Empathy Behavior Research Articles

Empathic pain: Underlying neural mechanism.

Empathy is usually regarded as the ability to perceive the emotional state of others, which is an altruistic motivation to promote prosocial behavior and thus plays a key role in human life and social development. Empathic pain-the capacity to feel and understand the pain of others-constitutes a significant aspect in the study of empathy behaviors. For an extended duration, investigations into empathic pain have predominantly centered on human neuroimaging studies. Fortunately, recent advancements have witnessed the utilization of animal models in the exploration of the fundamental neural underpinnings of empathic pain. There is substantial evidence implicating multiple brain regions and neural networks in the generation and maintenance of empathic pain. Nevertheless, further elucidation of the neural mechanisms underlying empathic pain is warranted. This review provides a concise overview of prior studies on the neural mechanisms of empathic pain, outlining the pertinent brain regions, neural pathways, synaptic mechanisms, and associated molecules while also delving into future prospects.

Categories of training to improve empathy: A systematic review and meta-analysis.

Due to the vital role of empathy in promoting prosocial behaviors and nurturing social bonds, there is a growing interest in cultivating empathy. Yet, the effectiveness of existing training methods on empathy, especially on different dimensions of empathy (i.e., affective, cognitive, motivational, and behavioral empathy), varies tremendously, and the underlying causes for this heterogeneity remain insufficiently explored. To address this issue, we categorized various training methods into three distinct approaches based on the premise that empathy can be influenced by factors associated with the subject, the object, and their relationship. Respectively, these are Subject-Oriented, Object-Oriented, and Socially Oriented approaches. To examine the effects of training and sustainability of these approaches on different dimensions of empathy, we conducted a meta-analysis encompassing 110 eligible studies with 32, 44, 39, 39, and 91 samples for affective, cognitive, motivational, behavioral, and composite empathy, respectively. Results showed that trainings produced small and unsustainable effects on affective empathy, moderate and unsustainable effects on cognitive empathy, small and sustainable effects on motivational empathy, and moderate and sustainable effects on behavioral empathy. The effects of training on composite empathy were robust but decreased over time. Among the three training approaches, Socially Oriented approaches were the most effective in improving all dimensions of empathy. Subject-Oriented and Object-Oriented approaches were effective only in improving cognitive and composite empathy. Altogether, our study offers practical guidance for selecting appropriate training approaches and proposes theoretical principles for developing optimal training strategies in both basic research and clinical applications. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reflections of the Empathy Concept on the School Environment

By nature, people tend to communicate with other individuals around them. When communication is healthy, the incompatibilities in the organizations are minimized. One of the most important factors that ensure healthy communication is the ability to empathize. Empathy can be explained as the ability to put oneself in the place of the other person in general. This qualitative research, which aims to examine the reflections of the concept of empathy on the school environment in terms of students, teachers, school administrators and parents according to the opinions of teachers, is structured in a phenomenological design. The study group consists of 30 teachers working in different branches. The researchers created a semi-structured interview form with open-ended questions. The data is structured under categories and themes. The findings of the study are presented under 10 themes. The participants expressed the concept of empathy as empathy and developing a perspective to understand the other person, while the high empathy skills of the school stakeholders positively affected the success of the social environment of the school and human relations. Studies to be carried out to improve the empathy skills of teachers, school administrators, students and parents, in-service training activities, student, and parent activities were among the prominent results. It may be recommended that lessons and practices aimed at developing the empathy skills of teacher candidates be included in teacher training programs, and that inspectors and administrators, who are expected to play a leadership role in education, develop empathy behaviour and guide teachers, students, and parents.

The Impact of Folklore-Based Storytelling on Empathy Behavior in Kindergarten Children

The purpose of this study is to understand the impact of using folklore as a storytelling method on the empathy behavior of children in Group B kindergarten. The study uses quantitative methods, specifically the Non-Equivalent Control Group Design technique, involving Group B Harapan Gandok Bopkri Kricak Kindergarten. The sample consists each of 10 childrens in the experimental group and in the control group, selected using total sampling strategy. This study analyzed the data on behavioral empathy gathered through observation using the Wilcoxon Mann-Whitney tests. The results showed that the pretest score for the experimental class was 15,50. After the treatment, the score increased to 28,70. In comparison, the control class had a pretest score of 16.10 and a posttest score of 16,90. The Wilcoxon test yielded a score of Asymp.Sig (2-tailed) = 0.005. The hypotheses test conducted resulted in a significant score of 0.005, which means that Ho is rejected (p 0.05). This study's conclusion can help other schools helped the problems that students going through.

