Cross-cultural adaptation and psychometric validation of the Chinese version of the empathy fatigue scale for health professionals among intensive care unit nurses.

INTRODUCTION

Intensive care unit (ICU) nurses are chronically exposed to patient suffering, death, and morally complex decisions, placing them at elevated risk of empathy fatigue. China currently lacks a psychometrically sound instrument developed specifically to capture empathy fatigue within the ICU specialty context.

OBJECTIVE

This study aimed to cross-culturally adapt the Empathy Fatigue Scale for Health Professionals (EFS-HP) into Chinese and evaluate its psychometric properties among ICU nurses.

METHODS

The EFS-HP was translated and adapted following Sousa's seven-step framework and Brislin's translation model. A convenience sample of 300 ICU nurses from a tertiary grade-A hospital in the Inner Mongolia Autonomous Region completed the Chinese EFS-HP and the Compassion Fatigue Scale for Medical Staff (CFS-MS). Item analysis, reliability testing (internal consistency, split-half, test-retest), and validity testing (content validity, exploratory and confirmatory factor analyses, convergent validity) were performed using SPSS 27.0 and AMOS 31.0.

RESULTS

The Chinese EFS-HP retained all 21 items but yielded a two-factor structure-Emotional Load and Exhaustion State-accounting for 78.165% of the total variance. The scale demonstrated excellent internal consistency (Cronbach's α = 0.981), split-half reliability (Spearman-Brown = 0.938), and test-retest reliability (r = 0.958). Confirmatory factor analysis supported the two-factor model over the original single-factor model. The total score showed a moderate and statistically significant positive correlation with the CFS-MS (r = 0.587, P < 0.001), supporting convergent validity.

CONCLUSION

The Chinese EFS-HP is a reliable and valid instrument for assessing empathy fatigue among ICU nurses and may serve as a practical screening tool to inform targeted mental health interventions.