Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis
Background: Shared decision-making is a cornerstone of patient-centred care. The 9-item Shared Decision-Making Questionnaire (SDM-Q-9) is a brief self-assessment tool for measuring patients’ perceived level of involvement in decision-making related to their own treatment and care. Information relate...
| Autores: | ; ; ; ; ; |
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| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2017 |
| País: | España |
| Institución: | Universitat de Lleida (UdL) |
| Repositorio: | Repositori Obert UdL |
| OAI Identifier: | oai:repositori.udl.cat:10459.1/59608 |
| Acceso en línea: | https://doi.org/10.1186/s12955-017-0656-2 http://hdl.handle.net/10459.1/59608 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | SDM-Q-9 Shared decision-making Multiple sclerosis Psychometrics Patient involvement |
| _version_ | 1878729634270412800 |
|---|---|
| author | Ballesteros, Javier |
| author2 | Moral, Ester Brieva Ruiz, Luis Ruiz-Beato, Elena Prefasi, Daniel Maurino, Jorge |
| author2_role | author author author author author |
| author_browse | Ballesteros, Javier Brieva Ruiz, Luis Maurino, Jorge Moral, Ester Prefasi, Daniel Ruiz-Beato, Elena |
| author_facet | Ballesteros, Javier Moral, Ester Brieva Ruiz, Luis Ruiz-Beato, Elena Prefasi, Daniel Maurino, Jorge |
| author_role | author |
| collection | Repositori Obert UdL |
| description | Background: Shared decision-making is a cornerstone of patient-centred care. The 9-item Shared Decision-Making Questionnaire (SDM-Q-9) is a brief self-assessment tool for measuring patients’ perceived level of involvement in decision-making related to their own treatment and care. Information related to the psychometric properties of the SDM-Q-9 for multiple sclerosis (MS) patients is limited. The objective of this study was to assess the performance of the items composing the SDM-Q-9 and its dimensional structure in patients with relapsing-remitting MS. Methods: A non-interventional, cross-sectional study in adult patients with relapsing-remitting MS was conducted in 17 MS units throughout Spain. A nonparametric item response theory (IRT) analysis was used to assess the latent construct and dimensional structure underlying the observed responses. A parametric IRT model, General Partial Credit Model, was fitted to obtain estimates of the relationship between the latent construct and item characteristics. The unidimensionality of the SDM-Q-9 instrument was assessed by confirmatory factor analysis. Results: A total of 221 patients were studied (mean age = 42.1 ± 9.9 years, 68.3% female). Median Expanded Disability Status Scale score was 2.5 ± 1.5. Most patients reported taking part in each step of the decision-making process. Internal reliability of the instrument was high (Cronbach’s α = 0.91) and the overall scale scalability score was 0.57, indicative of a strong scale. All items, except for the item 1, showed scalability indices higher than 0.30. Four items (items 6 through to 9) conveyed more than half of the SDM-Q-9 overall information (67.3%). The SDM-Q-9 was a good fit for a unidimensional latent structure (comparative fit index = 0.98, root-mean-square error of approximation = 0.07). All freely estimated parameters were statistically significant (P < 0.001). All items presented standardized parameter estimates with salient loadings (>0.40) with the exception of item 1 which presented the lowest loading (0.26). Items 6 through to 8 were the most relevant items for shared decision-making. Conclusions: The SDM-Q-9 presents appropriate psychometric properties and is therefore useful for assessing different aspects of shared decision-making in patients with multiple sclerosis. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_0bde3e2d632f8dbfc3c4dad538c57ece |
| institution | Universitat de Lleida (UdL) |
| instname_str | Universitat de Lleida (UdL) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.udl.cat:10459.1/59608 |
| publishDate | 2017 |
| publishDateSort | 2017 |
| publisher | BioMed Central |
| publisherStr | BioMed Central |
| reponame_str | Repositori Obert UdL |
| spelling | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis Ballesteros, Javier Moral, Ester Brieva Ruiz, Luis Ruiz-Beato, Elena Prefasi, Daniel Maurino, Jorge SDM-Q-9 Shared decision-making Multiple sclerosis Psychometrics Patient involvement Background: Shared decision-making is a cornerstone of patient-centred care. The 9-item Shared Decision-Making Questionnaire (SDM-Q-9) is a brief self-assessment tool for measuring patients’ perceived level of involvement in decision-making related to their own treatment and care. Information related to the psychometric properties of the SDM-Q-9 for multiple sclerosis (MS) patients is limited. The objective of this study was to assess the performance of the items composing the SDM-Q-9 and its dimensional structure in patients with relapsing-remitting MS. Methods: A non-interventional, cross-sectional study in adult patients with relapsing-remitting MS was conducted in 17 MS units throughout Spain. A nonparametric item response theory (IRT) analysis was used to assess the latent construct and dimensional structure underlying the observed responses. A parametric IRT model, General Partial Credit Model, was fitted to obtain estimates of the relationship between the latent construct and item characteristics. The unidimensionality of the SDM-Q-9 instrument was assessed by confirmatory factor analysis. Results: A total of 221 patients were studied (mean age = 42.1 ± 9.9 years, 68.3% female). Median Expanded Disability Status Scale score was 2.5 ± 1.5. Most patients reported taking part in each step of the decision-making process. Internal reliability of the instrument was high (Cronbach’s α = 0.91) and the overall scale scalability score was 0.57, indicative of a strong scale. All items, except for the item 1, showed scalability indices higher than 0.30. Four items (items 6 through to 9) conveyed more than half of the SDM-Q-9 overall information (67.3%). The SDM-Q-9 was a good fit for a unidimensional latent structure (comparative fit index = 0.98, root-mean-square error of approximation = 0.07). All freely estimated parameters were statistically significant (P < 0.001). All items presented standardized parameter estimates with salient loadings (>0.40) with the exception of item 1 which presented the lowest loading (0.26). Items 6 through to 8 were the most relevant items for shared decision-making. Conclusions: The SDM-Q-9 presents appropriate psychometric properties and is therefore useful for assessing different aspects of shared decision-making in patients with multiple sclerosis. The study was funded by Roche Farma SA, Spain BioMed Central https://doi.org/10.1186/s12955-017-0656-2 http://hdl.handle.net/10459.1/59608 |
| spellingShingle | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis Ballesteros, Javier SDM-Q-9 Shared decision-making Multiple sclerosis Psychometrics Patient involvement |
| status_str | publishedVersion |
| title | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| title_full | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| title_fullStr | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| title_full_unstemmed | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| title_short | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| title_sort | Psychometric properties of the SDM-Q-9 questionnaire for shared decision-making in multiple sclerosis: item response theory modelling and confirmatory factor analysis |
| topic | SDM-Q-9 Shared decision-making Multiple sclerosis Psychometrics Patient involvement |
| topic_facet | SDM-Q-9 Shared decision-making Multiple sclerosis Psychometrics Patient involvement |
| url | https://doi.org/10.1186/s12955-017-0656-2 http://hdl.handle.net/10459.1/59608 |