Manzoni Ana Carolina Taccolini, Fagundes Felipe Ribeiro Cabral, Fuhro Fernanda Ferreira, Cabral Cristina Maria Nunes
Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil.
J Chiropr Med. 2019 Jun;18(2):106-114. doi: 10.1016/j.jcm.2018.10.005. Epub 2019 Jun 26.
The purpose of this study was to translate, cross-culturally adapt to Brazilian Portuguese, and analyze the measurement properties of the Consultation and Relational Empathy (CARE) Measure and investigate whether empathy can be a predictor of clinical improvement.
This psychometric study was divided into 2 stages: the cross-cultural adaptation process included 30 patients, and the evaluation of the measurement properties included 106 patients with chronic musculoskeletal pain. After the third therapy session with the same physical therapist, the following questionnaires were applied to assess internal consistency, construct validity, and ceiling and floor effects: Pain Numerical Rating Scale, Brazilian Portuguese version of the CARE Measure (CARE-Br), MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care, and Global Perceived Effect Scale. To assess reliability and measurement error, the CARE-Br was answered 48 hours later. For prediction analysis of the CARE-Br in relation to clinical improvement, the participants answered the Pain Numerical Rating Scale and Global Perceived Effect Scale 2 months after baseline.
The internal consistency was adequate (Cronbach's ɑ = 0.88), reliability was substantial (intraclass correlation coefficient = 0.77), measurement error was good (standard error of the measurement = 5.16%), and a moderate correlation was found with the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care ( = 0.50). A ceiling effect was also found (39.6% of participants). Empathy was not considered a predictor of clinical improvement.
The Brazilian Portuguese version of the CARE Measure is reliable, adequate, and applicable in clinical settings and research in Brazil. However, it is not capable of predicting clinical improvement in patients with chronic musculoskeletal pain.
本研究旨在翻译《咨询与关系同理心（CARE）量表》，将其跨文化改编为巴西葡萄牙语版本，分析该量表的测量属性，并调查同理心是否可作为临床改善的预测指标。
这项心理测量学研究分为两个阶段：跨文化改编过程纳入了30名患者，测量属性评估纳入了106名慢性肌肉骨骼疼痛患者。在与同一名物理治疗师进行第三次治疗会话后，应用以下问卷来评估内部一致性、结构效度以及天花板效应和地板效应：疼痛数字评定量表、《咨询与关系同理心（CARE）量表》巴西葡萄牙语版本（CARE-Br）、测量患者对物理治疗护理满意度的MedRisk工具以及总体感知效果量表。为评估可靠性和测量误差，在48小时后再次让患者填写CARE-Br。为分析CARE-Br与临床改善的预测关系，参与者在基线后2个月回答疼痛数字评定量表和总体感知效果量表。
内部一致性良好（克朗巴哈α系数 = 0.88），可靠性较高（组内相关系数 = 0.77），测量误差较小（测量标准误 = 5.16%），并且与测量患者对物理治疗护理满意度的MedRisk工具存在中度相关性（ = 0.50）。还发现了天花板效应（39.6%的参与者）。同理心未被视为临床改善的预测指标。
《咨询与关系同理心（CARE）量表》的巴西葡萄牙语版本可靠、适用，可用于巴西的临床环境和研究。然而，它无法预测慢性肌肉骨骼疼痛患者的临床改善情况。
