Skip to main content
Top
Published in:

Open Access 01-12-2024 | Research

Measuring healthcare professionals’ perceptions of their ability to adopt shared decision making: Translation and psychometric evaluation of the Danish version of the IcanSDM questionnaire

Authors: Jeanette Finderup, Hilary L. Bekker, Nadia Thielke Albèr, Susanne Boel, Louise Engelbrecht Buur, Helle Sørensen von Essen, Anne Wilhøft Kristensen, Kristian Damgaard Lyng, Tina Wang Vedelø, Gitte Susanne Rasmussen, Pernille Christiansen Skovlund, Stine Rauff Søndergaard, Anik Giguère

Published in: BMC Medical Informatics and Decision Making | Issue 1/2024

Login to get access

Abstract

Background

Shared  decision making in healthcare is a fundamental right for patients. Healthcare professionals' perception of their own abilities to enable shared decision making is crucial for implementing shared decision making within service. IcanSDM (I can shared decision making) is a brief measure to investigate healthcare professionals' perception of shared decision making approaches to their practices. It was developed in Canada with French and English versions, and recently translated into German. This study aims to adapt the IcanSDM measure for Danish-speaking healthcare professionals, and evaluate its psychometric properties.

Methods

Cultural adaptation and translation based on Beaton et al.'s approach was applied. A forward translation by ten people and a backward translation by two people were performed. To assess comprehensibility, cognitive interviews were conducted with 24 healthcare professionals. Eighty healthcare professionals who were trained in shared decision making for either one hour (n = 65) or one day (n = 15) participated in the psychometric evaluation. The evaluation concerned acceptance, item characteristics, skewness, item difficulties, corrected item-total correlations, inter-item correlations, factorial structure, internal consistency, and responsiveness.

Results

The forward and backward translation revealed few discrepancies, and participants understood the items well. The psychometric evaluation showed a high completion rate and acceptable item difficulties and discrimination values. Both the factor analysis and the internal consistency showed a 2-factor structure: 1) healthcare professionals' capacity to implement shared decision making; and 2) healthcare professionals' capacity to practise shared decision making. The IcanSDM_Danish obtained a Cronbach’s alpha coefficient of 0.74. The evaluation of responsiveness showed improvement, but was not statistically significant.

