BMC Med Inform Decis Mak - Development and psychometric properties of a brief measure of subjective decision quality for breast cancer treatment.

Tópicos

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Resumo

CKGROUND: Breast cancer patients face several preference-sensitive treatment decisions. Feelings such as regret or having had inadequate information about these decisions can significantly alter patient perceptions of recovery and recurrence. Numerous objective measures of decision quality (e.g., knowledge assessments, values concordance measures) have been developed; there are far fewer measures of subjective decision quality and little consensus regarding how the construct should be assessed. The current study explores the psychometric properties of a new subjective quality decision measure for breast cancer treatment that could be used for other preference sensitive decisions.METHODS: 320 women aged 20-79 diagnosed with AJCC stage 0 - III breast cancer were surveyed at two cancer specialty centers. Decision quality was assessed with single items representing six dimensions: regret, satisfaction, and fit as well as perceived adequacy of information, time, and involvement. Women rated decision quality for their overall treatment experience and surgery, chemotherapy, and radiation decisions separately. Principle components was used to explore factor structure. After scales were formed, internal consistency was computed using Cronbach's alpha. The association of each of the four final scales with patient characteristics scores was examined by Pearson correlation.RESULTS: For overall breast cancer treatment as well as surgery, chemotherapy, and radiation decisions, the six items yielded a single factor solution. Factor loadings of the six decision items were all above .45 across the overall and treatment-specific scales, with the exception of "Right for You" for chemotherapy and radiation. Internal consistency was 0.77, 0.85, 0.82, and 0.78 for the overall, surgery, chemotherapy, and radiation decision quality scales, respectively.CONCLUSIONS: Our measure of subjective appraisal of breast cancer treatment decisions includes 5 related elements; regret and satisfaction as well as perceived adequacy of information, time, and involvement. Future research is needed to establish norms for the measure as is further psychometric testing, particularly to examine how it is associated with outcomes such as quality of life, psychological coping and objective decision quality.

Resumo Limpo

ckground breast cancer patient face sever preferencesensit treatment decis feel regret inadequ inform decis can signific alter patient percept recoveri recurr numer object measur decis qualiti eg knowledg assess valu concord measur develop far fewer measur subject decis qualiti littl consensus regard construct assess current studi explor psychometr properti new subject qualiti decis measur breast cancer treatment use prefer sensit decisionsmethod women age diagnos ajcc stage iii breast cancer survey two cancer specialti center decis qualiti assess singl item repres six dimens regret satisfact fit well perceiv adequaci inform time involv women rate decis qualiti overal treatment experi surgeri chemotherapi radiat decis separ principl compon use explor factor structur scale form intern consist comput use cronbach alpha associ four final scale patient characterist score examin pearson correlationresult overal breast cancer treatment well surgeri chemotherapi radiat decis six item yield singl factor solut factor load six decis item across overal treatmentspecif scale except right chemotherapi radiat intern consist overal surgeri chemotherapi radiat decis qualiti scale respectivelyconclus measur subject apprais breast cancer treatment decis includ relat element regret satisfact well perceiv adequaci inform time involv futur research need establish norm measur psychometr test particular examin associ outcom qualiti life psycholog cope object decis qualiti

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