Validity and reliability of the CARE Measure in secondary care

S. W. Mercer, D. J. Murphy

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    Purpose – The Consultation and Relational Empathy (CARE) Measure is a validated tool for assessing the patients' perception of the doctors' communication in primary care. The present study aims to evaluate the potential usefulness of the CARE Measure in secondary care in a single Hospital Trust in Scotland.

    Design/methodology/approach – A total of 1,015 out-patients attending 25 consultants across ten specialities anonymously completed the questionnaire immediately after their appointment. Overall satisfaction, estimated consultation length, satisfaction with consultation length, and demographic and socio-economic variables were also recorded.

    Findings – The number of missing values and “not applicable” responses to the ten CARE Measure items was extremely low (3.4 per cent). Almost 90 per cent of patients felt the CARE Measure items were of major importance. The measure had a high internal reliability (Cronbach's alpha 0.94) and reduced to a single factor. Overall CARE Measure score correlated with overall satisfaction (r=0.7, p<0.0001), whether patients would recommend the doctor (r=0.6, p<0.0001), and satisfaction with consultation length (r=0.6, p<0.0001). Multi-regression analysis showed that personal continuity of care, consultation length, and patient age positively influenced CARE Measure score, but the effect size was small. Patients' gender, marital status, general health, and socio-economic factors did not influence scores. Reliability analysis indicated that 40 patients were required per doctor in order to achieve an overall reliability co-efficient of above 0.7.

    Practical implications – Secondary care patients across a range of specialities have endorsed the CARE Measure as a relevant tool. It has high face and concurrent validity, internal and structural reliability and is not subject to major influences by demographic or socio-economic factors. These findings support the feasibility and reliability of the CARE Measure in secondary care.

    Originality/value – This pilot study indicates that the CARE Measure is considered by most patients to be of high relevance to everyday out-patient consultations in secondary care.

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    Original languageEnglish
    Pages (from-to)269-283
    JournalClinical Governance
    Issue number4
    Publication statusPublished - 2008


    • Communication
    • Customer satisfaction
    • Doctors
    • Individual perception
    • Medical care
    • Outpatients


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