Empathy among healthcare workers in the context of patient dying and death – a narrative review
DOI:
https://doi.org/10.12775/JEHS.2026.87.68468Keywords
empathy, medical caregiver, dying, death, nurse, physicianAbstract
Introduction: Empathy is a fundamental component of high‑quality care for patients at the end of life. In interactions with dying individuals and their families, healthcare workers navigate both professional responsibilities and emotional involvement, which shapes the quality of the care they provide.
Narrative Review: This review synthesizes research examining empathy among various groups of healthcare professionals, including nurses, physicians, medical caregivers, students, and community care workers. The overview identifies factors that strengthen or diminish empathy, explores strategies used by professionals to cope with patient death, and highlights the importance of organizational support. The reviewed studies underline the complexity of empathy as both an emotional response and a clinical competency.
Conclusions: The literature demonstrates that empathy is a dynamic, multifaceted construct influenced by personal characteristics, workplace conditions, and broader organizational structures. Strengthening empathy requires comprehensive support for healthcare workers, the development of advanced communication skills, and institutional strategies that promote resilience and compassionate care.
References
1. Engel M, Kars MC, Teunissen SCCM, van der Heide A. Effective communication in palliative care from the perspectives of patients and relatives: A systematic review. Palliat Support Care. 2023;21(5):890-913. doi:10.1017/S1478951523001165
2. Pérez-Rugosa V, Lladó-Jordan G, de Lorena-Quintal P, et al. The ethical challenge of negative compassion: Excessive empathy in end-of-life care. J Hosp Palliat Nurs. 2025. doi:10.1097/NJH.0000000000001172
3. Kolthoff KL, Hickman SE. Compassion fatigue among nurses working with older adults. Geriatr Nurs. 2017;38:106-109.
4. Stamm R, Lambert J, Garritano N, Miller J, Donnellan A. Advanced practice registered nurse subspecialty compassion satisfaction and compassion fatigue. J Nurse Pract. 2022;18:310-315.
5. Baqeas MH, Davis J, Copnell B. Compassion fatigue and compassion satisfaction among palliative care health providers: A scoping review. BMC Palliat Care. 2021;20:88.
6. Sperling D. Nurses’ lived experiences and perspectives on end-of-life care during COVID-19. BMC Palliat Care. 2024;23(35). doi:10.1186/s12904-024-01352-3
7. Nelson-Becker H, Victor C. Dying alone and lonely dying: Media discourse and pandemic conditions. J Aging Stud. 2020;55.
8. Hendriks VJJ, Faes MC, van der Meer JBL, Janse ES, van der Meer NJM, van der Linden CMJ. Shared decision-making in advance care planning among hospitalized older COVID-19 patients: A multicenter, retrospective cohort study. Aging Clin Exp Res. 2022;34(12).
9. Pan J, Wu H, Wang Y, Zhang B. Personality disorder functioning styles and empathy in trainee nurses: The mediating and moderating roles of death attitudes. Front Psychiatry. 2025;16:1532940. doi:10.3389/fpsyt.2025.1532940
10. Decety J. Empathy in medicine: What it is, and how much we really need it. Am J Med. 2020;133:561-566. doi:10.1016/j.amjmed.2019.12.012
11. Fernandez AV, Zahavi D. Basic empathy: Developing the concept of empathy from the ground up. Int J Nurs Stud. 2020;110:103695. doi:10.1016/j.ijnurstu.2020.103695
12. Di Lorenzo R, Incerti M, Bandiera GR, et al. Quality of professional life and empathy of healthcare workers in an emergency department of a general hospital: A cross-sectional study. Risk Manag Healthc Policy. 2025;18:3853-3873. doi:10.2147/RMHP.S534164
