验证 SDM-Q-Doc 问卷以衡量肿瘤学实践中医生的共享决策观点。
Validation of SDM-Q-Doc Questionnaire to measure shared decision-making physician's perspective in oncology practice.
机构信息
Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain.
Faculty of Psychology, Rovira and Virgili University, Tarragona, Spain.
出版信息
Clin Transl Oncol. 2017 Nov;19(11):1312-1319. doi: 10.1007/s12094-017-1671-9. Epub 2017 May 11.
OBJECTIVE
The aim of this study was to analyze the psychometric properties of the Shared Decision-Making Questionnaire-Physician version (SDM-Q-Doc) in a sample of medical oncologists who provide adjuvant treatment to patients with non-metastatic resected cancer and the correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided.
METHODS
Prospective, observational and multicenter study in which 32 medical oncologists and 520 patients were recruited. The psychometric properties, dimensionality, and factor structure of the SDM-Q-Doc were assessed.
RESULTS
Exploratory factor analyses suggested that the most likely solution was two-dimensional, with two correlated factors: one factor regarding information and another one about treatment. Confirmatory factor analysis based on cross-validation showed that the fitted two-dimensional solution provided the best fit to the data. Reliability analyses revealed good accuracy for the derived scores, both total and sub-scale, with estimates ranging from 0.81 to 0.89. The results revealed significant correlations between the total SDM-Q-Doc score and physician satisfaction with the information provided (p < 0.01); between information sub-scale scores (factor 1) and satisfaction (p < 0.01), and between treatment sub-scale scores (factor 2) and satisfaction (p < 0.01). Medical oncologists of older age and those with more years of experience showed more interest in the patient preferences (p = 0.026 and p = 0.020, respectively). Patient age negatively correlated with SDM information (p < 0.01) and physicians appear to provide more information to young patients.
CONCLUSION
SDM-Q-Doc showed good psychometric properties and could be a helpful tool that examines physician's perspective of SDM and as an indicator of quality and satisfaction in patients with cancer.
目的
本研究旨在分析非转移性切除癌症患者辅助治疗的医学肿瘤学家样本中,共享决策问卷-医生版(SDM-Q-Doc)的心理测量特性,以及总 SDM-Q-Doc 评分与医生对所提供信息的满意度之间的相关性。
方法
前瞻性、观察性和多中心研究,共招募了 32 名医学肿瘤学家和 520 名患者。评估了 SDM-Q-Doc 的心理测量特性、维度和因子结构。
结果
探索性因素分析表明,最可能的解决方案是二维的,有两个相关的因素:一个因素是关于信息,另一个因素是关于治疗。基于交叉验证的验证性因素分析表明,拟合的二维解决方案为数据提供了最佳拟合。基于衍生分数的可靠性分析显示,总分数和子量表分数都具有良好的准确性,估计值在 0.81 到 0.89 之间。结果显示,总 SDM-Q-Doc 评分与医生对所提供信息的满意度之间存在显著相关性(p<0.01);信息子量表评分(因子 1)与满意度之间存在显著相关性(p<0.01),治疗子量表评分(因子 2)与满意度之间存在显著相关性(p<0.01)。年龄较大和经验更丰富的医学肿瘤学家对患者偏好更感兴趣(分别为 p=0.026 和 p=0.020)。患者年龄与 SDM 信息呈负相关(p<0.01),医生似乎向年轻患者提供更多信息。
结论
SDM-Q-Doc 具有良好的心理测量特性,可以作为一种有用的工具,用于考察医生对 SDM 的看法,以及作为癌症患者质量和满意度的指标。