Abstract
BACKGROUND: Atraumatic care is a key approach in pediatric nursing that minimizes physical and psychological distress during hospitalization. Compassion competence and caring self-efficacy are thought to be critical personal resources that may influence nurses' attitudes toward atraumatic care. However, the mechanism through which compassion impacts these attitudes remains unclear. AIM: This study examined the mediating role of caring self-efficacy in the relationship between compassion competence and attitudes toward atraumatic care. METHODS: This cross-sectional correlational study included 214 pediatric nurses working in two public training and research hospitals in western Türkiye. Data were collected using the Compassion Competence Scale (CCS), Caring Self-Efficacy Scale (PWNCSES) and Pediatric Atraumatic Care Attitude Scale (PACAS) Statistical analyses included Pearson correlation, independent samples t-test, one-way ANOVA, and mediation analysis using the PROCESS macro (Model 4) in SPSS. RESULTS: Compassion competence was positively associated with both caring self-efficacy and attitudes toward atraumatic care (p < .001). However, the direct association between compassion competence and atraumatic care attitude became non-significant when caring self-efficacy was included in the model, suggesting that this relationship was statistically explained through caring self-efficacy. Additionally, caring self-efficacy significantly predicted both subdimensions of atraumatic care attitude: knowledge and awareness (β = 0.43, p < .001) and practice and family participation (β = 0.54, p < .001). Sociodemographic variables such as shift type, years of pediatric experience, and postgraduate education were significantly related to both caring self-efficacy and atraumatic care attitudes. CONCLUSION: Caring self-efficacy statistically accounted for the association between compassion competence and positive attitudes toward atraumatic care. Enhancing caring self-efficacy may promote the consistent application of atraumatic care principles among pediatric nurses. The findings support the integration of psychosocial competency-building interventions into pediatric nursing education and professional development.