决策控制工具评估自愿同意。
The decision making control instrument to assess voluntary consent.
机构信息
Department of Anesthesiology and Critical Care Medicine, the Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine (VAM)
Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center (RFI)
出版信息
Med Decis Making. 2011 Sep-Oct;31(5):730-41. doi: 10.1177/0272989X11398666. Epub 2011 Mar 14.
BACKGROUND
The decision to participate in a research intervention or to undergo medical treatment should be both informed and voluntary.
OBJECTIVE
The aim of the present study was to develop an instrument to measure the perceived voluntariness of parents making decisions for their seriously ill children.
METHODS
A total of 219 parents completed questionnaires within 10 days of making such a decision at a large, urban tertiary care hospital for children. Parents were presented with an experimental form of the Decision Making Control Instrument (DMCI), a measure of the perception of voluntariness. Data obtained from the 28-item form were analyzed using a combination of both exploratory and confirmatory factor analytic techniques.
RESULTS
The 28 items were reduced to 9 items representing 3 oblique dimensions: Self-Control, Absence of Control, and Others' Control. The hypothesis that the 3-factor covariance structure of our model was consistent with that of the data was supported. Internal consistency for the scale as a whole was high (0.83); internal consistency for the subscales ranged from 0.68 to 0.87. DMCI scores were associated with measures of affect, trust, and decision self-efficacy, supporting the construct validity of the new instrument.
CONCLUSION
The DMCI is an important new tool that can be used to inform our understanding of the voluntariness of treatment and research decisions in medical settings.
背景
参与研究干预或接受医疗的决定应该是知情和自愿的。
目的
本研究旨在开发一种工具，以衡量父母为重病子女做出决策时的自愿感。
方法
在一家大型城市三级儿童护理医院，共有 219 名父母在做出此类决定后的 10 天内完成了调查问卷。父母们接受了决策控制工具（DMCI）的实验形式，这是衡量自愿感的一种衡量标准。使用探索性和验证性因子分析技术的组合分析了 28 项表单获得的数据。
结果
28 个项目减少到 9 个项目，代表 3 个斜交维度：自我控制、缺乏控制和他人控制。我们模型的 3 因素协方差结构与数据一致的假设得到了支持。整个量表的内部一致性很高（0.83）；子量表的内部一致性范围为 0.68 至 0.87。DMCI 评分与情感、信任和决策自我效能感的衡量标准相关，支持了新工具的结构有效性。
结论
DMCI 是一种重要的新工具，可以帮助我们了解医疗环境中治疗和研究决策的自愿性。
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