Social intelligence, empathy and coping strategies: A descriptive analysis of selected psychosocial factors

Introduction to the issue

Social intelligence, empathy and coping strategies in stressful situations represent key psychosocial constructs that significantly influence the quality of interpersonal interactions and the overall adaptation of an individual. The concept of social intelligence was originally defined by Thorndike (1920) as the ability to understand people and effectively regulate social relationships. Current approaches perceive it as a complex, multidimensional construct including social understanding, social sensitivity and social adaptability. Morin (2020) adds that social intelligence is not an innate disposition, rather it is a set of abilities developed during life. According to this author, socially intelligent individuals have characteristics that fundamentally facilitate effective communication and harmonious interpersonal functioning. Morin (2020) identifies four key competencies that characterize socially intelligent individuals. The first of them is active listening, in which the individual pays attention to what others are saying instead of focusing on his own reaction. As a result, communication partners leave with a sense of understanding and mutual connection. The second area is represented by conversational skills. A socially competent person can interact with many types of people and maintain a conversation in a friendly, diplomatic tone and, as Maloney and Moore (2020) state, contribute to the achievement of planned goals. Another important component is reputation management, i.e. the ability to be aware of how an individual affects his social environment. Morin (2020) emphasizes that maintaining a positive social image is one of the most challenging dimensions of social intelligence. The last element is the tendency to avoid conflicts. Individuals with a high level of social intelligence do not consider arguments and enforcing their own preferences by force to be an effective way of communication, even when they disagree, they approach the opinions of others with openness and respect. These characteristics fit into the context of the statement of Frankovský and Birknerová (2017), who point out that social intelligence manifests itself primarily on a practical level, not in abstract theoretical concepts. It is a construct whose level can be most reliably identified through the observation of behavior in specific interpersonal situations and conditions that require adaptive social solutions. The close connection between social intelligence and empathy results from the fact that several of the competences of socially intelligent behavior – especially active listening, sensitivity to social signals and striving for harmonious interactions – also form the basis for empathic understanding of others. Empathy thus represents one of the key components through which social intelligence manifests itself in practical interpersonal situations.

Empathy

Empathy is traditionally understood in the psychological literature as a complex of cognitive and emotional processes that enable an individual to understand the inner experience of other people (Davis, 1983). Cognitive empathy involves the ability to understand another's perspective, while emotional empathy represents an affective response to their emotional state. Empathy has long been associated with prosocial behavior, altruistic tendencies, and the quality of interpersonal relationships, which makes it particularly important in professions oriented toward working with people. In the context of healthcare professions, empathy is considered one of the basic professional values, as it represents a key prerequisite for creating effective therapeutic relationships and contributes to increasing the quality of care provided and patient satisfaction (Menezes, Guraya, Guraya, 2021). In addition, empathic communication is considered an essential factor in establishing patient trust and increasing their adherence, which translates into better clinical outcomes (Pira et al., 2025). For this reason, the need for the systematic development of empathic competences within medical education is being emphasized more and more intensively. However, empathy is not a unitary or static construct. It is influenced by situational conditions and consists of several interconnected dimensions (Gamble et al., 2024). In doing so, individuals adjust their empathic responses based on comparing the behavior of others with their own expectations of how people should behave in similar situations. In the environment of healthcare organizations, empathic behavior is particularly important, as the perception and understanding of the patient's feelings is essential for strengthening the therapeutic relationship and overall satisfaction with the care provided (Salminen Tuomaala, Seppälä, 2022). However, empathy not only affects the quality of communication, but also how healthcare workers react to challenging and emotionally burdensome situations in clinical practice. The way they understand the patient's experience is reflected in their own emotional regulation and choice of coping strategies. Therefore, it is important to pay attention to the mechanisms of coping behavior, which play a fundamental role in maintaining professional functioning in the conditions of the healthcare environment.

