Summary
Decisional conflict is a central determinant of decision making, particularly in the
context of uncertainty. It is also one of the most frequently reported outcomes in
studies on decision support interventions. Decisional conflict is defined as personal
uncertainty about which option to choose. The Decisional Conflict Scale (DCS) is a
self-administered questionnaire that was originally designed to assess decisional
conflict in patients. The scale has since been adapted to and tested among health
professionals, since decisional conflict as seen by doctors, nurses and other healthcare
providers has proven useful in evaluating the quality of the shared decision making
(SDM) process.
In recent years, however, more and more researchers have found that evaluating the
perspectives of the patient and the health professional as interdependent members
of a dyad, rather than as two autonomous individuals, offers exciting avenues for
developing interventions to improve decision making in the clinical setting. For that
reason, the SDM community has increasingly turned its attention to a dyadic approach
to SDM. In this paper, we briefly review the history of the Dyadic Decisional Conflict
Scale (D-DCS), update its psychometrics based on published work, and propose a research
agenda for refining it further.
Zusammenfassung
Der Entscheidungskonflikt ist, insbesondere bei Entscheidungsunsicherheit, eine zentrale
Determinante der Entscheidungsfindung und gehört zu den am häufigsten in Studien über
Interventionen zur Entscheidungsunterstützung untersuchten Zielparametern. Ein Entscheidungskonflikt
ist definiert als persönliche Unsicherheit bei der Entscheidung zwischen verschiedenen
Optionen. Die Entscheidungskonflikt-Skala (Decisional Conflict Scale, DCS) ist ein
selbstauszufüllender Fragebogen, der ursprünglich zur Beurteilung von Entscheidungskonflikten
bei Patienten entwickelt wurde. Zwischenzeitlich ist der Fragebogen angepasst und
bei Ärzten und anderen im Gesundheitswesen Beschäftigten getestet worden, denn es
hat sich herausgestellt, dass der Entscheidungskonflikt, wie er von Ärzten, Pflegekräften
und anderen Anbietern von Gesundheitsleistungen gesehen wird, ein brauchbares Kriterium
für die Beurteilung der Qualität des Prozesses der partizipativen Entscheidungsfindung
(PEF, Shared Decision Making, SDM) darstellt.
In den letzten Jahren setzt sich unter Wissenschaftlern allerdings zunehmend die Auffassung
durch, dass sich völlig neue Möglichkeiten für die Entwicklung von Interventionen
zur Verbesserung der Entscheidungsfindung im klinischen Bereich ergeben, wenn man
bei der Evaluierung der jeweiligen Sichtweisen Arzt und Patient nicht als zwei autonome
Individuen betrachtet, sondern sie als wechselseitig voneinander abhängige Glieder
einer Dyade begreift. Aus diesem Grund hat sich das Interesse der PEF-Community mehr
und mehr in Richtung eines dyadischen Ansatzes verschoben. In diesem Beitrag gehen
wir kurz auf die Entwicklungsgeschichte der Dyadischen Entscheidungskonflikt-Skala
(D-DCS) ein, aktualisieren ihre psychometrischen Eigenschaften auf der Grundlage der
veröffentlichten Literatur und legen ein Forschungsprogramm vor, wie sich diese Skala
weiter verfeinern ließe.
Key words
Schlüsselwörter
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© 2012 Published by Elsevier Inc.
