Cross-cultural validation of the Decisional Conflict Scale in a sample of French patients

Abstract

Introduction: The Decisional Conflict Scale (DCS, 16 items, 5 dimensions) designed to measure the level of decisional conflict experienced by patients making health care decisions has not yet been validated in French.

Methods: A national sample of French cancer patients (n=644) facing the decision to undergo BRCA genetic testing was tested for this purpose, including a control group and an experimental group who had received an information booklet. Reliability and criterion validity were investigated. To check the validity of the factors selected, an exploratory factor analysis was then conducted, followed by confirmatory factor analyses.

Results: Reliability was satisfactory (alpha=0.913). Women who definitely wanted to undergo genetic testing showed significantly lower DCS scores than uncertain women (p<0.001). Exploratory factor analysis suggested an optimal 4-dimensional model. In the control group, confirmatory factor analyses showed that the French model was more accurate than the original one. When the decision-making conflicts decreased (in the experimental group), both models yielded only fairly accurate indices.

Conclusion: The French version of the DCS was found to give a reliable overall score. However, special care should be taken when using the individual subscores. In addition, it is necessary to take into account the context in which the decision-making occurs.