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Sánchez-Torres A, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. Validity and reliability of the Spanish version of the consultation and relational empathy measure in dental students (Sp-Dent-CARE): A cross-sectional study. Eur J Dent Educ 2024; 28:267-274. [PMID: 37649221 DOI: 10.1111/eje.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION An evaluation was made of the psychometric properties of a Spanish version of the Consultation and Relational Empathy Measure (CARE) to assess relational empathy in undergraduate dental students. In addition, the influence of demographic, socio-economic and consultation-related factors upon the degree of perceived empathy and overall satisfaction was studied. MATERIALS AND METHODS A cross-sectional study was carried out in patients seen in the Oral Surgery Unit by fourth year dental students. Dentists, specialized translators and psychologists developed the translation of the questionnaire. After a pilot test, a convenience sample of patients was included. Construct validity was tested by factor analysis using principal component analysis with varimax rotation and Kaiser standardization, and internal consistency was assessed by Cronbach's α. RESULTS Two pilot tests were carried out with a panel of experts until the final version of the questionnaire was established. In the validation stage, 191 patients participated (92 men and 99 women), with a mean age of 52.5 ± 17 years. The mean score of the CARE measure was 47.2 ± 4.4, and 57.6% of the patients (n = 110) reported the maximum score on the questionnaire. The final version showed a 1-factor solution explaining 68.6% of the total variance, with excellent final internal consistency (α = 93.4%). CONCLUSION The Spanish version of the CARE measure affords high reliability and validity in assessing relational empathy in dental students. Perceived empathy is related to overall satisfaction. Patient demographics and the number of visits do not influence perceived empathy.
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Affiliation(s)
- Alba Sánchez-Torres
- Department of Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Octavi Camps-Font
- Department of Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rui Figueiredo
- Department of Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Department of Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- IDIBELL Institute, L'Hospitalet de Llobregat, Barcelona, Spain
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Dufayet L, Piot MA, Geoffroy PA, Oulès B, Petitjean-Brichant C, Peiffer-Smadja N, Bouzid D, Tran Dinh A, Mirault T, Faye A, Lemogne C, Ruszniewski P, Peyre H, Vodovar D. CARECOS study: Medical students' empathy as assessed with the CARE measure by examiners versus standardized patients during a formative Objective and Structured Clinical Examination (OSCE) station. Med Teach 2024:1-9. [PMID: 38285021 DOI: 10.1080/0142159x.2024.2306840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To assess the Consultation And Relational Empathy (CARE) measure as a tool for examiners to assess medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), as the best tool for assessing empathy during OSCEs remains unknown. METHODS We first assessed the psychometric properties of the CARE measure, completed simultaneously by examiners and standardized patients (SP, either teachers - SPteacher - or civil society members - SPcivil society), for each student, at the end of an OSCE station. We then assessed the qualitative/quantitative agreement between examiners and SP. RESULTS We included 129 students, distributed in eight groups, four groups for each SP type. The CARE measure showed satisfactory psychometric properties in the context of the study but moderate, and even poor inter-rater reliability for some items. Considering paired observations, examiners scored lower than SPs (p < 0.001) regardless of the SP type. However, the difference in score was greater when the SP was a SPteacher rather than a SPcivil society (p < 0.01). CONCLUSION Despite acceptable psychometric properties, inter-rater reliability of the CARE measure between examiners and SP was unsatisfactory. The choice of examiner as well as the type of SP seems critical to ensure a fair measure of empathy during OSCEs.
