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Relationship of empathy to appraisal, depression, life satisfaction, and physical health in informal caregivers of older adults
Abstract
The relationship between empathy and caregiving appraisal and outcomes was examined among 140 informal caregivers of older adults. Caregivers with high cognitive empathy appraised the caregiving situation as less stressful and less threatening, were less depressed, and reported higher life satisfaction than did caregivers with low cognitive empathy. The caregivers' appraisal, along with educational levels and total household income, significantly predicted individual differences in caregiver depression, life satisfaction, and perceived physical health. Emotional empathy was negatively related to life satisfaction. There appeared to be distinct roles for emotional and cognitive empathy in informal caregiving outcomes. The study supported the important role of caregiving appraisal and resources in caregiving outcomes.
... Affective empathy refers to sharing another's feelings, thereby experiencing the feelings vicariously, while cognitive empathy refers to understanding another's feelings (Reniers et al, 2011). Whereas affective empathy (sharing emotional states) has been linked to poorer mental health outcomes (Hua et al, 2021) and decreased life satisfaction (Lee et al, 2001) in caregivers, cognitive empathy (taking the perspective of others) has been linked to decreased stress, lower rates of depression and higher life satisfaction (Lee et al, 2001;Jütten et al, 2019). Understanding how others feel without taking on the emotional burden can place caregivers in a position to help without becoming overwhelmed. ...
... Affective empathy refers to sharing another's feelings, thereby experiencing the feelings vicariously, while cognitive empathy refers to understanding another's feelings (Reniers et al, 2011). Whereas affective empathy (sharing emotional states) has been linked to poorer mental health outcomes (Hua et al, 2021) and decreased life satisfaction (Lee et al, 2001) in caregivers, cognitive empathy (taking the perspective of others) has been linked to decreased stress, lower rates of depression and higher life satisfaction (Lee et al, 2001;Jütten et al, 2019). Understanding how others feel without taking on the emotional burden can place caregivers in a position to help without becoming overwhelmed. ...
... A positive relationship was found for affective but not cognitive empathy, indicating that in caregivers of those with severe mental health disorders, higher levels of affective empathy are linked to higher levels of stress. These results are consistent with previous research which found that affective empathy, but not cognitive empathy, was associated with greater mental health issues in caregiver populations (Lee et al, 2001;Jütten et al, 2019;Hua et al, 2021). Also, similar to previous research, emotional intelligence correlated negatively with stress in caregivers (Singh and Sharma, 2012;Beauvais et al, 2017;Saeed et al, 2019), demonstrating that individuals with high levels of emotional intelligence reported lower stress levels. ...
Caregiving for persons with severe mental health disorders is associated with higher stress levels and a lower quality of life. As rates of mental health disorders increase worldwide, the need for assisting familial caregivers with strategies to reduce stress is paramount. The present study examines the relationships between empathy (cognitive and affective), emotional intelligence and stress in these caregivers. A parallel mediation model demonstrates that cognitive empathy, in particular, partially mediated the negative relationship between emotional intelligence and stress, indicating the importance of cognitive empathy in caregiving. The results of this study can help design targeted interventions to reduce caregiver stress.
... 5,10 Many of these characteristics are traits of caregivers of older people, as demonstrated in studies conducted with this population. 8,9,[11][12][13][14][15] Besides the positive aspects attributed to empathy, studies have found that a high level of this skill, especially in the affective domain, can have negative consequences, such as stress, 9,14 burnout, 16 depression 17 and anxiety. 13 In contrast, a high level of cognitive empathy offers protection from the occurrence of depressive symptoms. ...
... 5,10 Many of these characteristics are traits of caregivers of older people, as demonstrated in studies conducted with this population. 8,9,[11][12][13][14][15] Besides the positive aspects attributed to empathy, studies have found that a high level of this skill, especially in the affective domain, can have negative consequences, such as stress, 9,14 burnout, 16 depression 17 and anxiety. 13 In contrast, a high level of cognitive empathy offers protection from the occurrence of depressive symptoms. ...
... 13 In contrast, a high level of cognitive empathy offers protection from the occurrence of depressive symptoms. 13,14 Caregivers assist with activities that older people have difficulty doing by themselves. 11 Such caregivers may be formal or informal, depending on whether or not they are paid for providing care. ...
Objective:
To analyse factors associated with affective and cognitive empathy in informal and formal caregivers of older people.
Methods:
A cross‐sectional study was conducted with 111 formal and informal caregivers divided into three groups (lower, intermediate and higher empathy) based on the Multidimensional Interpersonal Reactivity Index score (total, affective and cognitive empathy). A sociodemographic questionnaire, the Zarit Burden Inventory, Patient Health Questionnaire‐9 and Functional Assessment Questionnaire were applied.
Results:
The participants were predominantly women (91%), and median [IQR] age was 46 [33‐57] years. In the multinomial regression analysis being an informal caregiver, being older and having depressive symptoms were associated with higher levels of empathy (total score and the affective domain). No associations were found for the cognitive domain.
Conclusion:
A high level of empathy, especially affective empathy, was associated with depressive symptoms, older age and being an informal caregiver. Family relationships and the lack of training among informal caregivers should be explored.
... Emotional and cognitive empathy are both beneficial in many contexts (Morelli et al., 2017;Wei et al., 2011). However, in the context of providing care for a loved one undergoing a distressing life experience, these facets of empathy may have quite different relationships with caregiver mental health (Lee et al., 2001). When a person with dementia experiences distress, a caregiver with high emotional empathy may feel or share the person's distress, which can lead to the caregiver being overwhelmed by the caregiver's own sense of distress, making high emotional empathy problematic for caregivers by increasing their distress vicariously. ...
... Despite these provocative insights from previous work, researchers have rarely examined familial caregivers' emotional and cognitive empathy in relation to their own mental health. One study found that higher emotional empathy in caregivers was associated with lower life satisfaction and that higher cognitive empathy was associated with greater life satisfaction (Lee et al., 2001). In another study ( Jüttenet al., 2019), higher emotional empathy in caregivers was associated with greater anxiety; cognitive empathy was associated with depression in a curvilinear fashion, such that highest levels of cognitive empathy predicted the lowest levels of depression. ...
... Ekman & Halpern, 2015). Having too much emotional empathy runs the risk of reducing this psychological distinction (Lee et al., 2001) and is considered an important cause of overidentification with patients in health care professionals (Decety & Fotopoulou, 2014). Our findings similarly exemplify the adages that "it depends on the context" and that one can have "too much of a good thing." ...
Caregiving for a person with dementia or neurodegenerative disease is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. In the present study, we assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person and providing continuous ratings of the valence of another person’s changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of people with dementia or neurodegenerative disease. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.
... For informal dementia caregivers, only three studies have examined the association between empathy and aspects of well-being (Lee, Brennan, & Daly, 2001;Shim, Barroso, & Davis, 2012;Sutter et al., 2014). Shim et al. (2012) con- ducted a qualitative study, among 57 spousal dementia caregivers. ...
... However, in regression analyses, only stress was significantly predicted by empathy after controlling for sociodemographic variables. Lee et al. (2001) con- ducted a cross-sectional study among 140 informal dementia caregivers. In univariate analyses, they found that more cognitive empathy was significantly correlated with lower stress appraisal, lower threat appraisal, fewer depression symptoms, and more life satisfaction. ...
... The levels of neither cognitive nor affective empathy differed between the groups. To our knowledge, only two studies quantitatively exam- ined the association between empathy and aspects of well-being in informal caregivers ( Lee et al., 2001;Sutter et al., 2014). Lee et al. (2001) found, using univariate anal- yses, that more cognitive empathy was correlated with less stress, less depression, less threat appraisal, and higher life satisfaction. ...
Background/Objective: Recent interventions aim to heighten informal caregivers’ empathy levels assuming that this will lead to better well-being. However, previous studies have explored linear associations between empathy and aspects of well-being and yielded mixed results. We hypothesized that quadratic models may be more fitting to describe these relationships. Method: A cross-sectional study, with two groups (201 informal caregivers, and 187 non-caregivers) was conducted. Participants completed questionnaires on cognitive and affective empathy, and depression, anxiety, and caregiver burden. AN(C)OVA's and multiple hierarchical regression analyses including linear and quadratic terms were used to analyze the data. Results: For caregivers, there was a negative quadratic relationship between depression and cognitive empathy, and a positive linear relationship between anxiety and affective empathy, irrespective of sociodemographic characteristics. For non-caregivers, there were positive quadratic relationships between depression and cognitive and affective empathy, and between anxiety and affective empathy. The empathy levels did not differ between the groups. Conclusions: While caregivers and non-caregivers had the same amount of empathy, the relationships between empathy and depression and anxiety differed between the groups. Interventions for informal caregivers could aim to heighten cognitive empathy and to lower affective empathy to diminish depression and anxiety symptoms.
... Outside of the Big Five model, caregivers with greater empathy report higher life satisfaction and less depression, as well as appraising caregiving as less threatening and stressful [25]. Broadly defined, empathy is the ability to correctly perceive another's feelings [26]. ...
... A proposed model of caregiver compassion [27] suggests personality characteristics such as empathy, level of intimacy, and attachment style moderate the level of compassion people feel in response to another's suffering, resulting in (or inhibiting) various helping behaviors [12]. As individuals develop empathy, they learn to recognize and feel what others feel before developing the capacity to maintain emotional distance from another's internal experience while retaining the ability to recognize another's feelings [25]. Caregivers in the early stages of empathy development may quickly feel overwhelmed by the emotional experience they share with the recipient [25]. ...
... As individuals develop empathy, they learn to recognize and feel what others feel before developing the capacity to maintain emotional distance from another's internal experience while retaining the ability to recognize another's feelings [25]. Caregivers in the early stages of empathy development may quickly feel overwhelmed by the emotional experience they share with the recipient [25]. In contrast, greater empathy has been associated with better provision of support by caregivers and reduced anxiety [28]. ...
The purpose of this study was to investigate among college students the relationship between personality traits and willingness to care for a relative with a chronic health condition. 329 undergraduate students completed an online questionnaire. Hierarchical multiple regressions found that after controlling for demographics personality traits explained 10% of the variance in willingness to provide emotional care, 7% in instrumental care, and 7% in nursing care. Within these models, greater empathy was uniquely associated with willingness to provide emotional, instrumental, and nursing care for a family member in the future. Similarly, participants with high agreeableness were more willing to provide emotional care, and participant older age was a unique predictor of instrumental care. The results can help shape research on interventions that incorporate perspective taking, motivational interviewing, and training in life skills as a means of boosting college students’ willingness to provide care for a relative with a chronic health condition.
... Outside of the Big Five model, caregivers with greater empathy report higher life satisfaction and less depression, as well as appraising caregiving as less threatening and stressful [25]. Broadly defined, empathy is the ability to correctly perceive another's feelings [26]. ...
... A proposed model of caregiver compassion [27] suggests personality characteristics such as empathy, level of intimacy, and attachment style moderate the level of compassion people feel in response to another's suffering, resulting in (or inhibiting) various helping behaviors [12]. As individuals develop empathy, they learn to recognize and feel what others feel before developing the capacity to maintain emotional distance from another's internal experience while retaining the ability to recognize another's feelings [25]. Caregivers in the early stages of empathy development may quickly feel overwhelmed by the emotional experience they share with the recipient [25]. ...
... As individuals develop empathy, they learn to recognize and feel what others feel before developing the capacity to maintain emotional distance from another's internal experience while retaining the ability to recognize another's feelings [25]. Caregivers in the early stages of empathy development may quickly feel overwhelmed by the emotional experience they share with the recipient [25]. In contrast, greater empathy has been associated with better provision of support by caregivers and reduced anxiety [28]. ...
The purpose of this study was to investigate among college students the relationship between personality traits and willingness to care for a relative with a chronic health condition. 329 undergraduate students completed an online questionnaire. Hierarchical multiple regressions found that after controlling for demographics personality traits explained 10% of the variance in willingness to provide emotional care, 7% in instrumental care, and 7% in nursing care. Within these models, greater empathy was uniquely associated with willingness to provide emotional, instrumental, and nursing care for a family member in the future. Similarly, participants with high agreeableness were more willing to provide emotional care, and participant older age was a unique predictor of instrumental care. The results can help shape research on interventions that incorporate perspective taking, motivational interviewing, and training in life skills as a means of boosting college students’ willingness to provide care for a relative with a chronic health condition.
... The current evolution of western healthcare systems related to demographic pressure has made institutions, society and research more and more aware of the importance of the informal care provided by relatives of persons suffering from severe conditions due to disease or ageing [17,61]. Informal elderly care is well established across the EU countries with its incidence ranging from 1-2% for [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] year olds peaking at over 10% (approximately 5 % for men) for over 50 year old women [68]. An analysis of the SHARE (Survey of Health, Ageing and Retirement in Europe) database [55] shows that partners/spouses are making up over 50% of persons providing personal care on a regular basis and children over 30%. ...
... Indeed, caregiving is stressful [56], and caregivers are at risk for physical and emotional problems [53]. Indeed, depression is common among informal caregivers [38]; in France, caregivers of patients suffering from Alzheimer's disease (AD) suffer more from depression than the general population [65]. Providing support to informal caregivers appears then as a necessity and as an opportunity to think about how new approaches can complement institutionalized healthcare services. ...
... We have also highlighted that being part of a group appears to be an important means for informal caregivers to fight isolation, learn and be reassured in assuming their caregiver role and to encourage the adoption of available help. This confirms and extends existing nursing studies [8,38], and complements studies of social support taking place online [4,29,34,36,43,50,60,67,69], that mainly concern patients or younger caregivers. We also provide design perspectives, that contrary to existing work on the design of online systems to foster social interactions among elderly people or informal caregivers [2,40,49], do not exclude online and offline activities but rather try to bridge them. ...