Conclusion

The IcanSDM_Danish has good cross-cultural validity and internal consistency, and a 2-factor structure. The IcanSDM_Danish is capable of providing reliable and valid measurement when evaluating constructed knowledge about shared decision making, and may be able to support the implementation of shared decision making training and evaluation of its impact.
Appendix
Available only for authorised users
Literature
1.
go back to reference Giguère AMC, Bogza L-M, Coudert L, Carmichael P-H, Renaud J-S, Légaré F, Lindig A, Voyer P. Development of the IcanSDM scale to assess primary care clinicians’ ability to adopt shared decision-making. medRxiv. 2020;07.01.20144204. Giguère AMC, Bogza L-M, Coudert L, Carmichael P-H, Renaud J-S, Légaré F, Lindig A, Voyer P. Development of the IcanSDM scale to assess primary care clinicians’ ability to adopt shared decision-making. medRxiv. 2020;07.01.20144204.
2.
go back to reference Stiggelbout AM, Pieterse AH, De Haes JC. Shared decision making: concepts, evidence, and practice. Patient Educ Couns. 2015;98:1172–9.CrossRefPubMed Stiggelbout AM, Pieterse AH, De Haes JC. Shared decision making: concepts, evidence, and practice. Patient Educ Couns. 2015;98:1172–9.CrossRefPubMed
3.
go back to reference Légaré F, Adekpedjou R, Stacey D, Turcotte S, Kryworuchko J, Graham ID, Lyddiatt A, Politi MC, Thomson R, Elwyn G, Donner-Banzhoff N. Interventions for increasing the use of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2018;19:CD006732. Légaré F, Adekpedjou R, Stacey D, Turcotte S, Kryworuchko J, Graham ID, Lyddiatt A, Politi MC, Thomson R, Elwyn G, Donner-Banzhoff N. Interventions for increasing the use of shared decision making by healthcare professionals. Cochrane Database Syst Rev. 2018;19:CD006732.
4.
go back to reference Bomhof-Roordink H, Gärtner FR, Stiggelbout AM, Pieterse AH. Key components of shared decision making models: a systematic review. BMJ Open. 2019;17: e031763.CrossRef Bomhof-Roordink H, Gärtner FR, Stiggelbout AM, Pieterse AH. Key components of shared decision making models: a systematic review. BMJ Open. 2019;17: e031763.CrossRef
5.
go back to reference Bekker HL, Winterbottom AE, Gavaruzzi T, Finderup J, Mooney A. Decision aids to assist patients and professionals in choosing the right treatment for kidney failure. Clin Kidney J. 2023;16:i20–38.CrossRefPubMedPubMedCentral Bekker HL, Winterbottom AE, Gavaruzzi T, Finderup J, Mooney A. Decision aids to assist patients and professionals in choosing the right treatment for kidney failure. Clin Kidney J. 2023;16:i20–38.CrossRefPubMedPubMedCentral
6.
go back to reference Kienlin S, Nytrøen K, Stacey D, Kasper J. Ready for shared decision making: pretesting a training module for health professionals on sharing decisions with their patients. J Eval Clin Pract. 2020;26:610–21.CrossRefPubMed Kienlin S, Nytrøen K, Stacey D, Kasper J. Ready for shared decision making: pretesting a training module for health professionals on sharing decisions with their patients. J Eval Clin Pract. 2020;26:610–21.CrossRefPubMed
7.
go back to reference Bravo P, Härter M, McCaffery K, Giguère A, Hahlweg P, Elwyn G. Editorial: 20 years after the start of international shared decision-making activities: is it time to celebrate? Probably…. Z Evid Fortbild Qual Gesundhwes. 2022;171:1–4.CrossRefPubMed Bravo P, Härter M, McCaffery K, Giguère A, Hahlweg P, Elwyn G. Editorial: 20 years after the start of international shared decision-making activities: is it time to celebrate? Probably…. Z Evid Fortbild Qual Gesundhwes. 2022;171:1–4.CrossRefPubMed
8.
go back to reference Waddell A, Lennox A, Spassova G, Bragge P. Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review. Implement Sci. 2021;16:74.CrossRefPubMedPubMedCentral Waddell A, Lennox A, Spassova G, Bragge P. Barriers and facilitators to shared decision-making in hospitals from policy to practice: a systematic review. Implement Sci. 2021;16:74.CrossRefPubMedPubMedCentral
9.