Coping

Coping strategies, or stress coping strategies are defined in classic literature as a dynamic process of cognitive and behavioral reactions through which an individual tries to cope with demands assessed as demanding or exceeding his current resources (Lazarus, Folkman, 1984). In a similar vein, Doolittle (2021) describes coping strategies as a set of mechanisms that individuals use to deal with and regulate challenging situations. Within coping behavior, a distinction is usually made between functional (adaptive) strategies, including, for example, active search for solutions or problem orientation, and dysfunctional (maladaptive) strategies, such as avoiding problems or passivity. This distinction is especially important in the context of the healthcare environment, where the quality of coping responses significantly affects psychological stress, work efficiency, and the quality of interactions with patients. Zhu et al. (2022) also point out that the choice of coping strategies is fundamentally shaped by individual differences, which include personality characteristics as well as the specific situational context. This means that the choice of coping responses is the result of the interaction of internal predispositions and external conditions, which is particularly relevant in a high-demand environment such as healthcare practice.

The theoretical link between coping and other psychosocial constructs – including social intelligence and empathy – lies in their joint influence on social functioning and adaptation in challenging situations. Although descriptive analyzes do not allow identifying causal relationships, they provide valuable insight into the level of these constructs in the population and their potential interrelationships.

Methodological aspects

The study had a quantitative, cross-sectional design. The primary objective was to determine the level of social intelligence and empathy and the preferences of coping strategies in medical practice. Doctors working in healthcare facilities in Slovakia were approached for the purposes of the survey. The inclusion criteria were age ≥ 24 years, permanent employment in a medical facility as a doctor. Exclusion criteria were incompleteness of the questionnaires, work in another position or work not in a medical facility. The research sample consisted of 145 doctors, with an average age of 31 years and an average total length of practice of 5.73 years.

The data were obtained using standardized measurement tools MESI - Measurement of Social Intelligence, DE14 questionnaire, CSI - Coping Strategy Indicator questionnaire, which were subsequently supplemented with socio-demographic characteristics: age, gender, education, total length of practice, length of practice at the current workplace, type of workplace, shift operation and type of organization. The MESI questionnaire - contains 21 items assessed on a 5-point scale (0 - never, 4 - very often. The questions refer to the three factors of social intelligence that Frankovský, Birknerová (2014) named: manipulation - the ability to influence, empathy, social irritability. DE14 - a standardized measurement tool (Tišanská, Kožený, 2012) - is oriented towards the estimation of empathic behavior in general context. Empathy is assessed through three domains: receptivity (VN), respect (RE). Respondents answer on a Likert scale from 1 – strongly disagree to 7. The CSI questionnaire (Amirkhan, 1990) focuses on the prediction of behavior. mentions and describes it in the beginning of the questionnaire. The questions refer to three subscales (social support, problem solving, avoidance), which represent individual coping strategies. Respondents answered on a 4-point Likert scale (1 - yes, 2 - rather yes, 3 - rather no, 4 - no).

Statistical analysis was aimed at assessing the level of social intelligence, empathy and coping strategies using descriptive indicators, including minimum and maximum values, mean (M) and standard deviation (SD).

The main aim of the study was to assess the level of social intelligence, empathy and coping strategies among doctors working in clinical practice.

Analysis of results

The level of social intelligence of doctors was assessed using the MESI questionnaire, which allows assessing social intelligence in three domains: empathy, manipulation and social irritability. As the results in Table 1 show, the mean value in the Empathy domain reached M = 2.60, indicating a relatively high level of empathic responses among the physicians included in our survey. This score indicates that the respondents see themselves as persons capable of recognizing when it is necessary to adapt to others, to estimate their wishes and intentions, as well as to respond adequately to their emotional experiences. We also found a comparable average value (M = 2.55) in the domain Manipulation, which is related to the ability to influence the decisions of others. The result indicates that doctors perceive their ability to guide the decision-making process of other persons as relatively strong. In the Social Irritability domain, respondents achieved a mean score of M = 2.26, which may indicate that physicians sometimes feel less confident in adapting to new or socially challenging situations.

Table 1. Descriptive analysis of social intelligence assessment

We assessed the degree of empathy using the DE14 questionnaire, which assesses empathy in three domains: respect, receptivity and openness. The mean values ​​shown in Table 2 indicate very similar results in all three domains, with scores hovering around M = 4.6. Such a level indicates that the doctors included in our survey are characterized by a high degree of receptivity and openness to learning and their own professional development — not only through formal education, but also by taking advantage of various available opportunities. At the same time, the results indicate that the respondents are aware of the value of cooperation and thus the fact that they are not the only experts participating in the care process. This is reflected in their ability to respect the opinions, attitudes and experiences of other members of the healthcare team as well as patients.