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Affiliation(s)
- Laurene Dufayet
- UFR de médecine, Université Paris Cité, Paris, France
- Unité Médico-judiciaire, Hôtel-Dieu, AP-HP, Paris, France
- Centre Antipoison de Paris, Hôpital Fernand-Widal, AP-HP, Paris, France
- INSERM, UMRS-1144, Faculté de pharmacie, Paris, France
| | - Marie-Aude Piot
- UFR de médecine, Université Paris Cité, Paris, France
- Département de psychiatrie de l'enfant et de l'adolescent, Hôpital Necker, AP-HP, Paris, France
- INSERM, UMR 1018, Université Paris-Saclay, Villejuif cedex, France
| | - Pierre-Alexis Geoffroy
- UFR de médecine, Université Paris Cité, Paris, France
- Département de psychiatrie et d'addictologie, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
- Psychiatrie & Neurosciences, Hôpital Saint-Anne, GHU Paris, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Bénédicte Oulès
- UFR de médecine, Université Paris Cité, Paris, France
- Service de dermatologie, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Clara Petitjean-Brichant
- Département de psychiatrie et d'addictologie, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- UFR de médecine, Université Paris Cité, Paris, France
- Service de maladies infectieuses et tropicales, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
- Université Paris Cité, INSERM UMR1137, IAME, Paris, France
| | - Donia Bouzid
- UFR de médecine, Université Paris Cité, Paris, France
- Université Paris Cité, INSERM UMR1137, IAME, Paris, France
- Service d'accueil des urgences, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Alexy Tran Dinh
- UFR de médecine, Université Paris Cité, Paris, France
- Département d'anesthésie-réanimation, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Tristan Mirault
- UFR de médecine, Université Paris Cité, Paris, France
- Service de médecine vasculaire, Hôpital Européen Georges Pompidou, Paris, France
| | - Albert Faye
- UFR de médecine, Université Paris Cité, Paris, France
- Service de Pédiatrie générale, Maladies infectieuses et Médecine interne, Hôpital Robert Debré, AP-HP, Paris, France
| | - Cédric Lemogne
- UFR de médecine, Université Paris Cité, Paris, France
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Center for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Paris, France
| | - Philippe Ruszniewski
- UFR de médecine, Université Paris Cité, Paris, France
- Service de gastro-entérologie et pancréatologie, Hôpital Beaujon AP-HP, Clichy, France
| | - Hugo Peyre
- UFR de médecine, Université Paris Cité, Paris, France
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital Robert Debré, APHP, Paris, France
- INSERM UMR 1141, Université Paris Cité, Paris, France
| | - Dominique Vodovar
- UFR de médecine, Université Paris Cité, Paris, France
- Centre Antipoison de Paris, Hôpital Fernand-Widal, AP-HP, Paris, France
- INSERM, UMRS-1144, Faculté de pharmacie, Paris, France
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Tranberg M, Ekedahl H, Fürst CJ, Engellau J. The influence of "bad news" and "neutral/good news" on patients' perception of physician empathy during oncology consultations. Cancer Med 2024; 13:e6903. [PMID: 38164055 PMCID: PMC10807689 DOI: 10.1002/cam4.6903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Being met with empathy increases information sharing, treatment coherence, and helps patients to recover faster. However, we do not know how the content of the conversation about disease progression, new treatments, or other issues concerning serious illness affects patients' perceptions of the physician's empathy, and thus, the quality of the conversation. This study aimed to test the hypothesis that patients will rate their physician lower following a "bad news" consultation using the consultation and relational empathy (CARE) measure. METHODS A total of 186 outpatients from the Department of Oncology were recruited for this study. After meeting with a patient, the physician filled out a form, placing the patient in either the "bad news" group, or the "neutral/good news" group along with information about the patient and the consultation. The patient was given the CARE measure after the visit. RESULTS The patients who had received bad news rated their physicians a significantly lower score on the CARE measure, even though the effect size was small, than those who had neutral/good news. On average, bad news consultations were 11 min longer. CONCLUSIONS Physicians need to be aware of the patients' need to be known and understood, in addition to having skills to attend to emotional cues and concerns, since the current study's finding could be a sign either of the content being projected onto the physician or that the physician is focused on the message rather than on the patient.
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Affiliation(s)
- Mattias Tranberg
- Division of Palliative Care, Department of Clinical Sciences LundLund UniversityLundSweden
- The Institute for Palliative Care at Lund University and Region SkåneLundSweden
| | - Henrik Ekedahl
- Department of OncologySkåne University HospitalLundSweden
| | - Carl Johan Fürst
- Division of Palliative Care, Department of Clinical Sciences LundLund UniversityLundSweden
- The Institute for Palliative Care at Lund University and Region SkåneLundSweden
| | - Jacob Engellau
- Department of OncologySkåne University HospitalLundSweden
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Dobransky J, Gartke K, Pacheco-Brousseau L, Spilg E, Perreault A, Ameen M, Finless A, Beaulé PE, Poitras S. Relationship Between Orthopedic Surgeon's Empathy and Inpatient Hospital Experience Scores in a Tertiary Care Academic Institution. J Patient Exp 2020; 7:1549-1555. [PMID: 33457613 PMCID: PMC7786763 DOI: 10.1177/2374373520968972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Studies have examined the relationship between physician empathy and patient experience, but few have explored it in surgeons. The purpose of this study was to report on orthopedic surgeon empathy in a mutlispecialty practice and explore its association with orthopedic patient experience. Patients completed the consultation and relational empathy (CARE) measure (March 2017-August 2018) and Canadian Patient Experience Survey-Inpatient Care (CPES-IC; March 2017-February 2019) to assess empathy and patient experience, respectively. Consultation and relational empathy measures were correlated to CPES-IC for 3 surgeon-related questions pertaining to respect, listening, and explaining. Surgeon CARE scores (n = 1134) ranged from 42.0 ± 9.1 to 48.6 ± 2.4 with 50.4% of patients rating their surgeon as perfectly empathic. There were no significant differences between surgeons for CPES-IC continuous and topbox scores (n = 834) for respect and correlations between CPES-IC questions. The CARE measure for both continuous and topbox scores were weak to moderate, but none were significant. Empathy was associated with surgeon respect and careful listening, despite lack of significant correlation. Possible future work could use an empathy tool more appropriate for this surgeon population.
