Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)

Objectives Compassion is a key indicator of quality care that is reportedly eroding from patients’ care experience. While the need to assess compassion is recognised, valid and reliable measures are lacking. This study developed and validated a clinically informed, psychometrically rigorous, patient...

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Main Authors: Lucy Selman, Aynharan Sinnarajah, Patrick Quail, Shane Sinclair, Thomas F Hack, Susan McClement, Genevieve Thompson, Carlo Leget, Harvey Chochinov, Neil Hagen, Cara C MacInnis, Priya Jaggi, Harrison Boss, Shelly Cory, Max Jajszczok, Leah Lechelt, Christina Puchalski
Format: Article
Language:English
Published: BMJ Publishing Group 2021-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/6/e045988.full
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author Lucy Selman
Aynharan Sinnarajah
Patrick Quail
Shane Sinclair
Thomas F Hack
Susan McClement
Genevieve Thompson
Carlo Leget
Harvey Chochinov
Neil Hagen
Cara C MacInnis
Priya Jaggi
Harrison Boss
Shelly Cory
Max Jajszczok
Leah Lechelt
Christina Puchalski
author_facet Lucy Selman
Aynharan Sinnarajah
Patrick Quail
Shane Sinclair
Thomas F Hack
Susan McClement
Genevieve Thompson
Carlo Leget
Harvey Chochinov
Neil Hagen
Cara C MacInnis
Priya Jaggi
Harrison Boss
Shelly Cory
Max Jajszczok
Leah Lechelt
Christina Puchalski
author_sort Lucy Selman
collection DOAJ
description Objectives Compassion is a key indicator of quality care that is reportedly eroding from patients’ care experience. While the need to assess compassion is recognised, valid and reliable measures are lacking. This study developed and validated a clinically informed, psychometrically rigorous, patient-reported compassion measure.Design Data were collected from participants living with life-limiting illnesses over two study phases across four care settings (acute care, hospice, long term care (LTC) and homecare). In phase 1, data were analysed through exploratory factor analysis (EFA), with the final items analysed via confirmatory factor analysis (CFA) in phase 2. The Schwartz Center Compassionate Care Scale (SCCCS), the revised Edmonton Symptom Assessment Scale (ESAS-r) and Picker Patient Experience Questionnaire (PPEQ) were also administered in phase 2 to assess convergent and divergent validity.Setting and participants 633 participants were recruited over two study phases. In the EFA phase, a 54-item version of the measure was administered to 303 participants, with 330 participants being administered the final 15-item measure in the CFA phase.Results Both EFA and CFA confirmed compassion as a single factor construct with factor loadings for the 15-item measure ranging from 0.76 to 0.86, with excellent test–retest reliability (intraclass correlation coefficient range: 0.74–0.89) and excellent internal reliability (Cronbach’s alpha of 0.96). The measure was positively correlated with the SCCCS (r=0.75, p<0.001) and PPEQ (r=0.60, p<0.001). Participants reporting higher experiences of compassion had significantly greater well-being and lower depression on the ESAS-r. Patients in acute care and hospice reported significantly greater experiences of compassion than LTC residents.Conclusions There is strong initial psychometric evidence for the Sinclair Compassion Questionnaire (SCQ) as a valid and reliable patient-reported compassion measure. The SCQ provides healthcare providers, settings and administrators the means to routinely measure patients experiences of compassion, while providing researchers a robust measure to conduct high-quality research.
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spelling doaj-art-c3a7caef5d384e7da259c34e272b27b02024-11-20T02:45:12ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-045988Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)Lucy Selman0Aynharan Sinnarajah1Patrick QuailShane Sinclair2Thomas F Hack3Susan McClement4Genevieve Thompson5Carlo Leget6Harvey ChochinovNeil HagenCara C MacInnis7Priya Jaggi8Harrison Boss9Shelly CoryMax JajszczokLeah LecheltChristina Puchalski4 Palliative and End of Life Care Research Group, Bristol Medical School, University of Bristol Faculty of Health Sciences, Bristol, UK2 Division of Palliative Medicine, Department of Oncology, University of Calgary, Calgary, Alberta, CanadaDepartment of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaCollege of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, CanadaCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, CanadaCollege of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada3 University of Humanistic Studies, Utrecht, The NetherlandsDepartment of Psychology, University of Calgary, Calgary, Alberta, CanadaFaculty of Nursing, University of Calgary, Calgary, Alberta, CanadaDepartment of Psychology, University of Calgary, Calgary, Alberta, CanadaObjectives Compassion is a key indicator of quality care that is reportedly eroding from patients’ care experience. While the need to assess compassion is recognised, valid and reliable measures are lacking. This study developed and validated a clinically informed, psychometrically rigorous, patient-reported compassion measure.Design Data were collected from participants living with life-limiting illnesses over two study phases across four care settings (acute care, hospice, long term care (LTC) and homecare). In phase 1, data were analysed through exploratory factor analysis (EFA), with the final items analysed via confirmatory factor analysis (CFA) in phase 2. The Schwartz Center Compassionate Care Scale (SCCCS), the revised Edmonton Symptom Assessment Scale (ESAS-r) and Picker Patient Experience Questionnaire (PPEQ) were also administered in phase 2 to assess convergent and divergent validity.Setting and participants 633 participants were recruited over two study phases. In the EFA phase, a 54-item version of the measure was administered to 303 participants, with 330 participants being administered the final 15-item measure in the CFA phase.Results Both EFA and CFA confirmed compassion as a single factor construct with factor loadings for the 15-item measure ranging from 0.76 to 0.86, with excellent test–retest reliability (intraclass correlation coefficient range: 0.74–0.89) and excellent internal reliability (Cronbach’s alpha of 0.96). The measure was positively correlated with the SCCCS (r=0.75, p<0.001) and PPEQ (r=0.60, p<0.001). Participants reporting higher experiences of compassion had significantly greater well-being and lower depression on the ESAS-r. Patients in acute care and hospice reported significantly greater experiences of compassion than LTC residents.Conclusions There is strong initial psychometric evidence for the Sinclair Compassion Questionnaire (SCQ) as a valid and reliable patient-reported compassion measure. The SCQ provides healthcare providers, settings and administrators the means to routinely measure patients experiences of compassion, while providing researchers a robust measure to conduct high-quality research.https://bmjopen.bmj.com/content/11/6/e045988.full
spellingShingle Lucy Selman
Aynharan Sinnarajah
Patrick Quail
Shane Sinclair
Thomas F Hack
Susan McClement
Genevieve Thompson
Carlo Leget
Harvey Chochinov
Neil Hagen
Cara C MacInnis
Priya Jaggi
Harrison Boss
Shelly Cory
Max Jajszczok
Leah Lechelt
Christina Puchalski
Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
BMJ Open
title Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
title_full Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
title_fullStr Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
title_full_unstemmed Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
title_short Development and validation of a patient-reported measure of compassion in healthcare: the Sinclair Compassion Questionnaire (SCQ)
title_sort development and validation of a patient reported measure of compassion in healthcare the sinclair compassion questionnaire scq
url https://bmjopen.bmj.com/content/11/6/e045988.full
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