Pediatric Caregiver Version of the Shared Decision Making Process Scale: Validity and Reliability for ADHD Treatment Decisions |
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| Institution: | 1. Division of General Internal Medicine (KD Valentine, H Vo, MJ Barry, and K Sepucha), Massachusetts General Hospital, Boston;2. Harvard Medical School (KD Valentine and K Sepucha), Boston, Mass;3. James M. Anderson Center for Healthy Systems Excellence (EA Lipstein), Cincinnati Children''s Hospital Medical Center, Ohio;4. Department of Pediatrics (EA Lipstein), University of Cincinnati College of Medicine, Ohio;5. Center for Survey Research (Carol Cosenza), University of Massachusetts, Boston;1. University of Washington School of Medicine, Department of Pediatrics (C Lewis), Seattle, Wash;2. Seattle Children''s (C Lewis), Seattle, Wash;3. Division of Pediatric Dentistry and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill (R Quinonez), Chapel Hill, NC;4. American Academy of Pediatrics (B Sisk), Itasca, Ill;5. American Academy of Pediatrics (L Barone), Itasca Ill;6. Child Health and Development Institute of Connecticut Inc, (D Krol), Farmington, Conn;7. American Academy of Pediatrics (KR Kornfeind), Itasca Ill;8. Denver Health and Hospital (PA Braun), Denver, Colo;9. University of Colorado School of Medicine, Department of Pediatrics (PA Braun), Aurora, Colo;1. Department of Pediatrics, Division of Pediatric Emergency Medicine (NJ Tedford), University of Utah, Salt Lake City, Utah;2. Pediatric Emergency Department (NJ Tedford), Intermountain Primary Children’ Hospital, Salt Lake City, Utah;1. Division of Hospital Medicine, Department of Pediatrics (AG Yu, L Agharokh and BC Lee), University of Texas Southwestern Medical Center and Children''s Health, Dallas, Tex;2. Children''s Hospital Association (M Hall and I Zaniletti), Lenexa, Kans;3. Department of Pediatrics (KM Wilson), University of Rochester Medical Center, Rochester, NY;4. Division of Hospital Medicine, Department of Pediatrics (DJ Williams), Vanderbilt University School of Medicine and the Monroe Carell Jr. Children''s Hospital at Vanderbilt, Nashville, Tenn;1. Department of Pediatrics (AR Schroeder), Stanford University School of Medicine, Stanford, Calif;2. Department of Pediatrics (LG Solan), Golisano Children''s Hospital at the University of Rochester Medical Center, Rochester, NY;3. Department of Pediatrics (D Williams), Vanderbilt University School of Medicine and the Monroe Carell Junior Children''s Hospital at Vanderbilt, Nashville, TN;4. Pediatric Academic Societies, Inc. (B Thomas, C Smith, and G Minshew);5. Department of Pediatrics (DA Rauch), Tufts University Medical School, Boston, Mass;1. Department of Pediatrics, Wake Forest School of Medicine (CL Brown), Winston-Salem, NC;2. Department of Epidemiology and Prevention, Wake Forest School of Medicine (CL Brown), Winston-Salem, NC;3. Department of Population Health Sciences, Duke University (AC Skinner), Durham, NC;4. Department of Pediatrics, University of North Carolina at Chapel Hill (MJ Steiner), Chapel Hill, NC;5. Department of Biostatistics and Bioinformatics, Duke University School of Medicine (T Truong, CL Green), Durham, NC;6. Department of Pediatrics, Duke University (CT Wood), Durham, NC;1. Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children''s Hospital of Chicago, Northwestern University Feinberg School of Medicine (S Ramgopal, M Attridge, and ML Macy), Chicago, Ill;2. Section of Critical Care, Oklahoma University Health Sciences Center (M Akande), Oklahoma, Okla;3. Division of Critical Care Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children''s Hospital of Chicago, Northwestern University Feinberg School of Medicine (DM Goodman), Chicago, Ill;4. Division of Pediatric Critical Care, University of Minnesota Masonic Children''s Hospital; University of Minnesota (JA Heneghan), Minneapolis, Minn;5. Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children''s Research Institute, Ann & Robert H. Lurie Children''s Hospital of Chicago (ML Macy), Chicago Ill |
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| Abstract: | ObjectiveShared decision making (SDM) is recommended for common pediatric conditions; however, there are limited data on measures of SDM in pediatrics. This study adapted the SDM Process scale and examined validity and reliability of the scale for attention-deficit/hyperactivity disorder (ADHD) treatment decisions.MethodsCross-sectional survey of caregivers (n = 498) of children (aged 5–13) diagnosed with ADHD, who had made a decision about ADHD medication in the last 2 years. Surveys included the adapted SDM Process scale (scores range 0–4, higher scores indicate more SDM), decisional conflict, decision regret, and decision involvement. Validity was assessed by testing hypothesized relationships between these constructs. A subset of participants was surveyed a week later to assess retest reliability.ResultsPediatric Caregiver version of the SDM Process scale (M = 2.8, SD = 1.05) showed no evidence of floor or ceiling effects. The scale was found to be acceptable (<1% missing data) and reliable (intraclass correlation coefficient = 0.74). Scores demonstrated convergent validity, as they were higher for those without decisional conflict than those with decisional conflict (2.93 vs 2.46, P < .001, d = 0.46), and higher for caregivers who stated they made the decision with the provider than those who made the decision themselves (3.0 vs 2.7; P = .003). Higher scores were related to less regret (r = ?0.15, P < .001), though the magnitude of the relationship was small.ConclusionsThe adapted Pediatric Caregiver version of the SDM Process scale demonstrated acceptability, validity and reliability in the context of ADHD medication decisions made by caregivers of children 5–13. Scores indicate pediatricians generally involve caregivers in decision making about ADHD medication. |
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