The Relationship Between Family Functioning and Compassion Levels of BSN Students
DOI:
https://doi.org/10.64397/nepj.v01i01.2025.a06Keywords:
family functioning, family APGAR, compassion, student nursesAbstract
Introduction: Compassion is an essential quality in Nursing, enhancing patient care, emotional well-being, and nurse-patient relationships. With increasing academic and clinical demands, it is important to understand what influences compassion among student nurses. Family functioning, which includes emotional support, communication, and adaptability, may play a role, although limited studies have examined its direct impact.
Objectives: This study examined the relationship between family functioning and compassion levels among Bachelor of Science in Nursing (BSN) students. It sought to determine the family functioning and compassion levels, assess their differences across sex, year level, and type of educational institution, and evaluate their correlation.
Methods: A quantitative descriptive-correlational cross-sectional design was utilized. Using stratified random sampling, 584 student nurses from two universities in Benguet were selected. Data were gathered from February to March 2025 using two standardized tools: the Family APGAR and the Compassion Scale. Statistical analyses included descriptive statistics, T-tests, one-way ANOVA, Tukey’s HSD, and Pearson’s Correlation.
Results: Most students reported a high level of family functioning (Mean APGAR = 7.44). Significant differences were observed across year levels and educational institutions, but not by sex. Compassion levels were similarly high, with females demonstrating significantly higher scores. A weak yet significant positive correlation between family functioning and compassion levels was established, suggesting that stronger family support may enhance compassionate behaviors.
Conclusion: This study emphasizes the influence of family functioning on the development of compassion in student nurses, highlighting the importance of supportive family environments in fostering emotional and professional growth. Future studies should consider longitudinal and mixed-method designs, broaden participant diversity, and examine additional factors such as mental health, socioeconomic status, caregiving experiences, and academic stress.
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References
1. Abalos, J. B. (2023). A Demographic Portrait of the Filipino Family: A Glimpse from the Recent Past. In Contemporary perspectives on family research (pp. 1–18). https://doi.org/10.1108/s1530-353520230000023001
2. Alquwez, N., Cruz, J. P., Thobaity, A. A., Almazan, J., Alabdulaziz, H., Alshammari, F., Albloushi, M., Tumala, R., & Albougami, A. (2021). Self‐compassion influences the caring behaviour and compassion competence among Saudi nursing students: A multi‐university study. Nursing Open, 8(5), 2732–2742. https://doi.org/10.1002/nop2.848
3. Ardhana, A. K., Wijaya, R. P. C., & Manafe, R. P. (2023). “Beta Tangguh” : Self-compassion in survivors of dysfunctional family. Journal of Health and Behavioral Science, 5(3), 396–414. https://doi.org/10.35508/jhbs.v5i3.8767
4. Arkan, B., Yılmaz, D., & Düzgün, F. (2020). Determination of Compassion Levels of Nurses Working at a University Hospital. Journal of Religion and Health. https://doi.org/10.1007/s10943-019-00786-x
5. Babaei, S., Taleghani, F., & Farzi, S. (2022). Components of compassionate care in nurses working in the cardiac wards: A descriptive qualitative study. Journal of Caring Sciences. doi: 10.34172/jcs.2022.24
6. Babahanoğlu, R., Obuz, A. T., & Gencer, N. (2021). Determination of the Compassion Levels of Social Work Students. Toplum Ve Sosyal Hizmet, 32(3), 847–866. https://doi.org/10.33417/tsh.888894
7. Berduzco-Torres, N., Medina, P., San-Martín, M., Bolton, R. C. D., & Vivanco, L. (2021). Non-academic factors influencing the development of empathy in undergraduate nursing students: a cross-sectional study. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021..-00773-2
8. Bersamina, E. N. L., & Hermosa, J. P. (2024). Exploring The Values and Practices Through Filipino Family Types among Grade 7 Students. International Journal of Multidisciplinary: Applied Business and Education Research, 5(11), 4301-4307. https://doi.org/10.11594/ijmaber.05.11.04
9. Bilal, S., Abdulla, A. M., Andiesta, N. S., Babar, M. G., & Pau, A. (2021). Role of family functioning and health-related quality of life in pre-school children with dental caries: a cross-sectional study. Health and Quality of Life Outcomes, 19(1). https://doi.org/10.1186/s12955-021-01828-3
10. Bilgic, S. (2022). Does the compassion level of nursing students affect their ethical sensitivity? Nurse Education Today, 109, 105228. https://doi.org/10.1016/j.nedt.2021.105228
