How Play Evokes Empathy: Emotional Dynamics in a Perspective-Taking Game about Long COVID

Long COVID is a debilitating, invisible condition affecting millions worldwide. Patients frequently face skepticism and social isolation due to an empathy gap that scalable interventions have yet to address. While serious games show promise for fostering chronic illness empathy, the emotional mechanisms through which gameplay drives empathy remain poorly understood. We developed My Pair of Shoes , a perspective-taking game simulating daily life with long COVID, and conducted an online mixed-methods experiment with 68 participants. Partial least squares structural equation modeling revealed that emotional variability in the control/power dimension positively predicted game-induced empathy ( β = 0.477), while valence variability showed an unexpected negative association ( β = − 0.361). Empathy, in turn, predicted personal helping intention ( β = 0.564) and attitude toward structural help ( β = 0.373). An exploratory thematic analysis of player diaries contextualized these findings, revealing responses ranging from deep engagement to defensive minimization. We derive design implications for perspective-taking games that leverage emotional dynamics to foster empathy.