1
|
Natali F, Corradini L, Sconza C, Taylor P, Furlan R, Mercer SW, Gatti R. Development of the Italian version of the Consultation and Relational Empathy (CARE) measure: translation, internal reliability, and construct validity in patients undergoing rehabilitation after total hip and knee arthroplasty. Disabil Rehabil 2023; 45:703-708. [PMID: 35191359 DOI: 10.1080/09638288.2022.2037742] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To translate and cross-culturally adapt the Consultation and Relational Empathy (CARE) measure into Italian, examine its internal reliability, and construct validity in a rehabilitation setting. MATERIALS AND METHODS The translation process consisted of two forward translations, a pre-final version, a back-translation, and a final version, in accordance with available guidelines. We administered the Italian version of the CARE measure to 101 patients hospitalised for rehabilitation after total hip or total knee arthroplasty (THA and TKA). We assessed face validity, internal reliability, and construct validity. RESULTS Face validity was high. Patients answered all questions and the "does not apply" option was never selected. Internal reliability (Cronbach's α = 0.962) resulted in line with the original version. The exploratory factor analysis confirmed the unidimensional structure of the CARE measure with 74.82% of variance explained by the first factor. CONCLUSIONS The Italian version of the CARE measure showed high face validity. Internal reliability and construct validity were in line with the original version in patients undergoing rehabilitation after THA and TKA.IMPLICATIONS FOR REHABILITATIONInternal reliability and construct validity of the Italian version of the CARE measure are in line with those of the original version of the CARE measure.The Italian CARE measure can be used to assess patient's perceived therapist's empathy in patients undergoing physical therapy after THA and TKA.Physiotherapists should use the CARE measure with more caution in other rehabilitative contexts.
Collapse
Affiliation(s)
- Fabrizio Natali
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Laura Corradini
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Cristiano Sconza
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Patricia Taylor
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Raffaello Furlan
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Stewart W Mercer
- Usher Institute Old Medical School, University of Edinburgh, Edinburgh, UK
| | - Roberto Gatti
- Physiotherapy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| |
Collapse
|
2
|
Takahashi N, Matsuhisa T, Takahashi K, Aomatsu M, Mercer SW, Ban N. A 2-item version of the Japanese Consultation and Relational Empathy measure: a pilot study using secondary analysis of a cross-sectional survey in primary care. Fam Pract 2022; 39:1169-1175. [PMID: 35471659 PMCID: PMC9680666 DOI: 10.1093/fampra/cmac034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The Consultation and Relational Empathy (CARE) measure is a patient-reported measure of physician empathy which is widely used internationally. The Japanese version of the CARE measure has very high internal reliability, suggesting that a shorter version may have adequate validity and reliability. OBJECTIVE To investigate a valid shorter version of the Japanese CARE measure. METHODS We conducted a pilot study using secondary analysis of previous data obtained from 9 general practitioners and 252 patients and used to develop the Japanese CARE measure. All 1,023 possible combinations of the Japanese CARE items (n = 1-10) were candidates for the short measure. The internal consistency (Cronbach's alpha) and the correlations between candidate short questionnaires and the original questionnaire were calculated. After selecting the most valid short questionnaire, inter-rater reliability was determined using generalizability theory, and construct validity (Spearman's rho) was determined using patient satisfaction. RESULTS Two items were selected for a pilot shorter version: item 6 "Showing care and compassion" and item 9 "Helping you to take control." These showed high internal consistency and correlations with the 10-item measure (Cronbach's alpha = 0.920, correlation = 0.979). Forty-five questionnaires per doctor allowed us to reliably differentiate between practitioners. The construct validity for the pilot short measure was high (Spearman's rho 0.706, P < 0.001). CONCLUSION We generated a pilot 2-item version of the Japanese CARE measure. This pilot 2-item version provides a basis for future validation studies of short CARE measures in other languages.
