title: The development and evaluation of a five-language multi-perspective standardised measure: clinical decision-making involvement and satisfaction (CDIS).
abstract: BACKGROUND
  The aim of this study was to develop and evaluate a brief quantitative five-language measure of involvement and satisfaction in clinical decision-making (CDIS) - with versions for patients (CDIS-P) and staff (CDIS-S) - for use in mental health services.
  
  
  METHODS
  An English CDIS was developed by reviewing existing measures, focus groups, semistructured interviews and piloting. Translations into Danish, German, Hungarian and Italian followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force principles of good practice for translation and cultural adaptation. Psychometricevaluation involved testing the measure in secondary mental health services in Aalborg, Debrecen, London, Naples, Ulm and Zurich.
  
  
  RESULTS
  After appraising 14 measures, the Control Preference Scale and Satisfaction With Decision-making English-language scales were modified and evaluated in interviews (n = 9), focus groups (n = 22) and piloting (n = 16). Translations were validated through focus groups (n = 38) and piloting (n = 61). A total of 443 service users and 403 paired staff completed CDIS. The Satisfaction sub-scale had internal consistency of 0.89 (0.86-0.89 after item-level deletion) for staff and 0.90 (0.87-0.90) for service users, both continuous and categorical (utility) versions were associated with symptomatology and both staff-rated and service userrated therapeutic alliance (showing convergent validity), and not with social disability (showing divergent validity), and satisfaction predicted staff-rated (OR 2.43, 95%CI 1.54- 3.83 continuous, OR 5.77, 95%CI 1.90-17.53 utility) and service user-rated (OR 2.21, 95%CI 1.51-3.23 continuous, OR 3.13, 95%CI 1.10-8.94 utility) decision implementation two months later. The Involvement sub-scale had appropriate distribution and no floor or ceiling effects, was associated with stage of recovery, functioning and quality of life (staff only) (showing convergent validity), and not with symptomatology or social disability (showing divergent validity), and staff-rated passive involvement by the service user predicted implementation (OR 3.55, 95%CI 1.53-8.24). Relationships remained after adjusting for clustering by staff.
  
  
  CONCLUSIONS
  CDIS demonstrates adequate internal consistency, no evidence of item redundancy, appropriate distribution, and face, content, convergent, divergent and predictive validity. It can be recommended for research and clinical use. CDIS-P and CDIS-S in all 3 five languages can be downloaded at http://www.cedar-net.eu/instruments.
  
  
  BACKGROUND
  ISRCTN75841675.
authors: Section for Recovery (Box P029), Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK. mike.slade@kcl.ac.uk.
authors: Mike
authors: M
authors: Slade
authors: Harriet
authors: H
authors: Jordan
authors: Eleanor
authors: E
authors: Clarke
authors: Paul
authors: P
authors: Williams
authors: Helena
authors: H
authors: Kaliniecka
authors: Katrin
authors: K
authors: Arnold
authors: Andrea
authors: A
authors: Fiorillo
authors: Domenico
authors: D
authors: Giacco
authors: Mario
authors: M
authors: Luciano
authors: Anikó
authors: A
authors: Égerházi
authors: Marietta
authors: M
authors: Nagy
authors: Malene Krogsgaard
authors: MK
authors: Bording
authors: Helle Østermark
authors: HØ
authors: Sørensen
authors: Wulf
authors: W
authors: Rössler
authors: Wolfram
authors: W
authors: Kawohl
authors: Bernd
authors: B
authors: Puschner
mesh_terms: D000293:Adolescent; D000328:Adult; D018864:Cultural Diversity; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D006801:Humans; D007802:Language; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D011795:Surveys and Questionnaires; D014177:Translations