Table 2 Descriptive Analysis of Empathy Assessment

We used the CSI questionnaire, which distinguishes three basic coping strategies: seeking social support, solving the problem, and avoiding the problem, to assess the ways doctors cope with difficult situations. The results presented in Table 3 show that the mean score for the social support strategy was M = 2.43 and for the problem solving strategy M = 2.38, indicating that the respondents use these practices, but not regularly or intensively. The highest mean value appeared for the strategy of problem avoidance (M = 2.50), which may indicate that doctors naturally reach for a delaying or evasive way of responding in certain situations.

Table 3 Descriptive analysis of assessment of ways of solving difficult situations

Discussion

The respondents of our survey achieved a higher level of empathy and an adequate level of social intelligence with slightly lower social irritability within the framework of determining the level of social intelligence. The presented findings of Birknerová and Frankovský (2014) testify to the meaningfulness of investigating social intelligence as an important factor in predicting people's behavior in helping professions (health care, pedagogy, social work, management). Based on the presented results of the mentioned authors, it is possible to make the assumption that it is not possible to look at the helping professions as a single homogeneous whole, on the contrary, it is necessary to specify both the general characteristics of these professions and the specific requirements of a specific helping profession. Similarly, the results focused on the analysis of the level of empathy confirmed balanced scores in the domains of respect, receptivity and openness, which is consistent with the context of current knowledge that a higher level of empathy of doctors has direct relevance for clinical practice. Systematic reviews have shown that empathic communication increases patient satisfaction, improves adherence to treatment and, in some areas, clinical indicators (pain, function, safety of care). In this sense, Edwards, et al., (2025) points to the importance of empathy training, which can be an effective tool for all health professions, including students and health practitioners. The author presents the opinion that training that encourages active participation (eg experiential learning, reflective exercises) is generally associated with better results in practice compared to more passive methods. Training that integrates self-reflection and involves patients in training also appears to be the most effective according to the aforementioned author (Edwards, et al., 2025). The results in the domain of the level of coping showed a rather moderate use of social support and problem solving and a slightly higher tendency towards avoidance. Avoidant strategies may reduce stress in the short term, but in the long term they are associated with higher stress and the risk of burnout. Systematic reviews emphasize that adaptive strategies (e.g. active coping, support) are an important protective factor for health professionals (Souvatzi, et al., 2024). Healthcare workers with higher empathy and better regulation of their own distress more often use problem-oriented strategies, while avoidant coping is associated with lower empathy and greater psychological exhaustion (Calegari, et al., 2022). In the research of Abou Hashish, Atalla (2023), problem solving and seeking social support were positively related to understanding the patient and solidarity in the provision of care, while avoidance was significantly associated with fatigue and emotional exhaustion of health workers.

Conclusion

The results of the study provided a comprehensive picture of the level of social intelligence, empathy and coping strategies of doctors in clinical practice. The findings pointed to a relatively high level of empathy and social intelligence of doctors, which is an important prerequisite for high-quality communication and effective building of therapeutic relationships, increasing patient satisfaction and, last but not least, fulfilling health care goals.

In the field of coping, however, it has been shown that although doctors also use adaptive strategies aimed at solving the problem or social support, a slightly higher preference for avoidance procedures can represent a risk factor in terms of long-term psychological burden. These findings emphasize the need for systematic support for the development of emotional and social competences, as well as targeted intervention to strengthen functional stress management strategies. The integration of empathy, communication and coping skills training into continuous education could contribute not only to the improvement of the working well-being of doctors, but also to the quality of the provided health care and patient satisfaction. At the same time, the study opens up space for further research, especially in the area of ​​the connection between social intelligence, empathy and long-term forms of coping, as well as for monitoring these relationships in various clinical fields and working conditions. It should be emphasized that the obtained results cannot be generalized to the entire population of doctors, as they reflect the specifics of a specific sample of doctors involved in our research, therefore they are interpreted exclusively in the context of this set.

Contact: PhDr. Valéria Parová, PhD. Pavel Jozef Šafárik University, Faculty of Medicine, Institute of Nursing

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