Awareness of the huge amount of work faced by relatives in caring for a person suffering from a loss of autonomy has led to research focusing on ways to ease the burden on informal caregivers. Among them, services and devices aimed at providing social support and fighting the isolation that may be caused by the caregiving tasks appear important. However, little is known about the social support informal caregivers actually value and look for in practice. To fill this gap, we conducted a multi-sited study, focusing on older informal caregivers, because they are numerous and have lower experience with technology. Our study highlights that being part of a group is a key element in helping informal caregivers to feel that they are not alone, continue leisure activities, learn from others and sustain participation in organized activities. Through this understanding, we discuss design opportunities in a sociotechnical approach complementing online and offline social support.
... Multiple dimensions of anxiety also adversely impact affective and/or cognitive empathy [86,87]. Depression has been positively associated with affective empathy but negatively associated with cognitive empathy, with moderations by self-esteem, feeling in control of one's life, education, guilt, and executive function [88][89][90][91][92][93]. More broadly, internalizing behaviors have been associated with increased empathy and lower CU traits, and externalizing behaviors with reduced empathy and higher CU traits [39,94,95]. ...
... The effects of externalizing behaviors, individually and in some combinations with other mental health factors (interactions), were notably larger than all others. Our findings are in agreement with extensive prior reports of negative correlations between externalizing behaviors, social withdrawal, anxiety, depression, and prosocial behaviors, but positive associations between internalizing behaviors and empathy [39,87,88,162,163]. ...
Empathy is at the core of our social world, yet multidomain factors that affect its development in socially sensitive periods, such as adolescence, are incompletely understood. To address this gap, this study investigated associations between social, environmental and mental health factors, and their temporal changes, on adolescent empathetic behaviors/emotions and, for comparison, callous unemotional (CU) traits and behaviors, in the early longitudinal Adolescent Brain Cognitive Development sample (baseline: n = 11062; 2-year follow-up: n = 9832, median age = 119 and 144 months, respectively). Caregiver affection towards the youth, liking school, having a close friend, and importance of religious beliefs/spirituality in the youth’s life were consistently positively correlated with empathetic behaviors/emotions across assessments (p<0.001, Cohen’s f = ~0.10). Positive family dynamics and cohesion, living in a neighborhood that shared the family’s values, but also parent history of substance use and (aggregated) internalizing problems were additionally positively associated with one or more empathetic behaviors at follow-up (p<0.001, f = ~0.10). In contrast, externalizing problems, anxiety, depression, fear of social situations, and being withdrawn were negatively associated with empathetic behaviors and positively associated with CU traits and behaviors (p<0.001, f = ~0.1–0.44). The latter were also correlated with being cyberbullied and/or discriminated against, anhedonia, and impulsivity, and their interactions with externalizing and internalizing issues. Significant positive temporal correlations of behaviors at the two assessments indicated positive (early) developmental empathetic behavior trajectories, and negative CU traits’ trajectories. Negative changes in mental health adversely moderated positive trajectories and facilitated negative ones. These findings highlight that adolescent empathetic behaviors/emotions are positively related to multidomain protective social environmental factors, but simultaneously adversely associated with risk factors in the same domains, as well as bully victimization, discrimination, and mental health problems. Risk factors instead facilitate the development of CU traits and behaviors.
... Research found that it is the most challenging part of human life in upbringing because the individual has increased emotionality [12]. Empathy means for a person the ability to behave appropriately and manage everyday situations [8]. We can say that empathy is in many ways the opposite of aggressive behavior and aggression [14]. ...
... In future research we would expand the research with a life satisfaction questionnaire. We could explore the connection between level of empathy and life satisfaction [8,9]. Based on the results of presented research, we can say that 1st and 2nd year secondary school students have a high level of empathy and attachment. ...
The study aims to identify the mutual connection between empathy and attachment. The research sample consists of 240 secondary schools´ students. The participants' age range from 15 to 16 years. We used a non-standardized questionnaire Empathy Quotient-EQ to determine the level of empathy, and a standardized questionnaire Parental Bonding Instrument-PBI to determine the types of attachment. We identified a statistically significant correlation between the level of empathy and the type of attachment and that there was no difference between boys and girls in the level of empathy.
... Similarly, those caregivers who reported lower household incomes and assessed the caregiving situation as more stressful and threatening reported more depression (Lee et al., 2001). The researchers stated that caregivers' total household income and educational levels positively influenced caregiving outcomes, for instance, lower levels of depression (Lee et al., 2001). ...
... Similarly, those caregivers who reported lower household incomes and assessed the caregiving situation as more stressful and threatening reported more depression (Lee et al., 2001). The researchers stated that caregivers' total household income and educational levels positively influenced caregiving outcomes, for instance, lower levels of depression (Lee et al., 2001). Other studies found comparable evidence since lower educational attainment and less or no education were linked to depressive symptoms or burden (Abajo et al., 2017;Geng et al., 2018;Pinquart & Sörensen, 2011;Sanuade & Boatemaa, 2015). ...
Aim:
The aim of this study was to examine the reported social determinants of mental health among older caregivers in the previous caregiving literature.
Design:
An integrative literature review method of Whittemore and Knafl.
Methods:
CINAHL, MEDLINE (Ovid), PubMed, and Science Direct were searched from January 1999 to December 2019. A systematic approach and data analysis were used. The evidence of a multilevel framework by the World Health Organization was used to examine the social determinants of mental health.
Results:
Twelve articles were included. "Levels of physical health" was mainly cited factor linked to mental health inequalities among older caregivers. However, the evidence regarding caregivers' gender-related, ethnic and socioeconomic differences in mental health was relatively limited.
Conclusion:
Future research and screening programs on social determinants of mental health among older caregivers are necessary to tackle mental health inequalities. Implications informed by this research could sustain mental health equity among older caregivers.
... In the study carried out by Lee et al., 25 caregivers with higher levels of cognitive empathy assessed the task of caring as less stressful, were less depressed, and had greater satisfaction with life compared with caregivers with lower levels of cognitive empathy, while emotional empathy showed a negative correlation with life satisfaction. 25 In this way, comparing these findings with the results of our study, we can conclude that cognitive empathy can be a protective factor for the mental health of the professional. ...
... In the study carried out by Lee et al., 25 caregivers with higher levels of cognitive empathy assessed the task of caring as less stressful, were less depressed, and had greater satisfaction with life compared with caregivers with lower levels of cognitive empathy, while emotional empathy showed a negative correlation with life satisfaction. 25 In this way, comparing these findings with the results of our study, we can conclude that cognitive empathy can be a protective factor for the mental health of the professional. ...
Empathy is an important factor to guarantee the quality of care provided in the long-term care institutions (LTCIs) for older adults, and depression is a factor that affects the health of the professional and, consequently, the care. Thus, it is important that studies are conducted on the relationship of these variables in this context.
Objective:
The aim of this study is to verify the relationship between empathy and depressive symptoms among health professionals working in the LTCIs.
Methods:
A cross-sectional study was carried out at LTCIs in the state of São Paulo, Brazil. The final sample was constituted by 101 health professionals (i.e., caregivers and nursing technicians) with direct participation in the care of institutionalized older adults. The instruments were used as follows: the Interpersonal Reactivity Index (IRI) to assess empathy and the Patient Health Questionnaire-9 (PHQ-9) for the diagnosis of depression. For the analyses, the patients were divided into groups with and without depression, according to the score of the PHQ-9.
Results:
The prevalence of depression among health professionals was 19.8%. Significant statistical differences were found between the groups for the total score of the IRI (p=0.029), for the emotional domain (p=0.023), and for the personal distress (p=0.009).
Conclusions:
The findings indicate that the presence of depression among health professionals at LTCIs is related to the higher levels of empathy, especially in the emotional domain. Thus, future studies that contribute to understanding how care must be provided with empathy, but without harming the health of the professional, should be carried out.
... Furthermore, as reduced social contact was imposed on all for the purpose of promoting public health, it may have meant that psychological ability to think of others and conceive of the 'greater good' affected the experience of the lockdown. Higher empathic concern for others is associated with worse mental health, while higher ability to take the perspective of others is associated with better mental health (Lee, Brennan, & Daly, 2001;Tully, Ames, Garcia, & Donohue, 2016), so empathy may have moderated the effect of impaired social relationships on mental health, potentially creating highrisk groups for psychiatric distress during periods of lockdown. Therefore, we aimed to test, in a large prospective study initiated at the start of the UK lockdown, our hypotheses that poor structural social relationships measured by frequency of face-to-face and phone or video contact and functional social relationships (measured by perceived social support) would be associated with more depressive symptoms and higher risk of depression. ...
... Deprivation of social relationships may be felt more strongly for those who empathise more with others. Contrary to our hypothesis, higher perspective taking did not attenuate the detrimental effect of social isolation on mental health and instead, strengthened the Lee et al., 2001;Tully et al., 2016), suggesting that ability to conceptualise another's perspective may moderate the experience of their distress. However, our finding may indicate that people who had others' perspectives in mind found the lockdown more difficult as, in these circumstances, they had little agency to act to alleviate others' situations. ...
Background
The coronavirus disease 2019 (COVID-19) pandemic led to measures that reduced social contact and support. We explored whether UK residents with more frequent or supportive social contact had fewer depressive symptoms during March−August 2020, and potential factors moderating the relationship.
Methods
A convenience sample of UK dwelling participants aged ⩾18 in the internet-based longitudinal COVID-19 Social Study completed up to 22 weekly questionnaires about face-to-face and phone/video social contact frequency, perceived social support, and depressive symptoms using the PHQ-9. Mixed linear models examined associations between social contact and support, and depressive symptoms. We examined for interaction by empathic concern, perspective taking and pre-COVID social contact frequency.
Results
In 71 117 people with mean age 49 years (standard deviation 15), those with high perceived social support scored 1.836 (1.801–1.871) points lower on PHQ-9 than those with low support. Daily face-to-face or phone/video contact was associated with lower depressive symptoms (0.258 (95% confidence interval 0.225–0.290) and 0.117 (0.080–0.154), respectively) compared to no contact. The negative association between social relationships and depressive symptoms was stronger for those with high empathic concern, perspective taking and usual sociability.
Conclusions
We found during lockdown that those with higher quality or more face-to-face or phone/video contact had fewer depressive symptoms. Contact quality was more strongly associated than quantity. People who were usually more sociable or had higher empathy had more depressive symptoms during enforced reduced contact. The results have implications for COVID-19 and potential future pandemic management, and for understanding the relationship between social factors and mental health.
... Cognitive and affective empathy may have different influences on aspects of well-being of informal dementia caregivers. Cognitive empathy has been positively associated with lower stress appraisal, lower threat appraisal, and lower levels of depression among informal caregivers [5,12]. Affective empathy has been found to be associated with higher stress appraisal, less life satisfaction, and more anxiety symptoms [5,12]. ...
... Cognitive empathy has been positively associated with lower stress appraisal, lower threat appraisal, and lower levels of depression among informal caregivers [5,12]. Affective empathy has been found to be associated with higher stress appraisal, less life satisfaction, and more anxiety symptoms [5,12]. These findings suggest that, in addition to enhancing understanding, the intervention's focus should be on enhancing cognitive empathy (and/or reducing affective empathy) to enhance the caregivers' lives. ...
Objective
To evaluate whether the mixed virtual reality dementia simulator training Into D'mentia increased informal caregivers' understanding for people with dementia, their empathy, sense of competence, relationship quality with the care receiver, and/or decreased burden, depression, and anxiety.
Methods
A quasi-experimental longitudinal study with an intervention group (n = 145) and a control group (n = 56) was conducted. All participants were informal caregivers of people with dementia. They completed six questionnaires and semi-structured interviews 1 week before as well as 1 week, 2.5 months, and 15 months after the training. Data were analyzed on both group and individual level using linear mixed model analyses and Reliable Change Indices.
Results
Eighty-five percent of the participants in the intervention group found the intervention useful; 76% said they had changed their approach to caregiving, and 61% stressed that the intervention had increased their understanding of dementia. No significant differences were found between the two groups over time regarding empathy, sense of competence, relationship quality with the care receiver, burden, depression, and anxiety, at either group or individual level.
Conclusion
Caregivers indicated that the Into D'mentia intervention improved their understanding of dementia, that they had learned to be more patient, to take things more slowly, and to focus on positive aspects of caregiving. However, no significant change was found on the variables assessed via the questionnaires. Future research can consider enriching this intervention with other aspects such as more educational material, more simulations, and group sessions, tailored to the individual caregiver and his/her situation, and examine whether these new interventions yield change on questionnaires. These new, more personalized interventions for dementia caregivers could help caregivers to better understand the persons with dementia they care for and to ultimately enhance the well-being of both caregivers and persons with dementia.
... En el caso de la empatía, los resultados son algo más contradictorios, si bien no faltan estudios que encuentran que un exceso de empatía se asocia con la sintomatología depresiva (Keenan y Hipwell, 2005). No obstante, es importante destacar que cuando los investigadores han diferenciado entre empatía cognitiva y empatía afectiva han hallado que mientras que la primera se asocia positivamente con el ajuste y negativamente con la depresión, con la segunda ocurre lo contrario (Lee, Brennan y Daly, 2001). ...
