Prediction of Burnout Among Caregivers in Elderly Care Centers Based on Psychological Capital and Empathy: The Mediating Role of Caregiving Burden
Keywords:
burnout, caregivers, older adults, psychological capital, empathy, caregiving burdenAbstract
The aim of the present study was to examine the fit of a structural model for predicting burnout among caregivers in elderly care centers based on psychological capital and empathy, with the mediating role of caregiving burden. The statistical population consisted of all caregivers employed in elderly care centers located in the city of Karaj in 2025 who had more than five months of experience in caring for older adults. A non-random, voluntary sampling method was used, and due to adequate access to the target population, a relatively large sample size (N = 200) was selected to ensure greater precision in structural equation modeling analyses. In addition, according to Kline (2011), in structural equation modeling, the sample size should be at least five to ten times the number of observed variables. The research method was correlational using structural equation modeling. Data were collected using the Maslach Burnout Inventory (Maslach, 1985), the Psychological Capital Questionnaire developed by Luthans et al. (2007), the Empathy Quotient Questionnaire by Baron-Cohen (2004), and the Caregiver Burden Questionnaire by Novak and Guest (1989). Data analysis was conducted using the structural equation modeling (SEM) statistical approach. The results indicated that the indirect path coefficient between psychological capital and burnout (β = −0.238, p = 0.010), on the one hand, and the indirect path coefficient between empathy and burnout (β = −0.100, p = 0.003), on the other hand, were both negative and statistically significant. These findings indicate that caregiving burden significantly and negatively mediates the relationship between psychological capital and empathy with burnout among caregivers in elderly care centers.
Downloads
References
Abbasi Asl, M., Khanjani, M. S., Foroughan, M., Azkhosh, M., & Moloodi, R. (2025). Psychological Challenges of Family Caregivers of Older Adults With Dependency in Activities of Daily Living in Iran: A Qualitative Study. Archives of Rehabilitation, 26(3), 398-421. https://doi.org/10.32598/RJ.26.3.4025.1
Aghili, Y., Dehghani, F., Naderi, Z., & Bagherian Sararoudi, R. (2021). Comparing caregiver burden in caregivers of patients with cancer and chronic mental disorders. Isfahan Medical School Journal, 39(649), 859-852. https://www.sid.ir/paper/1034333/fa
Ahmadi, M., Arsalanian, N., Moghaddam, F., Nasih, L., Taghili, F., & Falahikhoshkanab, M. (2024). Occupational burnout among emergency nurses: A systematic review. Systematic Review Journal in Medical Sciences, 2(1), 56-68. http://ijsr.ir/article-1-134-fa.html
Bahari, A., Raheb, G., & Aghlimar, M. (2017). The impact of a psychosocial empowerment model on the mental health of women with chronically mentally ill spouses. Social Work Research Journal, 4(13), 71-37. https://rjsw.atu.ac.ir/article_10222_1888.html
Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., & Wheelwright, S. (2003). The systemizing quotient: an investigation of adults with Asperger syndrome or high-functioning autism, and normal sex differences. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, 358(1430), 361-374. https://doi.org/10.1098/rstb.2002.1206
Cangelosi, G., Sacchini, F., Biondini, F., Mancin, S., Morales Palomares, S., Ferrara, G., & Petrelli, F. (2025). Nutritional support in the prevention and treatment of pressure ulcers in healthy aging: a systematic review of nursing interventions in community care. Geriatrics, 10(1), 17. https://doi.org/10.3390/geriatrics10010017
Chen, H., Makhdzir, N., & Loh, W. C. (2024). Association of resilience with caregiver burden in caring for the elderly with stroke: a systematic review. Official Journal of Pakistan Medical Association, 49(3), 706. https://www.rmj.org.pk/fulltext/27-1723502583.pdf?1739141387#page=246