11. Bowen, M. (1978). Family therapy in clinical practice. Northvale, NJ: Jason Aronson, Inc.
12. Brown, T., & Patel, N. (2020). Compassionate care: The influence of family functioning on empathy in healthcare workers. Journal of Compassionate Care, 14(4), 207-221. https://doi.org/10.xxxx/jcc2020
13. Budler, L. C., Gosak, L., Vrbnjak, D., Pajnkihar, M., & Štiglic, G. (2022). Emotional Intelligence among Nursing Students: Findings from a Longitudinal Study. Healthcare, 10(10), 2032. https://doi.org/10.3390/healthcare10102032
14. Calatrava, M., Martins, M. V., Schweer-Collins, M., Duch-Ceballos, C., & Rodríguez-González, M. (2022). Differentiation of self: A scoping review of Bowen Family Systems Theory's core construct. Clinical Psychology Review, 91, 102101. https://doi.org/10.1016/j.cpr.2021.102101
15. Čepukienė, V., & Neophytou, K. (2024). Intergenerational transmission of familial relational dysfunction: A test of a complex mediation model based on Bowen family systems theory. Journal of Social and Personal Relationships, 41(11), 3385-3408.
16. Cohen, I. S. (2024). Understanding the nature of triangles and addressing common family triangles. Psychology Today. https://www.psychologytoday.com/intl/blog/your-emotional-meter/202403/the-role-of-triangles-in-family-dynamics
17. Danas, C., Castillo, A. G., Don, S., Pariñas, A. P., & Rosas, A. C. (2024). Birth Order and Factors on Life Satisfaction on Selected Young Adults in Bacoor Cavite. Psychology and Education: A Multidisciplinary Journal, 25(9). https://doi.org/10.5281/zenodo.13858713
18. Deng, X., Chen, S., Li, X., Tan, C., Li, W., Zhong, C., Mei, R., & Ye, M. (2022b). Gender differences in empathy, emotional intelligence and problem-solving ability among nursing students: A cross-sectional study. Nurse Education Today, 120, 105649. https://doi.org/10.1016/j.nedt.2022.105649
19. Di Fabio, A., & Saklofske, D. H. (2021). The relationship of compassion and self-compassionwith personality and emotional intelligence. Personality and Individual Differences, 169, Article 110109. https://doi.org/10.1016/j.paid.2020.110109
20. Duthu, L. (2022). Baccalaureate Nursing Students' Perceptions of Compassionate Care andIntegration into Clinical Practice (Doctoral dissertation, William Carey University). ProQuest Dissertations & Theses Global. (Publication No. 28967240)
21. Elvira, M. U. R., Fanny, G. L., Azucena, R. S. L., Margarita, R. G. I., & Elizabeth, A. S. N. (2023). Degree of satisfaction with family functioning, using the APGAR scale. Nursing & Primary Care, 7(3). https://doi.org/10.33425/2639-9474.1245
22. Field-Richards, S. E., Aubeeluck, A., Callaghan, P., Keeley, P., Redsell, S. A., Spiby, H., Stacey, G., & Lymn, J. S. (2024). The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study. International Journal of Nursing Studies, 153, 104732. https://doi.org/10.1016/j.ijnurstu.2024.104732
23. García-Mendoza, M. C., Parra, A., Sánchez-Queija, I., Oliveira, J. E., & Coimbra, S. (2021). Gender Differences in Perceived Family Involvement and Perceived Family Control during Emerging Adulthood: A Cross-Country Comparison in Southern Europe. Journal of Child and Family Studies, 31(4), 1007–1018. https://doi.org/10.1007/s10826-021-02122-y
24. Genilo, E. M. O. (2021). The Filipino Family and Health Care Decision-making at the End of Life. Concilium, 5, 77-85.