... Cuando se trataba de la empatía, mientras que la empatía afectiva, en las chicas, se asoció negativamente con la autoestima, la empatía cognitiva lo hizo positivamente con la autoestima y la satisfacción vital con independencia del sexo. Estos resultados son similares a los hallados por otros autores (Lee et al., 2001;Schieman y Turner, 2001), en cuanto al valor adaptativo para el bienestar emocional de la empatía cognitiva, y desadaptativo de la empatía afectiva. Esta relación se explica por el hecho de que la empatía afectiva supone una excesiva sensibilidad ante las emociones ajenas que puede dejar al sujeto en una situación de vulnerabilidad, sobre todo en momentos como la adolescencia en los que chicos y chicas aún no han desarrollado unas estrategias autorregulatorias eficaces para hacer frente a la resonancia afectiva generada ante los sufrimientos de otras personas. ...
In this study we analyzed the associations between competences or components of empathy and emotional intelligence, as well as their relationships with two variables referred to adolescent development and psychological adjustment, namely, self-esteem and life satisfaction. The study was conducted on a sample of 2,400 adolescents between 12 and 17 years of age. Participants were selected from 20 schools in Western Andalusia. The results showed significant correlations between some of the emotional competencies with self-esteem and life satisfaction. Moreover, two types of relationships were found between these competences related to empathy and emotional intelligence, one at emotional level and another at cognitive level. Furthermore, gender differences were in favor of girls in empathy and emotional attention, whereas boys scored higher on clarity, emotional repair, and self-esteem.
... En el caso de la empatía, los resultados son algo más contradictorios, si bien no faltan estudios que encuentran que un exceso de empatía se asocia con la sintomatología depresiva (Keenan y Hipwell, 2005). No obstante, es importante destacar que cuando los investigadores han diferenciado entre empatía cognitiva y empatía afectiva han hallado que mientras que la primera se asocia positivamente con el ajuste y negativamente con la depresión, con la segunda ocurre lo contrario (Lee, Brennan y Daly, 2001). ...
... Cuando se trataba de la empatía, mientras que la empatía afectiva, en las chicas, se asoció negativamente con la autoestima, la empatía cognitiva lo hizo positivamente con la autoestima y la satisfacción vital con independencia del sexo. Estos resultados son similares a los hallados por otros autores (Lee et al., 2001;Schieman y Turner, 2001), en cuanto al valor adaptativo para el bienestar emocional de la empatía cognitiva, y desadaptativo de la empatía afectiva. Esta relación se explica por el hecho de que la empatía afectiva supone una excesiva sensibilidad ante las emociones ajenas que puede dejar al sujeto en una situación de vulnerabilidad, sobre todo en momentos como la adolescencia en los que chicos y chicas aún no han desarrollado unas estrategias autorregulatorias eficaces para hacer frente a la resonancia afectiva generada ante los sufrimientos de otras personas. ...
In this study we analyzed the associations between competences or components of empathy and emotional intelligence, as well as their relationships with two variables referred to adolescent development and psychological adjustment, namely, self-esteem and life satisfaction. The study was conducted on a sample of 2,400 adolescents between 12 and 17 years of age. Participants were selected from 20 schools in Western Andalusia. The results showed significant correlations between some of the emotional competencies with selfesteem and life satisfaction. Moreover, two types of relationships were found between these competences related to empathy and emotional intelligence, one at emotional level and another at cognitive level. Furthermore, gender differences were in favor of girls in empathy and emotional attention, whereas boys scored higher on clarity, emotional repair, and self-esteem. © 2015, Fundacion para el Avance de la Psicologia Clinica Conductual. All rights reserved.
... In this regard, emotional empathy has been related to depression and anxiety in many previous studies conducted with clinical and general population [21][22][23][24]. Among the few studies that have evaluated the effects of empathy on anxiety and depression in caregivers, some authors found various associations between cognitive and emotional empathy, and stress perception and depression in caregivers of people with dementia [25]. In that study, high cognitive empathy was related to lower levels of stress perception and depression, while emotional empathy was negatively related to life satisfaction of the caregivers. ...
... We hypothesized that empathy would mediate this association [20,21]. Furthermore, we expected to find a stronger mediating effect from the components of emotional empathy, than those of cognitive empathy [25]. ...
Caring for people with an autism spectrum disorder (ASD) has been reported to have a negative impact on the caregivers' health. One of the most studied risk factors is the severity of the autistic symptomatology of the care recipient, greater severity of symptoms having been associated with poorer health outcomes in caregivers. However, to our knowledge, no studies have evaluated the role of empathy of the caregivers in this association. This study aimed to explore the possible mediating effect of both cognitive and emotional components of empathy in the relationship between autistic symptoms of the care recipient and caregiver depression and anxiety in 76 caregivers of people with ASD. Only personal distress mediates the association with anxiety, while both components of emotional empathy, personal distress and empathic concern, mediate the relationship between autistic symptoms and depressive symptomatology. In both cases, high scores in empathy were related to high levels of symptomatology. These results have implications for clinical practice, in that evaluating empathy in caregivers could help to foresee and hence take measures to prevent psychological disorders in this population.
... Carers bear not only the physical burden of the care provided, but are also effectively linked to the recipient. This fact may bring psychological distress, although some studies find positive effects of caregiving on the individual wellbeing in terms of, for example, a sense of satisfaction (Ingersoll-Dayton et al. 2001;Lee et al. 2001). ...
... Informal caregiving also represents economic costs to society in the form of negative externalities which may be translated into monetary terms. Indeed, since caregiving is stressful (Hirst 2003;Hirst 2005;Rubin and White-Means 2009), and diseases such as cardiovascular problems (Gräsel 2002) and depression (Lee et al. 2001;Marks et al. 2002;Pinquart and Sörensen 2007;Wilson et al. 2007;Hammer and Neal 2008) are more common among informal caregivers, despite the fact that attending people in need may also be a source of happiness. In addition, caregivers may also be less productive at work and may have to bear the costs of foregone labour-market opportunities (Pezzin and Steinberg 1999;Henz 2006;Wilson et al. 2007;Bolin et al. 2008;Hammer and Neal 2008;Pagani and Marenzi 2008;Malach-Pines et al. 2009), choosing, for instance, part-time rather than full-time jobs. ...
We analyse the impact of the provision of care on the health and quality of life (QoL) of adult female informal caregivers using a representative sample drawn from the survey of health, ageing and retirement in Europe (SHARE). We match each informal caregiver with a non-carer using propensity score matching and test whether matched individuals differ on self-assessed health and a functional indicator of QoL and whether this relationship differs across European regions. We find a North-South gradient both for self-assessed health and QoL, and our results show that the provision of caregiving to close relatives in Europe impacts on the caregivers’ QoL and health in a way that depends on their geographical location, the degree of formal care and specific cultural and social factors of the area. We find that informal caregiving is a complex phenomenon which may bring both psychological rewards and distress to providers of care and this complexity, along with the geographical gradient highlight the importance of ensuring that policies match the needs of individual carers in their own geographical areas and cultural contexts.
... Psychological reactions therefore precede physical reactions [25]. This model has been proven in terms of psychological and physical health [26,27], and path dependency [28]. The spillovers and the adverse effects of care were particularly pronounced in couples [27,29]. ...
Background:
The number of people in need of care in Germany has been rising since decades, which is related to an increasing need and relevance of informal caregiving. Likewise, the number of people with a migration background has been increasing. This study aims to analyse the impact of informal caregiving on physical health in comparative perspective for Ethnic German Immigrants (EGI) - the largest and oldest immigrant group in Germany - and non-migrant Germans (NMG).
Methods:
The sample was drawn from the years 2000-2018 of the German Socio-Economic Panel (n = 26,354). NMG (n = 24,634) and EGI (n = 1,720) were categorized into non-caregivers (n = 24,379) and caregivers (n = 1,975), where the latter were distinguished by 1) their caregiving status and history (current, former, and never caregiver) and 2) the number of years in the caregiver role. Generalized Estimating Equations were applied to examine main effects and the interaction effects of caregiving status and migration background for changes in physical health (n = 102,066 observations).
Results:
Adjusting for socioeconomic, household related, and individual characteristics, NMG and EGI had similar caregiving patterns and physical health. However, the interaction between migration background and caregiving revealed significantly higher declines in physical health for currently caregiving EGI. Sensitivity analyses indicated that particularly socioeconomic resources moderated this effect.
Conclusions:
Findings suggest that caregiving is associated with declines in physical health, particularly in the long term and for EGI. This implies that care-related disadvantages accumulate over time and that the association of caregiving, health and associated determinants are culturally diverse and shaped by migration background. Both the health disadvantages of caregivers and EGI might be mitigated by a positive social and socioeconomic setting, which highlights the relevance of supporting structures and benefits for these subgroups.
... Thus, it may be that grandmothers who have more cognitive empathy for their grandchild wish to be more involved in caring for them. Interestingly, adult caregivers of dementia patients who have more cognitive empathy report less subjective stress and depression [64,65]. This measure of desired involvement in caregiving may be a purer reflection of caregiving motivation because circumstances beyond the grandmothers' control (e.g. ...
In many societies, grandmothers are important caregivers, and grandmaternal investment is often associated with improved grandchild well-being. Here, we present, to our knowledge, the first study to examine grandmaternal brain function. We recruited 50 grandmothers with at least one biological grandchild between 3 and 12 years old. Brain function was measured with functional magnetic resonance imaging as grandmothers viewed pictures of their grandchild, an unknown child, the same-sex parent of the grandchild, and an unknown adult. Grandmothers also completed questionnaires to measure their degree of involvement with and attachment to their grandchild. After controlling for age and familiarity of stimuli, viewing grandchild pictures activated areas involved with emotional empathy (insula and secondary somatosensory cortex) and movement (motor cortex and supplementary motor area). Grandmothers who more strongly activated areas involved with cognitive empathy (temporo-parietal junction and dorsomedial prefrontal cortex) when viewing pictures of the grandchild desired greater involvement in caring for the grandchild. Finally, compared with results from an earlier study of fathers, grandmothers more strongly activated regions involved with emotional empathy (dorsal anterior cingulate cortex, insula and secondary somatosensory cortex), and motivation (nucleus accumbens, ventral pallidum and caudate nucleus). All in all, our findings suggest that emotional empathy may be a key component of grandmaternal responses to their grandchildren.
... Moreover, empathy allows individuals to feel connected with others which then can result in increased happiness and positive affect [36]. Hence, studies have found empathy to be positively associated with life satisfaction, well-being, and self-efficacy e.g., [36][37][38][39]. ...
(1) Background: Empathy affects an individual’s decision to participate in volunteering, and volunteering, in turn, influences mental health. Intriguingly, studies have been limited in exploring underlying mechanisms and boundary conditions for the relationship between empathy and mental health. Furthermore, volunteering studies have overlooked the multi-dimensionality of empathy. Therefore, this study seeks to contribute to extant literature by investigating the mediating effect of volunteering for the relationships between cognitive and affective empathy and mental health and the moderating effect of gender for the relationship between empathy and volunteering. (2) Methods; Data were collected using a survey in South Korea and consisted of 301 full-time employees who voluntarily engaged in their corporate volunteer programs. Furthermore, they voluntarily participated in the study. The hypotheses were tested with path analysis and a group comparison was also conducted. (3) Results: Volunteering was found to mediate the relationships between cognitive empathy and affective empathy with mental health. In addition, gender moderated the relationship between empathy and volunteering. (4) Conclusions: As the study found empathy to increase individuals’ engaging in volunteering activities which then improved mental health, the study supports extant theoretical frameworks on empathy and volunteering. Moreover, the study found gender differences on empathy and volunteering; thereby supporting and contributing to extant literature.
... High levels of affective empathy have been associated with increased stress, compassion fatigue, and decreased overall quality of life for carers [18] . Conversely, the development of cognitive empathy has been associated with overall wellbeing and lower stress among carers [6,19] . In a caregiving environment, the development of cognitive empathy, while limiting the development of affective empathy, may improve care provision while ensuring overall wellbeing for carers. ...
Background
Empathy is an essential behavioural competency required of healthcare providers. It is included in the Canadian National Competency Profile for Medical Radiation Technologists; supporting patient-centered care and the development of therapeutic relationships between carers and care recipients. This review synthesizes evidence on Virtual Reality (VR) as a tool for eliciting empathetic behaviour in carers.
Methods
Six Electronic databases (PubMed, EMBASE, PsycInfo, ERIC, Academic Search Premier and CINAHL) were searched for studies published from 1997–2020. Studies with MeSH terms “Empathy” and “Virtual Reality”, and conducted on adult carers, were eligible for inclusion. The Cochrane risk of bias tool guided the assessment of study quality. Prospero review registration number: CRD42020210049
Results
Seven studies, with 485 carers, were included in this review. Studies were heterogeneous in terms of interventions and tools for collecting outcome measures. All seven studies demonstrated VR could elicit empathetic behaviour in carers. Studies included one randomized controlled trial, three non-randomized controlled trials, two with quasi-experimental designs, and one non-experimental design. All studies had a moderate to high risk of bias.
Conclusion
This review suggests that VR may be an appropriate method for eliciting empathetic behaviours in carers. Future studies employing appropriately powered multicentere randomized controlled designs should seek to determine which VR experiences are the most effective in evoking empathetic behaviours.
... Some studies have reported a negative relationship between life satisfaction and depression. (48)(49)(50)(51). As can be understood from the results, increasing life satisfaction decreases depression (52). ...
Objective: Phubbing, defined as being busy on the phone by ignoring people, and life satisfaction, which appears as a person's attitude to life, also manifest themselves as variables that affect our mental health. The aim of this study was to determine the predictive effect of phubbing and life satisfaction on the depression symptoms level of the individual. Method: The study group of the research consists of 756 adults (51.7% Female, 48.3% Male) living in Central Anatolia. The data of the study were collected using the Phubbing Scale, Beck Depression Scale, Life Satisfaction Scale and personal information form. Results: A significant negative relationship between phubbing and life satisfaction, a significant negative relationship between life satisfaction and depression symptoms, and a significant positive relationship between phubbing and depression symptoms were found. According to the preliminary analysis, depression symptoms scores do not significantly differentiate according to gender; differentiates significantly according to marital status, educational level and perceived personality traits. According to the results of hierarchical regression analysis, life satisfaction and phubbing behavior were found to be medium-level predictors of depression symptoms. Conclusion: Phubbing has been identified as a new descriptor for depression symptoms. Phubbing and life satisfaction are important predictors for depression symptoms.
