Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

Abstract

Background Decisional regret during or after medical treatments is linked to significant distress. Regret affects not only patients but also caregivers having an active or passive role during decision making. The Decision Regret Scale (DRS) is a self‐report measure for regret in patients after treatment decisions. However, practical and psychometrically robust instruments assessing regret in caregivers are lacking. Objective To develop and validate a caregiver version of the DRS (Decision Regret Scale for Caregivers [DRS‐C]). Design Psychometric validation based on a web survey. Setting and participants 361 caregivers of deceased German people/patients with cancer. Main variables studied Besides structural validity and test‐retest reliability, we evaluated measurement invariance accounting for gender, age and closeness of relationship, and tested hypotheses on convergent/discriminant validity. Results Forty‐five per cent of all caregivers demonstrated decision regret. Confirmatory factor analyses strongly supported the unidimensional structure of the DRS‐C and pointed to strict invariance. The DRS‐C demonstrated very good internal consistency (α = 0.83, 95% CI [0.81, 0.86]) and test‐retest reliability (ICC [A,1] = 0.73, 95% CI [0.59, 0.83]) along with sound convergent/discriminant validity. Concerning responsiveness, DRS‐C scores remained stable over a 12‐week period in 83.3% of all caregivers. Receiver operating characteristic analysis yielded a cut point of 43 for the identification of significant decision regret (AUC = 0.62, 95% CI [0.56, 0.68]). Discussion and conclusions The lack of a gold standard instrument prevented us from examining the criterion validity and determining a minimally important difference. Nevertheless, the DRS‐C provides valid and reliable information regarding caregiver regret following medical decisions. Above all, it captures a crucial aspect of the treatment experience in caregivers.

Psychometric Evaluation of the Chinese Version of the Decision Regret Scale

“…Joseph-Williams et al (2010) also indicated that Items 2 and 4 focusing on different targets of the regret concept might affect the structure of the DRS. Though limited, the evidence of inconsistencies in measuring decisional regret when using the DRS was also reported by another study (Haun et al, 2019). Additionally, reversed wording might be another reason that affected the construct of the DRS.…”

“…The previous findings regarding the reproducibility of measuring regret are mixed. Haun et al (2019) indicated that the reproducibility of DRS was good for caregivers when using an average time interval of 12 weeks. However, another study showed that patients usually change their attitudes toward the original medical decisions (Becerra Pérez et al, 2016).…”

“…A receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff point of the DRSc (Haun et al, 2019). The ROC curve graphically presents the test's ability to correctly identify the "true-positive" and "true-negative" individuals for various test cutoff points (Haun et al, 2019). We estimated the area under the ROC (AUC) and determined the optimal point based on the Youden index.…”

Assessment of Factors Associated With Parental Perceptions of Voluntary Decisions About Child Participation in Leukemia Clinical Trials

“… 27 The scale has been validated in both adult oncology patients and their caregivers. 28 Acculturation was assessed using the Short Acculturation Scale for Hispanics, which evaluates factors of language use, media, and social relations among Hispanic individuals, 18 with scores ranging from 12 to 60 (lower scores indicating lower levels of acculturation). The NVS and the Short Acculturation Scale for Hispanics were validated in English and Spanish.…”

The era of the digital natives is approaching: Insights into online peer-to-peer support for persons affected by prostate cancer

“…In doing so, providers will not only account for the current body of evidence but also prepare the ground for a true shared decision-making process. Finally, with existing studies underscoring the feasibility of interventional trials in the context of OPS, clinical researchers should initiate well-designed and sufficiently powered RCTs accounting for patient and caregiver outcomes [ 10 ]. The worst-case scenario would be the expectable increase of OPS use without reliable evidence on its effects.…”