Validation of the Norwegian version of MAPPIN'SDM, an observation-based instrument to measure shared decision-making in clinical encounters

Simone Kienlin; Maria Kristiansen; Eirik Ofstad; Katrin Liethmann; Friedemann Geiger; Pål Joranger; Sidsel Tveiten; Jürgen Kasper

doi:10.1016/j.pec.2016.10.023

Validation of the Norwegian version of MAPPIN'SDM, an observation-based instrument to measure shared decision-making in clinical encounters

Patient Educ Couns. 2017 Mar;100(3):534-541. doi: 10.1016/j.pec.2016.10.023. Epub 2016 Oct 26.

Authors

Simone Kienlin¹, Maria Kristiansen², Eirik Ofstad³, Katrin Liethmann⁴, Friedemann Geiger⁵, Pål Joranger⁶, Sidsel Tveiten⁷, Jürgen Kasper⁸

Affiliations

¹ Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway; Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway. Electronic address: simone.kienlin@helse-sorost.no.
² Faculty of Health Sciences, Department of Health and Caring Sciences, University of Tromsø, Tromsø, Norway. Electronic address: maaskristiansen@gmail.com.
³ Department of Internal Medicine, Nordland Hospital, Bodø, Norway; Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, Tromsø, Norway. Electronic address: eirikofstad@gmail.com.
⁴ Unit of Health Sciences and Education, Faculty of Mathematics, Informatics and Natural Sciences, University of Hamburg, Hamburg, Germany; Institute of Neuroimmunology and Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: katrin.liethmann@uni-hamburg.de.
⁵ MSH Medical School Hamburg, Hamburg, Germany; Department of Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany. Electronic address: f.geiger@uksh.de.
⁶ Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway. Electronic address: pal.joranger@hioa.no.
⁷ Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway. Electronic address: sidsel.tveiten@hioa.no.
⁸ Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway; Faculty of Health Sciences, Department of Health and Caring Sciences, University of Tromsø, Tromsø, Norway. Electronic address: juergen.kasper@uit.no.

PMID: 28029570
DOI: 10.1016/j.pec.2016.10.023

Abstract

Objective: To validate the Norwegian version of MAPPIN'SDM observer scales with regard to reliability, accuracy and the extent to which the scales include the essentials of the shared decision-making concept.

Methods: Three MAPPIN'SDM scales, focusing on the skills of doctor, patient and dyad, were applied to audiovisual records of 35 decision sequences. Inter-rater reliabilities were determined based on kappa coefficients. Sensitivities and specificities were calculated with regard to an expert reference standard. Convergent validities were calculated with the OPTION₅ scale. MAPPIN'SDM was qualitatively compared to OPTION5 using Makoul & Clayman's Integrative Model structure.

Results: Inter-rater reliabilities were high on average over 11 items in each of three observer scales (MAPPIN_doctor=0.77, MAPPIN_patient=0.82, MAPPIN_dyad=0.77). Patient involvement was detected accurately (MAPPIN_dyad: mean sensitivity/specificity 93/91%). Comparison with OPTION₅ showed weak to moderate correlation (Spearman's ρ/p-value: MAPPIN_doctor:=0.44/0.009, MAPPIN_patient: 0.38/0.024, MAPPIN_dyad 0.40/0.016) and little content overlap.

Conclusion: MAPPIN'SDM_norge is capable of assessing SDM highly reliably and accurately. Divergence from OPTION₅ reflects explicit disagreement regarding the concept's assumptions.

Practice implications: MAPPIN'SDM_norge is ready for use in Norway. In-depth debate on the SDM concept's essentials is urgently needed.

Keywords: Measurement; Patient involvement; Physician patient relation; Reliability; Shared decision-making; Validity.

MeSH terms

Decision Making*
Decision Support Techniques*
Female
Humans
Male
Norway
Patient Participation*
Patient-Centered Care
Physician-Patient Relations*
Psychometrics
Reproducibility of Results
Translations