Ju, Yu-JengYu-JengJuLee, Meng-LinMeng-LinLeeChen, Jou-ChiehJou-ChiehChenWang, Yi-ChingYi-ChingWangChen, Chih-PingChih-PingChenTsai, Han-EnHan-EnTsaiWu, Tzu-YiTzu-YiWuCHING-LIN HSIEH2025-10-292025-10-292025-07https://scholars.lib.ntu.edu.tw/handle/123456789/733193The Empathic Communication Coding System (ECCS) is a promising measure of such behaviors, yet its reliability remains largely unestablished. The aim of the study was to examine the intra-rater and inter-rater reliability of the ECCS. Methods: Transcripts of occupational therapy audio recordings were used to examine the reliabilities. Two occupational therapists were trained to evaluate the data for inter-rater reliability, and one of them evaluated the data twice for intra-rater reliability. Transcripts of 20 patients treated by 18 therapists were evaluated for intra-rater reliability. Transcripts of 25 patients treated by 22 occupational therapy interns were evaluated for inter-rater reliability. Adult rehabilitated patients with basic verbal communication ability were recruited. The percentage of agreement and Cohen’s κ were calculated as the indices of reliability. Results: The results showed acceptable intra-rater reliability but poor inter-rater reliability of the ECCS. Conclusions: The ECCS demonstrates potential as a reliable tool for assessing empathic behaviors over time when evaluated by the same raters.enAssessmentEmpathic Communication Coding Systemempathyoccupational therapyreliability[SDGs]SDG3journal article10.1177/0308022625131436740599214