Abstract
BackgroundThe information provided in patient-centered care and shared decision-making influences patients’ concerns and adherence to treatment. In the decision-making process, patients experience decisional conflict. The Decisional Conflict Scale (DCS) is a 16-item, self-administered questionnaire consisting of 5 subscales developed to assess patients’ decisional conflict. This study aimed to develop the Japanese version of the DCS and to clarify the influence of the information provided by pharmacists’ on decisional conflict among patients with cancer.MethodsWe developed the Japanese version of the DCS by using the forward-backward translation method. One hundred patients who were recommended a new chemotherapy regimen were recruited. The psychometric properties of the Japanese DCS, including internal consistency, convergent validity, discriminant validity, and construct validity, were examined. We assessed the decisional conflict of patients before and after the pharmacists’ provision of information.ResultsNinety-four patients, predominately female, with an average age of 58.1 years were sampled. The scores on the 5 subscales of the DCS showed high internal consistency (Cronbach’s alpha = 0.84–0.96). Multi-trait scaling analysis and cluster analysis showed strong validity. The mean total DCS score decreased significantly from 40.2 to 31.7 after patients received information from the pharmacists (p < 0.001, paired t-test). Scores on all 5 subscales, namely, uncertainty, informed, values clarity, support, and effective decision, also significantly improved (p < 0.001 for all categories, paired t-test).ConclusionsThe psychometric properties of the Japanese version of the DCS are considered appropriate for it to be administered to patients with cancer. Pharmacists’ provision of information was able to decrease decisional conflict among patients with cancer who were recommended a new chemotherapy regimen.
Highlights
The information provided in patient-centered care and shared decision-making influences patients’ concerns and adherence to treatment
After a pilot test to evaluate problems about semantic, idiomatic, and cognitive issues by using a hypothetical scenario of treatment choice with 40 health care providers, including physicians, nurses, pharmacists, and medical processors, we finalized the Japanese version of the Decisional Conflict Scale (DCS)
We excluded the data of six patients from analysis due to deviation from protocol; two were not administered the second DCS and four completed only one side of a double-sided questionnaire
Summary
The information provided in patient-centered care and shared decision-making influences patients’ concerns and adherence to treatment. This study aimed to develop the Japanese version of the DCS and to clarify the influence of the information provided by pharmacists’ on decisional conflict among patients with cancer. O’Connor et al defined a state of uncertainty concerning which course of action to take as decisional conflict and developed the Decisional Conflict Scale (DCS) to evaluate the decisional conflict that patients experience regarding the health care decision-making process [9]. The DCS is divided into five subscales of uncertainty, informed, values clarity, support, and effective decisionmaking, and is composed of 16 items that use a 5-point Likert-type response (i.e., strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree). Previous studies have indicated that decisions supporting intervention can ameliorate decisional conflict [10]
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