Reliability and validity of the Chinese version of the CARE Measure in a primary care setting in Hong Kong

Abstract

The Consultation and Relational Empathy (CARE) Measure is a validated patient-rated measure of consultation quality in the UK. To provide preliminary evidence of the reliability and validity of a Chinese version of the CARE Measure in a primary care setting in Hong Kong. Following translation, back-translation and pilot testing, a Chinese version of the CARE Measure was developed and tested on 253 unselected primary care patients in Hong Kong. The Chinese-CARE Measure was regarded by patients as being relevant to their consultations, with on average only 5.5% of patients rating the items as not important (range 3.6-10.2% for individual items), suggesting high acceptability and face validity. This was also supported by the relatively low number of 'not applicable' responses recorded for the measure (average 8.2%, range 0.4-21.7% for individual items). Internal reliability was high (Cronbach's alpha 0.962) and was reduced by the removal of any of the 10 items, and homogeneity was indicated by high corrected item-total correlations (0.786-0.876). Factor analysis showed a single solution for the Chinese-CARE Measure items with high item loadings (0.821-0.891). Construct validity was further supported by significant hypothesized relationships with other variables (patient enablement and patient satisfaction). Consultation length and continuity of care were independent predictors of Chinese-CARE Measure score in stepwise multiple regression analysis but together explained <10% of variation in CARE score. These preliminary data support the reliability and validity of the Chinese version of the CARE Measure in primary care in Hong Kong.