Measuring Measures of Compassion: What is the Most Valid and Reliable Compassion Scale?

Dr. Shane Sinclair

March 2, 2022

A Report Card of Compassion Measures?

After publishing the results of the development and validation of the Sinclair Compassion Questionnaire (SCQ), we wanted to determine how the SCQ compared to other compassion scales that are currently available and to determine what is the most valid and reliable measure of compassion. We did this by updating our previous systematic review that we conducted prior to developing the SCQ, to determine the gaps, strengths, and limitations within the field. At that time, the highest scoring compassion measure scored only 38/100 on the EMPRO, a valid and reliable tool for Evaluating Measures of Patient-Reported Outcomes, causing us to conclude, that at that time, there were no existing compassion scales that measured compassion in a comprehensive and methodologically rigorous fashion. The results of our updated review*, which included both new measures and subsequent research on previously identified measures, indicate that this has now changed--with the SCQ being identified as the most valid and reliable compassion measure for research, practice, and healthcare system evaluation.

Lessons Learned: Establishing Construct Validity,  Patient Engagement, and Adhering to Measure Development Guidelines

With the exception of the SCQ, limitations of existing compassion measures were significant and prevalent, undermining their validity and clinical utility in the process. A chief limitation was poor construct validity, whereby the concept of interest--compassion, was poorly defined and conflated with other concepts such as empathy, sympathy, self-compassion, and routine care--resulting in measures that sat on a shaky conceptual foundation. While we identified four measures that were patient reported compassion measures, in contrast to healthcare provider assessments of their perceived ability in providing compassion to their patients, only the SCQ included the voice of patients across each stage of measure development. Additionally, the majority of existing measures did not adhere to measure development guidelines, further compromising their rigor and utility. As a result, only the SCQ, met the EMPRO's threshold for a valid and reliable measure.

A New Gold Standard in Measuring Compassion

Overall, out of the gate, the SCQ scored 9 points higher than its closest competitor in overall EMPRO scores, while achieving perfect EMPRO scores for the most important sub-scales of internal consistency, reliability, validity, and respondent burden--which were up to 43 points higher than any other compassion measure. What makes these results all the more impressive is the fact that these other measures had the advantage of up to a ten year head start to conduct additional research to assess responsiveness, interpretability, and alternate modes of administration--measure and development criteria that can only be assessed after a measure is developed, yielding additional points on the EMPRO as a result. Now that the SCQ has been developed, achieving near perfect scores across each of these initial criteria, its' responsiveness, interpretability and alternate modes of administration can now be determined, driving the SCQ's EMPRO scores even higher and further distinguishing it as the compassion measure of choice.

As the new gold standard compassion measure, the SCQ recasts the empirical foundation for research focused on assessing and improving compassion, while also providing healthcare leaders and providers with an evidence based, clinically relevant, patient-informed tool to measure compassion in real time clinical care. To learn more about this systematic review; the development and validation of the SCQ; how to use, score, and interpret the SCQ; or to obtain it for research, practice and systems evaluation be sure to check out the links below.

Open Access Research Article:

SCQ Video Tutorials: The Sinclair Compassion Questionnaire

Compassion Measure Website:

*This research article was recognized on Springer's 2022 top 10 list of most read articles in the journal The Patient - Patient-Centred Outcomes Research

Photo by Elisa Michelet on Unsplash

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