Association Between Professional Self-Efficacy and Self-Reported Compassionate Communication Among Nurses: A Cross-Sectional Study with Exploratory Analyses of Generative Altruism Scale Scores

Background: Compassionate communication, professional self-efficacy, and generative altruism represent potentially related aspects of nursing practice. This study examined the adjusted association between professional self-efficacy and self-reported compassionate communication, alongside the measurement properties of the Generative Altruism Scale (GALS) and exploratory associations involving its scores. Methods: This cross-sectional study used nonprobability recruitment at one hospital in Türkiye. All analyses included 201 nurses with source-verified responses to the Compassionate Communication Scale (CCS), Nursing Profession Self-Efficacy Scale (NPSE), and Generative Altruism Scale (GALS). Hierarchical regression entered demographic and professional covariates in Block 1 and NPSE in Block 2, which constituted the primary adjusted model. GALS scores were added in an exploratory third block. Ordinal GALS factor models were estimated using weighted least squares with mean- and variance-adjusted test statistics (WLSMV). Results: CCS and NPSE scores were positively correlated (r = 0.591, p < 0.001). NPSE remained associated with CCS after covariate adjustment (B = 1.032, 95% CI [0.796, 1.267], p < 0.001). The primary adjusted model explained 52.2% of CCS-score variance; adding NPSE yielded ΔR2 = 0.187 (F-change (1, 190) = 74.550, p < 0.001). Sensitivity analyses yielded similar estimates. CCS alpha was 0.994, with identical responses within multiple item sets. Adding GALS provided no statistically significant increment (ΔR2 = 0.006, p = 0.115). Neither GALS factor model fitted adequately, and total-score reliability was limited (α = 0.613). Conclusions: The observed NPSE–CCS score association requires caution because CCS measurement validity remains uncertain. Cross-sectional self-report data do not establish causality or empirical construct distinctiveness. GALS findings do not support construct-level conclusions about generative altruism. Single-hospital recruitment and potential nonresponse bias limit generalizability. Multicenter longitudinal research with independent communication assessments is needed before educational recommendations can be made.