Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Patient Educ Couns. 2011 Dec;85(3):521-4. doi: 10.1016/j.pec.2010.12.012. Epub 2011 Feb 5.
To evaluate the psychometric properties of the 4-factor low literacy Decisional Conflict Scale (DCS-LL) with men eligible for prostate cancer screening (PCS).
We used baseline (T0; n=149) and post-intervention (T2; n=89) data from a randomized, controlled trial of a PCS decision aid to assess internal consistency reliability and construct, discriminant, and factor validity.
There was evidence of excellent internal consistency reliability (α's≥.80) and fair construct validity (most r's≥.40) for the DCS-LL except for the Supported subscale. The DCS-LL was able to discriminate between men who had decided and those who had not. There was evidence for the original 4-factor model at T0 but exploratory analysis suggested a 3-factor solution at T0 and T2 with Informed and Value Clarity as one factor.
For men eligible for PCS, feeling informed and feeling clear about values may not reflect distinct cognitive processes. Feeling supported may not be a factor contributing to uncertainty.
Research should address whether current DCS subscales best represent the factors that contribute to uncertainty for PCS and for other screening decisions. Research should also explore the influence of health literacy on the factor structure of the DCS-LL.
评估适用于前列腺癌筛查（PCS）男性的四因素低文化程度决策冲突量表（DCS-LL）的心理测量特性。
我们使用一项 PCS 决策辅助工具的随机对照试验的基线（T0；n=149）和干预后（T2；n=89）数据，评估内部一致性信度以及结构、判别和因子有效性。
除支持分量表外，DCS-LL 具有极好的内部一致性信度（α's≥.80）和良好的结构有效性（大多数 r's≥.40）。DCS-LL 能够区分已做出决策和未做出决策的男性。在 T0 时存在原始的 4 因素模型的证据，但探索性分析表明在 T0 和 T2 时存在 3 因素解决方案，知情和价值清晰作为一个因素。
对于有资格进行 PCS 的男性，感到知情和对价值观有清晰认识可能并不能反映出不同的认知过程。感到支持可能不是导致不确定性的一个因素。
研究应解决当前 DCS 分量表是否最能代表导致 PCS 及其他筛查决策不确定性的因素。研究还应探讨健康素养对 DCS-LL 因子结构的影响。
