Cross-cultural adaptation and psychometric validation of the Chinese version of the empathy fatigue scale for health professionals among intensive care unit nurses.

INTRODUCTION: Intensive care unit (ICU) nurses are chronically exposed to patient suffering, death, and morally complex decisions, placing them at elevated risk of empathy fatigue. China currently lacks a psychometrically sound instrument developed specifically to capture empathy fatigue within the ICU specialty context. OBJECTIVE: This study aimed to cross-culturally adapt the Empathy Fatigue Scale for Health Professionals (EFS-HP) into Chinese and evaluate its psychometric properties among ICU nurses. METHODS: The EFS-HP was translated and adapted following Sousa's seven-step framework and Brislin's translation model. A convenience sample of 300 ICU nurses from a tertiary grade-A hospital in the Inner Mongolia Autonomous Region completed the Chinese EFS-HP and the Compassion Fatigue Scale for Medical Staff (CFS-MS). Item analysis, reliability testing (internal consistency, split-half, test-retest), and validity testing (content validity, exploratory and confirmatory factor analyses, convergent validity) were performed using SPSS 27.0 and AMOS 31.0. RESULTS: The Chinese EFS-HP retained all 21 items but yielded a two-factor structure-Emotional Load and Exhaustion State-accounting for 78.165% of the total variance. The scale demonstrated excellent internal consistency (Cronbach's α = 0.981), split-half reliability (Spearman-Brown = 0.938), and test-retest reliability (r = 0.958). Confirmatory factor analysis supported the two-factor model over the original single-factor model. The total score showed a moderate and statistically significant positive correlation with the CFS-MS (r = 0.587, P < 0.001), supporting convergent validity. CONCLUSION: The Chinese EFS-HP is a reliable and valid instrument for assessing empathy fatigue among ICU nurses and may serve as a practical screening tool to inform targeted mental health interventions.