 |
| Research article summary (published 30 Mar 2003): |
|
Free Full Text! See links below |
Shared decision making: developing the OPTION scale for measuring patient involvement.
Full Abstract
BACKGROUND:
A systematic review has shown that no measures of the extent to which healthcare professionals involve patients in decisions within clinical consultations exist, despite the increasing interest in the benefits or otherwise of patient participation in these decisions.
AIMS:
To describe the development of a new instrument designed to assess the extent to which practitioners involve patients in decision making processes.
DESIGN:
The OPTION (observing patient involvement) scale was developed and used by two independent raters to assess primary care consultations in order to evaluate its psychometric qualities, validity, and reliability.
STUDY SAMPLE:
186 audiotaped consultations collected from the routine clinics of 21 general practitioners in the UK.
METHOD:
Item response rates, Cronbach's alpha, and summed and scaled OPTION scores were calculated. Inter-item and item-total correlations were calculated and inter-rater agreements were calculated using Cohen's kappa. Classical inter-rater intraclass correlation coefficients and generalisability theory statistics were used to calculate inter-rater reliability coefficients. Basing the tool development on literature reviews, qualitative studies and consultations with practitioner and patients ensured content validity. Construct validity hypothesis testing was conducted by assessing score variation with respect to patient age, clinical topic "equipoise", sex of practitioner, and success of practitioners at a professional examination.
RESULTS:
The OPTION scale provided reliable scores for detecting differences between groups of consultations in the extent to which patients are involved in decision making processes in consultations. The results justify the use of the scale in further empirical studies. The inter-rater intraclass correlation coefficient (0.62), kappa scores for inter-rater agreement (0.71), and Cronbach's alpha (0.79) were all above acceptable thresholds. Based on a balanced design of five consultations per clinician, the inter-rater reliability generalisability coefficient was 0.68 (two raters) and the intra-rater reliability generalisability coefficient was 0.66. On average, mean practitioner scores were very similar (and low on the overall scale of possible involvement); some practitioner scores had more variation around the mean, indicating that they varied their communication styles to a greater extent than others.
CONCLUSIONS:
Involvement in decision making is a key facet of patient participation in health care and the OPTION scale provides a validated outcome measure for future empirical studies.
Learn Faster Today Improve your study skills
Author information
Author/s: Elwyn, G (G); Edwards, A (A); Wensing, M (M); Hood, K (K); Atwell, C (C); Grol, R (R);
Affiliation: Department of Primary Care, University of Wales Swansea Clinical School, Swansea SA2 8PP, UK. g.elwyn(-atsign-)swansea.ac.uk
Journal and publication information
Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review
Journal: Quality & safety in health care (Qual Saf Health Care), published in England. (Language: eng)
Reference: 2003-Apr; vol 12 (issue 2) : pp 93-9
Dates: Created 2003/04/07; Completed 2003/06/06; Revised 2006/11/15;
PMID: 12679504, status: MEDLINE (last retrieval date: 11/6/2008)
Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.
Comments and Corrections
CommentIn: Qual Saf Health Care. 2003 Apr;12(2):87. (PMID: 12679502)
External Links for this article (including full text providers, if available):
Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.
This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.
MeSH headings (categories)
This article was linked to the MESH Headings shown below.
|
|
Related articles
This article has not been indexed for related articles as yet, however you can still use the live related article search links below.
See a large map of 100+ related articles.