Empathy as Therapeutic Infrastructure in Wound Care: A Conceptual Synthesis

To develop a conceptual understanding of empathy in chronic wound care through synthesis of patient, healthcare professional, and informal carer perspectives. An integrative qualitative synthesis was conducted using empirical and review literature representing multiple stakeholder perspectives in chronic wound care. A reflexive thematic synthesis approach was applied to identify patterns across datasets and develop higher-order conceptual constructs through iterative comparison and abstraction. Rigour was supported through triangulation and reflexive team discussions. Empathy emerged as a multidimensional construct operating across relational, clinical, and organisational levels. Five interconnected themes were identified: relational connection, engagement and adherence, distributed care networks, structural constraints, and emotional labour. These themes informed the concept of empathy as therapeutic infrastructure, conceptualising empathy as a set of interconnected processes underpinning care delivery and care experiences across settings. Empathy in wound care extends beyond interpersonal interaction to function as a foundational component of care systems. Conceptualising empathy as therapeutic infrastructure highlights the importance of embedding empathy within clinical practise, professional education, and organisational structures. This framework provides a foundation for future research and the development of interventions to strengthen person-centred wound care.