ArticleBMC primary care2025
Validity and reliability of the 2-item version compared with the 10-item version of the Japanese consultation and relational empathy (CARE) measure: primary analysis of a cross-sectional survey.
Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe Consultation and Relational Empathy Measure is an internationally used five point each and 10-item questionnaire that assesses a physician's empathy from the patient's perspective. A 2-item version that uses item 6 "Showing care and compassion" and item 9 "Helping you to take control" from the Japanese 10-item version without changing the text was preliminarily developed through secondary data analysis.
objectiveTo examine the validity and reliability of the Japanese 2-item version.
methodsSelectively sampled patients who visited 11 collaborating general practitioners working in primary care clinics in both urban and rural areas of the Tokai region of Japan completed the 2-item and 10-item versions, and a patient background questionnaire. Face validity, criterion validity, construct validity, and internal consistency were examined. The 10-item version was used to assess the criterion validity of the 2-item version. Inter-rater reliability was examined using generalizability theory. The correlation between each item in the 2-item version was identified. Missing data analysis was performed.
resultsAmong all 349 participating patients, questionnaires completed by 347 patients who gave clear consent to participate in the study were analyzed. The 2-item version showed high face validity, with few missing and "does not apply" values. Criterion validity was identified with strong correlations between the 2-item and 10-item scores (Pearson's correlation coefficient 0.805, P < 0.001), along with construct validity with correlations between the 2-item score and patient satisfaction (Spearman's rho 0.583, P < 0.001). The two items showed acceptable internal consistency (Cronbach's α 0.919). Eighty-five patients were required to ascertain inter-rater reliability of the 2-item measure. A mean score of 7.5 and a score range of 7-8 was estimated in the 2-item total. A strong positive correlation was identified between each item in the 2-item version (Pearson's correlation coefficient 0.852, P < 0.001). Missing data analysis revealed that the 2-item version, 10-item version, and consultation characteristics were missing completely at random, except for patient characteristics.
conclusionsAlthough the high number of patients required per doctor to reliably discriminate between doctors' empathy may limit its feasibility in practice and careful interpretation is warranted, the Japanese 2-item version has high validity and internal reliability.
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