Translation and validation of Warmometer, a tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese

Abstract

BACKGROUND: Empathy in the patient-provider relationship is associated with important outcomes in healthcare practice. Our aim was to translate and validate Warmometer, a visual tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese. DESIGN AND SETTING: Cross-sectional study conducted at an antenatal clinic of a public university hospital in São Paulo, Brazil. METHODS: The instrument was translated into Brazilian Portuguese and culturally adapted. It was tested for reliability and validity among 32 pregnant women, between June 2015 and January 2016. To assess construct validity, it was correlated with the Consultation and Relational Empathy (CARE) scale (gold standard for patient-provider relationships) and the Interpersonal Reactivity Index (IRI). RESULTS: The translated version of Warmometer had good face and content validity, low intra-observer reproducibility (intraclass correlation coefficient, ICC: 0.224; 95% confidence interval, CI -0.589 to 0.621;P = 0.242) and high inter-observer reproducibility (ICC: 0.952; 95% CI 0.902 to 0.977; P < 0.001). There was a strong correlation between Warmometer and CARE ( r = 0.632) and a weak correlation between Warmometer and IRI ( r = 0.105). CONCLUSIONS: Warmometer was translated, culturally adapted and validated for use in Brazilian Portuguese. The translated version is a reliable tool for assessing the degree of empathy perceived by the patient in a patient-provider relationship.

Understanding of empathetic communication in acute hospital settings: a scoping review

“… 24 34 40 44 48 Three studies (14%) used the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE), 28 33 45 a five-question patient-completed questionnaire like CARE used to evaluate provider empathy. 56 One study used both JSPPPE and CARE, 45 and one study used both CARE and Warmometer, 47 a tool used to measure the perceived warmth (considered to be equivalent to empathy by the study) of the patient–provider relationship from the patient’s perspective. One study used the Active Empathetic Listening Scale, 41 an 11-item tool evaluating three subscales of someone else’s listening—sensing, processing and responding.…”

“…48 One study referred to empathy as 'perceived warmth'. 47 Two definitions of empathy appeared to be identical to a definition by Kurtz et al, 39 44 52 where it is defined as a two-phase process where the first involves understanding and appreciating another's feelings and emotions and the second communicating understanding back in a supportive way. Two definitions simply described empathy as the essence of all nurse-client communication and nurse-patient interaction, respectively, 34 48 which appear to be identical.…”

“…The value of professional distinctions is unclear in the context of the broad definitional similarities. Furthermore, we identified an instance of one empathy definition contradicting the tool used in the study, 47 equating perceived warmth to empathy when the article discussing the tool's creation clearly differentiates the two. 57 Several studies noted the lack of clarity and numerous inconsistencies between definitions of empathy in the literature, 27 28 39 44 48 and one study mentioned the difficulty of defining a vague concept like empathy.…”

“…23 25-29 32-39 43 44 Emotional and affective empathy were considered to be equivalent by Savieto et al, 46 describing them as 'the ability to put oneself in another person's shoes', and Wu 34 considered affective empathy as partaking in the same feelings as someone else is experiencing them, and both of these appear to be similar. However, a definition mentioned by Gerace et al 48 describes emotional empathy as being part of 'emotional reactions to another person's experiences', and a definition mentioned by Brooke et al 47 describes an affective component of empathy being the ability to share the emotions of others. Another definition mentioned by Moreno-Poyato et al 32 considers affective empathy to consist of two dimensions-the 'tendency to experience feelings oriented towards others such as compassion and concern' or 'empathic concern', and the tendency to emotionally react based on another's suffering, which is consistent with the definition noted by Gerace et al 48 These multiple definitions suggest that there are possibly inconsistencies in how emotional and affective empathy are defined.…”

Usual-Risk Pregnant Women’s Health-Related Quality of Life through Pregnancy and Puerperium with Anthroposophical Prenatal Care: A Retrospective Study

“…Had the bond between the patient and the interdisciplinary team not been strong, it would not have been possible to achieve the results described in this study. The highlighted feature of this bond is empathy, with a warm atmosphere [24].…”