Collapse
Affiliation(s)
- Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Takaharu Matsuhisa
- Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Kunihiko Takahashi
- Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Stewart W Mercer
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Nobutaro Ban
- Medical Education Center, Aichi Medical University School of Medicine, Nagakute, Japan.,Nakatsugawa Community Healthcare Center, Nakatsugawa, Japan
| |
Collapse
|
3
|
Matsuhisa T, Takahashi N, Takahashi K, Yoshikawa Y, Aomatsu M, Sato J, Mercer SW, Ban N. Effect of physician attire on patient perceptions of empathy in Japan: a quasi-randomized controlled trial in primary care. BMC FAMILY PRACTICE 2021; 22:59. [PMID: 33789572 PMCID: PMC8011374 DOI: 10.1186/s12875-021-01416-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/16/2021] [Indexed: 12/30/2022]
Abstract
Background There is limited quantitative research on the effect of physician attire on patient–physician relationships. This study aimed to measure the influence of Japanese family physicians’ attire on the “human” aspects of medical care in terms of patient-perceived relational empathy. Methods This was a multicenter, prospective, controlled trial conducted in primary clinics in Japan. We explored the effects of family physician attire (white coat vs. casual attire) on patient-perceived empathy. Family physicians were allocated to alternate weeks of wearing a white coat or casual attire during consultations. Patients’ perceptions of physician empathy were evaluated using the self-rated Japanese Consultation and Relational Empathy (CARE) Measure. We used a linear mixed model to analyze the CARE Measure scores, adjusting for cluster effects of patients nested within doctor, age, and sex of patients, and doctors’ sex and years of clinical experience. We used the same method with Bonferroni adjustment to analyze patient sex differences in perceived empathy. Results A total of 632 patients of seven family physicians were allocated to white coat-wearing consultations (n = 328), and casual attire-wearing consultations (n = 304). There was no difference in CARE Measure scores between white coat and casual primary care consultations overall (p = 0.162). Subgroup analysis of patient sex showed that CARE Measure scores of male patients were significantly higher in the Casual group than in the White coat group (adjusted p-value = 0.044). There was no difference in female patient scores between White coat and Casual groups (adjusted p-value = 1.000). Conclusions This study demonstrated that physician attire (white coat or casual attire) in a primary care setting did not affect patient-perceived relational empathy overall. However, male patients of physicians wearing casual attire reported higher physician empathy. Although empathy cannot be reduced to simple variables such as attire, white coats may have a negative effect on patients, depending on the context. Family physicians should choose their attire carefully. Trial registration Japanese University Hospital Medical Information Network (UMIN-ICDR). Clinical Trial identifier number UMIN000037687 (Registered August 14, 2019, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042749). The study was prospectively registered.
Collapse
Affiliation(s)
- Takaharu Matsuhisa
- Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8560, Japan.