go back to reference Joseph-Williams N, Abhyankar P, Boland L, Bravo P, Brenner AT, Brodney S, Coulter A, Giguère A, Hoffman A, Körner M, Langford A, Légaré F, Matlock D, Moumjid N, Munro S, Dahl Steffensen K, Stirling C, van der Weijden T. What works in implementing patient decision aids in routine clinical settings? A rapid realist review and update from the International Patient Decision Aid Standards Collaboration. Med Decis Making. 2021;41:907–37.CrossRefPubMed Joseph-Williams N, Abhyankar P, Boland L, Bravo P, Brenner AT, Brodney S, Coulter A, Giguère A, Hoffman A, Körner M, Langford A, Légaré F, Matlock D, Moumjid N, Munro S, Dahl Steffensen K, Stirling C, van der Weijden T. What works in implementing patient decision aids in routine clinical settings? A rapid realist review and update from the International Patient Decision Aid Standards Collaboration. Med Decis Making. 2021;41:907–37.CrossRefPubMed
10.
go back to reference Miller T, Reihlen M. Assessing the impact of patient-involvement healthcare strategies on patients, providers, and the healthcare system: a systematic review. Patient Educ Couns. 2023;110: 107652.CrossRefPubMed Miller T, Reihlen M. Assessing the impact of patient-involvement healthcare strategies on patients, providers, and the healthcare system: a systematic review. Patient Educ Couns. 2023;110: 107652.CrossRefPubMed
11.
go back to reference Lindig A, Hahlweg P, Christalle E, Giguère A, Härter M, von dem Knesebeck O, Scholl I. Translation and psychometric evaluation of the German version of the IcanSDM measure - a cross-sectional study among healthcare professionals. BMC Health Serv Res. 2021;21:541.CrossRefPubMedPubMedCentral Lindig A, Hahlweg P, Christalle E, Giguère A, Härter M, von dem Knesebeck O, Scholl I. Translation and psychometric evaluation of the German version of the IcanSDM measure - a cross-sectional study among healthcare professionals. BMC Health Serv Res. 2021;21:541.CrossRefPubMedPubMedCentral
12.
go back to reference Puschner B, Neumann P, Jordan H, Slade M, Fiorillo A, Giacco D, Egerházi A, Ivánka T, Bording MK, Sørensen HØ, Bär A, Kawohl W, Loos S, CEDAR study group. Development and psychometric properties of a five-language multiperspective instrument to assess clinical decision making style in the treatment of people with severe mental illness (CDMS). BMC Psychiatry. 2013;13:48.CrossRefPubMedPubMedCentral Puschner B, Neumann P, Jordan H, Slade M, Fiorillo A, Giacco D, Egerházi A, Ivánka T, Bording MK, Sørensen HØ, Bär A, Kawohl W, Loos S, CEDAR study group. Development and psychometric properties of a five-language multiperspective instrument to assess clinical decision making style in the treatment of people with severe mental illness (CDMS). BMC Psychiatry. 2013;13:48.CrossRefPubMedPubMedCentral
13.
go back to reference Berkowitz J, Martinez-Camblor P, Stevens G, Elwyn G. The development of incorpoRATE: a measure of physicians’ willingness to incorporate shared decision making into practice. Patient Educ Couns. 2021;104:2327–37.CrossRefPubMed Berkowitz J, Martinez-Camblor P, Stevens G, Elwyn G. The development of incorpoRATE: a measure of physicians’ willingness to incorporate shared decision making into practice. Patient Educ Couns. 2021;104:2327–37.CrossRefPubMed
14.
go back to reference Dahl Steffensen K, Mølri Knudsen B, Finderup J, Willemann Würgler M, Olling K. Implementation of patient-centred care in Denmark: the way forward with shared decision-making. Z Evid Fortbild Qual Gesundhwes. 2022;171:36–41.CrossRefPubMed Dahl Steffensen K, Mølri Knudsen B, Finderup J, Willemann Würgler M, Olling K. Implementation of patient-centred care in Denmark: the way forward with shared decision-making. Z Evid Fortbild Qual Gesundhwes. 2022;171:36–41.CrossRefPubMed
15.
go back to reference Toft BS, Rodkjaer L, Andersen AB, de Thurah A, Nielsen B, Nielsen CP, Hørlück JT, Kallestrup L, Schougaard LMV, Ludvigsen MS, Hoybye MT, Ellegaard T, Bekker H. Measures used to assess interventions for increasing patient involvement in Danish healthcare setting: a rapid review. BMJ Open. 2022;12: e064067.CrossRefPubMedPubMedCentral Toft BS, Rodkjaer L, Andersen AB, de Thurah A, Nielsen B, Nielsen CP, Hørlück JT, Kallestrup L, Schougaard LMV, Ludvigsen MS, Hoybye MT, Ellegaard T, Bekker H. Measures used to assess interventions for increasing patient involvement in Danish healthcare setting: a rapid review. BMJ Open. 2022;12: e064067.CrossRefPubMedPubMedCentral
