Methods Inf Med - Trying to optimise the German version of the OPTION scale regarding the dyadic aspect of shared decision making.

Tópicos

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Resumo

JECTIVES: The OPTION scale ("observing patient involvement in decision making") assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorporate active patient behavior in consultations.METHODS: Modification was done on scoring level, attempting a dyadic, relationship-centred approach in that high ratings can be evoked also by the behaviour of active patients. The German version of the OPTION scale was compared with a modified version by analysing video recordings of primary care consultations dealing with cardiovascular prevention. Fifteen general practitioners provided 40 videotaped consultations. Videos were analysed by two rater pairs and two experts in shared decision making (SDM).RESULTS: Reliability measures of the modified version were lower than those of the original scale. Significant associations of the dichotomised scale with the expert SDM rating as well as with physicians' expertise in SDM were only found for the modified OPTION scale. Receiver Operating Characteristic (ROC) analyses confirmed a valid differentiation between the presence of SDM (yes/no) on total score level, even though the cut-off point was quite low. Standard deviations of the single items in the modified version were higher compared to the original OPTION scale, while the means of total scores were similar.CONCLUSIONS: The original OPTION scale is physician-centered and neglects the activity and a possible self-involvement of the patient. Our modified instruction was able to capture the dyadic element partially. The development of a separate dyadic instrument might be more promising.

Resumo Limpo

jectiv option scale observ patient involv decis make assess extent clinician involv patient decis across rang situat clinic practic far just cover physician behavior intend modifi score option scale incorpor activ patient behavior consultationsmethod modif done score level attempt dyadic relationshipcentr approach high rate can evok also behaviour activ patient german version option scale compar modifi version analys video record primari care consult deal cardiovascular prevent fifteen general practition provid videotap consult video analys two rater pair two expert share decis make sdmresult reliabl measur modifi version lower origin scale signific associ dichotomis scale expert sdm rate well physician expertis sdm found modifi option scale receiv oper characterist roc analys confirm valid differenti presenc sdm yesno total score level even though cutoff point quit low standard deviat singl item modifi version higher compar origin option scale mean total score similarconclus origin option scale physiciancent neglect activ possibl selfinvolv patient modifi instruct abl captur dyadic element partial develop separ dyadic instrument might promis

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