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Affiliation(s)
- Johanna Dobransky
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kathleen Gartke
- Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lissa Pacheco-Brousseau
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Physiotherapy, School of Rehabilitation, University of Ottawa, Ottawa, Ontario, Canada
| | - Edward Spilg
- Division of Geriatrics, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Ashley Perreault
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Mohammad Ameen
- Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Alexandra Finless
- Division of Orthopaedic Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, Department of Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Stéphane Poitras
- Department of Physiotherapy, School of Rehabilitation, University of Ottawa, Ottawa, Ontario, Canada
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Rajput S, Kumar A, Puranik MP, Shanbhag N. Exploring the educational opportunity and implementation of CARE among dental students in India. J Educ Health Promot 2020; 9:249. [PMID: 33209941 PMCID: PMC7652080 DOI: 10.4103/jehp.jehp_22_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/17/2020] [Indexed: 06/11/2023]
Abstract
CONTEXT Empathy is considered to be backbone of the patient-physician relationship. The consultation and relational empathy (CARE) measure is widely used internationally to measure empathy. However, no validated tool is available to gather patient feedback on dentists' empathy in India. OBJECTIVE The objective of this study was to explore the reliability and validity of a CARE measure and to assess the factors influencing CARE score and to determine if there was an association between their CARE score and satisfaction of the patient. SETTING AND DESIGN A cross-sectional study was done in dental colleges. SUBJECTS AND METHODS A questionnaire study was carried out among 100 patients from 6 dental colleges in Bangalore using validated CARE measure. STATISTICAL ANALYSIS Internal consistency of items was evaluated by the Cronbach's alpha, and construct validity was assessed by confirmatory factor analysis. Satisfaction was assessed by a question response on 5-point Likert scale. Descriptive and inferential statistics were performed with significance set at 5%. RESULTS The mean CARE score was 43.80 ± 5.36. Internal reliability was high (Cronbach's alpha: 0.859) and was reduced by the removal of any of 10 items. High corrected item-total correlations ranged from 0.752 to 0.847. Factor analysis showed a single solution with high item loadings (>0.80). Self-perception of overall health (odds ratio [OR] = 3.78), relationship with family (OR = 4.61) and friends (OR = 3.78), and previous dental experience (OR = 16.00) were more likely, whereas dentist-provided treatment (OR = 0.20), number (OR = 0.07) and dental treatment taken (OR = 0.13), presence of anxiety (OR = 0.03), and fear (OR = 0.05) were less likely to have CARE score. The satisfaction of the patient regressed significantly with the relationship with family members (ß = 0.77) and CARE score (ß = 0.21). CONCLUSION This study confirms the educational opportunity and implementation of CARE in dental students. CARE scores among patients varied depending on personal factors and dental treatment-related factors. The satisfaction of the patient was influenced by the relationship with family members and CARE scores.
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Affiliation(s)
- Soni Rajput
- Department of Community Dentistry, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Amit Kumar
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Manjunath P. Puranik
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Namita Shanbhag
- Department of Public Health Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India
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Hannan J, Sanchez G, Musser ED, Ward-Peterson M, Azutillo E, Goldin D, Lara EG, Luna AM, Galynker I, Foster A. Role of empathy in the perception of medical errors in patient encounters: a preliminary study. BMC Res Notes 2019; 12:327. [PMID: 31182161 PMCID: PMC6558753 DOI: 10.1186/s13104-019-4365-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/05/2019] [Indexed: 11/10/2022] Open
Abstract
Objective Healthcare professionals’ empathy have been empirically demonstrated to decrease the risk of medical errors. Medical errors affect patient’s outcomes and healthcare providers’ well-being. Therefore, the purpose of this study was to determine the relationship between patients’ perception of healthcare providers’ empathy, their intention to adhere to treatment, and their perception of medical errors made. An anonymous survey was emailed to staff at a health center and an urban university in Miami, Florida, USA. Results A total of 181 participants were enrolled. Participants rating their healthcare provider as high in empathy had 80% lower odds of reporting errors (CI 0.04–0.6). The intention to follow-up with recommendations or return to the provider were not significantly associated with provider’s empathy. Patients of high empathy providers were no more treatment adherent that those who rated their provider with low empathy but were less likely to perceive medical error. Providers’ empathy significantly affected patients’ perception of medical errors. Our results underscore that healthcare curricula need to address the link between empathy and perception of medical errors, including its potential legal implications.
