title: The consultation and relational empathy measure: an investigation of its scaling structure.
abstract: OBJECTIVE
  The Consultation and Relational Empathy (CARE) measure is recommended to evaluate the quality of care. However, there is no evidence that it is valid in rehabilitation. Aims were to examine the internal construct (factorial) validity of the CARE in the assessment of the patient-therapist relationship.
  
  
  METHODS
  CARE data were part of an experimental study of acupuncture and different currently used acupuncture placebo controls, including 213 patients (age 66.8, SD 8.3, 58% female) with chronic stable hip or knee pain of mechanical origin, waiting for a joint replacement. CARE was completed two weeks into the study and on completion, two weeks later.
  
  
  METHODS
  Cronbach alpha, factor analysis and Rasch analysis.
  
  
  RESULTS
  Internal construct validity was supported (82% of variance explained by the first factor; fit to the Rasch model χ(2) = 18.2, P = 0.57). CARE was unidimensional, had local independence of items, good item fit, absence of Differential Item Functioning and invariance over time. Three percent of people did not complete items 9 & 10.
  
  
  CONCLUSIONS
  CARE satisfied strict criteria for internal construct validity. An interval scale transformation is available that can be used in clinical practice and research. Further work is required to investigate item non-response and how this may be dealt with in clinical settings.
authors: PCRC, School of Rehabilitation and Occupation Studies, Auckland University of Technology, Auckland, New Zealand. pkersten@aut.ac.nz
authors: Paula
authors: P
authors: Kersten
authors: Peter John
authors: PJ
authors: White
authors: Alan
authors: A
authors: Tennant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004645:Empathy; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D059825:Physical Therapists; D011369:Professional-Patient Relations; D011594:Psychometrics / Q000379:methods*; D011787:Quality of Health Care / Q000592:standards*; D012017:Referral and Consultation / Q000592:standards*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires