Abstract
AIM: To explore the nuanced structural relationship between insightful self-reflection and empathy using network analysis among undergraduate nursing students. BACKGROUND: Empathy, which is an essential component of humanistic nursing care, should be fostered in nursing students. Self-reflection is considered a precondition for the development of empathy. However, the fine-grained interconnections between the different dimensions of self-reflection and empathy remain unclear. DESIGN: A cross-sectional online survey. METHODS: Convenience sampling was used to recruit participants from four nursing schools from January to February 2024. Participants completed the Chinese version of the Jefferson Scale of Empathy-Nursing Student (CJSE-NS) and the Self-Reflection and Insight Scale (SRIS). Network analysis was used to examine the structural relationships between self-reflection and empathy. RESULTS: A total of 258 valid questionnaires were received. The node perspective taking had the highest centralities and predictability, emerging as the most central node of the network. Exhibiting the highest bridge strength, the node insight served as the bridge node connecting self-reflection and empathy. The strongest positive correlation in the cross-community was between the nodes need for self-reflection and walking in their shoes (weight = 0.142). Network stability and accuracy were confirmed by bootstrapping methods, indicating the robustness of the findings. CONCLUSIONS: This study highlights the intricate connections between self-reflection and empathy among nursing students. Salient central and bridge nodes may inform intervention targets; prospective or experimental studies are needed to test whether targeting these nodes improves empathy.