Abstract
BackgroundPatients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement.ObjectiveTo address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing.MethodsNon-hospitalized patients with multiple chronic conditions were sampled using an on-line platform. Classical test theory and Rasch measurement theory were used to evaluate psychometric properties of the scale. Structured questions elicited cognitive responses regarding clarity of each item.ResultsClassical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability. Patients’ ratings of compassionate behaviors using the Schwartz Center Compassionate Care Scale correlated significantly with a related instrument designed to measure empathy, demonstrating convergent validity. Rasch measurement theory showed that reducing the number of response options on 3 items in the scale would improve respondents’ discrimination between responses on these items. Although person-item threshold distribution analysis showed that patients may wish to rate compassionate care at levels both higher and lower than the scale permits, items could be ordered on an interval scale from low to high levels of compassionate care.ConclusionsThe current 12-item Schwartz Center Compassionate Care Scale demonstrates excellent psychometric properties by Classical Test Theory and Rasch measurement theory. The 12-item Schwartz Center Compassionate Care Scale adds questions related to understanding and discussing emotional, contextual issues and the needs of the patient and family. Easily completed on-line, it could be used for work-place based assessment and feedback to clinicians and performance or quality improvement.
Highlights
Compassion for those who suffer is fundamental to the purpose of healthcare
Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration
Classical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability
Summary
Compassion for those who suffer is fundamental to the purpose of healthcare. Compassion represents a family of other-oriented emotions that includes empathic concern, caring, and tenderness for one who is suffering [1]. Extensive research has shown that these emotions, elicited by and congruent with the perceived welfare of someone in need, evokes a motivational state to ameliorate his or her concerns, pain, distress and suffering [1], [2]. Compassion is often conflated with the concepts of empathy and sympathy. Compassion enacted by healthcare providers adds the action component of helping behaviors. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement
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