Validity and reliability of the CARE Measure in secondary care

Abstract

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The Consultation and Relational Empathy (CARE) Measure is a validated tool for assessing the patients' perception of the doctors' communication in primary care. The present study aims to evaluate the potential usefulness of the CARE Measure in secondary care in a single Hospital Trust in Scotland. Design/methodology/approach -A total of 1,015 out-patients attending 25 consultants across ten specialities anonymously completed the questionnaire immediately after their appointment. Overall satisfaction, estimated consultation length, satisfaction with consultation length, and demographic and socio-economic variables were also recorded. Findings -The number of missing values and "not applicable" responses to the ten CARE Measure items was extremely low (3.4 per cent). Almost 90 per cent of patients felt the CARE Measure items were of major importance. The measure had a high internal reliability (Cronbach's alpha 0.94) and reduced to a single factor. Overall CARE Measure score correlated with overall satisfaction (r ¼ 0.7, p , 0.0001), whether patients would recommend the doctor (r ¼ 0.6, p , 0.0001), and satisfaction with consultation length (r ¼ 0.6, p , 0.0001). Multi-regression analysis showed that personal continuity of care, consultation length, and patient age positively influenced CARE Measure score, but the effect size was small. Patients' gender, marital status, general health, and socio-economic factors did not influence scores. Reliability analysis indicated that 40 patients were required per doctor in order to achieve an overall reliability co-efficient of above 0.7. Practical implications -Secondary care patients across a range of specialities have endorsed the CARE Measure as a relevant tool. It has high face and concurrent validity, internal and structural reliability and is not subject to major influences by demographic or socio-economic factors. These findings support the feasibility and reliability of the CARE Measure in secondary care. Originality/value -This pilot study indicates that the CARE Measure is considered by most patients to be of high relevance to everyday out-patient consultations in secondary care.

The consultation and relational empathy measure: an investigation of its scaling structure

“…It appears to be free of bias, invariant across time, and has a level of reliability consistent with individual use. The high Cronbach alpha and findings from the factor analysis are in line with results from previous studies [14,24,25]. Therefore, this measure appears a good candidate for the evaluation of the empathic nature of the consultation process between therapists and patients.…”

“…The general consistency between factor analysis and Rasch analysis is encouraging as is the consistency with pervious work on this measure [24,25]. The factor analysis simply determines if a set of items form a unidimensional construct, which also is an assumption of the Rasch Model.…”

“…Each question also has a 'does not apply' response option and when this is ticked the data for this question is entered as 'missing'. The scale's unidimensionality has been supported using factor analysis [24][25][26]. Since patients would not be able to comment upon the therapists' empathy before the start of the study these data were collected two weeks into the study (after which patients would have had four sessions with the therapists) and at the end (after a total of eight sessions).…”

“…The CARE measure was developed following a review of existing measures [15], qualitative research and pilot studies [14] in primary care. It has been shown to be valid and reliable in primary and secondary care [22][23][24][25] and more recently also as part of a composite measure, the Consultation Quality Index or CQI of holistic interpersonal care in primary care consultations [4,26]. To date validation studies have employed procedures, such as factor analysis, which is a commonly used approach to examine the construct validity of health status measures [27].…”

“…The CARE is a short patientassessed measure that has been shown to provide doctors with direct feedback of their strengths and weaknesses in terms of relational empathy, as perceived by their patients [15,[21][22][23][24][25]. It is recommended for use in physiotherapy by the UK Chartered Society of Physiotherapy [12].…”