THE EFFECTIVENESS OF THE STORYTELLING METHOD USING FOLKTALES ON EARLY CHILDHOOD EMPATHY BEHAVIOR AT VILLA BETA KINDERGARTEN PADANG CITY

Storytelling provides opportunities for children to develop empathy for the world around them. This study was conducted with the aim of seeing the effectiveness of the storytelling approach on early childhood empathy behavior at Villa Beta Kindergarten, Padang City. Respondents in this study were 7 students of Villa Beta Kindergarten with 5 female respondents and 2 male respondents. The research design used in this study is an experimental design of the One-Group Pretest-Posttest Design type. Data collection was carried out using an empathy scale modified from Davis (1980), the empathy scale consists of four main aspects, namely perspective taking, fantasy, empathic concern, and personal distress. The resulting significance is p = 0.028 <0.05 so that the results obtained from this study are that there are significant differences in children's empathy behavior after treatment in the form of storytelling methods.

유아기 자녀를 둔 부모공감능력의 의미와 구성요인에 관한 델파이 연구

Objectives This study aims to clarify the meaning of parental empathy ability using the Delphi technique and to derive constituent and sub-factors. Methods To this end, the concept of parental empathy ability was defined through preceding research and liter-ature review, and the structuring factors of the ability were derived. An expert Delphi survey was conducted using the derived data to confirm the exploratory study of deriving the components of parental empathy ability. The data analysis method of the first Delphi survey questionnaire was conducted in order to define the concept of parental empathy and derive the structuring factors. A structured questionnaire, free-choice and open-ended questions were conducted with 13 experts in order to confirm the content validity. Using SPSS 25.0, the average value, standard deviation, skewness, agreement, convergence, and CVR ranges of each variable were calculated, and questions that did not meet each criterion were modified and deleted. Since the number of panels participating in the Delphi survey in this study is 13, if the CVR value is .554 or higher, it can be judged that the content validity is valid. The contents, were revised and supplemented with the experts, used to construct the second Delphi survey. It was used to construct the second questionnaire by reflecting the opinions of experts and revising and supplementing the contents. The second survey tool were gathered from the responses of the first survey. In or-der to clarify the opinions of each panel, structured questions with a 5-point rating scale were presented. Results First, the area of the scale consisted of three areas: ‘emotional empathy ability’, ‘cognitive empathy abil-ity’, and ‘behavioral empathy ability’, ‘emotional empathy ability’ consisted of perspective acceptance, cognitive empathy, and perspective acceptance, ‘cognitive empathy ability’ consisted of emotional response, emotional al-location, and emotional perception, and ‘behavioral empathy ability’ consisted of pseudo-movement, expression consistency, listening, and relationship formation. Conclusions The study is significant in that it derives categories and sub-factors of parental empathy ability that have recently come into focus. Furthermore, the study is significant in that it can be used as basic data for deriving the question composition through focus group interviews in the future.

Associations between alcohol consumption and empathy in a non-clinical sample: drinking motives as a moderator

People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.

Implications of perceived empathy from spouses during pregnancy for health-related quality of life among pregnant women: a cross-sectional study in Anhui, China

BackgroundEmpathy is a critical component of nursing care, impacting both nurses’ and patients’ outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women’s perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL.MethodsThis cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021. A general information questionnaire, the Interpersonal Reactivity Index (IRI), a purpose-designed empathy questionnaire and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) were used to evaluate the pregnant women’s general information, perceptions of empathy and HRQoL. Data were analysed using SPSS 22 at a threshold of P < 0.05. Descriptive analysis, Pearson correlation analysis, Student’s t test, ANOVA, and multiple regression analysis were used for analysis.ResultsThe pregnant women’s total empathy, physical component summary (PCS) and mental component summary (MCS) scores were 41.6 ± 9.0, 41.6 ± 7.6, and 47.7 ± 9.1, respectively. Correlation analysis revealed that the purpose-designed empathy questionnaire items were significantly positively correlated with perspective taking and empathic concern but were not correlated with the personal distress dimension and were only partially correlated with the fantasy dimension. Maternal physical condition during pregnancy, planned pregnancy, and occupational stress were predictors of the PCS score (β = 0.281, P < 0.01; β = 0.132, P = 0.02; β = -0.128, P = 0.02). The behavioural empathy item of our purpose-designed empathy questionnaire and empathic concern were important predictors of the MCS score (β = 0.127, P = 0.02; β = 0.158, P < 0.01), as well as other demographic and obstetric information, explaining 22.0% of the variance in MCS scores totally (F = 12.228, P < 0.01).ConclusionsPregnant women perceived lower empathy from their spouses and reported lower HRQoL. Perceived empathy, particularly behavioural empathy, may significantly impact pregnant women’s MCS scores but has no effect on their PCS scores. Strategies that foster perceived empathy from spouses among pregnant women are essential for facilitating healthy pregnancies and potentially improving maternal and child health.