Duarte, J., Pinto-Gouveia, J., & Cruz, B. (2016). Relationships between nurses' empathy, self-compassion and dimensions of professional quality of life: A cross-sectional study. International journal of nursing studies, 60, 1-11. https://doi.org/10.1016/j.ijnurstu.2016.02.015
Guo, Y., & Shi, J. (2024). Factors Associated With Psychological Wellbeing in Home Care Older Adults With Alzheimer's Disease: A Longitudinal Analysis. Journal of Applied Gerontology, 43(8), 1069-1081. https://doi.org/10.1177/07334648241231406
Hjazeen, A., Kannan, S., Al-Maqableh, H. O., Maitah, S., Abu-Radwan, M., & Sabbah, M. (2024). Relationship between psychological empowerment and nurses' job satisfaction: A systematic review and Correlational Meta-analysis. Cureus, 16(4). https://doi.org/10.7759/cureus.58228
Jain, P. (2024). Quality Of Life And Burnout: A Study On Caregivers Of Elderly. International Journal of Interdisciplinary Approaches in Psychology, 2(4), 1368-1399. https://www.psychopediajournals.com/index.php/ijiap/article/view/282
Kharidaratiq, S., & Zeynali, A. (2019). The role of emotional and cognitive empathy in predicting job satisfaction and burnout among nurses. Nursing Education Journal, 7(5), 45-51. http://jne.ir/browse.php?a_id=972&sid=1&slc_lang=fa
Kiani, F., Solimani, F., & Azarbarzin, M. (2022). The impact of a family-centered empowerment model on the resilience of family caregivers of patients undergoing hemodialysis: A randomized controlled clinical trial. Journal of Qom University of Medical Sciences, 16(10), 844-857. https://doi.org/10.32598/qums.16.10.2737.1
Konrath, S., Meier, B. P., & Bushman, B. J. (2018). Development and validation of the Single Item Trait Empathy Scale (SITES). Journal of research in personality, 73, 111-122. https://doi.org/10.1016/j.jrp.2017.11.009
Kukihara, H., Ando, M., Koga, K., Nishio, M., Nakashima, F., & Yamawaki, N. (2024). The mediating roles of psychological resilience and psychological well-being of caregivers for the older adults. Journal of Rural Medicine, 19(4), 241-249. https://doi.org/10.2185/jrm.2023-037
Liu, T., Zhang, R., Yao, H., Que, L., & Bai, W. (2025). Efficacy of an emotion and stress management program based on empowerment theory on family caregivers of stroke survivors. Pakistan Journal of Medical Sciences, 41(2), 494. https://doi.org/10.12669/pjms.41.2.11350
Liu, X., Wang, Z., Zhang, C., Zhang, C., Peng, L., & Xu, H. (2024). Effects of income on subjective well-being in the elderly: Complete mediation roles of self-rated health and psychological capital. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 61, 00469580241284967. https://doi.org/10.1177/00469580241284967
Lutthans, F., Youssef, M., & Avolio, J. (2007). Psychological Capital Developing the Human Competitive Edge. Oxford University Press. https://academic.oup.com/book/26255?searchresult=1&utm_source=Tren
Mikaeili, F., Khalili, M., & Kazemi Fard, D. (2023). Predicting occupational burnout based on mental well-being, psychological capital, demands, and job resources among nurses. Mashhad Medical Sciences Journal, 66(5), 27-11. https://www.sid.ir/paper/1440699/fa
Rangriz, H., & Mousavi, Z. (2014). The impact of work-related burnout on nurse shortages in hospitals in Iran considering the general health policies. Strategic and Macro Policies Journal, 2(7), 43-64. https://www.jmsp.ir/article_7725.html?lang=fa
Rezaei, N., Babakhani, N., & Bagheri, N. (2021). A model explaining occupational burnout based on psychological capital and self-differentiation with the mediating role of perceived social responsibility among nurses at Tehran University of Medical Sciences. Iranian Journal of Nursing Research, 16(4), 28-17. https://www.sid.ir/paper/962068/fa
