title: [Patient involvement in decision making in primary care clinics: development of a measuring tool].
abstract: 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.
authors: Unidad Docente de Medicina de Familia, Córdoba, España. roger.ruiz.sspa@juntadeandalucia.es
authors: Roger
authors: R
authors: Ruiz Moral
authors: Lucía
authors: L
authors: Peralta Munguia
authors: Luis Angel
authors: LA
authors: Pérula de Torres
authors: Enrique
authors: E
authors: Gavilán Moral
authors: José Ramón
authors: JR
authors: Loayssa Lara
mesh_terms: 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