title: Psychometric assessment of the Chinese version of the decisional conflict scale in Chinese women making decision for breast cancer surgery.
abstract: OBJECTIVE
  The decisional conflict scale (DCS) measures the perception of uncertainty in choosing options, factors contributing to decision conflict and effective decision making. This study examined the validity and reliability of the Chinese version of the DCS in Hong Kong Chinese women deciding breast cancer (BC) surgery.
  
  
  METHODS
  A Chinese version of the 16-item DCS was administered to 471 women awaiting initial consultation for BC diagnosis. Confirmatory factor analysis (CFA) assessed the factor structure. Internal consistency, and convergent and discriminant validities of the factor structure were assessed.
  
  
  RESULTS
  CFA revealed the original factor structure of the DCS showed poor fit to this sample. Exploratory factor analysis revealed an alternative three-factor structure, Informed and Values Clarity, Uncertainty and Effective Decision and Support, was optimal. Cronbach's alpha ranged from 0.51 to 0.87. Correlations between decision-making difficulties and satisfaction with medical consultation demonstrated acceptable convergent validity. Construct validity was supported by correlations between decision regret and psychological distress. Discriminant validity was supported by differentiation between delaying and non-delaying decision-makers.
  
  
  CONCLUSIONS
  The three-factor DCS-14 is a valid and practical measure for assessing decisional conflict in deciding BC surgery. It shows good potential for use in assessing decision satisfaction for women diagnosed with BC.
authors.affiliation: Department of Community Medicine and Unit for Behavioural Sciences, Centre for Psycho-oncological Research and Training, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Wendy W T
authors.initials: WW
authors.lastname: Lam
authors.forename: Marie
authors.initials: M
authors.lastname: Kwok
authors.forename: Qiuyan
authors.initials: Q
authors.lastname: Liao
authors.forename: Miranda
authors.initials: M
authors.lastname: Chan
authors.forename: Amy
authors.initials: A
authors.lastname: Or
authors.forename: Ava
authors.initials: A
authors.lastname: Kwong
authors.forename: Dacita
authors.initials: D
authors.lastname: Suen
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery*; D003657:Decision Making; D005163:Factor Analysis, Statistical; D005260:Female; D006723:Hong Kong; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D011594:Psychometrics; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards*; D035501:Uncertainty