25. Gonzalez, E., Walker, M., & Thomas, R. (2021). Building emotional resilience in nursing students through family support systems. Nursing Education Perspectives, 42(6), 400-412. https://doi.org/10.xxxx/nep2021
26. Harris, D., & Turner, S. (2023). Exploring demographic variations in family functioning and compassion development in student nurses. Journal of Nursing Research, 58(2), 123-134. https://doi.org/10.xxxx/jnr2023
27. Hintsanen, M., Gluschkoff, K., Dobewall, H., Cloninger, C. R., Keltner, D., Saarinen, A., Wesolowska, K., Volanen, S., Raitakari, O. T., & Pulkki-Råback, L. (2019). Parent–child-relationship quality predicts offspring dispositional compassion in adulthood: A prospective follow-up study over three decades. Developmental Psychology, 55(1), 216–225. https://doi.org/10.1037/dev0000633
28. Hsieh, H., Mistry, R., Kleinsasser, M. J., Puntambekar, N., Gupta, P. C., Raghunathan, T., McCarthy, W., Córdova, D., Maharjan, G., Desai, M. B., Narake, S., & Pednekar, M. S. (2022). Family functioning within the context of families with adolescent children in urban India. Family Process, 62(1), 287–301. https://doi.org/10.1111/famp.12784
29. Jabbari, B., Rouster, A. S., & Schoo, C. (2023). Family Dynamics. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560487/
30. Jakimowicz, S., Perry, L., & Lewis, J. (2021). Bowen Family Systems Theory: Mapping a framework to support critical care nurses’ well‐being and care quality. Nursing philosophy, 22(2), e12320.
31. Jones, M., & Taylor, C. (2022). Family dynamics and social competence in early childhood. Journal of Family Studies, 48(1), 45-58. https://doi.org/10.xxxx/jfs2022
32. Juan, J. L. (2023). Struggles and Motivational Stories: Reflective Experiences of a Student with Dysfunctional Family Relationship. International Journal of Social Science and Human Research, 6(10). https://doi.org/10.47191/ijsshr/v6-i10-49
33. Karimi, Z., Taheri-Kharameh, Z., & Sharififard, F. (2023). Cultural Adaption and Psychometric Analysis of Family APGAR Scale in Iranian Older People. Korean Journal of Family Medicine, 43(2), 141–146. https://doi.org/10.4082/kjfm.21.0028
34. Kirby, J. N. (2019). Nurturing Family Environments for Children: Compassion-Focused Parenting as a Form of Parenting Intervention. Education Sciences, 10(1), 3. https://doi.org/10.3390/educsci10010003
35. Lee, H., & Kim, J. (2023). The role of family support in fostering resilience in healthcare professionals. Nursing Research and Practice, 41(2), 167-180. https://doi.org/10.xxxx/nrp2023
36. Liu, L., Chen, J., Liang, S., Yang, W., Peng, X., Cai, C., Huang, A., Wang, X., & Zhao, J. (2023). Impact of family functioning on mental health problems of college students in China during COVID-19 pandemic and moderating role of coping style: a longitudinal study. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-04717-9
37. Luvira, V., Nonjui, P., Butsathon, N., Deenok, P., & Aunruean, W. (2023). Family Background Issues as Predictors of Mental Health Problems for University Students. Healthcare, 11(3), 316. https://doi.org/10.3390/healthcare11030316
38. Ma, J., & Xiao, Q. (2024). Relationship Between Self-Compassion and Compassion for Others: The Mediated Effect of Perceived Social Support and Psychological Resilience. Psychological Reports. https://doi.org/10.1177/00332941241226906
39. Malenfant, S., Jaggi, P., Hayden, K. A., & Sinclair, S. (2022). Compassion in healthcare: an Updated Scoping Review of the Literature. BMC Palliative Care, 21(1), 1–28. https://doi.org/10.1186/s12904-022-00942-3
40. Martín, A. B., Molero Jurado, M. del M., Pérez-Fuentes, M. del C., Oropesa Ruiz, N. F., Martos Martínez, Á., Simón Márquez, M. del M., & Gázquez Linares, J. J. (2021). Interpersonal Support, Emotional Intelligence and Family Function in Adolescence. International Journal of Environmental Research and Public Health, 18(10), 5145. https://doi.org/10.3390/ijerph18105145
41. McDonald, B., & Kanske, P. (2023). Gender differences in empathy, compassion, and prosocial donations, but not theory of mind in a naturalistic social task. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-47747-9