... Specifically, if we consider the full sample, no signif- icant results are shown, but if the sample is restricted to women caregivers, they show less probability of being depressed compared to non-caregivers with the same observable characteristics. Even if the main body of literature is concentrated on the difficulties and problems shouldered by carers, some authors suggest that feeling of rewards and satisfaction may buffer the negative effects of caregiving [38,39], especially if the choice of providing care is not imposed by duty, financial and social binds or by institutional inefficiencies [40]. A contentious issue may be represented by the fact that no information on the recipient's health status is available, and it is not possible to stratify the intensity of care provided. ...
Setting and objective: In Italy, over the last decades, elderly care has been mostly provided by family members, especially adult offspring, and in particular daughters. This paper investigates the relationship between informal caregiving and mental distress among Italians aged 35 to 59, with a focus on gender effect and parenthood responsibilities.
Data: The dataset is the European Health Interview Survey (EHIS), second wave, year 2015. As far as it is known, the Italian EHIS has not been used for studies on ageing and caregiving.
Methods: Using selected subsamples, a Propensity Score Matching between caregivers and noncaregivers aged 35 to 59 is implemented, with the aim of measuring the difference in level of depression, if any, between the two groups.
Results: Findings show that women providing their frail relatives with informal care are less likely to suffer from mental distress compared to non-carers. However, results change radically if they have children aged less than 15 at home, and a higher probability of being depressed is detected for women overwhelmed by the double responsibility of assisting both dependent relatives and their
own children. Results are not significant for men
... Globally, both empathic concern and perspective taking components have been linked to psychological health [46,47]. A study of older adults' informal caregivers showed that those with greater cognitive empathy appraised the caregiving situation as less stressful and threatening; in contrast, caregivers with lower empathy had reduced well-being and more depressive symptoms [48]. In the healthcare setting, greater empathic concern and perspective-taking were associated with higher healthcare professionals' psychosocial well-being. ...
Optimism and self-efficacy have been associated with psychological health. Empathy has also been found to have a unique role in community health volunteering and promote positive functioning. This study investigated whether self-efficacy and optimism were associated with psychological health in terms of psychological and subjective well-being in healthcare volunteers. It also investigated whether empathy added to the explanation of psychological health, over and above that accounted for by self-efficacy and optimism. A convenience sample of 160 Italian clown doctors volunteering in various hospitals completed self-report measures of self-efficacy, optimism, empathy, psychological well-being, and subjective well-being. Results of hierarchical multiple regression analysis indicated that self-efficacy and optimism were associated with both outcomes and that aspects of empathy, such as others’ perspective taking and personal distress for others’ difficulties, added to the explanation of psychological health with opposite effects. The present study adds to previous research on the role of self-efficacy, optimism, and empathy for community health volunteers’ psychological health. It also offers suggestions regarding the training for this type of volunteer.
... Partindo de outra perspectiva, Barbosa et al. (2013) demonstraram que um treinamento específico para desenvolvimento da empatia pode contribuir para diminuição da ansiedade e um aumento na empatia em estudantes de cursos da área da saúde. Por esta razão, alguns autores sugerem que a empatia pode atuar como uma espécie de fator de proteção à saúde mental, influenciando a maneira como as pessoas avaliam seu contexto de trabalho e lidam com situações de estresse (Lee, Brennan & Daly, 2001). ...
O presente estudo investigou as relações entre empatia, depressão, ansiedade e estresse em profissionais de saúde brasileiros. Duzentos participantes (87% mulheres), com idades entre 22 e 67 anos (M = 35,1; DP = 9,7) responderam o Índice de Reatividade Interpessoal (Davis, 1983), o Inventário de Sintomas de Estresse (Lipp, 2000), o Inventário de Depressão de Beck e o Inventário de Ansiedade de Beck. Foram observadas correlações positivas entre depressão, ansiedade e estresse, assim como entre ansiedade, depressão, angústia pessoal e fantasia. A análise de regressão indicou que aspectos cognitivos da empatia podem prever sintomas de depressão. De forma geral, os resultados sugerem que a empatia pode estar associada à Saúde Mental dos profissionais de saúde. Discute-se a necessidade de estar atento a essa relação específica, considerando sua importância para a prática profissional desses trabalhadores, assim como para pesquisas na área de Psicologia da Saúde e outras afins.
... Globally, both empathic concern and perspective taking components have been linked to psychological health [46,47]. A study of older adults' informal caregivers showed that those with greater cognitive empathy appraised the caregiving situation as less stressful and threatening; in contrast, caregivers with lower empathy had reduced well-being and more depressive symptoms [48]. In the healthcare setting, greater empathic concern and perspective-taking were associated with higher healthcare professionals' psychosocial well-being. ...
Optimism and self-efficacy have been associated with psychological health. Empathy has also been found to promote positive functioning and to have a unique role in community health volunteering. This study investigated whether self-efficacy and optimism were associated with psychological and subjective well-being in a group of healthcare volunteers and whether empathy added incrementally to these associations. A sample of 160 Italian clown doctors volunteering in various hospitals completed self-report measures of self-efficacy, optimism, empathy, psychological well-being, and subjective well-being. Results indicated that self-efficacy and optimism were associated with both outcomes and that aspects of empathy, such as others’ perspective-taking and personal distress for others’ difficulties, incrementally added to these associations, although with opposite effects. The present study adds to previous research on the role of self-efficacy, optimism, and empathy for community health volunteers’ psychological health and offers suggestions regarding the training of this type of volunteer.
... Factors associated with positive experience of caregiving, better care approach, a sense of competence in dementia care, and health and well-being outcomes (i.e.burden, quality of life, and psychological well-being) include appraisal of the caregiving situation, coping strategies, attitudes toward people with dementia, and empathy (J€ utten, Mark, & Sitskoorn, 2019;Lee, Brennan, & Daly, 2001;Lethin et al., 2017;Mullan & Sullivan, 2016;Wang et al., 2018). Knowledge about dementia alone does not lead to better care approach, so improving caregivers' attitudes and empathy toward people with dementia and coping strategies should be considered when providing interventions (Surr, Smith, Crossland, & Robins, 2016;Wang et al., 2018). ...
Objectives: The present study was a 2 × 2 factorial randomized controlled trial that examined if a simulation-based empathy enhancement program and a lecture-based education program, together or separately, improved outcomes of family caregivers of people with dementia.
Method: A total of 101 participants were randomly assigned to simulation-based education only, lecture-based education only, simulation-based education plus lecture-based education, or treatment as usual. Data were analyzed using a two-way analysis of covariance while controlling for pretest results, kinship, and gender.
Results: Statistically significant interaction effects between the simulation program and the lecture program were found in the levels of well-being and helplessness. The lecture program accompanied by the simulation program led to higher level of well-being in terms of happiness and lower level of helplessness than the lecture program alone. Caregivers with the lecture program provided led to less frequent use of dysfunctional coping strategies than those with no lecture program provided. Caregivers with the simulation program provided led to more frequent use of emotion-focused coping strategies than those with no simulation program provided.
Conclusions: Findings of the present study support benefits of combined of and separate simulation-based and lecture-based programs on family caregivers of people with dementia in important outcomes affecting quality of care and quality of lives in families of people with dementia. Further studies are needed to identify intervention components that can improve empathy of family caregivers of people with dementia and be embedded into a multicomponent program tailored better to families in different needs.
... The empathy-dependent stress reaction to other passengers is also intensified by travel distance increases. It is reasonable as the longer the flight the greater actual and anticipated consumption of physical resource (i.e., physical exhaustion) and affective resource (i.e., negative moods), and consequently the less likelihood for individuals to employ the cognitive and affectively demanding empathy, in order to conserve resources in case of physical and emotional exhaustion (Lee, Brennan, & Daly, 2001, Passalacqua & Segrin, 2012. It is also understandable that the trust resource consumption is not closely related to the physical travel distance increase, hence the identified lack of impacts from physical distance on stress toward regular airline/airport service delivery. ...
... Conversely, one could posit a weakening of the association in the context of pre-existing depression, as the relationship functioning of such couples may already be compromised and, thus, have less room to deteriorate. Similarly, much as empathy buffers caregivers of older adults from worse relationship functioning (Lee, Brennan, & Daly, 2001), partners' empathy may enable them to sustain higher levels of relationship satisfaction in spite of stress caused by PTSD symptoms. On the other hand, partners high in empathy may experience greater psychological distress when survivors are highly distressed, which could lead to worsened relationship functioning (e.g., Dekel, Siegel, Fridkin, & Svetlitzky, 2018). ...
Posttraumatic stress disorder (PTSD) is associated with impairments in relationship functioning. Beyond the abundance of research that has demonstrated this basic link, more recent research has begun to explore possible mediators and moderators of this association. The present paper reviews and synthesizes existing literature in the context of an overarching organizational framework of potential ways in which PTSD impacts relationship functioning. The framework organizes findings in terms of specific elements of PTSD and comorbid conditions, mediators (factors that are posited to explain or account for the association), and moderators (factors that are posited to alter the strength of the association). Specific symptoms of PTSD, comorbid symptoms, and many of the potential mediators explored have extensive overlap, raising questions of possible tautology and redundancy in findings. Some findings suggest that non-specific symptoms, such as depression or anger, account for more variance in relationship impairments than trauma-specific symptoms, such as re-experiencing. Moderators, which are characterized as individual, relational, or environmental in nature, have been the subject of far less research in comparison to other factors. Recommendations for future research and clinical implications of the findings reviewed are also presented.
... Caregiving appraisal is a broad concept encompassing caregiving burden, satisfaction, mastery, demand, and impact (Lawton et al., 1989). Rehabilitation nurses must determine the caregiving appraisal, which can be a significant predictor of QOL (Lee, Brennan, & Daly, 2001). Our results showed that caregivers' self-care and strain led to more problems of negative caregiving appraisal, consistent with the findings of previous studies (Lageman et al., 2015;Morley et al., 2012). ...
Purpose:
This study aimed to construct a structural equation model to predict the quality of life of caregivers of individuals with Parkinson's disease.
Design:
A cross-sectional survey using a structured questionnaire in South Korea.
Methods:
A total of 208 subjects participated in this study from August 31 to November 26, 2015. The questionnaire included caregiving appraisal, social support, educational program needs, and the Parkinson's Disease Questionnaire-Carer.
Findings:
Participants were either spouses (46.2%) or adult children (45.2%) of individuals with Parkinson's disease. The mean score obtained on the caregiver's quality of life was 40.94 ± 25.30. Social support, caregiving appraisal, and educational program needs were the predictors, explaining 67.0% of the variance in caregivers' quality of life.
Conclusions:
Predicting the quality of life is useful for the development of support resources for caregivers of individuals with Parkinson's disease. Further studies exploring the multidimensional aspects of caregivers' quality of life are needed.
Clinical relevance:
Rehabilitation nurses should identify caregivers at high risk in order to improve their quality of life. Nurses should assess education program needs and caregiving appraisal of caregivers of individuals with Parkinson's disease and develop a customized intervention program.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
... Les résultats obtenus parLee et al. (2001) sur l vulnérabilité aux effets négatifs de la relation difficultés pour les soignants de se détacher des problèmes des soignés et seraient de fait plus ie pourrait dans une certaine mesure « trancher » les divergences caractéristique développementale. mention pour établir la frontière entre empathie et sympathie. ...
Accès restreint aux membres de l'Université de Lorraine jusqu'au 2012-12-31
... There is empirically validated evidence that shows close contacts, such as roommates of patients suffering from depression have higher chance to get affected, even after controlling for the shared negative life stress (Haeffel et al., 2014). Most interestingly, in the context of mental health, studies have empirically verified that caregiver's emotional empathy is positively correlated with their mental health outcomes (Lee et al., 2001;Ruiz-Robledillo et al., 2015). Inter-brain connectivity, as a neuroimaging marker of mutual empathy, has the potential to become a key tool in the research on depression contagion. ...
Contemporary mental health practice primarily centers around the neurobiological and psychological processes at the individual level. However, a more careful consideration of interpersonal and other group-level attributes (e.g., interpersonal relationship, mutual trust/hostility, interdependence, and cooperation) and a better grasp of their pathology can add a crucial dimension to our understanding of mental health problems. A few recent studies have delved into the interpersonal behavioral processes in the context of different psychiatric abnormalities. Neuroimaging can supplement these approaches by providing insight into the neurobiology of interpersonal functioning. Keeping this view in mind, we discuss a recently developed approach in functional neuroimaging that calls for a shift from a focus on neural information contained within brain space to a multi-brain framework exploring degree of similarity/dissimilarity of neural signals between multiple interacting brains. We hypothesize novel applications of quantitative neuroimaging markers like inter-subject correlation that might be able to evaluate the role of interpersonal attributes affecting an individual or a group. Empirical evidences of the usage of these markers in understanding the neurobiology of social interactions are provided to argue for their application in future mental health research.
... [3,4]. 선행연구에 따르면 공감능력은 대인관계를 긍정적으로 유지해주는 수단이 될 뿐 아니라 [5] 임상수행능력에도 긍정적인 영향을 주는 것으로 보 고되고 있다 [6]. ...
