The Chinese-version of the CARE measure reliably differentiates between doctors in primary care: a cross-sectional study in Hong Kong.

Stewart W Mercer,Samuel Ys Wong,Colman Sc Fung,Frank Wk Chan,Fiona Yy Wong,Douglas Murphy

doi:10.1186/1471-2296-12-43

Abstract

BackgroundThe Consultation and Relational Empathy (CARE) Measure is a widely used patient-rated experience measure which has recently been translated into Chinese and has undergone preliminary qualitative and quantitative validation. The objective of this study was to determine the reliability of the Chinese-version of the CARE Measure in reliably differentiating between doctors in a primary care setting in Hong KongMethodsData were collected from 984 primary care patients attending 20 doctors with differing levels of training in family medicine in 5 public clinics in Hong Kong. The acceptability of the Chinese-CARE measure to patients was assessed. The reliability of the measure in discriminating effectively between doctors was analysed by Generalisability-theory (G-Theory)ResultsThe items in the Chinese-CARE measure were regarded as important by patients and there were few 'not applicable' responses. The measure showed high internal reliability (coefficient 0.95) and effectively differentiated between doctors with only 15-20 patient ratings per doctor (inter-rater reliability > 0.8). Doctors' mean CARE measure scores varied widely, ranging from 24.1 to 45.9 (maximum possible score 50) with a mean of 34.6. CARE Measure scores were positively correlated with level of training in family medicine (Spearman's rho 0.493, p < 0.05).ConclusionThese data demonstrate the acceptability, feasibility and reliability of using the Chinese-CARE Measure in primary care in Hong Kong to differentiate between doctors interpersonal competencies. Training in family medicine appears to enhance these key interpersonal skills.

Highlights

The Consultation and Relational Empathy (CARE) Measure is a widely used patient-rated experience measure which has recently been translated into Chinese and has undergone preliminary qualitative and quantitative validation
A cross-sectional study using a questionnaire which included the Chinese CARE Measure was conducted between July 2008 and February 2009 in primary care clinics in the public health care system run by the Hospital Authority (HA) in Hong Kong
The gender and age group distribution of the participating patients was very similar to that of all patients attending General Out Patient Clinics (GOPCs) clinics in the New Territories East Cluster in the previous year

Summary

Introduction

The Consultation and Relational Empathy (CARE) Measure is a widely used patient-rated experience measure which has recently been translated into Chinese and has undergone preliminary qualitative and quantitative validation. The Consultation and Relational Empathy (CARE) Measure is a patient-rated experience measure (PREM) developed in the United Kingdom [7,8,9] which has been extensively validated [7,8,9,10,11,12,13] and shown to be highly reliable in differentiating between doctors [9,10,11]. We have subsequently carried out extensive work on the translation of the CARE measure into Chinese, and presented preliminary evidence of reliability and validity on 253 primary care patients in Hong Kong [15]

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Conclusion