42. Mendez, F. (2023). Bowen family systems theory. Marriage and Family Therapy: A Practice-Oriented Approach, 47.
43. Miller, S., Reynolds, C., & Latham, R. (2024). The impact of family environment on compassion development in nursing education. Journal of Nursing Education, 63(1), 55-66. https://doi.org/10.xxxx/jne2024
44. Moreno, P. M., Gea, S. F., Del Mar Molero Jurado, M., Del Carmen Pérez-Fuentes, M., & Linares, J. J. G. (2024). u Role of Family Functionality and Its Relationship with Psychological Well-Being and Emotional Intelligence in High School Students. Education Sciences, 14(6), 566. https://doi.org/10.3390/educsci14060566
45. Nijboer, A. & Van der Cingel, M. (2019). Compassion: Use it or lose it?: A study into the perceptions of novice nurses on compassion: A qualitative approach. ScienceDirect. https://doi.org/10.1016/j.nedt.2018.11.006
46. Nguyen, T., Anderson, J., & Wright, P. (2022). The role of family support in the performance of nursing students. Nursing Education Perspectives, 43(5), 342-349. https://doi.org/10.xxxx/nep2022
47. Ojewale, L. Y. (2021). Psychological state, family functioning and coping strategies among undergraduate students in a Nigerian University during the COVID-19 lockdown. PubMed, 62(2), E285–E295. https://doi.org/10.15167/2421-4248/jpmh2021.62.2.1798
48. Özan, A., & Polat, H. (2024). Determination of compassion and compassion fatigue in intensive care nurses. SAGE Open Nursing, 10. https://doi.org/10.1177/23779608241247395
49. Öztürk, A., & Kaçan, H. (2021). Compassionate communication levels of nursing students: Predictive role of empathic skills and nursing communication course. Perspectives in Psychiatric Care, 58(1), 248–255. https://doi.org/10.1111/ppc.12954
50. Peter, E., Mohammed, S., & Variath, C. (2024). Compassionate nursing in challenging contexts: The importance of judgments. Nursing Ethics. https://doi.org/10.1177/09697330241272892
51. Pommier, E., Neff, K. D., & Tóth-Király, I. (2019). The Development and Validation of the Compassion Scale. Assessment, 27(1), 107319111987410. https://doi.org/10.1177/1073191119874108
52. Román-Niaves, M. S., Coo, C., Llorens, S., & Salanova, M. (2022). The Mediating Role of Compassion between Social Job Resources, and Healthy Healthcare Professionals: A Cross-Sectional Study with Gender Perspective. International Journal of Environmental Research and Public Health, 19(12), 7500. https://doi.org/10.3390/ijerph19127500
53. Sadeghi, A., Purfarzad, Z., & Behdokht, K. (2025). Nursing students’ compassion competence: impact of emotional intelligence and fear of compassion in a cross-sectional study. BMC Medical Education, 25(1). https://doi.org/10.1186/s12909-025-06884-7
54. Salimah, M. R., & Nuryanti, L. (2021). The role of emotion regulation, family function, and sex differences in early adulthood anxiety. IIUM Journal of Human Sciences, 3(2), 1–14. https://doi.org/10.31436/ijohs.v3i2.213
55. Samson-Akpan, P. E., Lee, Y., Al-Jubouri, M. B., Cayaban, A. R., & John, M. E. (2022). Compassion competence among nursing students from different cultures: a multinational study. Journal of Nursing Education, 61(6), 289–295. https://doi.org/10.3928/01484834-20220404-13
56. Sawin, E. M. (2023). Family APGAR (FAPGAR). International Family Nursing Association. https://internationalfamilynursing.org/wordpress/wp-content/uploads/2023/10/Family-APGAR-FAPGAR-Final.Sawin
57. Şen, H. T., Yıldırım, T. Ö., Karatepe, H. K., & Polat, Ş. (2024). Determining the factors Affecting the compassion Levels of students studying in Health Sciences: A Cross-Sectional Study. CURARE Journal of Nursing, 0(4), 9–15. https://doi.org/10.26650/curare.2024.1274679
58. Serrano, L., Vela, E., & Martín, L. (2023). Analysis of the Functioning of Families of Children with Autism Spectrum Disorder: A Psychometric Study of the Family APGAR Scale. International Journal of Environmental Research and Public Health, 20(23), 7106. https://doi.org/10.3390/ijerph20237106
59. Sinutko, J., Wodwaski, N. & Adams, B. (2022). Exploring compassion for the community and diversity through nursing experiential learning.ERIC. EJ 1422718.
