The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure

Mercer, Stewart W; Maxwell, Margaret; Heaney, David; Watt, Graham

doi:10.1093/fampra/cmh621

Cited by 663 publications

(643 citation statements)

References 13 publications

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“…We measured patient perceptions of physician empathy using the Consultation and Relational Empathy Measure (CARE), a validated 10-item questionnaire measuring patient perceptions of empathetic behaviors on a five-point Likert scale from "poor" to "excellent". [9][10][11][12][13][14] The instrument is scored for a total of 10-50 points, with higher scores indicating more empathic behavior. The Patient Enablement Instrument (PEI), a six-item questionnaire previously validated among practicing physicians, [9][10][11][12]15,16 measured patient ratings of health-related enablement.…”

Section: Methodsmentioning

confidence: 99%

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

et al. 2015

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Section: Methodsmentioning

confidence: 99%

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

et al. 2015

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“…Additionally, three instruments were found where respondents assessed an external event [18,72,73], and one instrument related to the primary health care field [74]. Over 400 items were identified, and 122 were retained in the item pool.…”

Section: Resultsmentioning

confidence: 99%

Development and validation of the ExPRESS instrument for primary health care providers’ evaluation of external supervision

Schriver

Cubaka

Vedsted

et al. 2018

Global Health Action

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Background: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. Aim: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. Methods: “External supervision: Provider Evaluation of Supervisor Support” (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test–retest design, the second for confirmatory factor analysis. Results: We included 16 items in section A (‘The most recent experience with an external supervisor’), and 13 items in section B (‘The overall experience with external supervisors’). Item-content validity index was acceptable. In field test I, test–retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. Conclusions: ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.

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“…They were either instructed or not instructed to mimic non-verbal SP emotional expressions during consultation and both groups were video recorded. After each of the twenty individual consultations, the SP rated the level of empathy received from the staff by using the Consultation and Relational Empathy (CARE) measure [18]. This validated and standardized tool is frequently used to measure the quality of the doctor-patient relationship during clinical consultations.…”

Section: Methodsmentioning

confidence: 99%

Mimicking non-verbal emotional expressions and empathy development in simulated consultations: An experimental feasibility study

Zhou

Fischer

2018

Patient Education and Counseling

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Objective: To explore the feasibility of applying an experimental design to study the relationship between non-verbal emotions and empathy development in simulated consultations. Method:In video-recorded simulated consultations, twenty clinicians were randomly allocated to either an experimental group (instructed to mimic non-verbal emotions of a simulated patient, SP) or a control group (no such instruction). Baseline empathy scores were obtained before consultation, relational empathy was rated by SP after consultation.Multilevel logistic regression modelled the probability of mimicry occurrence, controlling for baseline empathy and clinical experience. ANCOVA compared group differences on relational empathy and consultation smoothness.Results: Instructed mimicry lasted longer than spontaneous mimicry. Mimicry was marginally related to improved relational empathy. SP felt being treated more like a whole person during consultations with spontaneous mimicry. Clinicians who displayed spontaneous mimicry felt consultations went more smoothly. Conclusion:The experimental approach improved our understanding of how non-verbal emotional mimicry contributed to relational empathy development during consultations.Further work should ascertain the potential of instructed mimicry to enhance empathy development.Practice implications: Understanding how non-verbal emotional mimicry impacts on patients' perceived clinician empathy during consultations may inform training and intervention programme development.

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The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure

Abstract: These preliminary results support the validity and reliability of the CARE measure as a tool for measuring patients' perceptions of relational empathy in the consultation.

Cited by 663 publications

References 13 publications

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

Development and validation of the ExPRESS instrument for primary health care providers’ evaluation of external supervision

Mimicking non-verbal emotional expressions and empathy development in simulated consultations: An experimental feasibility study

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