Exploring the delivery of empathic care in task-shared settings: A psychometric study in rural Pakistan

Empathy plays a crucial role in psychosocial and psychological interventions, greatly impacting rapport building, patient adherence, and satisfaction with treatment. Empathetic interactions enhance patient's self-reflection and the delivery of more personalized therapeutic interventions tailored to the unique needs of each patient, thereby improving the overall quality of care. Despite empathy being central to psychosocial interventions, there are currently no valid and reliable patient-centered tools that assess the lay-therapist empathy that they show and/or exhibit toward their patients. In this study, the patient-rated Empathy Scale for Lay Therapists was developed to assess empathy in community health workers delivering psychosocial interventions. Psychometric validation was based on a cross-sectional study embedded in a non-inferiority cluster randomized trial of the Thinking Healthy Programme for perinatal depression in Pakistan. Community testing with perinatal women confirmed the scale's understandability and logical structure, highlighting its face validity. Among the 980 trial participants, a high level of agreement with the Empathy Scale for Lay Therapists (mean score 2.616) was observed, indicating effective communication and empathy from health workers. The scale demonstrated excellent internal consistency (Cronbach's alpha 0.96). Exploratory Factor Analysis revealed a unidimensional structure, capturing 87.81% of the total variance, with strong factor loadings.