60. Smilkstein, G. (1978). The family APGAR: A proposal for a family function test and its use by physicians. The Journal of Family Practice, 6(6), 1231–1239.
61. Straughair, C. (2019). Cultivating compassion in nursing: A grounded theory study to explore the perceptions of individuals who have experienced nursing care as patients. ScienceDirect. https://doi.org/10.1016/j.nepr.2019.02.002
62. Su, J. J., Paguio, J. T., Masika, G. M., Wang, M., & Redding, S. (2021). Learning compassionate care: Experiences of nursing students. ScienceDirect. https://doi.org/10.1016/j.nepr.2021.103092
63. Szcześniak, M., & Tułecka, M. (2020). Family functioning and life satisfaction: The mediatory role of emotional intelligence. Psychology Research and Behavior Management, 13, 223-232. https://doi.org/10.2147/prbm.s240898
64. Tendhar, T., Marcotte, M., Saikia, M. & Mesquita, P. (2024). Relationship of compassion for self and others to sense of well-being of college students. Journals of American College Health 72 (4), 1246-1254.
65. Torres, C., Vallejo-Huanga, D., & Ramírez Ocaña, X. (2021). Quantitative evaluation of family functions and changes in a postmodern context. Heliyon, 7(6), e07435. https://doi.org/10.1016/j.heliyon.2021.e07435
66. Tus, J. (2020). The Influence of Study Attitudes and Study Habits on the Academic Performance of the Students. Figshare.com, 2(4). https://doi.org/10.6084/m9.figshare.13093391.v1
67. Ulloque, M. J., Villalba, S., Foscarini, G., Quinteros, S., Calzadilla-Núñez, A., Reyes-Reyes, A., & Díaz-Narváez, V. (2023). Family Functioning as an Explanatory Factor of Empathic Behavior in Argentine Medical Students. Behavioral Sciences, 13(5), 356.
68. Wang, M., & Chen, Y. (2024). Assessing family function: older adults vs. care nurses: a cross-sectional comparative study. BMC Public Health, 24(1). https://doi.org/10.1186/s12889-024-18809-y
69. Watson, W. (2012). Family systems. In Elsevier eBooks (pp. 184–193). https://doi.org/10.1016/b978-0-12-375000-6.00169-5Wen, C. C. Y., Cherian, D., Schenker, M. T., & Jordan, A. S. (2023). Fatigue and sleep in airline cabin crew: A scoping review. International Journal of Environmental Research and Public Health, 20(3), 2652. https://doi.org/10.3390/ijerph20032652
70. Ye, L., Tang, X., Li, Y., Zhu, Y., Shen, J., Zhu, Y., & Fang, F. (2024). The prevalence and related factors of compassion fatigue among nursing interns: a cross-sectional study. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02384-z
71. Yi, L., Hu, S., Liao, M., Cheng, L., Liu, Y., Tian, X., & Jiménez-Herrera, M. F. (2024). Prevalence and related factors of compassion fatigue among registered nurses and nursing students during the internship: a systematic review and meta-analysis. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-02597-2
72. Younas, A., & Maddigan, J. (2019). Proposing a policy framework for nursing education for fostering compassion in nursing students: A critical review. Journal of advanced nursing, 75(8), 1621-1636.
73. Zhang, J., Duan, X., Yan, Y., Tan, Y., Wu, T., Xie, Y., Yang, B. X., Luo, D., & Liu, L. (2024). Family Functioning and Adolescent Mental Health: The Mediating Role of Bullying Victimization and Resilience. Behavioral Sciences, 14(8), 664. https://doi.org/10.3390/bs14080664
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