[Patient involvement in decision making in primary care clinics: development of a measuring tool].
OBJECTIVE
This work aims to explore to what extent Spanish primary care providers involve patients in decisions and describe the development of a suggested tool for assessing patient involvement in these settings.


METHODS
Cross-sectional, development of a measurement tool.


METHODS
Primary care clinics.


METHODS
Family doctors and residents.


METHODS
Based on a review of the literature and the opinions of primary care doctors, a selection was made of items from a previous scale used to measure general communication skills (CICAA-Patient Centred) and new specific items were added to this to measure involvement.


METHODS
The involvement of patients in decision-making was evaluated initially with this tool in 31 different clinical visits and the scale was then reformulated. A pool of 161 interviews was used to complete the process. Some psychometric properties (reliability and internal consistency) were estimated for the different samples and stages of the process.


RESULTS
Some degree of patient involvement was found in just 31 visits. Despite this, only in 18 of these (58%) was there some involvement in a discussion about more than one treatment option. The Cohen's kappa values of the CICAA-Decision scale were between 0.48 and 0.94. Cronbach's alpha was 0.60/0.51. The global Intra-class correlation coefficient was 0.96.


CONCLUSIONS
The levels of patient involvement were lower than expected. A simple question, such as that defined by one item in particular, and the CICAA-D scale, in general, could be useful to assess patient involvement in decision making in primary care.
Ruiz Moral
Roger
R
Unidad Docente de Medicina de Familia, Córdoba, España. roger.ruiz.sspa@juntadeandalucia.es
Peralta Munguia
Lucía
L
Pérula de Torres
Luis Angel
LA
Gavilán Moral
Enrique
E
Loayssa Lara
José Ramón
JR
D003430:Cross-Sectional Studies; D006268:Health Facilities; D006801:Humans; D010358:Patient Participation / Q000706:statistics & numerical data*; D011320:Primary Health Care; D013030:Spain; D011795:Surveys and Questionnaires