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Affiliation(s)
- Jean Hannan
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11200 SW 8th Street, Academic Health Center 3 Office 324A, Miami, FL, 33199, USA.
| | - Gabriel Sanchez
- Citrus Health Network/Florida International University, 4175 West 20th Ave, Hialeah, FL, 33012, USA
| | - Erica D Musser
- Center for Children and Families, 11200 SW 8th Street, AHC 4, Room 455, Miami, FL, 33199, USA
| | - Melissa Ward-Peterson
- Department of Epidemiology, Florida International University, Robert Stempel College of Public Health & Social Work, 11200 SW 8th Street, AHC5-483, Miami, FL, 33199, USA
| | - Elizabeth Azutillo
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11200 SW 8th Street, Academic Health Center 3 Office 324A, Miami, FL, 33199, USA
| | - Deana Goldin
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, 11200 SW 8th Street, AHC 3 Office 228, Miami, FL, 33199, USA
| | - Edgar Garcia Lara
- Miami Dade College Benjamin Leon School of Nursing, 950 NW 20th Street, Miami, FL, 33127, USA
| | - Aniuska M Luna
- Department of Psychiatry & Behavioral Health, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, AHC4 280, Miami, FL, 33199, USA
| | - Igor Galynker
- Icahn School of Medicine, Beth Israel-Fierman, 317 E 17th St, New York, NY, 10003, USA
| | - Adriana Foster
- Department of Psychiatry & Behavioral Health, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, AHC1 335A, Miami, FL, 33199, USA
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Bikker AP, Fitzpatrick B, Murphy D, Forster L, Mercer SW. Assessing the Consultation and Relational Empathy (CARE) Measure in sexual health nurses' consultations. BMC Nurs 2017; 16:71. [PMID: 29204104 PMCID: PMC5702142 DOI: 10.1186/s12912-017-0265-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/13/2017] [Indexed: 12/30/2022] Open
Abstract
Background Increasingly healthcare policies emphasise the importance of person-centred, empathic care. Consequently, healthcare professionals are expected to demonstrate the ‘human’ aspects of care in training and in practice. The Consultation and Relational Empathy (CARE) Measure is a patient-rated measure of the interpersonal skills of healthcare practitioners. It has been widely validated for use by healthcare professionals in both primary and secondary care. This paper reports on the validity and reliability of the CARE Measure with sexual health nurses. Methods Patient questionnaires were collected for 943 consultations with 20 sexual health nurses. Participating patients self-completed the questionnaire immediately after the encounter with the nurse. The questionnaire included the ten item CARE Measure, the Patient Enablement Index, and overall satisfaction instruments. Construct validity was assessed through Spearman’s correlation and principal component analysis. Internal consistence was assessed through Cronbach’s alpha and the inter-rater reliability through Generalisability Theory. Data were collected in 2013 in Scotland. Results Female patients completed 68% of the questionnaires. The mean patient age was 28.8 years (standard deviation 9.8 years). Two of the 20 participating nurses withdrew from the study. Most patients (71.7%) regarded the CARE Measure items as very important to their consultation and the number of ‘not applicable’ and missing responses’ were low (2.6% and 0.1% respectively). The participating nurses had high CARE Measure scores; out of a maximum possible score of 50, the overall mean CARE measure score was 47.8 (standard deviation 4.4). The scores were moderately correlated with patient enablement (rho = 0.232, p = 0.001) and overall satisfaction (rho = 0.377, p = 0.001. Cronbach’s alpha showed the measure’s high internal consistency (Cronbach’s alpha coefficient = 0.95), but the inter-rater reliability could not be calculated due to the high achieved CARE Measure scores that varied little between nurses. Conclusions Within this clinical context the CARE Measure has high perceived relevance and face validity. The findings support construct validity and some evidence of reliability. The high CARE Measure scores may have been due to sample bias. A future study which ensures a representative sample of patients on a larger group of nurses is required to determine whether the measure can discriminate between nurses.
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Affiliation(s)
- Annemieke P Bikker
- Usher Institute for Population Sciences and Informatics, The University of Edinburgh, 9 BioQuarter, Little France Road, Edinburgh, EH16 4UX UK
| | - Bridie Fitzpatrick
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX UK
| | - Douglas Murphy
- School of Medicine, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF UK
| | - Lorraine Forster
- Sandyford Sexual Health Services, 2-6 Sandyford Place, Glasgow, G3 7NB UK
| | - Stewart W Mercer
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX UK
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