou E, Savakis E, Trigoni M, Galanis P, Anagnostopoulos F. Empathy and burnout of healthcare professionals in public hospitals of Greece. Int J Caring Sci. 2019;12(2):611-26.

17. Román-Sánchez D, Bocchino A, Palazón-Fernández JL, Ma- ta-Pérez C, Cruz-Barrientos A, de la Fuente Rodríguez JM, et al. Empathy, burnout, and attitudes toward patients with mental disorders among mental health nurse residents in Spain: a cross-sectional study. Nurs Rep. 2025;15(11):381. https://doi.org/10.3390/nursrep15110381

18. Kuo J-C, Cheng J-F, Chen Y-L, Livneh H, Tsai T-Y. An explo- ration of empathy and correlates among Taiwanese nurses. Jpn J Nurs Sci. 2012;9(2):169-76. Available at: https://doi.org/10.1111/j.1742-7924.2011.00199.x

19. Lindgren BM, Molin J, Graneheim UH. Balancing between a person-centred and a common staff approach: nursing staff’s experiences of good nursing practice for patients who self-harm. Issues Ment Health Nurs. 2021;42(6):564-

    72. https://doi.org/10.1080/01612840.2020.1817206

20. Sturzu L, Lala A, Bisch M, Guitter M, Dobre D, Schwan R. Empathy and burnout among mental healthcare provi- ders in France. J Med Life. 2019;12(1):21-9. Available at: https://doi.org/10.25122/jml-2018-0050

21. Winter R, Issa E, Roberts N, Norman RI, Howick J. Assessing the effect of empathy-enhancing interventions in health education and training: a systematic review of randomi- zed controlled trials. BMJ Open. 2020;10(9):e036471. https://doi.org/10.1136/bmjopen-2019-036471

22. Kiosses VN, Karathanos VT, Tatsioni A. Empathy promo- ting interventions for health professionals: a systematic review of RCTs. J Compassionate Health Care. 2016;3:7. https://doi.org/10.1186/s40639-016-0024-9

23. El-Gawad MA, Mousa A. Empathy toward patients with mental illness among baccalaureate nursing students: impact of a psychiatric nursing and mental health educa- tional experience. J Educ Pract. 2015;6(24):98-107.

    
    

24. Mihanović M. Edukacija iz grupne analize kao dio tran- sformacije i humanizacije psihijatrijske bolnice „Sveti Ivan“. Psihoterapija. 2019;33(2):299-307. https://doi. org/10.24869/psihei.2020.299 Croatian

25. Fazlović M. Uvodna izobrazba iz grupne analize – iz dnev- nika jedne edukantice. Psihoterapija. 2018;32(2):260-79.

26. Luthans FL, Avolio BJ, Avey JA. Psychological Capital Que- stionnaire (PsyCap). APA PsycTests; 2007. https://doi. org/10.1037/t06483-000

27. Murgić D, Rijavec M, Miljković D. Inicijalna validacija skra- ćenog upitnika psihološkog kapitala (UPK-12) na hr- vatskom uzorku. Ekonomski pregled. 2019;70(1):3–21. https://doi.org/10.32910/ep.70.1.1 Croatian

28. Hojat M, Gonnella JS, Nasca TJ, Mangione S, Veloksi JJ, Ma- gee M. The Jefferson Scale of Physician Empathy: further psychometric data and differences by gender and special- ty at item level. Acad Med. 2002;77(10 Suppl):S58–60. https://doi.org/10.1097/00001888-200210001-00019

29. Hojat M, Maxwell K, S Carroll, J Cass. Jefferson Scales of Empathy (JSE): Professional manual and user’s guide. Philadelphia (PA): Jefferson Medical College, Center for Research in Medical Education and Health Care; 2016.

30. Kline RB. Principles and practice of structural equation modeling. New York: The Guilford Press; 2005.

31. Yuan Z, Zhang X, Wang F, Jin M, Teng M, He H, et al. Lev- els of psychological capital among nurses: a systematic review and meta-analysis. Int Nurs Rev. 2023;70:89-96. https://doi.org/10.1111/inr.12803

32. Di Maggio I, Ginevra MC, Nota L. The role of psychological capital in human service professionals’ work experienc- es. Eur J Investig Health Psychol Educ. 2021;11(3):639-

    48. https://doi.org/10.3390/ejihpe11030046

33. Grudić Kvasić S, Nikolić G, Milojica V. Utjecaj autentičnog vodstva na psihološki kapital zaposlenika u ugostiteljstvu. Posl izvrs. 2021;15(1):1-15. https://doi.org/10.22598/ pi-be/2021.15.1.9 Croatian

34. Smrtić N, Rijavec M. Psihološki kapital, smislenost posla, zadovoljstvo poslom i dobrobit nastavnika u privatnim i državnim školama. Život i škola. 2019;45(1-2):15-28. https://doi.org/10.32903/zs.65.1-2.1 Croatian