... Life satisfaction refers to ''a judgmental process in which individuals assess the quality of their lives on the basis of their own unique set of criteria" (Pavot and Diener, 1993, p. 164). Life satisfaction predicts various life outcomes such as physical and mental health, marital satisfaction, social relationships, risk of suicide, and alcohol and chemical abuse (Lee et al., 2001;Rauma et al., 2014). Many studies have demonstrated the association between an individual's usage of social media and his/her life satisfaction (Saslow et al., 2013;Kross et al., 2013;Valenzuela et al., 2009). ...
... Another study found that empathy can be a double-edged sword when it comes to caregiving (Lee, Brennan, & Daly, 2001). On the one hand, caregivers who were high in a more cognitive form of empathy, reported lower stress and depression, and higher life satisfaction. ...
... Psychologically, being empathic may give parents a greater sense of purpose, increasing eudemonic well being (Steger, Kashdan, & Oishi, 2008). These findings are consistent with work demonstrating that greater empathy and perspective-taking predicted higher job satisfaction among professions involving caretaking (e.g., physicians;Gleichgerrcht & Decety, 2013) and higher well-being in caregivers of older adults (Lee, Brennan, & Daly, 2001). It is also in line with research suggesting that providing social support to others is related to better psychological outcomes (Silverstein, Chen, & Heller, 1996), including reduced depressive symptoms. ...
Objective:
Parental empathy is associated with a host of beneficial psychosocial outcomes for children. However, less is known about the effects of being empathic for parents. The current study tested the hypothesis that, although parental empathy may be beneficial to children both psychologically and physiologically, it may take a physiological toll on parents.
Method:
The current study examined psychological and physiological correlates of parental empathy in 247 parent-adolescent dyads. During a baseline laboratory visit, parents and adolescents provide blood samples from which markers of systemic inflammation, including interleukin 1-ra, interleukin 6, and C-reactive protein, were assayed. Parents completed self-report questionnaires of empathy, well-being, and self-esteem, and also reported on their child's emotion regulation. Following the laboratory visit, adolescents completed 2 weeks of daily diary reporting on their emotion regulation abilities.
Results:
In adolescents, parental empathy was significantly associated with both better emotion regulation and with less systemic inflammation. For parents, being empathic was associated with greater self-esteem and purpose in life, but also with higher systemic inflammation.
Conclusions:
These findings reinforce the importance of simultaneously considering both psychological and physical health-related effects of psychosocial traits and suggests that empathy may have diverging effects across providers and recipients of empathy. (PsycINFO Database Record
... These conditions have been described under different terms-empathic distress, compassion fatigue or burnout, all of which were associated with an intense sharing of the other's negative emotions (Batson et al., 1987;Eisenberg et al., 1989;Gleichgerrcht and Decety, 2012). It has been also found that emotional empathy in caregivers positively correlated with emotional exhaustion (Williams, 1989) or with decreased life satisfaction (Lee et al., 2001). ...
Excessive empathy has been associated with compassion fatigue in health professionals and caregivers. We investigated an effect of empathy on emotion processing in 137 healthy individuals of both sexes. We tested a hypothesis that high empathy may underlie increased sensitivity to negative emotion recognition which may interact with gender. Facial emotion stimuli comprised happy, angry, fearful, and sad faces presented at different intensities (mild and prototypical) and different durations (500ms and 2000ms). The parameters of emotion processing were represented by discrimination accuracy, response bias and reaction time. We found that higher empathy was associated with better recognition of all emotions. We also demonstrated that higher empathy was associated with response bias towards sad and fearful faces. The reaction time analysis revealed that higher empathy in females was associated with faster (compared with males) recognition of mildly sad faces of brief duration. We conclude that although empathic abilities were providing for advantages in recognition of all facial emotional expressions, the bias towards emotional negativity may potentially carry a risk for empathic distress.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
... Fields, Hojat, Gonnella, Mangione, Kane and Magee (2004) found no significant difference in empathy scores when comparing female physicians to female nurses using the Jefferson Scale of Physician Empathy (JSPE). Lee, Brennan, and Daly (2001) outlined several factors of interest in their study of informal caregivers of older adults. The researchers noted an average level of emotional empathy and a substantively lower level of cognitive empathy representing "a less-thanadequate level in therapeutic relationships according to the standards provided by Barrett-Lennard (1986), who suggested that a score of 24 represents adequate levels of empathy in a helping relationship and a score of 16 represents a less-than-adequate level in a therapeutic relationship" (p. ...
... There is also some evidence for the relationship between empathy and depression in late life. For example, one study found that caregivers with high cognitive empathy reported better appraisals of their caregiving sitatuation and were less depressed than caregivers with low cognitive empathy (Lee et al., 2001). From a neuro-behavioral approach, there is preliminary support for the idea that changes in the oxytocin system with age may have putative effects on socioemotional functioning, including decreased empathy and increased depression (Ebner et al., 2013). ...
Empathy is thought to be a mechanism underlying prosocial behavior across the lifespan, yet little is known about how levels of empathy relate to individual differences in brain functioning among older adults. In this exploratory study, we examined the neural correlates of affective and cognitive empathy in older adults. Thirty older adults (M=79 years) underwent fMRI scanning and neuropsychological testing and completed a test of affective and cognitive empathy. Brain response during processing of cognitive and emotional stimuli was measured by fMRI in a priori and task-related regions and was correlated with levels of empathy. Older adults with higher levels of affective empathy showed more deactivation in the amygdala and insula during a working memory task, whereas those with higher cognitive empathy showed greater insula activation during a response inhibition task. Our preliminary findings suggest that brain systems linked to emotional and social processing respond differently among older adults with more or less affective and cognitive empathy. That these relationships can be seen both during affective and non-emotional tasks of "cold" cognitive abilities suggests that empathy may impact social behavior through both emotional and cognitive mechanisms.
Published by Elsevier Ireland Ltd.
Empathy, the ability to understand and respond to others’ emotional experiences, is often regarded as a universally positive trait. However, its role in psychological adjustment following adversity is more complex. The current study examined the relationships between empathy – measured globally and through its positive (compassionate concern) and negative (callousness) dimensions – and three outcomes of stress or trauma: depressive symptoms, resilience, and posttraumatic growth (PTG). College students (N = 403) completed online surveys assessing these variables, with controls for age, sex, and personality traits. Hierarchical regression analyses showed that global and positive empathy were positively associated with PTG, indicating empathy’s role in fostering personal and relational growth. However, positive empathy also predicted depressive symptoms, reflecting its potential to heighten vulnerability to emotional distress. Negative empathy was inversely related to PTG but unrelated to depressive symptoms or resilience. Resilience demonstrated weaker links with empathy, instead aligning more closely with personality traits like extraversion and conscientiousness. These findings highlight empathy’s dual impact, where it can contribute to personal growth while also increasing susceptibility to distress. Future research should explore empathy’s cognitive and affective components and develop strategies to minimize its negative effects while enhancing adaptive outcomes like PTG.
The present research was conducted to study the relationship between resilience and measures of psychological well-being among university students. The research assumed that there would be a meaningful relationship between resilience and psychological well-being and that substantial gender disparities might exist in resilience among university students. Data was collected from 350 participants enrolled in various undergraduate, graduate and post-graduate programs at the University of Karachi. According to the findings of the correlational analysis, resilience has a significant positive association with thriving, flourishing, life satisfaction and positive affect. In contrast, resilience and negative affect have been proven to be inversely related. Moreover, the independent sample t-test result showed that men were more resilient than women. These results enabled the researchers to draw the conclusion that resilient university students display minimal amounts of negative emotions and noticeably high levels of positive affect, thriving, flourishing, and life satisfaction. Furthermore, these students embrace positivity and consider demanding life circumstances as a path leading to success.
Purpose
This study identifies the unique phenomena and subjectivity of empathy as exhibited by certified caregivers.
Methods
Q-methodology was used to define types and describe the characteristics of empathy in certified caregivers. After in-depth interviews with 10 certified caregivers and a review of the related literature, the final 38 Q-samples were selected by collecting experts’ opinions. These Q-samples were sorted by 30 certified caregivers (P-samples). The PC-QUNAL program was used to analyze the Q-sort data.
Results
Seven distinctive Q-factors for the empathy of certified caregivers were identified: I. Information-oriented cognition, II. Sensory communication, III. Compassion, IV. Performance-seeking through self-reflection, V. Intuitive empathy, VI. Role-centered sincerity, and VII. Passive obligation. The empathy of certified caregivers caring for older adults with dementia showed various characteristics according to each of their subjective values and judgments.
Conclusion
This study’s results help identify the empathy types and characteristics of certified caregivers caring for older adults with dementia and may contribute to improving the quality of care.
Empathic accuracy, the ability to accurately understand other people’s emotions, is typically viewed as beneficial for mental health. However, empathic accuracy may be problematic when a close relational partner is depressed because it promotes shared depression. Across two studies, we measured empathic accuracy using laboratory tasks that capture the ability to rate other people’s emotional valence accurately over time: first in a sample of 156 neurotypical married couples (Study 1; total N = 312), and then in a sample of 102 informal caregivers of individuals with dementia (Study 2). Across both studies, the association between empathic accuracy and depressive symptoms varied as a function of a partner’s level of depressive symptoms. Greater empathic accuracy was associated with (a) fewer depressive symptoms when a partner lacked depressive symptoms, but (b) more depressive symptoms when a partner had high levels of depressive symptoms. The ability to accurately detect changes in other people’s emotional valence may underpin shared depressive symptoms in dyads.
According to European Commission regulation the eco-design requirements for light sources and separate control
gears should be implemented and regulated properly, without entailing excessive costs for energy-related products which
account for significant number of sales and trade in countries are making a huge impact to environment. Pursuant to
European legislation policies, there are huge necessity for EU regulatory actions due to managing long lasting problems of
reducing e-waste, empower consumers to make reasonable and sustainable choices and allow EU citizens to take initiative in
managing sustainable and rightfully functioning internal markets. Therefore, this article analyzes the peculiarities of the legal
regulation of European Union and its implementation solutions in the Republic of Lithuania seeking the goal to achieve ewaste
reduction, understanding of existing e-waste problem of society and government activeness on decisions making in the
field of e-waste management in the process. The main purpose of this paper is to investigate whether Lithuanian legal
legislation corresponds and seeks the purpose indicated in EU regulation and resolutions of implementation of toxic-free
environment and single lightning efficiency. The Qualitative document and comparative data analysis are used to identify the
problems and propose the probable solution considering improvement of implementation of legal regulation for lighting
products in the Republic of Lithuania to seek the target of toxic-free environment and sustainable climate neutral and circular
economy.
Caregiving appraisal is a key driver to moderating caregiving outcomes. The caregiving appraisal of informal caregivers of people with dementia requires increased attention. This study aimed to explore the feasibility and acceptability of an evidence-based bibliotherapy protocol, and test the efficacy on improving caregiving appraisal. A two-arm pilot randomized controlled trial was adopted. Sixty informal caregivers were randomized to either the intervention group, receiving eight weekly professional-guided bibliotherapy sessions in addition to usual care; or the usual care group. The professional-guided bibliotherapy sessions were weekly sessions in which caregivers self-read the designated chapter and then received telephone coaching. Caregiving appraisal, coping, psychological well-being, positive aspects of caregiving, knowledge of dementia, and attitude toward dementia were assessed both at baseline and immediately after the intervention. Assessors were blinded to group allocation. Individual interviews among 10 participants from the intervention group were conducted to explorecaregivers' acceptance of the intervention. Descriptive statistics, χ² test, Mann–Whitney U test, independent t test, generalized estimating equation, and content analysis were used for data analysis. This study pioneered the use of bibliotherapy among informal caregivers of people with dementia. The participant recruitment rate was 69.8%. The attrition rate of the intervention group was 20%. Bibliotherapy had a significant time-by-group interaction effect on caregiving appraisal (p < 0.001), coping (p = 0.003), positive aspects of caregiving (p = 0.001), knowledge of dementia (p = 0.017), and attitude toward dementia (p < 0.001). The effect on psychological well-being, however, was only significant on the personal growth subscale (p = 0.025). The acceptability was also confirmed. No adverse event was documented.
Background
The number of people with dementia is increasing worldwide, and the majority are cared for by informal caregivers in home settings. Both positive and negative caregiving outcomes have been found among informal caregivers, the essential determinant was caregiving appraisal. Improving their caregiving appraisal is important for both the caregiver and care‐recipient’s health. However, as professional support for informal caregivers are limited, self‐help approaches are needed. Bibliotherapy, a self‐help intervention requiring minimal professional support, has been proved to be effective on improving caregiving appraisal in other populations, the effect on dementia caregivers is yet to be explored. Objectives: To explore the efficacy of bibliotherapy on improving caregiving appraisal and coping among informal caregivers of people with dementia.
Method
A two arm randomized controlled trial was conducted in Zhengzhou, China. Participants were randomized to either the intervention group, receiving 8 weekly bibliotherapy sessions at home without withdrawing from usual care; or the control group, receiving usual care from the community health centers. Assessors were blinded to group allocation. Generalized estimating equation was used for data analysis.
Results
Sixty participants were recruited, and 24 out of 30 participants in the intervention group finished the intervention. Bibliotherapy had significant group (Wald χ ² =4.98, p =0.026), time (Wald χ ² =15.27, p <0.001) and group‐by‐time interaction effects (Wald χ ² =16.51, p <0.001) on the total score of caregiving appraisal. In terms of the subscales, there were significant time effects on subjective burden (Wald χ ² =8.81, p =0.003), caregiving impact (Wald χ ² =11.31, p =0.001) and caregiving mastery (Wald χ ² =11.74, p =0.001), and significant group effects on caregiving satisfaction (Wald χ ² =7.39, p =0.007). The group‐by‐time interaction was significant on all the subscales (Wald χ ² =5.38‐10.89, p =0.001‐0.020). Bibliotherapy also had significant group (Wald χ ² =10.93‐15.24, p <0.001), time (Wald χ ² =10.99‐33.02, p <0.001) and group‐by‐time interaction (Wald χ ² =8.91‐17.80, p =0.001‐0.003) effects on the total score of coping and the positive coping subscale. However, the effects on negative coping were not significant (Wald χ ² =0.53‐3.17, p =0.075‐0.467). No adverse events were found.