16.
go back to reference Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63:737–45.CrossRefPubMed Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63:737–45.CrossRefPubMed
17.
go back to reference Légaré F, Stacey D, Forest PG, Archambault P, Boland L, Coutu MF, Giguère AMC, LeBlanc A, Lewis KB, Witteman HO. Shared decision-making in Canada: Update on integration of evidence in health decisions and patient-centred care government mandates. Z Evid Fortbild Qual Gesundhwes. 2022Jun;171:22–9.CrossRefPubMed Légaré F, Stacey D, Forest PG, Archambault P, Boland L, Coutu MF, Giguère AMC, LeBlanc A, Lewis KB, Witteman HO. Shared decision-making in Canada: Update on integration of evidence in health decisions and patient-centred care government mandates. Z Evid Fortbild Qual Gesundhwes. 2022Jun;171:22–9.CrossRefPubMed
18.
go back to reference Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011;17:268–74.CrossRefPubMed Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011;17:268–74.CrossRefPubMed
19.
go back to reference Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25:3186–91.CrossRefPubMed Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25:3186–91.CrossRefPubMed
20.
go back to reference Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, Bouter LM, de Vet HCW, Mokkink LB. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27:1159–70.CrossRefPubMedPubMedCentral Terwee CB, Prinsen CAC, Chiarotto A, Westerman MJ, Patrick DL, Alonso J, Bouter LM, de Vet HCW, Mokkink LB. COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. 2018;27:1159–70.CrossRefPubMedPubMedCentral
21.
go back to reference Charters E. The use of think-aloud methods in qualitative research: an introduction to think-aloud methods. Brock Educ J. 2003;12:68–82.CrossRef Charters E. The use of think-aloud methods in qualitative research: an introduction to think-aloud methods. Brock Educ J. 2003;12:68–82.CrossRef
22.
go back to reference Devet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine – practical guides to biostatistics and epidemiology. 8th ed. Cambridge: Cambridge University Press; 2017. Devet HCW, Terwee CB, Mokkink LB, Knol DL. Measurement in medicine – practical guides to biostatistics and epidemiology. 8th ed. Cambridge: Cambridge University Press; 2017.
23.
go back to reference Weaver KF, Morales V, Dunn SL, Godde K, Weaver PF. An introduction to statistical analysis in research. Hoboken: John Wiley & Sons, Inc; 2018. Weaver KF, Morales V, Dunn SL, Godde K, Weaver PF. An introduction to statistical analysis in research. Hoboken: John Wiley & Sons, Inc; 2018.
25.
go back to reference Buur LE, Bekker HL, Søndergaard H, Kannegaard M, Madsen JK, Khatir DS, Finderup J. Shared decision making for patients with kidney failure to improve end-of-life care: Development of the DESIRE intervention. J Clin Nurs. 2024Aug;33(9):3498–512.CrossRefPubMed Buur LE, Bekker HL, Søndergaard H, Kannegaard M, Madsen JK, Khatir DS, Finderup J. Shared decision making for patients with kidney failure to improve end-of-life care: Development of the DESIRE intervention. J Clin Nurs. 2024Aug;33(9):3498–512.CrossRefPubMed
26.
go back to reference SAS Enterprise Miner 13.1. Cary, NC: SAS Institute Inc. SAS Enterprise Miner 13.1. Cary, NC: SAS Institute Inc.
27.
go back to reference Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017Dec 6;17(1):162.CrossRefPubMedPubMedCentral Jakobsen JC, Gluud C, Wetterslev J, Winkel P. When and how should multiple imputation be used for handling missing data in randomised clinical trials - a practical guide with flowcharts. BMC Med Res Methodol. 2017Dec 6;17(1):162.CrossRefPubMedPubMedCentral
28.
