ABSTRACT Objective Various studies have examined the effectiveness of interventions to increase empathy in health professionals. However, internal contradictions in the way studies define and assess empathy threaten the validity of research findings. This study aims to assess the coherence between the definition, intervention and assessment of empathy within the context of nursing empathy intervention studies. Furthermore, it scrutinises the intervention and assessment methods based on the knowledge–attitude–behaviour model. Methods We conducted a systematic literature review of randomised controlled trials across two databases from January 1995 to March 2025. The selected nursing empathy intervention studies were categorised based on dimensions of empathy and aspects of knowledge–attitude–behaviour. The alignment among definition, intervention and assessment was then evaluated. Results Of the final twelve studies included, only one demonstrated a consistent definition, intervention and assessment of empathy. One other study exhibited partial consistency, while the remaining ten were inconsistent. Only one study was consistent in its intervention and assessment concerning knowledge–attitude–behaviour aspects. Conclusion Our study exposes a significant discrepancy in the alignment of empathy dimensions and knowledge–attitude–behaviour aspects. Researchers should ensure consistency between the definition, intervention and assessment of empathy as well as knowledge–attitude–behaviour aspects for the intervention and assessment. Readers need to be aware of internal contradictions in nursing empathy intervention studies, for they threaten the validity of study results.
Hsieh et al. (Fri,) studied this question.