Conclusion
Bibliotherapy had significant preliminary effects on improving caregiving appraisal and positive coping. The effect on negative coping is still limited. Future randomized controlled trials with larger sample sizes and long‐term follow‐ups are encouraged.
Bu araştırmanın amacı, üniversite öğrencilerinin empatik eğilimleriyle yaşam doyumu ve affetme düzeyleri arasındaki ilişkide mutluluğun aracılık rolünün olup olmadığını saptamaktır. Araştırma ilişkisel tarama modeline uygun olarak düzenlenmiştir. Araştırmanın verileri 2016-2017 eğitim öğretim yılı güz yarıyılında bir devlet üniversitesinde öğrenim gören 209 kız, 142 erkek olmak üzere toplam 351 öğrenciden oluşmaktadır. Öğrencilerin yaş ortalaması 20.3’tür. Araştırmada Kişisel Bilgi Formu, Toronto Empati Ölçeği, Yaşam Doyumu Ölçeği Türkçe Formu, Öznel Mutluluk Ölçeği ve Affedicilik Ölçeği kullanılmıştır. Hipotez edilen yol modelini incelemek için veriler SPSS 24 ve Mplus 5.1 programları kullanılarak analiz edilmiştir. Verilerin normal dağıldığı gözlenmiştir ve bu yüzden maksimum olabilirlik tahmin metodu kullanılmıştır. Çoklu bağlantı probleminin olmadığı ve model veri uyum değerlerinin kabul edilebilir olduğu görülmüştür ( =1.58, CFI=.99, TLI=.97, RMSEA=.04, SRMR=.01). Sonuçta, empatinin affetme ve yaşam doyumu üzerinde doğrudan bir etkisinin olduğu bulunmuştur. Ayrıca mutluluğun empati, yaşam doyumu ve affetme arasında aracı rolü olduğu saptanmıştır.
Past research suggests that many young people hold negative attitudes toward the elderly. Simulated aging is one method to reduce aging that had been successfully applied with those individuals working in the helping professions. However, it has not yet been applied to ordinary young adults. The current study examined whether a simulated aging activity would cause more positive attitudes toward the aged, an increased desire to help, and higher satisfaction with life. Seventy-eight college students participated; half were randomly assigned to complete three tasks with sensory deficits designed to simulate aging (i.e., wearing non-magnified glasses covered with petroleum jelly, wearing foam earplugs, and wearing cloth gloves), and half served as the control. Three questionnaires were completed that measured attitudes toward older adults, prosocial desires, and satisfaction with life. Results showed that young adults who experienced simulated aging had more favorable attitudes toward older adults than did individuals in the control condition. These results suggest that simulated aging activities may be an effective method to reduce ageism. This has potential implications for multigenerational family therapy, such as to assist younger people to understand what their grandparents may be experiencing.
Bu arastırmada çocuk yuvaları ve yetistirme yurtlarında çalısan personelin empatik
eğilim düzeyleri incelenmistir.
Arastırmanın örneklemi, Güneydoğu Anadolu Bölgesinden Diyarbakır, Adıyaman,
Gaziantep ve Sanlıurfa; Doğu Anadolu Bölgesinden Van, Elazığ, Bingöl ve Malatya
illerinde bulunan 11 çocuk yuvası ve 8 yetistirme yurdunda çalısan 243 personelden
olusmustur.
Arastırmada çocuk yuvaları ve yetistirme yurtlarında çalısan personelin empatik
eğilim düzeyi Dökmen (1988) tarafından gelistirilen “ Empatik Eğilim Ölçeği” ile çesitli
kisisel niteliklerine iliskin bilgiler ise “Kisisel Bilgi Formu” ile elde edilmistir.
Elde edilen veriler, grupların ikili olmaları durumunda bağımsız gruplar için
kullanılan t-testi, ikiden fazla olması durumunda Tek Yönlü Varyans Analizi tekniği ile
çözümlenmistir. Varyans analizi sonucunda elde edilen F değerinin anlamlı çıkması
durumunda gruplar LSD testi ile karsılastırılmıstır. Arastırmada anlamlılık düzeyi .05
olarak kabul edilmistir.
Verilerin analizi sonucunda çocuk yuvaları ve yetistirme yurtlarında çalısan
personelin cinsiyet, eğitim düzeyi, kendini algılama biçimi ve aldıkları maasa göre empatik
eğilim düzeylerinde anlamlı fark bulunmustur. Ayrıca, çocuk yuvaları ve yetistirme yurtlarında çalısan personelin çalıstıkları kurum, yas, medeni durum ve çocuk sahibi olup-olmamalarına göre empatik eğilim
düzeylerinde anlamlı bir fark bulunmamıstır.
In this study, the empathetic tendency levels of the staff working at nursery schools
and orphanage have been examined.
The sampling of the research consists of 243 staff members who work at 11 nursery
schools and 8 orphanages situated in the provinces Diyarbakır, Adıyaman, Gaziantep and
Sanlıurfa from Southeast Anatolia; Van, Elazığ, Bingöl and Malatya from Eastern
Anatolia.
The empathetic tendency levels of the staff working at the nursery schools and
orphanages have been measured with "Empathetic Tendency Scale" developed by Dökmen
(1988) and information about their different personal characteristics has been obtained by
using "Personal Information Form". For binary groups, the obtained data have been analyzed with t-test which is used for
independent groups and for the groups more than two, One Way Analysis of Variance
method has been used. When the F value obtained as a result of analysis of variance is
significant, the groups have been compared by using LSD test. The significance level of
the research is regarded as 0,5.
As a consequence of the data analysis, it has been found out that there is a significant
difference in the empathetic tendency levels of the staff working at the nursery schools and
orphanages regarding their sex, education level, self-perception style and the salary they
get.
Furthermore, it has been revealed that there is no any remarkable difference in the
empathetic tendency levels of the mentioned staff members considering the institution they
work at, age, marital status and whether they have children or not.
Reviews the literature of social and developmental psychology on empathy theory and research. These 2 subdisciplines differ in their definitions and measures from each other, as well as from the counseling/psychotherapy area. At the same time, all 3 disciplines identify 2 major types of empathy: (a) affective empathy, or feeling the same way as another person, and (b) cognitive or role-taking empathy. Four proposals that result from an integration of these 3 literatures are discussed: First, empathy should be viewed as a multistage interpersonal process that can involve emotional contagion, identification, and role taking. Second, empathy in children is probably different from empathy in adolescence and adulthood. Third, empathy can but does not necessarily lead to helping behaviors. Last, empathy in counseling/psychotherapy can be helpful in certain stages, with certain clients, and for certain goals. However, at other times it can interfere with positive outcomes. (79 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study is a preliminary attempt to connect cause and effect in the therapy process. Its chief stimulus and theoretical base is Rogers' conception of the necessary conditions for therapeutic change. Specifically, it begins with the proposition that therapeutic personality change occurs in proportion to the degree that the client experiences certain qualities in his therapist's response to him. The total sample consisted of 42 clients in the Counseling Center of the University of Chicago, and their 21 separate therapists. Subjects answered the Relationship Inventory after five therapy interviews, and at predetermined later points. The main experimental hypotheses were, in essence: (a) that each relationship factor as measured after five interviews would significantly predict the indices of change, and that these predictions would be stronger when the relationship was measured from client perceptions than when it was measured from therapist perceptions and (b) that results for two matched, "equivalent" groups of clients, with relatively "expert" and "nonexpert" therapists would reveal that cases with experts give higher scores on each relationship measure and show evidence of greater change than the cases with nonexperts. The two principal hypotheses were essentially confirmed throughout, by the results obtained, for four of the measured variables of relationship. Although the findings to date are consistently promising in their support of the theory under investigation, future need for extended development of this theory is envisaged. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Delineates a sequence of distinct stages involved in empathic interaction and describes conditions that initiate this sequence, which has 3 main interior phases: (Phase 1) empathic resonation by Person A in response to B (who is personally expressive in some way), (Phase 2) A's attempt to convey responsive understanding to B, and (Phase 3) B's actual reception/awareness of A's communication. When the process continues, Phase 1 is again the core feature, and 2 and 3 follow in cyclical mode. There is room for considerable slippage between the inner resonation, communication, and reception levels, and measures based on data from different phases would at best be moderately associated. Principal existing (state) scales are located in reference to the model, and illustrative results take on new meaning not involving contradiction. (34 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Coping refers to behavior that protects people from being psychologically harmed by problematic social experience, a behavior that importantly mediates the impact that societies have on their members. The protective function of coping behavior can be exercised in 3 ways: by eliminating or modifying conditions giving rise to problems; by perceptually controlling the meaning of experience in a manner that neutralizes its problematic character; and by keeping the emotional consequences of problems within manageable bounds. The efficacy of a number of concrete coping behaviors representing these 3 functions was evaluated. Results indicate that individuals' coping interventions are most effective when dealing with problems within the close interpersonal role areas of marriage and child-rearing and least effective when dealing with the more impersonal problems found in occupation. The effective coping modes are unequally distributed in society, with men, the educated, and the affluent making greater use of the efficacious mechanisms.
1. Empathy has been a consistent topic in nursing literature. Although authors attest to the importance of empathy for quality nursing care, an understanding of empathy and its role in the nurse-patient relationship remains elusive. 2. The study of empathy in nursing has been hampered by a lack of theoretical and methodological clarity, a factor that has contributed to the inexplicable findings in empathy studies. 3. The recognition of two distinct types--basic empathy, a human developmental trait, and trained empathy, a clinical skill state--is set forth as a possible solution to methodological problems.
This study demonstrated that therapeutic empathy has a moderate-to-large causal effect on recovery from depression in a group of 185 patients treated with cognitive-behavioral therapy (CBT). The authors simultaneously estimated the reciprocal effect of depression severity on therapeutic empathy and found that this effect was quite small. In addition, homework compliance had a separate effect on clinical recovery, over and above the effect of therapeutic empathy. The patients of novice therapists improved significantly less than did the patients of more experienced therapists, when controlling for therapeutic empathy and homework compliance. Ss who terminated therapy prematurely were less likely to complete the self-help assignments between sessions, rated their therapists as significantly less empathic, and improved significantly less. Ss with borderline personality disorder improved significantly less, but they rated their therapists as just as empathic and caring as other patients. The significance of these findings for psychotherapy research, treatment, and clinical training is discussed.
Current and lifetime rates of disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev., DSM-III-R) were compared in 78 adult children caring for a parent with a progressive dementia and 78 control subjects. The frequencies of depressive and anxiety disorders did not differ between groups in the years prior to caregiving, and there were no differences between groups in first-degree relatives' incidence of psychiatric disorder. During the years they had been providing care, 34% of caregivers met DSM-III-R criteria: 24% for a depressive disorder and 10% for an anxiety disorder. In contrast, 8% of the matched controls met criteria during the same time period for depressive or anxiety disorders. Results support the chronic strains of caregiving being linked to the onset of both depressive and anxiety disorders in adult children caring for a demented parent.
A stress and coping model was used to study predictors of individual differences in caregiver adaptation. A total of 54 family caregivers of elderly dementia patients completed interviews and questionnaires assessing the severity of patient impairment and caregiving stressors; caregiver appraisals, coping responses, and social support and activity; and caregiver outcomes, including depression, life satisfaction, and self-rated health. Correlational and regression analyses supported the utility of the stress and coping model. Appraisal, coping responses, and social support and activity were significant predictors of caregiver outcome, even when severity of caregiving stressors was statistically controlled. The importance of a multidimensional approach to assessing caregiver outcomes was supported by regression analyses indicating that each caregiver outcome was predicted by different patterns of stressors, appraisal, coping, and social support and activity. Results are discussed in terms of a stress and coping model of caregiving, and clinical implications for work with caregiving families.
While providing home care for a family member with senile dementia is clearly extremely stressful, there has been little controlled research assessing the specific effects of this stress on caregiver psychological, social, and health functioning. To address this question, 44 primary caregivers of senile dementia patients and 44 matched controls completed a series of questionnaires and interview assessments. Caregivers reported significantly higher levels of depression and negative affect toward their relatives, and lower overall life satisfaction than controls. Caregivers also had significant impairment of their social activities, including visits with friends, vacations, and church attendance when compared with controls. Caregivers expressed less satisfaction with their social networks than did controls, but the groups did not differ in objective size of social network or number of network contacts. Caregivers reported poorer health, more prescription medication use, and higher utilization of health care than controls. Results clearly indicate the serious and wide-ranging effects of the stress of caregiving, and reinforce the importance of providing comprehensive services for caregiving families.
Investigated were changes over time for caregivers of dementia patients, with a focus on factors associated with nursing home
placement. Caregivers were all spouses, and at the time of the initial interview were caring for the patient at home. Subsequent
nursing home placement was more strongly associated with subjective factors, particularly caregivers' perceived burden, than
with objective indicators of the severity of dementia. Although wives initially reported more burden than husbands, no differences
were found at the follow-up.
