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The Mediating Role of Resilience Between Empathy and Professional Competence Among Emergency Nurses in the West Bank, Palestine: Partial Least Squares Structural Equation Modeling.

Anas Shehadeh,Ahmad Shuhaiber,Malakeh. Z. Malak,A. Ayed,Hisham Zahran

Published 2026 in International Nursing Review

ABSTRACT

AIM This study examined the levels of and relationship between resilience, empathy, and professional competence among emergency nurses in Palestine. BACKGROUND Emergency nurses working in conflict-affected regions such as Palestine encounter extreme stressors that may adversely impact their resilience, empathy, and professional competence. These factors are vital for sustaining high-quality nursing care, yet their interrelationships remain insufficiently understood. METHODS A cross-sectional design was employed, recruiting 236 emergency nurses from governmental hospitals across the West Bank, Palestine. Data were collected using the Connor-Davidson Resilience Scale, Toronto Empathy Questionnaire, and the short Nurse Professional Competence Scale. Data analysis involved IBM SPSS Statistics 26.0 and SmartPLS 4.0, applying structural equation modeling to assess relationships among variables. RESULTS Participants had low resilience (M = 72.8, SD = 26.7), above-average empathy (M = 46.3, SD = 13.1), and high professional competence (M = 78.0, SD = 10.7). Empathy did not directly predict professional competence (β = 0.11, p = 0.13) but significantly predicted resilience (β = 0.96, p < 0.01). Resilience strongly predicted professional competence (β = 0.86, p < 0.01) and fully mediated the empathy-competence relationship (indirect effect = 0.81, p < 0.01). CONCLUSION The mediation effect underscores resilience as a pivotal mechanism through which empathy influences professional competence in high-stress, conflict-affected settings. Enhancing resilience is essential to translate empathy into effective professional performance among emergency nurses in Palestine. IMPLICATIONS FOR NURSING Interventions focusing on resilience-building and emotional regulation can improve nurses' competence, reduce burnout, and support sustainable quality nursing care delivery. IMPLICATIONS FOR NURSING POLICY Policymakers should prioritize resilience enhancement strategies in nursing education and workplace policies, especially in conflict-affected healthcare environments.

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