The decision evaluation scales

Abstract

There are several instruments to assess how patients evaluate their medical treatment choice. These are used to evaluate decision aids. Our objective is to investigate which psychological factors play a role when patients evaluate their medical treatment choices. A pool of 36 items was constructed, covering concepts such as uncertainty about and satisfaction with the decision, informed choice, effective decision making, responsibility for the decision, perceived riskiness of the choice, and social support regarding the decision. This pool was presented to patients at high risk for breast and ovarian cancer, awaiting a genetic test result, and facing the choice between prophylactic surgery or screening. Additional measures were assessed for validation purposes. Factor and Rasch analyses were used for factor and item selection. Construct validity of emerging scales was assessed by relating them with the additional measures. Three factors summarised the psychological factors concerning decision evaluation: Satisfaction-Uncertainty, Informed Choice, and Decision Control. Reliabilities (Cronbach's a) of the three scales were 0.79, 0.85, and 0.75, respectively. Construct validity hypotheses were confirmed. The first two scales were similar to previously developed scales. Of these three scales, the Decision Control scale correlated most strongly with the well-being measures, was associated with partner's agreement and physician's preferences as perceived by patients, and with a negative emotional reaction to the information material. In conclusion, the Decision Control scale is a new scale to evaluate decision aids, and it appears to be rooted in health psychological theories.

Measuring (shared) decision-making – a review of psychometric instruments

“…Items relate to the dimensions 'satisfaction -uncertainty' (Cronbach's a ¼ .79), 'informed choice' (Cronbach's a ¼ .85) and 'decision control' (Cronbach's a ¼ .75) [41]. All factors of this Dutch scale proved to be internally consistent.…”

“…All factors of this Dutch scale proved to be internally consistent. Associations exist between the scales and a high strength of treatment preference (r ¼ 0.36À0.64), improvements in anxiety (r ¼ À0.25-À0.40), depression (r ¼ À0.15-À0.30) and general health (r ¼ 0.20) as well as with subjective knowledge (r ¼ 0.19À0.52), amount of information (r ¼ 0.23 -0.61) and satisfaction with information quality (r ¼ 0.22-0.58) [41].…”

Patient involvement in treatment decision-making: The case for a broader conceptual framework

“…Several models of different forms of patient involvement in decision-making have been elucidated [18][19][20], and a number of measures of patient involvement or associated concepts have been developed [9,21,22]. While these have been helpful in stimulating and supporting discussion, practice development and research, they have often focused quite narrowly on particular aspects of involvement and decision-making.…”

Cross-cultural validation of the Decisional Conflict Scale in a sample of French patients

“…In the present context, where patients themselves are becoming more involved in decision making processes, several instruments have been proposed to assess the effects of these practices [1]. The conflict associated with decision making is one of the main issues for which suitable means of measurement need to be found.…”