Associations Between Emotional Competence and Emotional Empathy in Secondary-Level Vocational Nursing Students at One Croatian School: A Cross-Sectional Study

Abstract

Empathy is essential to humanized nursing care, yet its relationship with emotional competence before professional entry remains insufficiently specified. This single-school cross-sectional study examined whether distinct dimensions of emotional competence were differentially associated with emotional empathy among 337 secondary-level vocational nursing students enrolled in a five-year Croatian program for general care nurses/medical technicians. Students completed the Emotional Skills and Competence Questionnaire (ESCQ-45) and the Emotional Empathy Scale from the E-Questionnaire, which primarily captures affective responsiveness to others’ distress and other negative-valence states. Spearman correlations, Kruskal–Wallis tests with Dunn–Holm post hoc comparisons, Welch tests, and hierarchical linear regression with heteroscedasticity-consistent type 3 robust standard errors were used. Emotional empathy correlated with emotion perception and understanding (ρ = 0.35, p < 0.001) and emotion management (ρ = 0.28, p < 0.001), but not with emotion expression and naming (ρ = 0.10, p = 0.070). In the fully adjusted regression model, emotion perception and understanding (β = 0.254, p < 0.001), emotion management (β = 0.254, p = 0.003), and female versus male reported sex (β = 0.277, p < 0.001) were statistically significant predictors, whereas clinical exposure was not (p = 0.429). Emotion expression and naming had a negative adjusted coefficient (β = −0.158, p = 0.040) after simultaneous control for the remaining predictors. The findings support a dimensional interpretation of emotional competence and indicate that negative-valence emotional empathy is more closely associated with recognizing, understanding, and managing emotions than with expressive emotional skills considered in isolation.