Rasch Analysis of the 9-Item Shared Decision Making Questionnaire in Women With Breast Cancer

Background Shared decision making (SDM) is a best practice to help patients make optimal decisions by a process of healthcare, especially for women diagnosed with breast cancer and having heavy burden in long-term treatments. To promote successful SDM, it is crucial to assess the level of perceived involvement in SDM in women with breast cancer. Objective The aims of this study were to apply Rasch analysis to examine the construct validity and person reliability of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) in women with breast cancer. Methods The construct validity of SDM-Q-9 was confirmed when the items fit the Rasch model's assumptions of unidimensionality: (1) infit and outfit mean square ranged from 0.6 to 1.4; (2) the unexplained variance of the first dimension of the principal component analysis was less than 20%. Person reliability was calculated. Results A total of 212 participants were recruited in this study. Item 1 did not fit the model's assumptions and was deleted. The unidimensionality of the remaining 8 items (SDM-Q-8) was supported with good item fit (infit and outfit mean square ranging from 0.6 to 1.3) and very low unexplained variance of the first dimension (5.3%) of the principal component analysis. The person reliability of the SDM-Q-8 was 0.90. Conclusions The SDM-Q-8 was unidimensional and had good person reliability in women with breast cancer. Implications for Practice: The SDM-Q-8 has shown its potential for assessing the level of perceived involvement in SDM in women with breast cancer for both research and clinical purposes.