gms | German Medical Science

Background: Many cancer patients want active engagement in treatment decision-making. How to best implement shared decision-making (SDM) in a clinical setting has been often discussed in literature. In order to evaluate the barriers and facilitators for shared decision-making implementation, psychometric measures are needed. The Organizational Readiness for Implementing Change (ORIC) instrument assesses change commitment and change efficacy of health care professionals (HCPs). The IcanSDM instrument measures appropriateness of SDM and perceived ability to adopt SDM. Both measures were not available in German language.

Aims: The aims of the study were

1.

to translate the English versions of ORIC and IcanSDM to German,

2.

to assess understandability by the target population and adapt the measures if necessary, and

3.

to psychometrically test the two measures.

Methods: The two measures were translated into German following recommendations from the team translation protocol TRAPD (Translation, Review, Adjudication, Pretesting and Documentation). Understandability of the translations was tested via cognitive interviews with HCPs (n=11). Two members of the research team discussed the results of qualitative analysis of the interviews, and developed a consensus version of the measures. In case of disagreement, results were discussed with a third team member. The measures will be psychometrically tested using data from baseline assessment of a study evaluating the implementation of a multi-component SDM implementation program.

Preliminary Results: HCPs of different professions (nurses = 8, physicians = 3), gender (f = 9, m = 2), and different years of experience in oncology (< 5 years = 3, 6-10 years = 4, 11-20 years = 3 years, > 20 years = 1) took part in the cognitive interviews. The translation of the ORIC and IcanSDM was successful. Most of the items were understood well, and did not need further revision. One item in each measure needed several cycles of adaptation to reach adequate acceptance. Baseline assessment that can be used for psychometric evaluation will be concluded in April 2018. We currently have data from N=43 HCPs. Psychometric results of the two measures will be presented at the conference.

Discussion: To foster SDM implementation in routine care, it is essential to evaluate acceptance of SDM and readiness for change. This study provides the first German versions of the ORIC, which is also usable to evaluate other changes in organizations, and the IcanSDM, a new measure for SDM-specific appropriateness.

Practice implications: Preliminary results suggested that the translated and adapted measures could be helpful instruments to evaluate SDM implementation from HCPs perspective. Both instruments can be used for evaluation of feasibility in future SDM implementation studies in German-speaking countries.