go back to reference Bannon W Jr. Missing data within a quantitative research study: how to assess it, treat it, and why you should care. J Am Assoc Nurse Pract. 2015;27:230–2.CrossRefPubMed Bannon W Jr. Missing data within a quantitative research study: how to assess it, treat it, and why you should care. J Am Assoc Nurse Pract. 2015;27:230–2.CrossRefPubMed
29.
go back to reference Kline RB. Principles and practice of structural equation modelling. 4th ed. New York: The Guilford Press; 2016. Kline RB. Principles and practice of structural equation modelling. 4th ed. New York: The Guilford Press; 2016.
30.
go back to reference Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess. 1995;7:286–99.CrossRef Floyd FJ, Widaman KF. Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess. 1995;7:286–99.CrossRef
32.
go back to reference Joseph-Williams N, Lloyd A, Edwards A, Stobbart L, Tomson D, Macphail S, Dodd C, Brain K, Elwyn G, Thomson R. Implementing shared decision making in the NHS: lessons from the MAGIC programme. BMJ. 2017;18: j1744.CrossRef Joseph-Williams N, Lloyd A, Edwards A, Stobbart L, Tomson D, Macphail S, Dodd C, Brain K, Elwyn G, Thomson R. Implementing shared decision making in the NHS: lessons from the MAGIC programme. BMJ. 2017;18: j1744.CrossRef
33.
go back to reference Lawani MA, Turgeon Y, Côté L, Légaré F, Witteman HO, Morin M, Kröger E, Voyer P, Rodríguez C, Giguère AM. User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study. BMC Med Inform Decis Mak. 2021;21:59.CrossRefPubMedPubMedCentral Lawani MA, Turgeon Y, Côté L, Légaré F, Witteman HO, Morin M, Kröger E, Voyer P, Rodríguez C, Giguère AM. User-centered and theory-based design of a professional training program on shared decision-making with older adults living with neurocognitive disorders: a mixed-methods study. BMC Med Inform Decis Mak. 2021;21:59.CrossRefPubMedPubMedCentral
34.
go back to reference Geiger F, Liethmann K, Reitz D, Galalae R, Kasper J. Efficacy of the doktormitSDM training module in supporting shared decision making - results from a multicenter double-blind randomized controlled trial. Patient Educ Couns. 2017;100:2331–8.CrossRefPubMed Geiger F, Liethmann K, Reitz D, Galalae R, Kasper J. Efficacy of the doktormitSDM training module in supporting shared decision making - results from a multicenter double-blind randomized controlled trial. Patient Educ Couns. 2017;100:2331–8.CrossRefPubMed
35.
go back to reference Geiger F, Novelli A, Berg D, Hacke C, Sundmacher L, Kopeleva O, Scheibler F, Rüffer JU, Kuch C, Wehkamp K. The hospital-wide implementation of shared decision-making – initial findings of the Kiel SHARE TO CARE program. Dtsch Arztebl Int. 2021;118:225–6.PubMedPubMedCentral Geiger F, Novelli A, Berg D, Hacke C, Sundmacher L, Kopeleva O, Scheibler F, Rüffer JU, Kuch C, Wehkamp K. The hospital-wide implementation of shared decision-making – initial findings of the Kiel SHARE TO CARE program. Dtsch Arztebl Int. 2021;118:225–6.PubMedPubMedCentral
37.
go back to reference Steffensen KD, Hansen DG, Espersen K, Lauth S, Fosgrau P, Pedersen AM, Groen PS, Sauvr C, Olling K. “SDM:HOSP” - a generic model for hospital-based implementation of shared decision making. PLoS ONE. 2023;18: e0280547.CrossRefPubMedPubMedCentral Steffensen KD, Hansen DG, Espersen K, Lauth S, Fosgrau P, Pedersen AM, Groen PS, Sauvr C, Olling K. “SDM:HOSP” - a generic model for hospital-based implementation of shared decision making. PLoS ONE. 2023;18: e0280547.CrossRefPubMedPubMedCentral
Metadata
Title
Measuring healthcare professionals’ perceptions of their ability to adopt shared decision making: Translation and psychometric evaluation of the Danish version of the IcanSDM questionnaire
Authors
Jeanette Finderup
Hilary L. Bekker
Nadia Thielke Albèr
Susanne Boel
Louise Engelbrecht Buur
Helle Sørensen von Essen
Anne Wilhøft Kristensen
Kristian Damgaard Lyng
Tina Wang Vedelø
Gitte Susanne Rasmussen
Pernille Christiansen Skovlund
Stine Rauff Søndergaard
Anik Giguère
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2024
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-024-02747-1