| | - Noriyuki Takahashi
- Department of Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Kunihiko Takahashi
- M&D Data Science Center, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yuki Yoshikawa
- Department of General Medicine/Family & Community Medicine, Nagoya University Hospital, Tsurumai-cho 65, Showa-ku, Nagoya, 466-8560, Japan
| | - Muneyoshi Aomatsu
- Department of Medical Education, Saku Central Hospital, 197 Usuda, Saku, 385-0051, Japan
| | - Juichi Sato
- Department of General Medicine/Family & Community Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8560, Japan
| | - Stewart W Mercer
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland
| | - Nobutaro Ban
- Medical Education Center, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan
| |
Collapse
|
4
|
Gehenne L, Lelorain S, Anota A, Brédart A, Dolbeault S, Sultan S, Piessen G, Grynberg D, Baudry A, Christophe V. Testing two competitive models of empathic communication in cancer care encounters: A factorial analysis of the CARE measure. Eur J Cancer Care (Engl) 2020; 29:e13306. [DOI: 10.1111/ecc.13306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/12/2020] [Accepted: 08/07/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Lucie Gehenne
- CNRS, UMR 9193 ‐ SCALab ‐ Sciences Cognitives et Sciences Affectives Univ. Lille Lille France
| | - Sophie Lelorain
- CNRS, UMR 9193 ‐ SCALab ‐ Sciences Cognitives et Sciences Affectives Univ. Lille Lille France
| | - Amélie Anota
- Methodology and Quality of Life in Oncology Unit (IMSER UMR 1098) University of Besançon Besançon France
| | - Anne Brédart
- Psycho‐oncology and Social Service Institut Curie Paris France
- Psychopathology and Health Process Laboratory (LPPS UR 4057) Psychology Institute University Paris Descartes France
| | - Sylvie Dolbeault
- Psycho‐oncology and Social Service Institut Curie Paris France
- University Paris SudUniversity PSL Paris France
| | - Serge Sultan
- Sainte Justine University Health Center Montréal QC Canada
- Departments of Pediatrics and Psychology University of Montreal Montréal QC Canada
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery Claude Huriez University Hospital University of Lille Lille France
- Jean‐Pierre Aubert Research Center – Neurosciences and Cancer University of Lille (IMR‐S 1172‐JPArc) Lille France
| | - Delphine Grynberg
- CNRS, UMR 9193 ‐ SCALab ‐ Sciences Cognitives et Sciences Affectives Univ. Lille Lille France
- Institut Universitaire de France Paris France
| | - Anne‐Sophie Baudry
- CNRS, UMR 9193 ‐ SCALab ‐ Sciences Cognitives et Sciences Affectives Univ. Lille Lille France
- Oncology and Medical Specialties Department Valenciennes Hospital Valenciennes France
| | - Véronique Christophe
- CNRS, UMR 9193 ‐ SCALab ‐ Sciences Cognitives et Sciences Affectives Univ. Lille Lille France
| | | |
Collapse
|
5
|
Harada Y, Hirayama Y, Wakuda K, Imura H, Otaki J. Assessing the empathy of medical students during medical interview training in Japan by using mixed-methods surveys of simulated patients. MEDEDPUBLISH 2019; 8:179. [PMID: 38089274 PMCID: PMC10712511 DOI: 10.15694/mep.2019.000179.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background: Medical interviews are performed during objective structured clinical examinations, to assess the communication skills of medical students. In particular, medical students are assessed regarding whether they demonstrate empathy during these staged interviews. However, no studies to date have analyzed the validity of the methods to evaluate empathy during objective structured clinical examinations. Aim: Here we sought to identify factors affecting whether simulated (standardized) patients (SPs) felt that the medical students had treated them empathetically during medical interview training. Methods: The training involved the participation of SPs during the bedside learning of fifth-year medical students in Japan. After the students completed medical interview training, we conducted a questionnaire-based survey. We developed the list of questionnaire items through semi-structured interviews asking SPs to describe when the student had been empathetic. Results: The item "I felt that the student was empathic throughout the interview" was significantly correlated with "I was given enough time to talk at the beginning of the interview," "The student made good eye contact," "The student's attitude was appropriate," "I was able to say enough of what I wanted to talk about," and "The student used phrases that expressed empathy." Multiple regression analysis revealed that "The student used phrases that expressed empathy" was the only independent predictor of "I felt that the student was empathic throughout the interview." Conclusions: The factor that correlated most strongly with the SP feeling that the student was empathic during a medical interview was "The student used phrases that expressed empathy." However, correlations also occurred with open-ended questions and the student's level of attention at the beginning of the interview and with the student's attitude. Together, these findings indicate that several types of both verbal and nonverbal communication determined whether SPs felt that medical students showed empathy during staged medical interviews.
Collapse
Affiliation(s)
| | | | - Kana Wakuda
- Department of General Medicine and Primary Care
| | | | - Junji Otaki
- Department of General Medicine and Primary Care
| |
Collapse
|