Empathy and Psychological Outcomes in Informal Caregivers of Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

Abstract

Objectives: Scholars have increasingly recognized the crucial role that empathy plays as informal caregivers provide unpaid care to their older family and friends (i.e., care recipients). Yet, the existing literature exhibits substantial variability in study approaches and results, which limits the extent to which this literature can inform interventions intended to benefit informal caregivers. We sought to address this critical gap by synthesizing research that examined how caregivers' and care recipients' empathy were associated with caregivers' psychological health. Methods: We conducted a literature search using PubMed, PsycInfo, CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, and Scopus databases and systematically reviewed 21 peer-reviewed studies that were eligible for the current study. We utilized a multilevel random-effects approach and meta-analyzed 17 studies focused on caregivers' negative psychological outcomes (e.g., depressive symptoms, anxiety, burden, burnout, stress). Results: We observed small, nonsignificant associations linking caregivers' emotional and cognitive empathy to their negative psychological outcomes. Yet, there were moderate, significant associations between greater emotional and cognitive empathy in care recipients and less negative psychological outcomes in caregivers. We also ran sensitivity tests for different aspects of emotional and cognitive empathy. Discussion: This review reveals considerable heterogeneity in extant research but still offers robust evidence linking care recipients' empathy to caregivers' psychological health. Findings highlight the importance of engaging care recipients in interventions targeting caregivers and call for more consistent and nuanced investigations of empathy in caregiving.