What Do People Really Know about Shared Decision-Making? – Developing and Validating a Questionnaire

BACKGROUND:The current level of shared decision-making (SDM) in healthcare remains below expectations, necessitating an evaluation. Current methods of measuring SDM measure perceived levels of SDM without verifying whether individuals truly understand the concept of SDM. Thus, a tool is needed that measures patients' comprehension of the SDM-concept. OBJECTIVE:To develop and validate a questionnaire that can assess the extent to which patients and the general public understand the concept of SDM, and to identify individual characteristics related to SDM-knowledge. METHODS:Developing the questionnaire was theory- and evidence-based, using established guidelines for questionnaire development, while integrating conceptual models for structuring SDM-knowledge. The questionnaire was tested and refined through expert reviews, pilot tests, and two validation studies. Clinimetric analyses included item analysis, internal consistency assessment (Cronbach's alpha), Rasch model testing, and hypothesis testing. RESULTS:A 24-item Shared Decision-Making Knowledge Questionnaire (SDM-K-Q) was developed, based on the responses of 210 patients and visitors of a large university hospital. It demonstrated good validity and reliability (Cronbach's alpha = 0.70 and Rasch model acceptance). Mean SDM-knowledge level among participants was 73.8 %. Significant predictors of SDM-knowledge included higher educational levels, healthcare occupation, and consistent appointment preparation, whereas a migration background was inversely correlated. DISCUSSION:The questionnaire appears to be an innovative, reliable tool to measure SDM-knowledge as a single construct and was able to differentiate between specific groups. Consistency was based on single administration. Further validation efforts should solidify effectiveness and establish threshold values to differentiate SDM-knowledge. PRACTICAL VALUE:The SDM-K-Q tool can appreciate the extent to which patients understand the concept of SDM. It may help identify knowledge gaps and evaluate the impact of educational interventions. Further utilization of the SDM-K-Q can assist in developing SDM implementation strategies. FUNDING:This research did not receive any funding.