Summary
The aim of our study is to introduce a statistical framework using latent variable
modeling for the investigation of correspondence between patients’ and physicians’
perceptions that were measured using dyadic instruments. This statistical approach
combines multitrait-multimethod and measurement invariance methodologies. In an illustrative
example we used a sample of 285 primary care consultations on chronic diseases to
test correspondence between patients’ and physicians’ views on the process of shared
decision-making (SDM), which was measured by the patient and physician version of
the nine-item Shared Decision-Making Questionnaire (SDM-Q-9 and SDM-Q-Doc), respectively.
We revealed that while patients and physicians seem to agree on what is the core of SDM, they differ in their ratings regarding to which extent it is present in a certain consultation. The described statistical approach provides
important insights into correspondence between perceptions of different stakeholders
that cannot be gained using traditional approaches. However, its generalizability
is questionable due to the partly explorative data-driven approach and its flexibility
is limited by the requirement of samples including at least 200 cases.
Zusammenfassung
Das Ziel der vorliegenden Studie ist die Vorstellung einer statistischen Analysemethode
zur Untersuchung der Übereinstimmung zwischen mehreren Beobachtern in der Forschung
zur Partizipativen Entscheidungsfindung. Diese Methode nutzt die Modellierung latenter
Variablen und kann als eine Kombination von Multitrait-Multimethod- und Messinvarianz-Analysen
verstanden werden. Das Verfahren wird anhand eines Beispiels erläutert, in dem eine
Stichprobe von 285 Arzt-Patient-Konsultationen zu chronischen Erkrankungen untersucht
wurde. Sowohl die Patienten als auch die Ärzte wurden gebeten, den in der Konsultation
erlebten Entscheidungsprozess mittels der Patienten- bzw. der Arztversion des Fragebogens
zur Partizipativen Entscheidungsfindung (PEF-FB-9 und PEF-FB-Doc) zu beurteilen. Die
Ergebnisse zeigen, dass Patienten und Ärzte weitgehend darin übereinstimmen, was PEF ist. Allerdings beurteilen sie das Ausmaß an PEF in den erlebten Konsultationen substanziell unterschiedlich. Die vorgestellte
Analysemethode führte zu Erkenntnissen, die mittels herkömmlicher Analysemethoden
nicht hätten gewonnen werden können.
Key words
Schlüsselwörter
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