Development and Psychometric testing of the 'Empathy and Understanding in Dementia Index' for Health Professionals

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Empathy among health professionals requires the application of empathic understanding in practice and in the way, care is provided. To date, few tools have been specifically designed to measure empathy concerning dementia training. Therefore, this study aimed to develop a psychometrically valid and reliable tool to measure empathy among health professionals. A mixed methods sequential exploratory design was adopted guided by Fields' theoretical structure. Phase 1-4 (development) of the instrument was based on (1) an extensive literature review, (2) qualitative research, and (3-4) the contribution of a variety of stakeholders and supported by an empathic theoretical framework. Phase 5 (validation) involved a quantitative study among a convenient sample of multi-health professionals (n = 223) to evaluate validity and reliability and finalize the tool. Full ethical approval was acquired. A 19-item questionnaire that includes four constructions (Previous training α = 0.88, empathy α = 0.91; Understanding behavior α=0.85; and Person-centered practice α = 0.91) emerged from qualitative findings and a strong theoretical basis. It was verified that the tool had acceptable psychometric properties, acceptable factor loadings, and internal consistency measures. The intervention had a significant impact on the empathy of the participants. The tool proved to be an effective measure of empathy, understanding, and empathy in the performance of health professionals concerning the care of a person living with dementia. It proved to be an effective measure of change over time as a result of an intervention. The intervention produced a significant change in empathy and understanding of the symptoms and impact of dementia. This difference was observed regardless of the health profession. The 'Empathy and Understanding in Dementia Index' are potentially useful tool for estimating empathy among health professionals using virtual reality. The questionnaire demonstrated sufficient structural validity and internal consistency in empathy and understanding of the symptoms of health professionals and the impact on the person living with dementia. Further psychometric investigation including larger samples is recommended.
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalInternational Journal of Research in Nursing
Issue number1
Publication statusPublished (in print/issue) - 19 Dec 2022

Bibliographical note

This survey did not receive any specific grants from public, commercial or non-profit development agencies.


  • Dementia
  • Empathy
  • Questionnaire
  • Validation
  • psychometrics


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