title: The German version of the Four Habits Coding Scheme - association between physicians' communication and shared decision making skills in the medical encounter.
abstract: OBJECTIVE
  To translate a measure of physicians' communication skills, the Four Habits Coding Scheme (4HCS), into German, to examine its psychometric properties, and to analyze its association with the OPTION Scale, which assesses physicians' shared decision making (SDM) behavior.
  
  
  METHODS
  We performed a secondary data analysis of 67 audio-recorded medical consultations. Reliability, internal consistency, and factorial validity of the translated 4HCS were analyzed. The association with the OPTION Scale was examined using correlation and linear regression.
  
  
  RESULTS
  Testing of reliability revealed intraclass correlation coefficients above .70. Results regarding internal consistency and factorial validity were inconclusive. The correlations between the OPTION score and the four dimensions of the 4HCS were .04 (p=.782), -.14 (p=.303), -.15 (p=.279) and .55 (p<.001), respectively. In multiple regression the four dimensions of the 4HCS explained substantial amount of variation in the OPTION scores (R(2)=.42, P<.001).
  
  
  CONCLUSIONS
  The measure showed good observer reliability, however further testing is necessary. Due to the strong interrelation of both measures, SDM should be seen in the context of broader communication skills.
  
  
  CONCLUSIONS
  The 4HCS can be used in research and medical education. Further studies are necessary that investigate SDM within the context of communication skills.
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: i.scholl@uke.de.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Scholl
authors.affiliation: Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nicolai
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Pahlke
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Levente
authors.initials: L
authors.lastname: Kriston
authors.affiliation: Center for Evaluation, Harvard Medical School, Boston, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Krupat
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D059019:Clinical Coding; D003142:Communication; D003657:Decision Making; D004650:Employee Performance Appraisal / Q000379:methods* / Q000592:standards; D005260:Female; D005858:Germany; D006184:Habits; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011361:Professional Competence / Q000592:standards*; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014175:Translating; D014741:Video Recording
keywords: Communication skills; Germany; Measurement; Primary care; Psychometrics; Shared decision making