The development of Tibetan children's racial bias in empathy: The mediating role of ethnic identity and wrongfulness of ethnic intergroup bias.

In Experiment 1 (N = 108, aged 7-12), ethnic identity was primed using Tibetan and Han names. Then negative and neutral events were applied to measure the RBEs of Tibetan children. In Experiment 2 (N = 148, aged 7-12), negative events were replaced by pain events. In Experiment 3 (N = 60, aged 7-12), Tibetan children's ethnic identity and the awareness of the wrongfulness of ethnic intergroup bias were added to examine the underlying mechanism. Results found that RBEs increased among Tibetan children aged 7-10 and decreased among those aged 11-12, Moreover, we analyzed age as a continuous variable and found that 10 years old was the inflection point in the development of RBEs in Tibetan children. Importantly, children aged 11-12 years old realized more wrongfulness of ethnic intergroup bias than children aged 7-10. The ethnic identity of Tibetan children aged 7-10 mediated the relation between age group and RBEs. And the wrongfulness of ethnic intergroup bias mediated the link between age group and RBEs in Tibetan children aged 9-12. Our study sheds light on the development of RBEs in Tibetan school-aged children and highlights the importance of identifying the appropriate timing for intervening in prejudice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Compassion buffers the association between trauma exposure and PTSD symptom severity: Findings of a cross-sectional study

To advance intervention science dedicated to improve refugees’ mental health, a better understanding of factors of risk and resilience involved in the etiology and maintenance of post-traumatic stress disorder (PTSD) is needed. In the present study, we tested whether empathy and compassion, two trainable aspects of social cognition related to health, would modulate risk for PTSD after war-related trauma. Fifty-six refugees and 42 migrants from Arabic-speaking countries reported on their trauma experiences, PTSD symptoms, and perceived trait empathy and compassion. They further completed the EmpaToM, a naturalistic computer task measuring behavioral empathy and compassion. Moderation analyses revealed that behavioral, but not self-reported compassion was a significant moderator of the trauma-PTSD link. Trauma was more strongly related to PTSD symptoms when individuals had low (β =.59, t = 4.27, p <.001) as compared to high levels of behavioral compassion. Neither self-reported nor behavioral empathy moderated the trauma-PTSD link (β =.24, t = 1.57, p =.120). Findings indicate that the ability to go beyond the sharing of others’ suffering and generate the positive feeling of compassion may support resilience in the context of trauma and subsequent development of PTSD. Hence, compassion may be a suitable target for prevention and intervention approaches reducing PTSD symptoms after trauma.

Downsides to the empathic brain? A review of neural correlates of empathy in major depressive disorder.

Empathy as one of the basic prerequisites for successful social interactions seems to be aberrant in individuals with major depressive disorder (MDD). Although understanding empathic impairments in MDD is crucial considering the frequently reported social skill deficits in patients, the current state of research is still inconclusive, pointing to both elevated and impaired levels of empathy. In this review, we extend previous reports of MDD-related aberrations in self-reported and behavioral empathy by shedding light on the neural correlates of empathy in MDD. Study findings indicate a complex and potentially state-dependent association, comprising both elevated and lower neural activity in empathy-related brain regions such as the inferior frontal gyri, bilateral anterior insulae, and cingulate areas. Predominantly, lower activity in these areas seems to be induced by antidepressant treatment or remission, with accompanying behavioral results indicating a reduced negativity-bias in empathic processing compared to acute states of MDD. We propose a preliminary model of empathy development throughout the course of the disorder, comprising initially elevated levels of empathy and a somewhat detached and lower empathic responding during the further progression of the disorder or post-treatment. The seemingly multifaceted nature of the association between empathy and MDD requires further exploration in future multimodal and longitudinal studies. The study of neural correlates of empathy in MDD should prospectively be enlarged by including further socio-affective and -cognitive capacities in MDD and related mental disorders.

