Patients and Observers Perceptions of Involvement Differ. Validation Study on Inter-Relating Measures for Shared Decision Making 英文参考文献.docVIP

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Patients and Observers Perceptions of Involvement Differ. Validation Study on Inter-Relating Measures for Shared Decision Making 英文参考文献.doc

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Patients and Observers Perceptions of Involvement Differ. Validation Study on Inter-Relating Measures for Shared Decision Making 英文参考文献

Patients’andObservers’PerceptionsofInvolvement Differ.ValidationStudyonInter-RelatingMeasuresfor SharedDecisionMaking Ju¨rgenKasper1,2*,ChristophHeesen1,SaschaKo¨pke3,GaryFulcher4,FriedemannGeiger5,6 1InstituteofNeuroimmunologyandClinicalMSResearch(INiMS),UniversityMedicalCenterHamburg,Hamburg,Germany,2UnitofHealthSciencesandEducation,MIN- Faculty,UniversityofHamburg,Hamburg,Germany,3MIN-Faculty,InstituteofHealthSciencesandEducation,UniversityofHamburg,Hamburg,Germany,4MSAustralia NSW,Lidcombe,Australia,5TumorCenter,UniversityMedicalCenterSchleswig-Holstein,Kiel,Germany,6DepartmentofPediatrics,UniversityMedicalCenterSchleswig- Holstein,Kiel,Germany Abstract Objective: Patient involvement into medical decisions as conceived in the shared decision making method (SDM) is essential in evidence based medicine. However, it is not conclusively evident how best to define, realize and evaluate involvementtoenablepatientsmakinginformedchoices.Weaimedatinvestigatingtheabilityoffourmeasurestoindicate patient involvement. While use and reporting of these instruments might imply wide overlap regarding the addressed constructs this assumption seems questionable with respect to the diversity of the perspectives from which the assessmentsareadministered. Methods: The study investigated a nested cohort (N=79) of a randomized trial evaluating a patient decision aid on immunotherapy for multiple sclerosis. Convergent validities were calculated between observer ratings of videotaped physician-patient consultations (OPTION) and patients’ perceptions of the communication (Shared Decision Making Questionnaire,ControlPreferenceScaleDecisionalConflictScale). Results: OPTION reliability was high to excellent. Communication performance was low according to OPTION and high accordingtothethreepatientadministeredmeasures.Nocorrelationswerefoundbetweenobserverandpatientjudges, neitherformeansnorforsingleitems.Patientreportmeasuresshowedsomemoderatecorrelations. Conclusion:ExistingSDMmeasuresdono