Cent Eur J Nurs Midw 2026, 17(3):2518-2527 | DOI: 10.15452/cejnm.2026.17.0019
Translation and validation of the Multifaceted Empathy Test into Croatian in a sample of health professionals
- 1 Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
- 2 Centre for Mind and Behaviour, University of Rijeka, Rijeka, Croatia
- 3 Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
- 4 Division of Cognitive Sciences, Faculty of Humanities and Social Sciences, University of Rijeka, Rijeka, Croatia
Aim: The aim was to translate the Multifaceted Empathy Test (MET-core-2) into Croatian using the back translation method and validate it on a sample of health professionals.
Design: A cross-sectional correlational study.
Methods: The sample consisted of 179 health professionals (age range 21–58 years). The Empathy Quotient questionnaire was used to test convergent validity, while the Big Five Inventory and the Dirty Dozen questionnaire were used to test divergent validity.
Results: Our results suggested similar psychometric properties of the Croatian version of the MET-core-2 and two comparative studies: high reliability of the emotional empathy scales (Cronbachʼs alpha > 0.950) and low reliability of the cognitive empathy scales (Cronbachʼs alpha from 0.273 to 0.411). The results for convergent and divergent validity of emotional empathy were in line with predicted patterns based on previous studies using empathy questionnaires, whereas some deviations from expected patterns were obtained for cognitive empathy. These discrepancies can be explained by differences in how empathy is assessed using performance-based tests versus self-report questionnaires.
Conclusion: Overall, our findings suggest that the Croatian version of the MET-core-2 is suitable for research use among health professionals.
Keywords: back translation method, cognitive empathy, emotional empathy, health professionals, Multifaceted Empathy Test
Received: October 8, 2025; Revised: June 16, 2026; Accepted: August 10, 2026; Published: September 6, 2026 Show citation
| ACS | AIP | APA | ASA | Harvard | Chicago | Chicago Notes | IEEE | ISO690 | MLA | NLM | Turabian | Vancouver |
References
- Amalean, A., Pavuluri, H., Schmidt, W. M., & Fowler, L. A. (2021). The effects of sleepiness, time of day, and 12-h shifts on affective and cognitive empathy in emergency medical technicians. Sleep and Biological Rhythms, 19, 105-107. https://doi.org/10.1007/s41105-020-00280-y
Go to original source... - Amestoy, M. E., DʼAmico, D., & Fiocco, A. J. (2023). Neuroticism and stress in older adults: The buffering role of self-esteem. International Journal of Environmental Research and Public Health, 20(12), 6102. https://doi.org/10.3390/ijerph20126102
Go to original source...
Go to PubMed... - Baron-Cohen, S. & Wheelwright, S. (2004). The empathy quotient: an investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163-175. https://doi.org/10.1023/b:jadd.0000022607.19833.00
Go to original source...
Go to PubMed... - Beadle, J. N., Sheehan, A. H., Dahlben, B., & Gutchess, A. H. (2015). Aging, empathy, and prosociality. The Journals of Gerontology, 70(2), 213-222. https://doi.org/10.1093/geronb/gbt091
Go to original source... - Benet-Martínez, V., & John, O. P. (1998). Los Cinco Grandes across cultures and ethnic groups: multitrait multimethod analyses of the Big Five in Spanish and English. Journal of Personality and Social Psychology, 75(3), 729-750. https://doi.org/10.1037//0022-3514.75.3.729
Go to original source... - Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85.
- Dehning, S., Gasperi, S., Krause, D., Meyer, S., Reiß, E., Burger, M., Jacobs, F., Buchheim, A., Müller, N. & Siebeck, M. (2013). Emotional and cognitive empathy in first-year medical students. International Scholarly Research Notices, 2013(1), 801530. https://doi.org/10.1155/2013/801530
Go to original source...
Go to PubMed... - Delgado Bolton, R. C., San-Martín, M., & Vivanco, L. (2022). Role of empathy and lifelong learning abilities in physicians and nurses who work in direct contact with patients in adverse working conditions. International Journal of Environmental Research and Public Health, 19(5), 3012. https://doi.org/10.3390/ijerph19053012
Go to original source...
Go to PubMed... - de Lima, F. F., & Osório, F. L. (2021). Empathy: assessment instruments and psychometric quality - a systematic literature review with a meta-analysis of the past ten years. Frontiers in Psychology, 12, 781346. https://doi.org/10.3389/fpsyg.2021.781346
Go to original source...
Go to PubMed... - Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013). Effectiveness of empathy in general practice: a systematic review. The British Journal of General Practice, 63(606), e76-e84. https://doi.org/10.3399/bjgp13X660814
Go to original source... - Duradoni, M., Gursesli, M. C., Fiorenza, M., Donati, A., & Guazzini, A. (2023). Cognitive empathy and the Dark Triad: a literature review. European Journal of Investigation in Health, Psychology and Education, 13(11), 2642-2680. https://doi.org/10.3390/ejihpe13110184
Go to original source...
