A longitudinal mixed-methods study on the development of empathy in healthcare students towards people with dementia

Abstract

Background: Dementia prevalence is rising, and by 2050, almost two million people in the UK will be affected. Most healthcare professionals will work with people with dementia at some point in their career. However, people with dementia often report care that lacks empathy. To deliver high quality person-centred care, future healthcare professionals need to have the capacity and skills to practice with empathy. Currently, there is a lack of knowledge about the factors that impact empathy towards people with dementia in undergraduate healthcare education. To address this gap in knowledge, this PhD aimed to develop a conceptual model to present the main factors that can impact the longitudinal development of empathy towards people with dementia in healthcare students.
Methods: A mixed-methods study was completed using a sequential design of three sub-studies. Sub-study 1: a systematic review (n=25 papers) on interventions used to enhance empathy was conducted. Sub-study 2: a longitudinal qualitative study using grounded theory approaches was undertaken to understand the concept of empathy, and identify the factors that impacted empathy in students towards people with dementia. Semi-structured interviews were completed with 30 nursing, physiotherapy, and medical students. A second interview was completed with 26 of those students eighteen months later. Sub-study 3: secondary analysis was completed on longitudinal paired healthcare student survey data (n=1,611) to test whether empathy changed, and identify what factors were associated with empathy outcomes. Regression analysis was used to test the factors that impacted empathy scores over time. The findings from the three sub-studies were integrated to inform a conceptual model.
Results: Student capacity for empathy towards people with dementia was influenced by an interplay between their moral values and principles, their experiences during clinical exposure, shifting ideals, and impacts on their emotional self-efficacy. Difficulty connecting with and understanding the lived experience of dementia, a lack of resources, poor role models, and fear of emotional distress limited student empathy towards dementia. To facilitate their capacity for empathy, students need to be equipped with sufficient knowledge of dementia, and person-centredness, and have exposure to suitable learning environments that foster empathy.
Conclusion: The development of empathy towards people with dementia in healthcare students is poorly understood. This is the first study to explore its development longitudinally in a multidisciplinary group of healthcare students. The findings informed the development of a conceptual model that can be incorporated into real world educational approaches to improve the development of empathy in healthcare students.

Date of Award	Feb 2026
Original language	English
Awarding Institution	University of Brighton
Supervisor	Stephanie Daley (Supervisor), Nicolas Farina (Supervisor) & Molly Hebditch (Supervisor)