Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary.
Eur J Health Econ. 2019 Jun;20(Suppl 1):43-55. doi: 10.1007/s10198-019-01061-2. Epub 2019 May 20.
The nine-item Shared Decision Making Questionnaire (SDM-Q-9) is one of the most frequently applied instruments for assessing patients' involvement in medical decision-making. Our objectives were to develop a Hungarian version of SDM-Q-9, to evaluate its psychometric properties and to compare its performance between primary and specialised care settings.
In 2019, a sample of adults (n = 537) representative of the Hungarian general population in terms of age, gender and geographic region completed an online survey with respect to a recent health-related decision. Outcome measures included SDM-Q-9 and Control Preferences Scale-post (CPS). Item characteristics, internal consistency reliability and the factor structure of SDM-Q-9 were determined.
The overall ceiling and floor effects for SDM-Q-9 total scores were 12.3% and 2.2%, respectively. An excellent internal consistency reliability (Cronbach's alpha 0.925) was demonstrated. Exploratory factor analysis resulted in a one-factor model explaining 63.5% of the variance of SDM-Q-9. A confirmatory factor analysis supported the acceptability of this model. Known-groups validity was confirmed with CPS categories; mean SDM-Q-9 total scores were higher in the 'Shared decision' category (72.6) compared to both 'Physician decided' (55.1, p = 0.0002) and 'Patient decided' (57.2, p = 0.0086) categories. In most aspects of validity and reliability, there was no statistically significant difference between primary and specialised care.
The overall good measurement properties of the Hungarian SDM-Q-9 make the questionnaire suitable for use in both primary and specialised care settings. SDM-Q-9 may be useful for health policies targeting the implementation of shared decision-making and aiming to improve efficiency and quality of care in Hungary.
九项共享决策问卷（SDM-Q-9）是评估患者参与医疗决策的最常用工具之一。我们的目标是开发匈牙利语版本的 SDM-Q-9，评估其心理测量特性，并比较其在初级保健和专科保健环境中的表现。
2019 年，一个代表匈牙利一般人群在年龄、性别和地理区域方面的成年人样本（n=537）完成了一项关于最近一次与健康相关的决策的在线调查。结果测量包括 SDM-Q-9 和控制偏好量表后（CPS）。确定了 SDM-Q-9 的项目特征、内部一致性信度和因子结构。
SDM-Q-9 总分的总天花板和地板效应分别为 12.3%和 2.2%。显示出极好的内部一致性信度（Cronbach's alpha 0.925）。探索性因子分析得出的一个因素模型解释了 SDM-Q-9 变异的 63.5%。验证性因子分析支持该模型的可接受性。与 CPS 类别证实了已知组有效性；SDM-Q-9 总分在“共同决策”类别（72.6）中高于“医生决策”（55.1，p=0.0002）和“患者决策”（57.2，p=0.0086）类别。在有效性和可靠性的大多数方面，初级保健和专科保健之间没有统计学上的显著差异。
匈牙利语 SDM-Q-9 的总体良好测量特性使其适用于初级保健和专科保健环境。SDM-Q-9 可能对旨在实施共享决策并旨在提高匈牙利医疗保健效率和质量的卫生政策有用。