Go to PubMed... - Dziobek, I., Rogers, K., Fleck, S., Banhemann, M., Heekeren, H. R., Wolf, O. T. & Convit, A. (2008). Dissociation of cognitive and emotional empathy in adults with Asperger syndrome using the Multifaceted Empathy Test (MET). Journal of Autism and Developmental Disorders, 38(3). 464-473. https://doi.org/10.1007/s10803-007-0486-x
Go to original source...
Go to PubMed... - Eurostat. (2021, March 8). Majority of health jobs held by women. https://ec.europa.eu/eurostat/web/products-eurostat-news/-/EDN-20210308-1
- Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
Go to original source...
Go to PubMed... - Fernandes Vieira de Lima, F., Rossi, G., Dos Santos, R. G., & de Lima Osório, F. (2023). Multifaceted Empathy Test (MET): validity evidence for the Brazilian population concerning the computer-based (face-to-face) and online versions. PLoS ONE, 18(7), e0284524. https://doi.org/10.1371/journal.pone.0284524
Go to original source... - Foell, J., Brislin, S. J., Drislane, L. E., Dziobek, I., & Patrick, C. J. (2018). Creation and validation of an English-language version of the Multifaceted Empathy Test (MET). Journal of Psychopathology and Behavioral Assessment, 40(3), 431-439. https://doi.org/10.1007/s10862-018-9664-8
Go to original source... - Grühn, D., Rebucal, K., Diehl, M., Lumley, M., & Labouvie-Vief, G. (2008). Empathy across the adult lifespan: longitudinal and experience-sampling findings. Emotion, 8(6), 753-765. https://doi.org/10.1037/a0014123
Go to original source...
Go to PubMed... - Guadagni, V., Burles, F., Ferrara, M. & Iaria, G. (2014). The effects of sleep deprivation on emotional empathy. Journal of Sleep Research, 23(6), 657-663. https://doi.org/10.1111/jsr.12192
Go to original source...
Go to PubMed... - Guilera, T., Batalla, I., Forné, C., & Soler-González, J. (2019). Empathy and big five personality model in medical students and its relationship to gender and specialty preference: a cross-sectional study. BMC Medical Education, 19(1), 57. https://doi.org/10.1186/s12909-019-1485-2
Go to original source...
Go to PubMed... - Heym, N., Firth, J., Kibowski, F., Sumich, A., Egan, V., & Bloxsom, C. A. J. (2019). Empathy at the heart of darkness: empathy deficits that bind the Dark Triad and those that mediate indirect relational aggression. Frontiers in Psychiatry, 10, 95. https://doi.org/10.3389/fpsyt.2019.00095
Go to original source... - Hufer-Thamm, A., & Riemann, R. (2021). On the link of self-esteem, life satisfaction, and Neuroticism. Journal of Personality, 89(5), 998-1011. https://doi.org/10.1111/jopy.12632
Go to original source... - Jolliffe, D., & Farrington, D. P. (2006). Development and validation of the Basic Empathy Scale. Journal of Adolescence, 29(4), 589-611. https://doi.org/10.1016/j.adolescence.2005.08.010
Go to original source...
Go to PubMed... - Jonason, P. K., & Webster, G. D. (2010). The dirty dozen: a concise measure of the dark triad. Psychological Assessment, 22(2), 420-432. https://doi.org/10.1037/a0019265
Go to original source...
Go to PubMed... - Kardum, I., Hudek-Knezevic, J., Marijanović, K., & Shackelford, T. K. (2023). Predicting mate poaching experiences from personality traits using a dyadic analysis. Journal of Sex Research, 60(3), 384-398. https://doi.org/10.1080/00224499.2022.2092586
Go to original source...
Go to PubMed... - Kardum, I., Gračanin, A., & Hudek-Knežević, J. (2006). Odnos crta ličnosti i stilova privrženosti s različitim aspektima seksualnosti kod žena i muškaraca [Relations of personality traits and attachment styles with different aspects of sexuality in men and women]. Psihologijske teme, 15(1), 101-128.
- Lawrence, E. J., Shaw, P., Baker, D., Baron-Cohen, S., & David, A. S. (2004). Measuring empathy: reliability and validity of the Empathy Quotient. Psychological Medicine, 34(5), 911-920. https://doi.org/10.1017/s0033291703001624
Go to original source... - Lenhard, W., & Lenhard, A. (2022). Computation of effect sizes. https://www.psychometrica.de/effect_size.html. Psychometrica. DOI: 10.13140/RG.2.2.17823.92329
Go to original source... - Martos Martínez, Á., Pérez-Fuentes, M. D. C., Molero Jurado, M. D. M., Simón Márquez, M. D. M., Barragán Martín, A. B., & Gázquez Linares, J. J. (2021). Empathy, affect and personality as predictors of engagement in nursing professionals. International Journal of Environmental Research and Public Health, 18(8), 4110. https://doi.org/10.3390/ijerph18084110
Go to original source...
