Abstract
BackgroundEmpathy 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).MethodsThe 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.ResultsSeven 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).ConclusionsThe 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.
Highlights
Empathy is a key element of “Patient and Family Centered Care”, a clinical approach recommended by the American Academy of Pediatrics
A “Copernican revolution” is happening in medicine with the shift from the traditional “doctor-centered” approach to a “patient centered” model where healthcare is tailored to the patient’s needs, values and expectations [1,2,3,4,5]. This approach is embodied in the Patient and Family Centered Care (PFCC) programme, which sets out behavioral guidelines and procedures to be practised by healthcare professionals in order to build a real partnership with patients and their families [6, 7]
The doctor invited the patient and family to participate to the survey and, if accepted, a questionnaire was answered by the patient and accompanying parent/legal guardian in the reception area of the Pediatric Emergency Room
Summary
Empathy is a key element of “Patient and Family Centered Care”, a clinical approach recommended by the American Academy of Pediatrics. A “Copernican revolution” is happening in medicine with the shift from the traditional “doctor-centered” approach to a “patient centered” model where healthcare is tailored to the patient’s needs, values and expectations [1,2,3,4,5]. In pediatrics, this approach is embodied in the Patient and Family Centered Care (PFCC) programme, which sets out behavioral guidelines and procedures to be practised by healthcare professionals in order to build a real partnership with patients and their families [6, 7]. There remains a lack of reliable tools to measure empathy amongst healthcare professionals operating in the pediatric clinical setting [23, 24]
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