الفهرس 
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Abstract
Empathy and patient-centered care have been associated with better patient outcomes. Active listening and self-awareness are regarded to be connected to empathy and, in turn, patient-centered care. Students studying nursing have shown a great deal of interest in the idea of empathy. For a Health Care Provider (HCP) to comprehend a patient’s experience, forge a therapeutic bond with the patient, and provide care based on this knowledge, PCC aspects are essential. Consequently, PCC delivery is essential for improving patient outcomes, including safety, as well as for meeting patient values and wants. Increased empathy and self-awareness may result in better patient-centered care. These two skills can be improved.
Aim of the study:
This study aims to determine the relation between patient-centered care and empathy among nursing students at Alexandria Technical Health Institute
.
Setting
This study was conducted at the Technical Health Institute. This is the only institute associated with the Ministry of Population and Health at Alexandria Governorate provide 2 years of studying nursing after preliminary stage which provide three years of studying nursing. which they have the necessary degrees of empathy, which are related to providing PCC and getting better results for patients.
Subjects
The study subjects include Nursing Students in the pre-selected setting, who are in the fourth, and fifth years of technical nursing diploma. the Epi-Info program was used to estimate the sample size using Expected frequency = 50 %, Acceptable error = 5 %., Confidence coefficient = 95 %, and the total at two years of Nursing students’ population is 1360. The program revealed the minimum sample size to be 300 nursing students.
Tools:
Four tools will be used in this study as follows:
Tool (1): The Patient-Practitioner Orientation Scale (PPOS)
This scale was developed by Krupat et al. (2000). It was adopted by the researcher to assesses nursing students’ PCC and it consists of 18 self-assessment items using a six-point Likert-type scale, where 6 is strongly disagree and 1 strongly agree. The PPOS measures all four characteristics of PCC (caring, sharing, communication, and therapeutic relationship). Total scores range from 18 to 108, where; Low level of PCC score ranges from 18 < 48, Moderate level ranges from 48 < 78, while high levels range from 78-108. This tool was tested for reliability using Cronbach’s alpha, (r=0.92) (Haley et al., 2017).
Tool (2): Active-Empathic Listening Scale (AELS)
This tool was developed by Gearhart and Bodie (2011). It was adopted by the researcher to assesses nursing students’ active listening through three different stages of the listening process; sensing (4 items), processing (3 items), and responding (4 items), using a seven-point Likert- scale, ranged from never or almost never (1) to always or almost always true (7), The overall score ranges from 11 to 77, where; the Low level of active listening ranges from 11< 33, Moderate level ranges from 33< 55, while, high levels ranges from 55-77.
This tool was tested for its internal reliability using Cronbach’s alpha, and it was reliable (r=0.89) (Gearhart & Bodie, 2011).
Tool (3): Self-Consciousness Scale-Revised (SCS-R)
This scale was developed by DaSilveira et al. (2015). It was adapted by the researcher to assesses nursing students’ self-awareness. The SCS- R consists of 22 self-assessment items using a three-point Likert-type scale, whereas;1 indicates is not like me at all up to 3 which indicates a lot like me. Total scores range from 22 to 66 as follow; Low level of self-awareness score ranges from 22 - 36, Moderate level ranges from 37- 51, while, High levels of it ranges from 52-66. This tool was tested for reliability using Cronbach’s alpha, it was reliable. (r=0.91) (DaSilveira et al., 2015).
Tool (4): Kiersma Chen Empathy Scale (KCES):
This tool was developed by Kiersma et al. (2013) to assesses nursing students’ empathy. It was adapted by the researcher. It consists of 15 self-assessment items using a Seven-Point-Likert type scale ranging from strongly disagree (1) to strongly agree (7). Total scores range from 15 to 105, where, Low level of empathy score ranges from 15 < 45, Moderate ranges from 45<75, while, High levels ranges from75-105. This tool was tested for the reliability by using Cronbach’s alpha, and it was reliable (r=0.80) in nursing students (Kiersma et al., 2013).
Methods
1. An approval for conducting the study was obtained from the Research Ethics Committee of the Faculty of Nursing, Alexandria University.