An Empathy and Arts Curriculum During a Pediatrics Clerkship: Impact on Student Empathy and Behavior.

Empathy is critical within medicine and improves patient outcomes and satisfaction. Empathy declines during the clerkship years due to the hidden curriculum, where students observe emotional distancing and desensitization by providers. Studies show arts curricula can preserve empathy but are limited by sample bias and preclerkship occurrence. We implemented and evaluated a brief pediatric clerkship arts curriculum to improve empathic behaviors. We created two 1-hour required small-group sessions for pediatric clerkship medical students. The first session paired arts observation techniques with various paintings. The students then applied these techniques to video-based simulated patient interactions in the second session. We used the Toronto Empathy Questionnaire (TEQ) and an empathy behavior checklist (EBC) as pre/post assessments to gauge self-reported empathy and empathetic behaviors. We compared responses of learners who attended the sessions (curriculum group) to learners unable to attend (control group). Thirty-four students participated in the curriculum; 19 were in the control group. Neither the control nor the curriculum group had a significant change in pre/post TEQ scores. Students with pre-TEQ scores less than 45 who participated in the curriculum had significant improvement in post-TEQ scores compared to their control group counterparts (p = .02). On the EBC, there was a significant difference between the curriculum and control groups for those who explored more about the child/family's experience (p < .05). Our work suggests that a brief clerkship arts curriculum is useful for improving self-reported empathy ratings and empathetic skills, particularly for students identified as having below-average empathy.

Empathy in Preschoolers: Exploring Profiles and Age- and Gender-Related Differences.

Empathy is a key skill in the daily life of preschoolers, and it is important to understand how it evolves during this crucial period of development. This paper includes two studies. The first study, which had a cross-sectional design, examined affective, cognitive, and behavioral empathy in 354 children (aged from 3 to 6 years) through a performance-based measure and questionnaires completed by their mothers. Although girls tended to have better affective empathy than boys on the performance-based task, no difference was noted in the mothers' perceptions of their children's empathy. Empathy dimensions varied depending on the age of the children. The hierarchical cluster analyses of the cases identified differentiated subgroups of children, according to their empathic skills in the three dimensions. The second study, which was longitudinal, used the same measures and investigated the developmental trajectory of empathy in 69 preschoolers over one year. The results showed that each empathic dimension predicted itself one year later, but did not predict the two others. The implications for potential interventions are emphasized in this study.

The Effects of Healthcare Robot Empathy Statements and Head Nodding on Trust and Satisfaction: A Video Study

Clinical empathy has been associated with many positive outcomes, including patient trust and satisfaction. Physicians can demonstrate clinical empathy through verbal statements and non-verbal behaviors, such as head nodding. The use of verbal and non-verbal empathy behaviors by healthcare robots may also positively affect patient outcomes. The current study examined whether the use of robot verbal empathy statements and head nodding during a video recorded interaction between a healthcare robot and patient improved participant trust and satisfaction. One hundred participants took part in the experiment, online through Amazon Mechanical Turk. They were randoimnized to watch one of four videos depicting an interaction with a `patient' and a Nao robot that (1) either made empathetic or neutral statements, and (2) either nodded its head when listening to the patient or did not. Results showed that the use of empathetic statements by the healthcare robot significantly increased participant perceptions of robot empathy, trust and satisfaction, and reduced robot distrust. No significant findings were revealed in relation to robot head nodding. The positive effects of empathy statements support the model of Robot-Patient Communication, which theorizes that robot use of recommended clinical empathy behaviors can improve patient outcomes. The effects of healthcare robot nodding behavior needs to be further investigated.

