Sociodemographic, Educational, and Motivational Correlates of Multidimensional Empathy Among Croatian Vocational Nursing Students: A Multicentre Cross-Sectional Study

Background: Evidence on multidimensional empathy in secondary-level vocational nursing education is limited. This study tested prespecified differences in Perspective Taking (PT), Fantasy (FS), Empathic Concern (EC), and Personal Distress (PD) by reported sex, educational year, residence, socioeconomic status (SES), and motivation. Methods: This multicentre cross-sectional study included 879 third- and fifth-year students from nine Croatian nursing schools. Hypothesis-aligned Welch contrasts and Hedges’ g were followed by simultaneous HC3 models and 4999-permutation multivariate block tests. Holm correction controlled four-outcome families. Results: In adjusted analyses (n = 858), sex (Pillai trace = 0.047, p < 0.001), educational year (0.019, p = 0.003), residence (0.020, p = 0.024), and intrinsic/altruistic motivation (0.021, p = 0.001) were associated with the IRI profile; SES was not (p = 0.124). Female students reported higher PT, FS, EC, and PD. Contrary to the hypothesis, fifth-year students reported lower PT and EC. The rural–urban hypothesis was unsupported; the residence result mainly reflected higher PD among suburban than urban students. Intrinsic/altruistic motivation was associated with higher PT, EC, and PD. Conclusions: Prespecified hypotheses received mixed support. Cross-sectional year differences do not demonstrate educationally caused change, and PD must not be interpreted as uniformly adaptive empathy.