What role does patient-reported compassion have on family physician ratings? A regression analysis and validation of the Sinclair Compassion Questionnaire (SCQ) in primary care

The main goal of this project was to begin validating the Sinclair Compassion Questionnaire – Primary Care (SCQ-PC) through confirmatory factor analysis (CFA) and to examine the unique contribution of patient-reported experiences of compassion on patient evaluations of their physicians and their overall patient quality care ratings and physician ratings. Additionally, we explored whether patients’ reported experiences of compassion in family medicine settings differed across sociodemographic groups (i.e., gender, ethnicity, age, marital status, Indigenous identification, employment status, and employment industry). Provincial data for this cross-sectional study were collected from a large primary care questionnaire from patients in Alberta, Canada. Data from 2291 family medicine patients (71% women, 28% men, 0.7% other genders) were provided by Health Quality Alberta and analyzed. The primary outcomes were patients’ overall quality care ratings for their most recent visit and patients' ratings of their family physician. Measures included sociodemographic and health-related items from the Health Quality Alberta’s Primary Care Patient Experience Survey. Confirmatory Factor Analysis (CFA) for the SCQ-PC demonstrated standardized factor loadings between .85 and .93. Global fit indices were χ 2 = 1610.49, p <.001, CFI = .97, RMSEA = .09, SRMR = .02. Stepwise hierarchical linear multiple regression indicated that among the 25 included variables, compassion the factor most strongly associated with physician ratings ( b =1.25, 95% CI [1.13, 1.38], p <.001, f 2 =0.25), and was also strongly associated with overall care ratings ( b =.53, 95% CI 0.47-0.59, p<.001, f 2 =0.23), explaining 9% and 4% unique variance beyond all other measures, respectively. One-way ANOVAs indicated significant demographic difference in mean compassion scores, such that unemployed (vs. retired) patients reported lower compassion (MD -.19, 95% CI [-0.01, -0.38], p =.040). The SCQ-PC is a valid and reliable tool for measuring patient-reported compassion in primary care. Compassion was identified as a key contributor to overall quality ratings and physician ratings in family medicine settings. Experiences of compassion varied by employment status. Our findings provide compelling evidence of the central role of compassion in primary care.