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. 2018 Feb 13;18(1):57.
doi: 10.1186/s12887-018-1050-x.

Measuring empathy in pediatrics: validation of the Visual CARE measure

Michele Arigliani  1 , Luigi Castriotta  2 , Anna Pusiol  3 , Annachiara Titolo  4 , Enrico Petoello  4 , Alberto Brun Peressut  5 , Elisabetta Miorin  3 , Iana Elkina  3 , Federico Marzona  3 , Davide Cucchiaro  3 , Elisa Spanghero  3 , Matteo Pavan  6 , Raffaele Arigliani  7 , Stewart W Mercer  8 , Paola Cogo  3
Affiliations

Measuring empathy in pediatrics: validation of the Visual CARE measure

Michele Arigliani et al. BMC Pediatr. .

Abstract

Background: Empathy is a key element of "Patient and Family Centered Care", a clinical approach recommended by the American Academy of Pediatrics. However, there is a lack of validated tools to evaluate paediatrician empathy. This study aimed to validate the Visual CARE Measure, a patient rated questionnaire measuring physician empathy, in the setting of a Pediatric Emergency Department (ED).

Methods: The empathy of physicians working in the Pediatric ED of the University Hospital of Udine, Italy, was assessed using an Italian translation of the Visual Care Measure. This test has three versions suited to different age groups: the 5Q questionnaire was administered to children aged 7-11, the 10Q version to those older than 11, and the 10Q-Parent questionnaire to parents of children younger than 7. The internal reliability, homogeneity and construct validity of the 5Q and 10Q/10Q-Parent versions of the Visual Care Measure, were separately assessed. The influence of family background on the rating of physician empathy and satisfaction with the clinical encounter was also evaluated.

Results: Seven physicians and 416 children and their parents were included in the study. Internal consistency measured by Cronbach's alpha was 0.95 for the 10Q/10Q-Parent versions and 0.88 for the 5Q version. The item-total correlation was > 0.75 for each item. An exploratory factor analysis showed that all the items load onto the first factor. Physicians' empathy scores correlated with patients' satisfaction for both the 10Q and 10Q-Parent questionnaires (Spearman's rho = 0.7189; p < 0.001) and for the 5Q questionnaire (Spearman's rho = 0.5968; p < 0,001). Trust in the consulting physician was lower among immigrant parents (OR 0.43. 95% CI 0.20-0.93).

Conclusions: The Visual Care Measure is a reliable second-person test of physician empathy in the setting of a Pediatric Emergency Room. More studies are needed to evaluate the reliability of this instrument in other pediatric settings distinct from the Emergency Room and to further evaluate its utility in measuring the impact of communication and empathy training programmes for healthcare professionals working in pediatrics.

Keywords: Emergency medical services; Not included in the title; Patient satisfaction; Quality of health care.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Regional Ethics Committee of Friuli-Venezia Giulia, Italy. The written consent of parents and the verbal assent of each child included in the study were obtained.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Gerteis M, Edgman-Levitan S, Daley J, Delbanco T. Through the Patient’s eyes: understanding and promoting patient-centered care. 1 st ed. San Francisco: Jossey-Bass; 1993.
    1. Epstein RM, Street RL. The values and value of patient-centered care. Ann Fam Med. 2011;9:100–103. doi: 10.1370/afm.1239. - DOI - PMC - PubMed
    1. Rosenzveig A, Kuspinar A, Daskalopoulou SS, Mayo NE. Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Medicine (Baltimore) 2014;93:e120. doi: 10.1097/MD.0000000000000120. - DOI - PMC - PubMed
    1. Bardes CL. Defining “patient-centered medicine.”. N Engl J Med. 2012;366:782–783. doi: 10.1056/NEJMp1200070. - DOI - PubMed
    1. Barry MJ, Edgman-Levitan S. Shared decision making--pinnacle of patient-centered care. N Engl J Med. 2012;366:780–781. doi: 10.1056/NEJMp1109283. - DOI - PubMed

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