Translation and validation of Warmometer, a tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese

ABSTRACT BACKGROUND: Empathy in the patient-provider relationship is associated with important outcomes in healthcare practice. Our aim was to translate and validate Warmometer, a visual tool for assessing warmth in patient-provider relationships, for use in Brazilian Portuguese. DESIGN AND SETTING: Cross-sectional study conducted at an antenatal clinic of a public university hospital in São Paulo, Brazil. METHODS: The instrument was translated into Brazilian Portuguese and culturally adapted. It was tested for reliability and validity among 32 pregnant women, between June 2015 and January 2016. To assess construct validity, it was correlated with the Consultation and Relational Empathy (CARE) scale (gold standard for patient-provider relationships) and the Interpersonal Reactivity Index (IRI). RESULTS: The translated version of Warmometer had good face and content validity, low intra-observer reproducibility (intraclass correlation coefficient, ICC: 0.224; 95% confidence interval, CI -0.589 to 0.621;P = 0.242) and high inter-observer reproducibility (ICC: 0.952; 95% CI 0.902 to 0.977; P < 0.001). There was a strong correlation between Warmometer and CARE (r = 0.632) and a weak correlation between Warmometer and IRI (r = 0.105). CONCLUSIONS: Warmometer was translated, culturally adapted and validated for use in Brazilian Portuguese. The translated version is a reliable tool for assessing the degree of empathy perceived by the patient in a patient-provider relationship.

Empathy is a Stable Predictor of Compassionate Emotions Independent of an Attribution of Responsibility Manipulation / La empatía es un predictor estable de emociones compasivas independiente de una manipulación de atribución de responsabilidad

ABSTRACT The goal of the present research was to investigate if individual differences in empathy and personal distress were stable predictors of compassionate emotions and whether these emotions, in turn, mediate the effect of attribution on prosocial propensity. We formulated four hypotheses to be tested concerning direct and indirect effects between the variables in our model. 627 participants, mainly female (N = 408), were randomly assigned to one of two conditions in which we manipulated the attribution of responsibility of a target person (uncontrollability x controllability). Our results corroborated totally or partially all four hypotheses, indicating that empathy was a stable predictor of compassionate emotions and that these emotions mediated the effect of attribution on prosocial propensity. Notably, we found that empathy was an even stronger predictor of compassionate emotions compared to the attribution that participants made. We found evidence corroborating the assumption that these prosocial individual differences measures can predict the tendency to actually experience compassionate emotions in different situations. Thus, we conclude that the comprehension of prosocial decision-making and attribution processes underlying prosocial situations must take into account individual differences as antecedents of compassionate emotions.

RESUMEN El objetivo de la presente investigación fue evaluar si las diferencias individuales en empatía y angustia personal eran predictores estables de emociones compasivas y si estas emociones a su vez median el efecto de la atribución sobre la propensión prosocial. Hemos formulado cuatro hipótesis que se someterán a prueba por medio de los efectos directos e indirectos entre las variables del modelo. 627 participantes, principalmente mujeres (N = 408), fueron asignados aleatoriamente a una de las condiciones en las que manipulamos la atribución de responsabilidad (incontrolabilidad x controlabilidad). Nuestros resultados corroboraron total o parcialmente las cuatro hipótesis, indicando que la empatia es un predictor estable de emociones compasivas y que estas emociones mediaron el efecto de la atribución sobre la propensión prosocial. Es importante destacar que encontramos que la empatia fue un predictor aún más fuerte de emociones compasivas en comparación con la atribución que los participantes hicieron. Encontramos evidencias que corroboran el supuesto de que estas medidas de las diferencias individuales prosociales pueden predecir la tendencia a experimentar emociones compasivas en diferentes situaciones y concluimos que la comprensión de los procesos de toma de decisiones y de atribución prosociales subyacentes a las situaciones prosociales debe tener en cuenta las diferencias individuales como antecedentes de emociones compasivas.