Can teaching serious illness communication skills foster multidimensional empathy? A mixed-methods study

BackgroundTo investigate the impact of a serious illness communication skills training course on medical students’ attitudes regarding clinical empathy, self-efficacy in empathic communication, and learning on different dimensions of empathy.MethodsA mixed-methods design was used. A blended learning Serious Illness Communication Skills Training (SI-CST) course was delivered to sixth-year medical students. Students (n=185) completed questionnaires with the 20-item Jefferson Scale of Empathy (JSE) and self-rated preparedness level for five empathic communication tasks at baseline (T1), six weeks (T2), and three-to-six months post-training (T3). Written reflections on key lessons learned were analyzed using inductive thematic analysis.ResultsTotal JSE scores significantly improved from T1 to T2 (111.4 vs 113.9, P=.01) and from T1 to T3 (111.4 vs 113.9, P=.01). There was an increase in Standing in Patient’s Shoes subscale of the JSE with an effect size of 0.56 whereas the Perspective-Taking and Compassionate Care subscales showed no significant changes. Self-rated preparedness for all five empathic communication tasks significantly improved from T1 to T2 (P ≤ .001) and from T1 to T3 (P ≤ .001) with large effect sizes (1.09-1.41). Four key themes emerged from the qualitative analysis. They were appreciating the important role of empathy in clinical care (moral empathy), learning skills in detecting and understanding patient emotions (cognitive empathy), learning skills in responding to emotion with empathy (behavioral empathy), and appreciating that communication skills can be improved with continual practice and self-reflection.ConclusionsOur results revealed that SI-CST improved medical students’ empathic attitudes and self-efficacy in empathic communication. Qualitative results found learning on the cognitive, behavioral and moral dimensions of empathy.

Effects of weight bias training on student nurse empathy: A quasiexperimental study

AimThis study aimed to identify the efficacy of weight bias training on the empathy skills of student nurses when working with a person with obesity. BackgroundWeight bias with nurses harboring negative attitudes towards patients with obesity results in inferior care and patients' reluctance to seek medical care. Empathy is a communication skill used in nursing to build trust and rapport with patients to provide optimal patient-centered care. MethodsThis study used a quasi-experimental design with 121 undergraduate nursing students in their first semester of the nursing program. The students completed learning activities on weight bias, including reading an article on weight bias, watching a video showing an individual with obesity's experiences in the healthcare setting and participating in a group discussion and reflection on the article and video. In addition, students completed the Jefferson Scale of Empathy-Health Professions Students’ version before and after the learning activities. Following the learning activities, students participated in a simulation activity with a standardized patient wearing an obesity suit. The standardized patient completed the Jefferson Scale of Patient Perceptions of Nurse Empathy to rate the patient's perception of the nursing student's level of empathy based on their interactions in the simulation scenario. ResultsA comparison of the scores on the Jefferson Scale of Empathy-HPS showed there was not a significant difference in the scores before learning activities (M = 15.45, SD = 12.7) and post-learning activities (M = 15.94, SD = 11.5); t(120) = 0.476, p = .635. Data analysis identified significant changes in empathy scores on the Jefferson Scale of Empathy-HPS in the accelerated second-degree cohort with differences in scores before learning activities (M = 113.7, SD = 10.5) and post-learning activities (M = 116.5, SD = 13.4); t(50) = 2.02, p = .049. The traditional cohort did not have a significant change in empathy scores. Empathy scores and the patient's perception of empathy scores showed no relationship. Most (79 %) of the patient's perception of empathy scores was moderate. Student comments in this study support the findings that some nursing students harbor weight bias towards individuals with obesity. ConclusionThere is a need to identify learning activities that eliminate weight bias in the nursing student population and result in the student's ability to demonstrate appropriate communication skills and nursing behaviors in a nondiscriminatory manner to the patient with obesity. To improve empathy behaviors, students should practice communication skills throughout the nursing curriculum.

Inconstant Empathy—Interpersonal Factors That Influence the Incompleteness of User Understanding

AbstractEmpathy can help designers discover and fulfill users’ latent needs in design, which can lead to better design solutions. To achieve deep user understanding, designers utilize their ability to empathize with users. However, empathy is always incomplete and inconstant in user understanding. This study applies a quantitative behavioral empathy measure to a case of designers attempting to understand the needs of users of a future semi-autonomous vehicle technology. In total, 16 designers and 48 users are involved. We study how interpersonal differences between designers and users and different users’ mental content impact the level of empathic understanding. Specifically, these factors are national cultural differences, visiting experience, binary gender differences, the relationship between users and designers, and user mental content types. The results show that cultural differences and visiting experiences significantly affect designers’ empathic accuracy and emotional tone accuracy in both physical and online interviews. These influences vary depending on contextual factors that are related to the participant's own experience and the experiment itself.

A developmental analysis of dimensions of empathy during early adolescence: Behavioral empathy but not cognitive empathy is associated with lower psychopathology.

