Cross-cultural adaptation and psychometric assessment of the statement format Decisional Conflict Scale for Mandarin version

Cui Lu,Fei Han,Yue-Xian Shi,Ying-Hui Jin,Ge Li,Yan Li,Wei Mu,Tian Xia

doi:10.1186/s12913-019-4717-6

Abstract

BackgroundThe statement format of the Decisional Conflict Scale (sf-DCS) is designed and widely used to assess patients’ state of uncertainty during health related decision making. As yet no Mandarin version of the sf-DCS has been produced. This study aims to produce the first Mandarin version of the sf-DCS and test its validity and reliability in mainland China.MethodsThe translation and cross-cultural adaptation of the original English version of the sf-DCS into Mandarin was carried out in accordance with previously published guidelines. The psychometric properties of sf-DCS were assessed in two hypothesized decision-making contexts through online surveys.ResultsIn the online survey designed to test scale validity and reliability, 437 people responded to the influenza immunization survey and 238 responded to the breast cancer screening survey. The results confirm that the Mandarin version of sf-DCS has good criteria validity and the exploratory factor analysis suggested a fitted revised five factors model by removing three items. Respondents who were “unsure” about their decisions/intentions, had read less information, and reported lower self-perceived prior knowledge level scored higher on sf-DCS. The Cronbach’s alpha for the sf-DCS total score was 0.963 and that for each subscale ranged from 0.784 to 0.937 in both decision making contexts, and the test-retest correlation coefficient was 0.528.ConclusionsThe Mandarin version of sf-DCS has good criteria validity and its internal consistency is satisfactory. Our analysis suggests a refinement of the original sf-DCS’s factor structure is needed.

Highlights

The statement format of the Decisional Conflict Scale is designed and widely used to assess patients’ state of uncertainty during health related decision making
Over the past two decades, it has been widely used as a measurement tool to assess the effect of decision support interventions, especially Patient Decision Aids (PDAs) [2,3,4]
To facilitate the patient’s safe self-stewardship in the face of uncertainty, it is very important to assess personal perceptions of uncertainty in choosing options and modifiable factors contributing to uncertainty such as feeling uninformed or unclear about personal values and unsupported in decision making [1], which is the precise purpose of the Decisional Conflict Scale (DCS)

Summary

Introduction

The statement format of the Decisional Conflict Scale (sf-DCS) is designed and widely used to assess patients’ state of uncertainty during health related decision making. This study aims to produce the first Mandarin version of the sf-DCS and test its validity and reliability in mainland China. The Decisional Conflict Scale (DCS) was first developed in 1995 for measuring perceptions of uncertainties in the study of patient’s personal healthcare decision-making process [1]. To facilitate the patient’s safe self-stewardship in the face of uncertainty, it is very important to assess personal perceptions of uncertainty in choosing options and modifiable factors contributing to uncertainty such as feeling uninformed or unclear about personal values and unsupported in decision making [1], which is the precise purpose of the DCS.

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Conclusion