Development of a "Patient Rights" Subscale to Measure Informed Decision-Making Within the Dyadic Decisional Conflict Scale for Obstetric Care.

BACKGROUND AND PURPOSE: A modified Dyadic Decisional Conflict Scale (D-DCS) and new Patient Rights subscale to measure perceptions of informed decision-making regarding use of epidural analgesia during childbirth are tested.

METHODS: Thirty-five primiparous women and 52 providers from three hospitals tested the modified instrument. Cronbach's α coefficient assessed reliability. Mokken scale, principal components, and correlation analyses assessed unidimensionality of subscales.

RESULTS: Internal reliability was demonstrated for the D-DCS-Patient (Cronbach's α = 0.846) and D-DCS-Provider (α = 0.888). Further analyses suggest the Patient Rightssubscale has potential to make a unique contribution to the D-DCS.

CONCLUSIONS: The modified D-DCS and Patient Rights subscale allow for a more comprehensive study of informed healthcare decision-making that includes legal and ethical elements, which may aid development of targeted interventions to improve decision-making.