Different empathy types show opposing associations with burnout: systematic review and meta-analyses

Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, has become an increasingly pressing issue in recent years. The current research aimed to clarify whether empathy is associated with higher or lower levels of burnout as measured using the Maslach Burnout Inventory, and to explore whether this relationship depends upon the nature of the empathic construct (cognitive, compassion, or contagion) being assessed. Through a systematic review of existing literature, we obtained 73 usable articles (79 samples), representing 20 595 participants. Overall, higher empathy was significantly associated with lower emotional exhaustion, Hedges's g = -0.10 (95%CI [-.16, -.03], p = .005), and lower depersonalization, Hedges's g = -0.28, (95%CI [-.37, -.20, p < .001). Higher empathy was also associated with significantly greater personal accomplishment, Hedges's g = 0.37, (95%CI [.28, .45], p < .001). These main effects were moderated by the empathy construct: Cognitive empathy and Compassion were associated with lower burnout symptoms, whereas emotional Contagion was associated with higher burnout symptoms. These results were consistent across healthcare and non-healthcare professionals. Overall, other-oriented empathy constructs appear protective against burnout, while self-oriented empathy constructs may be a risk factor. Thus, practitioners need not avoid trying to understand or feel compassion for their patients but may wish to avoid mirroring their patients' feelings.