Sadeghi, A., Jahangiri, M., & Taghvaei, D. (2024). The effectiveness of self-compassion-focused therapy on depression, caregiver burden, and emotional dysregulation in caregivers of elderly patients with Alzheimer's disease. Journal of Research in Psychological Health, 18(2), 1-20. https://system.khu.ac.ir/rph/article-1-4524-fa.pdf
Şenol Çelik, S., Sariköse, S., & Çelik, Y. (2024). Structural and psychological empowerment and burnout among nurses: A systematic review and meta‐analysis. International Nursing Review, 71(1), 189-201. https://doi.org/10.1111/inr.12878
Serrada-Tejeda, S., Martínez-Cuervo, F., Pérez-de-Heredia-Torres, M., Montes-Montes, R., Obeso-Benítez, P., & Palacios-Cena, D. (2025). Healthcare's empathy in elderly care: How anxiety, depression, and professional quality of life influence empathic abilities. Geriatric Nursing, 62, 188-193. https://doi.org/10.1016/j.gerinurse.2025.01.033
Shen, X., Bu, H., Zhang, J., Duan, W., Wang, H., Tao, Y., & Qiao, Z. (2024). The dual roles of empathy in mediating structural empowerment and compassion fatigue among Chinese nurses. BMC Nursing, 23(1), 837. https://doi.org/10.1186/s12912-024-02499-3
Sun, J., Yu, P., Zhou, L., & Lu, X. (2024). Cognitive status, psychological state and needs of caregivers for elderly patients with home-induced pressure injuries: a qualitative study. British Journal of Hospital Medicine, 85(8), 1-15. https://doi.org/10.12968/hmed.2024.0133 10.12968/hmed.2024.0449
Sun, Y. (2025). Psychological capital and subjective well-being: a multi-mediator analysis among rural older adults. BMC psychology, 13(1), 315. https://doi.org/10.1186/s40359-025-02407-7
Wang, X., Zhou, L., Wen, X., & Gou, L. (2024). Exploring the relationship between ethical leadership and nurses' moral courage in China: the mediating effect of psychological empowerment. Journal of nursing management, 2024(1), 6664191. https://doi.org/10.1155/2024/6664191
World Health, O. (2018). Global status report on alcohol and health 2018. World Health Organization. https://books.google.com/books?hl=fa&lr=&id=qnOyDwAAQBAJ&oi=fnd&pg=PR7&dq=Global+status+report+on+alcohol+and+health+2018&ots=a2qrOKqicm&sig=6aD--KKqO5-BjslMCT4MEdyDJpM
Xue, D., Sun, B., Li, W., Li, X., & Xiao, W. (2024). The relationship between resiliency, psychological empowerment, and teacher burnout across different genders: A psychological network analysis. Behavioral Sciences, 14(10), 878. https://doi.org/10.3390/bs14100878
Yang, L., Ye, J., Zhu, H., Tang, Y., & Li, X. (2024). Development and evaluation of a family-child reading picture book on reducing autism spectrum disorder caregivers' psychological stress: a mixed method study. Frontiers in Psychiatry, 15, 1390430. https://doi.org/10.3389/fpsyt.2024.1390430
Yang, Q. Q., Chen, Y. D., Schwade, M., & Zhang, Q. (2025). Exploring the dynamics of compassion fatigue, compassion satisfaction, and burnout in family caregivers of disabled elderly: A moderated mediation analysis of social support. Geriatric Nursing, 65, 103537. https://doi.org/10.1016/j.gerinurse.2025.103537
Yazdanparast, S., Manzari Tavakoli, H., Sharafi, S., Shokouh, Z., & Sayadi, S. (2024). Investigating the relationship between psychological empowerment and occupational burnout with the mediating role of emotional intelligence among nurses in private hospitals in Shiraz. Sadra Medical Sciences Journal, 11(4), 430-441. https://smsj.sums.ac.ir/article_49716.html
Zavar, E., & Rezvani, M. (2018). Investigating the relationship between empathy and occupational burnout in psychotherapists and counselors. Proceedings of the Second International Conference on Psychology, Counseling, Education, and Training, Mashhad.
Zhou, J., Yang, Y., Qiu, X., Yang, X., Pan, H., Ban, B., & et al. (2018). Serial multiple mediation of organizational commitment and job burnout in the relationship between psychological capital and anxiety in Chinese female nurses: A cross-sectional questionnaire survey. International journal of nursing studies, 83, 75-82. https://doi.org/10.1016
