Examining work fatigue and well-being as mediators between empathy, emotional intelligence, and moral inclusivity in...

The potential mediating effects of work fatigue and well-being on the relationship between personal abilities and inclusive healthcare practices among community pharmacists remain an understudied area in Lebanon. The aim is to examine the factors associated with community pharmacists' professional inclusivity and their moral/ethical attitudes. It also investigates how pharmacists' well-being and work fatigue mediate the relationship between personal abilities, specifically empathy and emotional intelligence, and the expected outcomes.

Online cross-sectional study, conducted in 2023 among 430 Lebanese community pharmacies. Inclusivity, equity, and professional integrity were evaluated using the Pharmacy Inclusivity and Accessibility Scale (PIAS-13), the Population Prioritization and Equity Index (PPEI-24), and the Professional Commitment and Integrity Scale (PCIS-15). Moral and ethical perceptions were assessed using the Ethical Pharmacy Practice Scale (EPPS-16), the Moral Exception and Blame-Avoidance Scale (MEBAS), and the short form of the Moral Expansiveness Scale (MESx). Emotional Intelligence was measured using the Wong and Law Emotional Intelligence Scale (WLEIS), empathy using the Toronto Empathy Questionnaire (TEQ), and work fatigue using the Three-Dimensional Work Fatigue Inventory (3D-WFI). Multivariable and mediation analyses were conducted to examine relationships among variables.

Among graduate pharmacists, well-being mediated the associations between empathy, emotional intelligence, and priority assessment-a measure of inclusive practice-with β = -.02, 95% CI [-.11, -.04], P = 0.058, and β = -.03, 95% CI [-.07, .001], P = 0.013, respectively. Well-being also mediated the association between empathy and moral expansiveness (an indicator of inclusive attitudes) (β = -.02, 95% CI [.006, .079], P = 0.044). In contrast, work fatigue did not mediate any of the examined associations in this group. Among undergraduate pharmacists, work fatigue partially and negatively mediated the relationships between empathy and emotional intelligence with professional commitment and integrity, whereas well-being showed no mediating effects.

This study highlights the complex interplay of factors influencing community pharmacists' professional inclusivity and moral/ethical attitudes. Both concepts were associated with emotional intelligence, empathy, and moral expansiveness. Additional research is necessary to validate these findings, investigating targeted educational interventions, in particular, to enhance inclusivity in pharmacy practice.