35. Rubinjoni L. Karakteristike rada, psihološki kapital i zado- voljstvo poslom kod odgojitelja u državnim i privatnim vrtićima [Master’s thesis]. Zagreb: Hrvatsko katoličko sveučilište; 2021. Available at: https://urn.nsk.hr/ urn:nbn:hr:224:223322 Access: Croatian

36. Bušić K. Sociodemografske varijable, opći psihološki resursi i radni psihološki kapital kao odrednice radne angažiranosti [Master’s thesis]. Zagreb: Sveučilište u Zagrebu, Fakultet hrvatskih studija; 2020. Available at: https://urn.nsk.hr/ urn:nbn:hr:111:802872 Access: [Croatian]

37. Tang Y, Wang Y, Zhou H, Wang J, Zhang R, Lu Q. The rela- tionship between psychiatric nurses’ perceived organiza- tional support and job burnout: Mediating role of psycho- logical capital. Front Psychol. 2023;14:1099687. https:// doi.org/10.3389/fpsyg.2023.1099687

38. Flinkman M, Coco K, Rudman A, Leino-Kilpi H. Registered nurses’ psychological capital: A scoping review. Int J Nurs Pract. 2023;29(5):e13183. https://doi.org/10.1111/ ijn.13183

39. Liu X, Li C, Yan X, Shi B. Psychological capital has a positive correlation with humanistic care ability among nurses. Front Psychol. 2022;13:955627. https://doi. org/10.3389/fpsyg.2022.955627

40. Shaban M, Shaban MM, Mohammed HH, Alanazi MA, Elk- est HRA. Analyzing the correlation between psychologi- cal capital in community nurses and their stress manage- ment and job satisfaction. BMC Nurs. 2025;24(1):488. https://doi.org/10.1186/s12912-025-03071-3

41. Kliszcz J, Nowicka-Sauer K, Trzeciak B, Nowak P, Sadows- ka A. Empathy in health care providers: validation study of the Polish version of the Jefferson Scale of Empathy. Adv Med Sci. 2006;51:219-25.

42. Bitunjac A, Vižintin K, Cindrić Ž. Empatija medicinskih se- stara. Sestrinski glasnik. 2022;27(3):155-9. https://doi. org/10.11608/sgnj.27.3.1 [Croatian]

43. Taleghani F, Ashouri E, Saburi M. Empathy, burnout, demographic variables and their relationships in oncol- ogy nurses. Iran J Nurs Midwifery Res. 2017;22(1):41-5. https://doi.org/10.4103/ijnmr.IJNMR_66_16

44. Román-Sánchez D, Paramio-Cuevas JC, Paloma-Castro O, Palazón-Fernández JL, Lepiani-Díaz I, de la Fuente Rodrí- guez JM, et al. Empathy, burnout, and attitudes towards mental illness among Spanish mental health nurses. Int J Environ Res Public Health. 2022;19(2):692. https://doi. org/10.3390/ijerph19020692

45. Farrelly L. Measuring empathy in health care staff in rela- tion to job satisfaction, job-related affective well-being, gender, occupation and length of service [Dissertation]. Dublin: Dublin Business School; 2012. Available at: https://esource.dbs.ie/handle/10788/448 Access:

46. Facco S, Cirio L, Galante J, Dimonte V. La capacità empatica degli infermieri di area medica. Prof Inferm. 2014;67(1):31-

    6. https://doi.org/10.7429/pi.2014.661031 [Italian]

47. Ghaedi F, Ashouri E, Soheili M, Sahragerd M. Nurses’ em- pathy in different wards: a cross-sectional study. Iran J Nurs Midwifery Res. 2020;25(2):117-21. https://doi. org/10.4103/ijnmr.IJNMR_84_19

48. Vitinius F, Tieden S, Hellmich M, Pfaff H, Albus C, Ommen

    O. Perceived psychotherapist’s empathy and therapy mo- tivation as determinants of long-term therapy success: results of a cohort study of short-term psychodynamic inpatient psychotherapy. Front Psychiatry. 2018;9:660. https://doi.org/10.3389/fpsyt.2018.00660

49. Norcross JC, Wampold BE. Evidence-based therapy re- lationships: research conclusions and clinical practices. Psychotherapy (Chic). 2011;48(1):98-102. https://doi. org/10.1037/a0022161

50. Malin AJ, Pos AE. The impact of early empathy on alli- ance building, emotional processing, and outcome during experiential treatment of depression. Psychother Res. 2015;25(4):445-59. https://doi.org/10.1080/1050330

    7.2014.901572

51. Topçu N, Akbolat M, Amarat M. The mediating role of em- pathy in the impact of compassion fatigue on burnout among nurses. J Res Nurs. 2023;28(6-7):485-95. https:// doi.org/10.1177/17449871231177164

52. Zhang J, Wang X, Chen O, Li J, Li Y, Chen Y, et al. Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling. BMC Nurs. 2023;22(1):425. https://doi.org/10.1186/s12912-023-01565-6