Correlated measures of therapist empathy (N. Kagan's, et al, Affective Sensitivity Scale, the Interpersonal Checklist, A. Langield's Role Construct Repertory Test, R. Carkhuff's Empathetic Understanding in Interpersonal Process Scale, and the G. Barrett-Lennard Relationship Inventory) with each other, with R. Carkhuff and B. Berenson's Self-Exploration in Interpersonal Process Scale, and with the Tennessee Self-Concept Scale and MMPI measures of outcome. With the possible exception of client-perceived and tape-judged empathy, the empathy measures were unrelated to each other, indicating that previous research has been measuring several different variables employing a common label. Only tape-judged empathy was related to depth of self-exploration. Client-perceived empathy was strongly related to therapy outcome, tape-judged empathy less so, and the remaining empathy measures were unrelated to outcome. Implications for research methodology and for therapeutic theory are discussed. (28 ref.)
One hundred and nine of 125 patients from consecutive referrals to a clinical service had an informal carer in contact at
least once a week. Thirty-two of the carers had major or minor depression. The active management strategy 'being firm in directing
behaviour' was significantly inversely associated with depression amongst carers living with the dementia sufferers, whilst
carers who prioritized their daily routines were significantly more likely to be depressed. The active psychological coping
strategy 'constructing a larger sense of the illness' was also significantly inversely associated with depression amongst
carers living with the patients and 'reduction of expectations' showed a trend in the same direction. There were no significant
differences between the coping strategies used by men and women.
The type of coping strategy used by carers has an important relationship with depression. Active practical and psychological
strategies were of benefit to carers and this has important treatment implications.
Lawton, Kleban, Moss, Rovine & Glicksman's (1989) construction of caregiving appraisal is examined through a principal components analysis and varimax rotation of a data set based on in-depth quantitative interviews with 144 caregivers. Five caregiving appraisal dimensions were identified. Two dealt specifically with the provision of care: "task load caregiving" and "dysfunctional caregiving." The remaining three were primarily concerned with social supportiveness: "intimacy and love," "social captivity," and "social distance." "Dysfunctional caregiving" was the only type of appraisal that had significant bivariate relationships with poor mental health, low psychological well-being and subsequent institutionalization. A sixth dimension identified in this analysis, "inner strength and efficacy," represented psychological resources. Its independence from the appraisal measures supports Lawton et al.'s (1989) assumption that resources and appraisals can be measured separately. In contrast, social resources are better conceptualized as an integral part of caregiving appraisals.
This article explores the relationships between caregiving stressors and caregiver well-being in a representative community
sample of disabled elders and their informal caregivers. The direct and indirect effects of stressors and potential mediators
on the outcome of caregiver psychological well-being, as measured by depression, were examined using path analysis. Potential
mediators of the primary stressors on depression included mastery, emotional support, quality of relationship between the
caregiver and the care recipient, formal service use and role overload. Findings indicate that the caregiving stressors (needs
for care) led to caregiver depression indirectly through their effect on hours of care provided and the resulting caregiver
perception of role overload. Quality of the caregiver/care recipient relationship mediated the relationship of the caregiving
stressors and caregiver overload and depression. Finally, regardless of the level of primary stressors, caregivers with high
levels of mastery or emotional support were at lower risk of depression. These findings can be used to inform the design of
proactive caregiver interventions.
The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
It is increasingly important that nursing care be associated with measurable patient outcomes. A correlational study examined relationships between nurse-expressed empathy and two patient outcomes: patient perceived empathy and patient distress. Subjects (N = 140) were randomly selected from RNs and patients on medical and surgical units in two urban, acute care hospitals. Nurse-subjects (N = 70) completed two measures of nurse-expressed empathy: the Behavioral Test of Interpersonal Skills and the Staff-Patient Interaction Response Scale. Patient-subjects (N = 70) completed the Profile of Mood States, the Multiple Affect Adjective Checklist, and the Barrett-Lennard Relationship Inventory. Findings indicated a negative relationship (r =−.71, p<.001) between a set of empathy variables and a set of patient distress variables and a positive relationship between nurse-expressed and patient perceived empathy (r=37 −.47,p<.05). This study is one of the first to link behavioral measures of nurse empathy to patient outcomes
Emotional empathic tendency is defined as an individual’s characteristic inclination to respond with emotions similar to those
of others who are present. Within a three-dimensional framework for describing temperament, more empathic persons were found
to be more arousable, and secondarily, more pleasant. Greater skin conductance and heart-rate responses of more empathic persons
to emotional stimuli confirmed their greater arousability. Also, more empathic individuals were more emotional, evidenced
by their greater tendency to weep. Males were found consistently to be less empathic than females. Compared with parents of
low-empathy subjects, those of high-empathy subjects were found to spend more time with their children, display more affection
for them, and to be verbally more explicit about feelings. Also, more emphatic mothers were more tolerant of infant cries
and were less prone to engage in child abuse. High-empathy, compared with low-empathy, subjects engaged more in altruistic
behaviors, were less aggressive, more affiliative, rated positive social traits as more important, scored higher on measures
of moral judgment, and volunteered more to help others. A modified Emotional Empathic Tendency Scale (EETS) for children correlated
negatively with teacher ratings of child aggressiveness.
This study assessed variables associated with increased severity of depressive symptoms among 321 informal caregivers of demented subjects living in the community identified by a Canadian national population-based survey. Measures included patient and caregiver demographic variables; patient behavioral disturbance, activities of daily living, and cognitive impairment; living arrangement, and duration of disease. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Multiple regression analyses indicated that a higher CES-D score was significantly associated with three caregiver characteristics (being a spouse or child of the patient, self-identified ethnicity other than English and French Canadian, and lower education), and two patient characteristics (greater behavioral disturbance and moderate to severe functional impairment).
The Index of Independence in Activities of Daily Living (Index of ADL) is a scale whose grades reflect profiles of behavioral levels of six sociobiological functions, namely, bathing, dressing, toileting, transfer, continence, and feeding. Its hierarchical nature makes it possible to rank the overall functional status of people in an ordered manner, to make comparisons among them as individuals or groups, and to detect changes over time. Developmental studies have encompassed children as well as adults, the mentally retarded as well as physically disabled, and noninstitutionalized as well as institutionalized people. In view of relationships to behavior of primitive societies and parallelisms between the order of index functions and patterns of child growth and development, the Index of ADL appears to be based on functions of sociobiological primacy. This concept is supported by twenty years of methodological and applied observations. The Index has been used to produce predictive information about chronic conditions and to evaluate the benefits of long-term services. It has been used in profiled measures of severity of illness. As a screening measure and survey measure, it has contributed information about health needs and outcomes which is useful for management, planning, policy making, research, and techning.
The purpose of the study was to develop a human-relations-modeled staff development program and obtain an objective measure of the level of empathy of registered nurses who practiced in an acute- and chronic-care hospital. The short-term human-relations-modeled staff development program was designed specifically to assist nurses who scored low in empathy to increase their abilities to perceive and respond with greater empathy. The study indicated that all nurses tested possessed an extremely low level of empathy, that the staff development program significantly raised their levels of empathy, but that more training was needed to enable all or the majority of subjects to reach at least the minimal facilitative level necessary to help another person successfully.
Nurses' self-reported levels of empathy were studied in relation to patients' perceptions of satisfaction with nursing care received. Data were obtained from a volunteer sample of registered nurses and patients using two standardized, paper and pencil questionnaires: Empathy Construct Rating Scale and LaMonica/Oberst Patient Satisfaction Scale. No significant relationship was manifested between the variables under study. It was concluded that empathy training programs for nurses may not be necessary. In addition, although patients are generally satisfied with nursing care received in acute care settings, the data do not support a relationship between nurses' empathy levels and patients' satisfaction. Suggestions for further study are offered.
After three decades, the efficacy of empathy in the clinical setting remains undocumented. Recently, concerns have been raised that the concept may be inappropriate and even harmful to the nurse-patient relationship. An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain phases of the illness experience. Directions for future research are suggested.
This descriptive, correlational study was designed to explore the relationship between the empathy skills of primary nurses and the distress level of their primary patients. Data on empathy skills were generated from the La Monica Empathy Profile. Data on patient distress were generated from the Profile of Mood State Inventory and a Visual Analogue Scale. A nonprobability convenience sample of 65 primary nurses employed on surgical primary nursing care units of a large teaching hospital participated in the study. Sixty-five cancer patients assigned to the participating primary nurses also took part in the study. Descriptive statistics of each variable were examined. Pearson product-moment correlations were used to examine the hypothesis and the demographic variables for nurses and patients. Analysis of variance was used to assess relationships among many of the demographic variables. A significant correlation (but not in the expected direction) was found between the perceiving/feeling/listening empathy skill and patient distress. Nurses' age, years of experience, and education were significantly correlated with some empathy skills. Distress levels of female patients were higher than those of male patients. In general, nurses scored low in the use of empathy skills, and patients scored low in distress. The complex nature of defining and measuring communication skills and relating these skills to outcomes in patient care, such as distress, requires more study. Research questions exploring how and why nurses' interpersonal skills make a difference to patients and their health care outcomes must be generated by nurse administrators, nurse educators, nurse researchers, and practicing nurses.
Providing long-term care for a demented relative profoundly affects caregivers' lives. We assessed changes in depression, immune function, and health in 69 spousal caregivers who had already been caregiving for an average of five years and 69 sociodemographically matched control subjects. Between the initial sample ("intake") and the follow-up data collected an average of 13 months later, caregivers showed decrements relative to controls on three measures of cellular immunity. Caregivers also reported significantly more days of infectious illness, primarily upper respiratory tract infections. Caregivers had a much greater incidence of depressive disorders than controls, with 25% of caregivers meeting syndromal criteria at intake and 32% at follow-up, compared with no cases among controls at intake and 6% at follow-up. Caregivers who reported lower levels of social support at intake and who were most distressed by dementia-related behaviors showed the greatest and most uniformly negative changes in immune function at follow-up.
Most elderly persons with dementia are cared for at home, usually by the spouse or an adult child. The objective of the present study was to determine whether there is an excess of psychological and physical health problems among family caregivers (CGs) of elderly persons with dementia. Data were obtained by interview from close family members of dementia patients (CGs), and from a comparison group made up of close family members of patients undergoing cataract surgery (non-caregivers, NCGs). CGs had significantly higher levels of depression and physical symptoms than NCGs. The association between caregiving and the health variables was stronger among subjects who were the patient's spouse than among those who were the patient's child. Furthermore, greater behavioral disturbance in the demented patient was associated with higher levels of morbidity in the CG. The results suggest that CGs might benefit from careful monitoring of their health status, and from greater access to specialized support services.
The purposes of this exploratory study of 49 family caregivers of patients receiving chemotherapy were to describe the time and difficulty associated with caregiving tasks, examine caregivers' appraisals of their situations, and to explore what variables are predictive of caregiver mood. Measures used in this study included the Caregiving Burden Scale, Appraisal of Caregiving Scale, Family Hardiness Index, and an abbreviated form of the Profile of Mood States. Multiple regression was used to examine predictive relationships. The 25 women and 24 men reported spending the most time giving emotional support and assisting with household tasks, errands, and transportation. Giving emotional support was the most time-consuming and difficult task; therefore, it received the highest burden score. Burden was predicted by level of patient dependency. Caregiving burden, family hardiness, and caregiver health predicted 50% of the variance in negative appraisal of caregiving. Negative appraisal and age of the caregiver explained 49% of the variance in mood disturbance. Findings suggest that caregivers' appraisals of their situations may mediate the effects of illness and contextual factors on caregiver outcomes and that family hardiness is an important caregiver resource.
Results from a 2-year (4 waves) longitudinal study show strong evidence for patient decline and high levels of depressive symptomatology among caregivers. Female caregivers reported high, stable rates of depressive symptomatology throughout the study, whereas male caregivers exhibited significant increases in depression over time. Cross-sectional multivariate analyses revealed significant positive relationships between depression and number of patient problem behaviors, negative social support, and concern about financial resources; negative relationships were found between depression and social support, quality of prior relationship, and satisfaction with social contacts. Three significant independent predictors of change in depression were found: Lower depression scores at Time 1 were related to increases in depression over time; men were more likely than women to experience increases; and a decline in social support resulted in increased depression.
Groups of spouse (N = 285) and adult child (N = 244) caregivers of elderly parents suffering from Alzheimer's disease were interviewed regarding their caregiving behaviors, evaluations of caregiving, and general psychological well-being. A model of caregiving dynamics where the objective stressor, caregiver resources, and subjective appraisal of caregiving (operationalized as caregiving satisfaction and burden) were studied as they affected both positive affect and depression was tested. For spouses, caregiving satisfaction was not related to aspects of the stressor, but was a significant determinant of positive affect. Among adult children, high levels of caregiving behavior resulted in both greater caregiving satisfaction and burden. Burden, in turn, was related to depression in both groups but, among adult child caregivers, positive affect was not affected by caregiving satisfaction. Limited support was found for the hypothesis that the positive and negative aspects of caregiving contributed to analogous aspects of generalized psychological well-being but not to the opposite-valence outcomes.
A non-anonymous questionnaire was distributed to all nursing staff (n = 557) including RNs, LPNs (psychiatric), LPNs (somatic) and nurses' aides, in one nursing home, one somatic long-term care clinic and one psychogeriatric clinic. Scales measuring empathy, burnout experience and attitudes towards demented patients were included in the questionnaire. The aim of the study was to compare levels of empathy, burnout experience and attitudes among different categories of nursing staff and to examine connections between empathy, burnout and attitudes. The nursing staff showed an overall figure of moderately well-developed empathy and the RNs showed the highest empathy. The RNs had a significantly lower degree of burnout compared to the nurses' aides and the LPNs. Of all respondents, 27.4% were assessed at risk from burnout. Overall, the staff showed a moderately positive attitude towards demented patients and the RNs were most positive. No linear correlation was found between empathy, burnout experience and attitudes. However, a weak negative correlation between burnout and empathy is in accordance with other authors who are suggesting that burnout experience leads to lower empathy in the nursing staff. The fact that the RNs showed the most positive attitudes towards demented patients and had the highest level of empathy compared to LPNs and nurses' aides could be related to lower degree of burnout assessed in the RNs. Qualitative and quantitative overload among the LPNs and nurses' aides connected to the growing number of demented patients in the institutions examined are discussed.