13. Feng H, Shen Y, Li X. Bereavement coping strategies among healthcare professionals: A qualitative systematic review and meta-synthesis. Palliat Support Care. 2024;22(6):2194-2206. doi:10.1017/S1478951524001147
14. Ghaedi F, Ashouri E, Soheili M, et al. Nurses’ empathy in different wards: A cross-sectional study. Iran J Nurs Midwifery Res. 2020;25:117-121. doi:10.4103/ijnmr.IJNMR_84_19
15. Moreno-Poyato AR, Rodríguez-Nogueira Ó; MiRTCIME.CAT working group. The association between empathy and the nurse-patient therapeutic relationship in mental health units: A cross-sectional study. J Psychiatr Ment Health Nurs. 2021;28:335-343. doi:10.1111/jpm.12675
16. Ibrahim AM, Abdel-Aziz HR, Zaghamir DEF, et al. Ethics and moral empathy in end-of-life palliative care. Palliat Support Care. 2025. doi:10.1017/S1478951525000458
17. Tran ANP, To QG, Huynh VN, et al. Quality of work life and associated factors among Vietnamese physicians and nurses. BMC Health Serv Res. 2023;23:924. doi:10.1186/s12913-023-09908-4
18. Cheng M, Lan Y, Chen Y, Fang F. Factors influencing healthcare professionals’ rating on quality of death and dying: A nationwide cross-sectional study in China. Front Public Health. 2025;13:1722430. doi:10.3389/fpubh.2025.1722430
19. Glyn-Blanco MB, Lucchetti G, Badanta B. How do cultural factors influence the provision of end-of-life care? A narrative review. Appl Nurs Res. 2023;73:151720. doi:10.1016/j.apnr.2023.151720
20.Saint Elizabeth Health. Support for grieving frontline home care workers. SE Health Research Centre; 2019.
21. SEHC (Saint Elizabeth Health Care). The grief experiences of frontline home care workers. 2019.
22. Patynowska KA, et al. Workplace support, wellbeing and intention to leave among lone working healthcare assistants providing palliative and end-of-life care in the community: A mixed-methods study. Palliat Med. 2025. doi:10.1177/02692163251395576
23. Wang CXY, Pavlova A, At F, Consedine NS. Beyond empathy decline: Do the barriers to compassion change across medical training? Adv Health Sci Educ Theory Pract. 2022;27:521-536. doi:10.1007/s10459-022-10100-2
24. Wei T, Guo M, Jin H, Zhang B. Attachment styles and empathy in trainee nurses: The mediating and moderating roles of attitudes toward death. Front Psychol. 2024;15:1445587. doi:10.3389/fpsyg.2024.1445587
25. Su H, Tam KI, Li Y. The role of emotional intelligence in end-of-life care: A scoping review of studies involving healthcare professionals. BMC Palliat Care. 2025;24(290). doi:10.1186/s12904-025-01928-7
26. Toriello HV, Van De Ridder JMM, Brewer P, et al. Emotional intelligence in undergraduate medical students: A scoping review. Adv Health Sci Educ. 2022;27:167-187. doi:10.1007/s10459-021-10079-2
27.Aradilla-Herrero A, Tomás-Sábado J, Gómez-Benito J. Death attitudes and emotional intelligence in nursing students. Omega (Westport). 2013;66:39-55.
28.Barker ME, Crowfoot G, King J. Empathy development and volunteering for undergraduate healthcare students: A scoping review. Nurse Educ Today. 2022;116:105441. doi:10.1016/j.nedt.2022.105441
29.Graves J, Joyce C, Hegazi I. From empathy to compassion fatigue: A narrative review of implications in healthcare. In: Empathy: Advanced Research and Applications. London: IntechOpen; 2023:1-28. doi:10.5772/intechopen.107399
30.Wang CXY, Pavlova A, At F, Consedine NS. Beyond empathy decline: Do the barriers to compassion change across medical training? Adv Health Sci Educ Theory Pract. 2022;27:521-536. doi:10.1007/s10459-022-10100-2
31. Hartrick Doane G, Stajduhar K, Causton E, Bidgood D, Cox A. End-of-life care and interprofessional communication: Not simply a matter of "more." Health Interprof Pract Educ. 2012;1(3):eP1028. doi:10.7772/2159-1253.1028
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