Emotional Preparedness Mediates the
Relationship Between Empathy and
Depersonalization Among Oncology Nurses:
A Cross-Sectional Study

Emotional Preparedness Mediates the
Relationship Between Empathy and
Depersonalization Among Oncology Nurses:
A Cross-Sectional Study

Burnout; cross-sectional studies;
depersonalization; empathy;
mediation analysis

Background: Depersonalization is a key dimension of burnout that threatens the
well-being of nurses and patient care, especially in oncology settings where exposure
to suffering is frequent. Empathy typically protects against depersonalization;
however, its effect may weaken in emotionally demanding environments. Emotional
preparedness may help sustain empathy and prevent depersonalization. However,
evidence on how emotional preparedness explains the relationship between
empathy and depersonalization remains limited.
Purpose: This study examined whether emotional preparedness mediates the
relationship between empathy and depersonalization among oncology nurses in
Indonesia.
Methods: A cross-sectional survey using convenience sampling was conducted
with 116 oncology nurses at a national cancer hospital in Jakarta, Indonesia.
Empathy, emotional preparedness, and depersonalization were measured using the
Jefferson Scale of Empathy (JSE), the Expanded Nursing Stress Scale (ENSS), and
the Maslach Burnout Inventory (MBI). Data were analyzed using Pearson
correlation, multiple linear regression, and mediation analysis with Hayes’
PROCESS Macro (Model 4).
Results: Emotional preparedness and empathy were both negatively correlated
with depersonalization (r = −0.28, p < .01; r = −0.54, p < .01, respectively). Empathy
significantly predicted depersonalization (β = −0.21, SE = 0.02, p < .001), and
mediation testing demonstrated that emotional preparedness fully mediated this
relationship (β = −0.08, SE = 0.06, 95% CI [−0.14, −0.02]).
Conclusion: Emotional preparedness fully mediates the association between
empathy and depersonalization among oncology nurses. Strengthening emotional
preparedness through structured training and psychosocial support may help
preserve empathy, reduce depersonalization, and enhance both nurse well-being
and the quality of patient care.

Shannastaniar Aisya Adif1,2, Huan-Fang Lee3, Chung-Ying Lin4, Bayu Fandhi Achmad5,
Miaofen Yen3, Mohammad Adreng Pamungkas6

https://doi.org/10.14710/nmjn.v15i3.75232

22 December 2025

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