Attitudes Toward Death and Medical Empathy in Nursing Students Caring for Palliative Care Patients

Introduction: Palliative care is a fundamental field within nursing, yet it poses an emotional challenge for many students in training. It is therefore essential to consider the role of affective variables in the caregiving process, such as empathic competencies and expressed attitudes toward death. Objective: To examine the structural relationships between medical empathy and attitudes toward death among nursing students, identifying the most influential variables, their clusters, and the stability of their interconnections. Materials and Methods: A cross-sectional survey study was conducted with a sample of 354 adult nursing students (276 women) who were doing professional internships in palliative care. The Jefferson Scale of Empathy – Student Version (JSE-S) and the Revised Death Attitude Profile (DAP-R) were used. Data were analyzed using psychological network analysis, with 5,000 bootstrap samples to assess metric stability, and Spearman’s coefficient was applied to examine the structure of correlations. Results: The empathic dimension of compassionate care was negatively associated with the tendency to avoid death (ρ = -0.218, p < 0.001) or escape (ρ = -0.252, p < 0.001) when reflecting on patients’ deaths, while perspective taking emerged as the most stable variable within the network structure. Both empathic dimensions were positively related to neutral acceptance of death (p < 0.001). Conclusion: Clinical empathy generates less polarization toward patient death in nursing students; their professionalization requires training in emotional skills that impact the quality of their care.