Go to PubMed... - McCrae, R. R., & Costa, P. T., Jr. (1987). Validation of the five-factor model of personality across instruments and observers. Journal of Personality and Social Psychology, 52(1), 81-90. https://doi.org/10.1037//0022-3514.52.1.81
Go to original source...
Go to PubMed... - Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The role of empathy in health and social care professionals. Healthcare, 8(1), 26. https://doi.org/10.3390/healthcare8010026
Go to original source...
Go to PubMed... - Nembhard, I. M., David, G., Ezzeddine, I., Betts, D., & Radin, J. (2023). A systematic review of research on empathy in health care. Health Services Research, 58(2), 250-263. https://doi.org/10.1111/1475-6773.14016
Go to original source... - Nowicki, S., Jr, & Carton, J. (1993). The measurement of emotional intensity from facial expressions. The Journal of Social Psychology, 133(5), 749-750. https://doi.org/10.1080/00224545.1993.9713934
Go to original source... - Onofrei, L., Serban, C. L., Chirita-Emandi, A., Jeleriu, R. M., & Puiu, M. (2023). The impact of theory of mind, stress and professional experience on empathy in Romanian community nurses - a cross-sectional study. BMC Nursing, 22(1), 400. https://doi.org/10.1186/s12912-023-01569-2
Go to original source...
Go to PubMed... - Paulhus, D. L, & Williams, K. M. (2002). The Dark Triad of personality: narcissism, machiavellianism, and psychopathy. Journal of Research in Personality, 36(6), 556-563. https://doi.org/10.1016/S0092-6566(02)00505-6
Go to original source... - Ratka A. (2018). Empathy and the development of affective skills. American Journal of Pharmaceutical Education, 82(10), 7192. https://doi.org/10.5688/ajpe7192
Go to original source...
Go to PubMed... - Rodríguez-Nieto, G., Mercadillo, R. E., Pasaye, E. H., & Barrios, F. A. (2022). Affective and cognitive brain-networks are differently integrated in women and men while experiencing compassion. Frontiers in Psychology, 13, 992935. https://doi.org/10.3389/fpsyg.2022.992935
Go to original source... - Sack, B., Broer, K., & Anders, S. (2019). Sleep deprivation selectively enhances interpersonal emotion recognition from dynamic facial expressions at long viewing times: an observational study. Neuroscience Letters, 694, 225-230. https://doi.org/10.1016/j.neulet.2018.10.035
Go to original source...
Go to PubMed... - Schreckenbach, T., Ochsendorf, F., Sterz, J., Rüsseler, M., Bechstein, W. O., Bender, B., & Bechtoldt, M. N. (2018). Emotion recognition and extraversion of medical students interact to predict their empathic communication perceived by simulated patients. BMC Medical Education, 18(1), 237. https://doi.org/10.1186/s12909-018-1342-8
Go to original source...
Go to PubMed... - Sommerlad, A., Huntley, J., Livingston, G., Rankin, K. P., & Fancourt, D. (2021). Empathy and its associations with age and sociodemographic characteristics in a large UK population sample. PLoS ONE, 16(9), e0257557. https://doi.org/10.1371/journal.pone.0257557
Go to original source...
Go to PubMed... - Song, Y., & Shi, M. (2017). Associations between empathy and big five personality traits among Chinese undergraduate medical students. PLoS ONE, 12(2), e0171665. https://doi.org/10.1371/journal.pone.0171665
Go to original source...
Go to PubMed... - von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & STROBE Initiative. (2008). Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Journal of Clinical Epidemiology, 61(4), 344-349. https://doi.org/10.1016/j.jclinepi.2007.11.008
Go to original source...
Go to PubMed... - Wertag, A., & Hanzec, I. (2016). Factor structure and psychometric properties of the Croatian short version of The Empathy Quotient. Suvremena psihologija, 19(1), 101-110. https://doi.org/10.21465/2016-SP-191-09
Go to original source... - Yilmaz Sezer, N., Aker, M. N., Öz, B., & Eren, D. (2023). Midwifery studentsʼ traumatic childbirth experiences, traumatic childbirth perceptions, and levels of fear of childbirth. Journal of Midwifery & Womenʼs Health, 68(2), 248-254. https://doi.org/10.1111/jmwh.13464
Go to original source... - Zaiontz, C. (2024). Cronbach's alpha basic concepts. Real Statistics Using Excel. https://real-statistics.com/reliability/internal-consistency-reliability/kuder-richardson-formula-20/
- Zhang, X., Pang, H. F., & Duan, Z. (2023). Educational efficacy of medical humanities in empathy of medical students and healthcare professionals: a systematic review and meta-analysis. BMC Medical Education, 23(1), 925. https://doi.org/10.1186/s12909-023-04932-8
Go to original source...
Go to PubMed...
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


