Cross-cultural validation of the Decisional Conflict Scale in a sample of French patients.
BACKGROUND
The Decisional Conflict Scale (DCS, 16 items, 5 dimensions) designed to measure the level of decisional conflict experienced by patients making health care decisions has not yet been validated in French.


METHODS
A national sample of French cancer patients (n=644) facing the decision to undergo BRCA genetic testing was tested for this purpose, including a control group and an experimental group who had received an information booklet. Reliability and criterion validity were investigated. To check the validity of the factors selected, an exploratory factor analysis was then conducted, followed by confirmatory factor analyses.


RESULTS
Reliability was satisfactory (alpha=0.913). Women who definitely wanted to undergo genetic testing showed significantly lower DCS scores than uncertain women (p<0.001). Exploratory factor analysis suggested an optimal 4-dimensional model. In the control group, confirmatory factor analyses showed that the French model was more accurate than the original one. When the decision-making conflicts decreased (in the experimental group), both models yielded only fairly accurate indices.


CONCLUSIONS
The French version of the DCS was found to give a reliable overall score. However, special care should be taken when using the individual subscores. In addition, it is necessary to take into account the context in which the decision-making occurs.
Mancini
Julien
J
INSERM UMR379, Epidemiology and Social Sciences Unit, Institut Paoli-Calmettes, 232 Bd Ste Marguerite, B.P. 156, F-13273, Marseille cedex 09, France. mancini@marseille.inserm.fr
Santin
Gaëlle
G
Chabal
Françoise
F
Julian-Reynier
Claire
C
D001943:Breast Neoplasms / Q000235:genetics*; D003220:Conflict, Psychological; D003469:Culture; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005260:Female; D005602:France; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics*; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D010353:Patient Education as Topic; D011795:Surveys and Questionnaires; D035501:Uncertainty