Department of Home Care and Regional Liaison Promotion, National Center for Geriatrics and Gerontology of Japan, Obu, Japan.
Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan.
PLoS One. 2021 Feb 10;16(2):e0246518. doi: 10.1371/journal.pone.0246518. eCollection 2021.
Shared decision-making (SDM) has only lately begun attaining recognition from the Japanese medical community. The purpose of this study was to create a Japanese version of the SDM-Q-Doc, which is a scale that measures SDM from the perspective of physicians, and to clarify its psychometric characteristics and identify the issues and factors that affect SDM.
The participants were 23 physicians and 130 patients who visited primary care clinics in Japan for the first time. Immediately following physician-patient interviews, the Japanese version of SDM-Q-9 and SDM-Q-Doc were administered to patients and physicians, respectively. For convergent validity, physician confidence in the medical interview (PCMI) was used. After the determination of internal consistency and validity of the SDM-Q-Doc, the relations among each item of SDM-Q-Doc, SDM-Q-9, physicians' sociodemographic attributes, and a presence or absence of nurse's attendance during outpatient consultation were assessed by a multiple regression analysis and structural equation modeling (SEM).
A factor analysis confirmed that the Japanese version of the SDM-Q-Doc displays a one-factor structure with a high internal consistency (Cronbach's α = 0.87, ω = 0.88). The correlation between the PCMI and SDM-Q-Doc confirmed an appropriate convergent validity (r = 0.406; p < 0.001). Multiple regression analyses showed that the attendance of a nurse during consultation significantly affected one item of the SDM-Q-Doc, which in turn affected one item of the SDM-Q-9. SEM showed a good fit of model for these three items.
The Japanese version of the SDM-Q-Doc's internal consistency and validity in the outpatient medical consultations in Japan were confirmed. Further, this study suggests the role of a nurse's attendance during a physician-patient consultation on facilitating the SDM. Further, using the Japanese version of the SDM-Q-Doc will promote communication skills training for medical professionals by checking the quality of SDM.
共享决策（SDM）最近才开始得到日本医学界的认可。本研究的目的是创建一个测量医生视角下的 SDM 的 SDM-Q-Doc 的日语版，并明确其心理测量学特征，确定影响 SDM 的问题和因素。
参与者为 23 名医生和 130 名首次到日本基层医疗机构就诊的患者。在医患访谈结束后，立即为患者和医生分别使用 SDM-Q-9 和 SDM-Q-Doc 的日语版。为了进行收敛效度检验，使用了医生对医疗访谈的信心（PCMI）。在确定 SDM-Q-Doc 的内部一致性和有效性后，通过多元回归分析和结构方程建模（SEM）评估了 SDM-Q-Doc 的每个项目与 SDM-Q-9、医生的社会人口统计学特征以及门诊咨询时是否有护士参与之间的关系。
因子分析证实，SDM-Q-Doc 的日语版具有较高的内部一致性（Cronbach's α = 0.87，ω = 0.88），呈单因素结构。PCMI 与 SDM-Q-Doc 的相关性证实了适当的收敛效度（r = 0.406；p < 0.001）。多元回归分析显示，咨询时护士的参与显著影响了 SDM-Q-Doc 的一个项目，进而影响了 SDM-Q-9 的一个项目。SEM 显示，这三个项目的模型拟合良好。
本研究在日本的门诊医疗咨询中验证了 SDM-Q-Doc 的日语版的内部一致性和有效性。此外，本研究表明，咨询时护士的参与在促进 SDM 方面发挥了作用。此外，使用 SDM-Q-Doc 的日语版将通过检查 SDM 的质量来促进医疗专业人员的沟通技巧培训。