Construct definitions of empathy have sought to distinguish between different dimensions of empathetic capacity that are significantly associated with psychological distress or wellbeing. Research has provided substantial evidence differentiating affective and cognitive empathy; however, more recent research has cited the importance of a third domain represented by empathetic behaviors and compassionate intent to comfort others. Examining developmental and maturational stage during the rapid transitional period of early adolescence is needed to model developmental trajectories, mechanisms of change and mental health outcomes. This study aims to assess relationships between pubertal developmental stage, dimensions of empathy, and depression, anxiety and externalizing behaviors among early adolescents. A cross-sectional survey among young adolescents ages 9-12 years was conducted in Dar es Salaam, Tanzania. The relationships between pubertal developmental stage, affective, cognitive, and behavioral empathy scores and internalizing and externalizing symptoms were evaluated using hierarchical regression modeling. Structural equation modeling was used to test a theoretical model of structural paths between these variables. A sample of 579 very young adolescents (270 boys and 309 girls) aged 9-12 years participated in the study. Pubertal development scale scores were associated with affective, cognitive, and behavioral empathy. Adolescents who had greater behavioral empathy scores reported lower internalizing and externalizing symptoms. Adolescents who had transitioned further through puberty and had higher cognitive empathy scores and reported higher internalizing symptoms. These findings support the importance of pubertal developmental stage in assessing risk and protective paths to mental health during adolescence. While empathetic capacity is widely perceived to be a positive trait, dimensional analysis of empathy among early adolescents indicates that behavioral skills and compassionate acts may be particularly protective and promote positive mental health outcomes.

Psychometric properties of the empathy questionnaire for children and adolescents in a sample of Tanzanian adolescents.

Construct definitions of empathy have sought to distinguish between different domains of empathetic capacity that are related to psychological distress or wellbeing. This study aims to validate the psychometric properties of the Empathy Questionnaire for Children and Adolescents (EmQue-CA) and to test for measurement invariance by gender in a sample of 579 very young adolescents (270 boys and 309 girls) ages 9-12 from Tanzania. Exploratory and confirmatory factor analysis were completed to assess the factor analytic structure of the EmQue-CA, indicating a three-factor model fit these data well. Concurrent validity was demonstrated through strong significant correlations with prosocial behavior and generosity measures. Convergent validity indicated the behavioral subdimension of empathy, intent to comfort, was significantly and negatively associated with externalizing behaviors. Measurement invariance by gender was not supported for these data due to configural invariance in covariance between cognitive empathy and intent to comfort latent constructs. These findings confirm the EmQue-CA is an important measure of three dimensions of empathy; affective empathy, cognitive empathy, and behavioral empathy (intent to comfort) in a sample of Tanzanian adolescents.

The impact of ageing simulation education on qualified acute care nurses' empathy towards older people: A mixed-methods study.

To evaluate the influence of an ageing simulation intervention on qualified acute care nurses' empathy towards older people. Life expectancy is increasing globally with an increased incidence of older people accessing healthcare services. As such, it is essential for qualified nurses within hospital settings to connect with older people by establishing healthful relationships. Empathy is an essential component of healthful nurse-patient relationships. Fortunately, empathy can be taught through education. A convergent mixed-methods design was utilised. Nurses (N=95) undertook an 8-hour ageing simulation intervention. Data were collected from April 2019 to May 2020 across three time points: before the intervention (T0); immediately after (T1) and at three months follow-up (T2). A mix of convenience (intervention) and purposeful (follow-up) sampling techniques were utilised. Quantitative data were collected via the Interpersonal Reactivity Index survey (n=86) and analysed using repeat measures ANOVA to compare mean scores across time points. Qualitative data were collected via debriefing discussions (N=95) and focus groups (n=38), and analysed using a systematic thematic analysis method. Data convergence occurred during the interpretation phase. Study reported with the TREND checklist. Primarily, when quantitative and qualitative findings were merged they confirmed each others' empathy outcomes. Quantitative results showed a statistically significant increase in affective and cognitive empathy levels among nurses post-intervention. Qualitative findings expanded on quantitative results and revealed an increase in nurses' affective, cognitive and behavioural empathy represented in themes 'enhancing my empathy', 'impact of ageing', 'from self to others' and 'person-centred moments'. This study adds empirical evidence how a mixed-methods design can be used to evaluate the influence of an ageing simulation intervention on nurses' empathy levels. Ageing simulation interventions are a suitable experiential educational approach to improve acute care nurses' affective, cognitive and behavioural empathy towards older people.