2. Permission for conducting the study was obtained from the Faculty of Nursing, Alexandria University, and the administrators of the identified institution to collect the necessary data
3. All the study tools were back-to-back translated (English-to-Arabic).
4. The study tools were evaluated for the quality of their content validity by (5) experts in the field of the study and the necessary modifications were done.
5. The study tools were evaluated for their reliability using Cronbach’s Alpha test. The reliability coefficient was .773 for tool one and .821 for tool two, .929 for tool three and .804 for tool four which were acceptable.
6. A pilot study was conducted on 5% (n= 15) of the study subjects, they not excluded from the sample. This pilot study was done for testing feasibility and applicability of the adopted tools, identify obstacles that may be encountered during data collection and determine data collection average time. No modifications were done.
a. Data was gathered from the study subjects through hand delivered questionnaire by the researcher after explaining the purpose of the study.
b. Written informed consent was optioned from the study subjects to collect the necessary data and the need explanations were given when requested.
c. The time needed to fill the previously mention questionnaire was about 40 minutes.
d. The confidentiality of the data and the anonymity of the study subjects were assured.
e. Data collection take a period of three months from 1\12\2021 to 3\3\2022.
The following were the main results of the present study:
The present study mainly concerned with identifies relationship between patient centered care and empathy among nursing students at the Alexandria Technical Health Institute. Results are presented for research question. The main variables that were measured in this study included relationship of empathy, active listening, and self-awareness, to PCC.
(1) Regarding characteristics of the study subjects. The results revealed that the highest percentage of students (65.3%) aged 19 years. While, the lowest percentage (11.7%)aged 20-<21 years. The findings showed that 74 % of the students were in the fourth year, Moreover, less than half of them (44.3 %) were have excellent academic performance according to GPA.
(2) In relation to the level of PCC as perceived by the study subjects, the findings revealed that, mean percent score of PCC was 64.94% as perceived by the study subjects. Also, the majority of the subjects (93.7%) had a moderate level of PCC
)3( In relation to level of active listening as perceived by the study subjects, the results revealed that more than half percent of the study subjects (56%) had a moderate level of active listening. On the other hand, the majority of them (91.7%) had a high responding level, and 73.7% of students had moderate level of sensing.
)4( As regards to mean percent score of active listening as perceived by the study subjects. The study concluded that, the total mean percent score of active listening was 69.87%. The results revealed that the highest mean present percentage of students (77.43%) was related to responding as a one dimension of active listening, while the sensing dimension had the lowest mean percent score (62.36).
(5) In relation to level of self-awareness as perceived by the study subjects, the results revealed that mean percent of self-awareness was (75.5%), the majority of the subjects (71.0 %) had a moderate level of self-awareness.
(6) In relation to mean percent of empathy as perceived by the study subjects. The study concluded that, the total mean percent score of empathy was 67.79%. Also, the study revealed that, 65% of the study subjects had a moderate level of empathy.
(7) Shows a relationship between the studied subjects’ demographic characteristics and PCC, self-awareness, empathy, and active listening. The findings revealed a significant relationship between students’ academic performance according to GPA and PCC, self-awareness, empathy, and active listening respectively (p=0.000, p=0.000, p=0.000, p=0.002). Where, the findings indicated that the study subject who have “Excellent” GPA (72.81±2.064) had higher perception about PCC than the others.
(8) Revealed relationship between students’ demographic characteristics and the mean score of active listening. The findings revealed a significant relation between students’ academic performance according to GPA and active listening (P=0.002). Where, the findings indicated that the students’ who have “Acceptable” GPA (54.49±1.389) had higher perception about active listening than the others degrees.
(9) Concerning the relationship between the studied students’ demographic characteristics and the mean score of self -awareness. The findings revealed a significant relation between students’ academic performance according to GPA and self -awareness (p=0.000). while, the findings indicated that the students who have “Good” GPA (51.65±3.058) had higher perception about PCC than the others degrees.
(10) Illustrates relationship between students’ demographic characteristics and the mean score of empathy. The findings revealed a significant relationship between students’ academic performance according to GPA and empathy (p=0.00). Where, the findings indicated that, the students who have “Good” GPA, had higher perception of empathy (73.25±3.966) than the others degrees.
(11) Shows a significant positive correlation between PCC, active listening, self-awareness and empty respectively (p=0.000, p=0.001, p=0.004).