This paper views caregiver stress as a consequence of a process comprising a number of interrelated conditions, including the socioeconomic characteristics and resources of caregivers and the primary and secondary stressors to which they are exposed. Primary stressors are hardships and problems anchored directly in caregiving. Secondary stressors fall into two categories: the strains experienced in roles and activities outside of caregiving, and intrapsychic strains, involving the diminishment of self-concepts. Coping and social support can potentially intervene at multiple points along the stress process.
Empathy is a topic of growing concern in a variety of disciplines. Although considerable empathy research is reported, often single dimensions of a multidimensional and multiphasic construct are actually being studied. Empathy is a unitary construct involving biopsychosocial components and is particularly well suited for nursing study because of its theoretical congruence with nursing philosophy and concerns. Empathy's importance goes beyond the usual emphasis on helper empathy. Although commonly associated with prosocial behavior, empathy involves underlying processes which may be used for either positive or negative social purposes. Recent technological improvements in research methodology, concerns regarding social violence, and conceptual shifts have led to greatly increased interest in the phenomenon of empathy and an expanded research thrust. One major recent change in empathy research is the tendency to view the phenomenon as multidimensional and consequently to include a variety of measures to capture different elements of the construct. This paper reviews the major approaches to measurement of empathy and classifies these approaches according to the dimensions of empathy that they measure. Physiological change in association with empathy is less frequently measured, but because empathy is commonly assumed to include an emotional response to another, concomitant physiological changes should accompany the emotional aspect of empathy and indicators of physiological response may be appropriate measures to include in nursing studies of empathy. A conceptualization of empathy is presented that considers empathy to be a multidimensional phenomenon, with emotional, cognitive, communicative, and relational components. Because empirical approaches can only examine the most easily measured aspects of empathy, phenomenological approaches are also needed to begin to capture the total construct.
This study deals with the self-rated impact of caring for a spouse with Alzheimer's disease at home. Impacts on the caregiver's marriage, work, recreation and mood were investigated as a function of the patient's disability level and of the coping resources which caregivers reported were available to and/or used by them.
The patient's disability level had a more negative impact on the caregiver's marriage and recreation than did the coping resource variables whereas the reverse was true for work. The caregiver's work was the only life area in which the availability and mobilization of coping resources influenced the caregiver's level of depression. To clarify these results, additional regression analyses were conducted separately for homemakers and employed subjects. While mobilized coping resources (social activity level and homemaking activity level) were correlated with depression among homemakers, none of the indicators of mobilized coping resources was correlated with depression among workers. These findings suggest that the role in which stress occurs is an important factor in understanding stress and the coping process.
Relationships between empathy and burnout and possible confounding influences of sex and profession were explored in a sample of 492 male and female nurses, social workers, and teachers. Respondents completed Mehrabian's Emotional Empathy Scale, Stotland's Fantasy-Empathy Scale, and the Maslach Burnout Inventory (MBI). There were no main effects of profession on empathy or burnout variables. There was, however, an interaction effect of sex and profession on depersonalization, which was accounted for by subjects in social work and teaching. Women had significantly higher empathy scores than men; however, men had higher scores than male normative groups. Age related negatively to depersonalization and emotional exhaustion for women, whereas percentage of work time spent in direct practice correlated with depersonalization for men. The possibility that empathy and burnout might represent opposite poles of the same underlying construct was examined but not found. Instead, emotional empathy was significantly positively correlated with both emotional exhaustion and personal accomplishment, whereas emotional exhaustion was also positively related to depersonalization. It is hypothesized that high emotional empathy may predispose helping professionals to emotional exhaustion and that emotional exhaustion, if not mediated by personal accomplishment, may lead to the development of depersonalization. This more complex, interactive model of the empathy-burnout relationship needs longitudinal study.
Ambulatory treatment for cancer has increased patients' self-care requirements and placed demands on family members to manage the illness and treatment side effects at home. This exploratory study was undertaken to assess family caregiving demands (load) and to examine caregivers' appraisals of the illness/caregiving experience. Forty-seven persons involved in the care of patients receiving radiotherapy for cancer were observed. Appraisal of stress was measured with the Appraisal of Caregiving Scale (ACS). This newly developed measure, derived from cognitive appraisal theory, is designed to assess the intensity of four possible appraisals of caregiving: harm/loss, threat, challenge, or benign. Participants also completed the Caregiver Load Scale, a measure of the time spent in caregiving activities. Satisfactory reliabilities were obtained for both measures. Family caregivers reported spending the most time in providing transportation, giving emotional support, and in extra household tasks. They received the most assistance from family and friends, and made minimal use of professional services. Caregiver load was correlated positively with the length of time on treatment and with patient dependency. Caregivers in the poorest health, those with less education, and those of lower socioeconomic status had higher scores on the ACS appraisals of harm/loss and threat. Older caregivers had significantly higher challenge and benign appraisals. There was a strong positive correlation between caregiver load and the harm/loss and threat appraisals. Findings suggest a need for frequent reassessment of demands on family caregivers throughout the course of treatment and offer direction for future research.
The purpose of the present research was to assess the empirical relationship of the psychosocial variables of empathy, attitudes, and ideological orientation toward treatment (custodial versus therapeutic). The sample consisted of 363 volunteers representing all levels of nursing personnel in seven different nursing homes. The data analysis indicated that a low level of empathy, negative attitudes toward the elderly, and a custodial orientation toward treatment were significantly positively correlated. Positive attitudes were not significantly correlated with empathy, orientation toward treatment, or negative attitudes. There were significant differences in empathy, negative attitudes, and custodial orientation toward treatment among the staff levels and nursing homes. However, positive attitudes varied significantly only among nursing homes. These data suggest directions for enhancing the ability of nursing personnel to interact therapeutically with elderly persons in nursing homes.
Fifteen years after 270 persons 60 years of age and over were first studied in a multidisciplinary longitudinal study of aging, 83 panelists were available for a sixth observation. In an investigation of the relationship between self and physicians' assessment of general health status the following was demonstrated: (1) There is a persistent, positive congruence of the two types of health ratings. (2) Whenever there is incongruity the tendency is for the individual to overestimate his health. (3) There is a substantial stability of both types of ratings through time. (4) The self health rating tends to be a better predictor of future physicians' ratings than the reverse. (5) Self-ratings of health have utility as a measure of health in survey research when objective measures are not feasible.
The Index of Independence in Activities of Daily Living (ADL), now in frequent use in rehabilitation settings, has application for prevention of disability and maintenance of rehabilitation gains in the aging person in all settings. Since the Index is sensitive to changes in meaningful self-care functions, uses well-defined criteria, and can be broadly taught to non-professionals, it has considerable practical value as a longitudinal measure of change and predictor of adaptive capacity in terms of community residences and congregate living facilities.
To compare two self-administered, one interviewer-administered, and one performance-based measure of physical function in community-based older persons.
Eighty-three subjects were recruited from meal sites, senior recreation centers, and senior housing units for a comprehensive geriatric assessment program. At the time of screening, study participants self-administered the Functional Status Questionnaire (FSQ) and were administered the Katz Activities of Daily Living (ADL) and the Older Americans Resources and Services Instrumental Activities of Daily Living (OARS-IADL) instruments by interview. Participants also completed the Physical Performance Test (PPT) and were given the Medical Outcomes Study SF-36 to self-administer on site or at home and return by mail.
All 83 subjects completed FSQ, Katz ADL, OARS-IADL, and PPT; 72 returned SF-36 forms. Correlations between the two self-administered physical function measures (FSQ and SF-36) were higher than between self-administered and interviewer-assessed (ADL and OARS-IADL) or performance-based (PPT) measures. When assessed for construct validity, the self-administered, OARS, and PPT measures had comparable correlations with role limitations as a result of physical health problems, but relationships between physical functional status measures and other SF-36 measures of health were inconsistent.
The relationships between commonly used self-administered, interviewer-administered, and performance-based measures of physical function were inconsistent and weak, suggesting that these instruments are not measuring the same construct.
The mandate by caring theorists to integrate caring into nursing curricula could be accomplished without major curricula change. The integration of empathy training, with special emphasis on expanding one's awareness of self as well as others, espouses a pedagogical approach to caring. The continuing effort of nurse researchers and educators to clarify how to best teach empathy and to integrate heuristic methods into nursing education and practice settings is imperative to the essence of nursing--caring.
This naturalistic field study was designed to explore the patient's perspective of the nature, meaning, and impact of empathic relationships with hospice nurses. The findings are part of a larger study, focused on the meaning and impact of empathic relationships that develop between hospice nurses and their patients. Data were generated through in-depth interviews with 14 terminally ill adults receiving home-based hospice care. According to the hospice patient, an empathic relationship developed through a process of reciprocal sharing and revealing of personhood within a context of caring and acceptance. The experience of an empathic relationship meant being acknowledged as an individual, a person of value. The outcome of the empathic relationships between hospice nurses and their patients was the improvement and maintenance of patients' physical and emotional well-being. Understanding the patient's perspective is critical for effective nursing interventions and meaningful outcomes. Future research needs to explore empathic relationships between the nurse and family caregivers in various settings.
The dementia caregiving literature is reviewed with the goals of (a) assessing the prevalence and magnitude of psychiatric and physical morbidity effects among caregivers, (b) identifying individual and contextual correlates of reported health effects and their underlying causes, and (c) examining the policy relevance of observed findings. Virtually all studies report elevated levels of depressive symptomatology among caregivers, and those using diagnostic interviews report high rates of clinical depression and anxiety. The evidence is more equivocal and generally weaker for the association between caregiving and physical morbidity, such as self-rated health, number of illnesses, symptomatology, health care utilization, preventive health behaviors, and cardiovascular functioning. Across studies, psychiatric morbidity in caregivers was linked to patient problem behaviors, income, self-rated health, perceived stress, and life satisfaction. Physical morbidity was associated with patient problem behaviors and cognitive impairment, and with caregiver depression, anxiety, and perceived social support. Possible causes of reported effects and policy implications are discussed.
Fifty-five spousal caregivers of persons with multiple sclerosis completed a questionnaire assessing the stress associated with caregiving. They were found to experience a range of negative effects, similar to those reported by other groups of carers of persons with degenerative neurological diseases. The behaviors causing most distress to the carers were associated with motor problems, sudden mood changes, partner upsetting other people, incontinence and pain. Overall, wives had higher burden scores than husbands. This was accounted for primarily by their higher levels of physical distress such as tiredness. Following the stress-appraisal-coping model of Lazarus and Folkman (1984) it was hypothesized that individual differences in burden would be accounted for primarily by the carers' appraisal of the symptoms, perceived social support, and satisfaction with coping. Regression analyses supported the importance of satisfaction with coping and social support as predictors of perceived burden. In addition, life satisfaction was found to be predicted by burden independently of other predictors.
This research examines the association among characteristics of the caregiving network, primary caregiver stress and burden, and area of residence. The purpose is two-fold: to determine whether the structure of the relationship between the caregiving network, and stress and burden is uniform across rural, small city, and urban samples; and, to assess whether stress and burden are explained by a similar set of variables within area of residence categories. The data are drawn from a matched sample of 1,388 impaired elders and their primary caregivers from the 1982 National Long-Term Care Survey and the National Survey of Informal Caregivers. In general, the analysis shows that several characteristics of the care-receiver and the primary caregiver have a differential effect on stress and burden across residential categories, and that, within rural, small city, and urban samples, the determinants of stress and burden are not homogeneous. When the frail elder is able to reciprocate by doing chores, babysitting, or providing some other type of assistance for the primary caregiver, however, both stress and burden are reduced in all three residential categories. Similarly, the increased provision of assistance with instrumental activities of daily living by the primary caregiver uniformly increases stress and burden. These findings suggest that interventions designed to alleviate primary caregiver stress and burden may be able to have some common components, but may also need to be tailored in some ways to specific residential environments.
Substantial interaction between mood and blood pressure, especially in the context of caregiving for a dependent elder, could increase the risk in the already at-risk population of black women for either higher blood pressure or the onset of hypertension.
To examine the relationship between mood symptoms and daytime ambulatory blood pressures during a 12-hour period in Black female caregivers and noncaregivers.
A prospective cohort design was employed to study black females 18 years of age or older identified by randomly selected elders as the provider or potential provider of 5 or more hours of care per week to the elder. Mood symptoms were measured on visual analogue scales by the subjects in a diary attached to a retractable clip key ring worn by the subject. Blood pressure responses were measured with automated portable blood pressure monitors every 30 minutes. Additional risk and treatment factors were considered for descriptive purposes.
The two groups were equivalent on all hypertension risk and treatment factors except alcohol use (more noncaregivers consumed alcohol). Among caregivers, anger and mean diastolic blood pressure (DBP) were negatively related (parameter = -0.64, SE = .23, p = .01) and the negative relationship between anger and systolic blood pressure approached significance (parameter = -0.81, SE = 0.65, p = 0.10). Anxiety and sadness were not significant predictors.
Among black caregivers, elevated anger was associated with significant decreases in DBP, while lowered anger was associated with significant increases in DBP. Whether lower anger scores reflect a low level of perceived anger or suppressed anger among black caregivers should be explored in future studies.