Journal of Education and Health Promotion

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.

Abstract BACKGROUND: Tobacco use is a disease of addiction and a behavior choice. It is valuable to
understand the psychosocial dimension of disease.
OBJECTIVES: The research aimed to assess the (I) behavioral determinants and pattern of tobacco
use (II) readiness to quit tobacco among patients with oral potentially malignant disorders (OPMDs)
using transtheoretical model (TTM) approach visiting the dental college in Goa, India.
MATERIALS AND METHODS: This cross‑sectional analytical study was conducted among
300 patients over 3 months. Information about sociodemographics, determinants including age
and reason of onset, behavioral stages, and the presence of OPMDs was collected using specially
designed pro forma. Descriptive and inferential statistics were performed using SPSS 18.0.
RESULTS: Smokeless form of tobacco 199 (66.34%) was most prevalent followed by smoking
79 (26.33%) and dual tobacco use 22 (07.33%) in males. Majority belonged to low socioeconomic
class. Peer influence was the most‑cited reason. Around 1/3rd of the participants had OPMDs
associated with tobacco use. Significant association was observed between the presence of OPMDs
and TTM behavioral stages. Patients with OPMDs are more motivated for tobacco cessation
(odd’s ratio = 2.30, P = 0.002), that is, they are more in preparation and action stages.
CONCLUSION: The findings reflect that smokeless tobacco use is more prevalent in males with low
level of education and socioeconomic class. Readiness to quit tobacco increases among patients
with OPMDs using TTM.