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Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation

BACKGROUND: Patients making important medical decisions need to evaluate complex information in the light of their own beliefs, attitudes and priorities. The process can be considered in terms of the theory of planned behaviour. Decision support technologies aim at helping patients making informed t...

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Autores principales: Kasper, Jürgen, Köpke, Sascha, Fischer, Korbinian, Schäffler, Nina, Backhus, Imke, Solari, Alessandra, Heesen, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416666/
https://www.ncbi.nlm.nih.gov/pubmed/22747904
http://dx.doi.org/10.1186/1472-6947-12-60
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author Kasper, Jürgen
Köpke, Sascha
Fischer, Korbinian
Schäffler, Nina
Backhus, Imke
Solari, Alessandra
Heesen, Christoph
author_facet Kasper, Jürgen
Köpke, Sascha
Fischer, Korbinian
Schäffler, Nina
Backhus, Imke
Solari, Alessandra
Heesen, Christoph
author_sort Kasper, Jürgen
collection PubMed
description BACKGROUND: Patients making important medical decisions need to evaluate complex information in the light of their own beliefs, attitudes and priorities. The process can be considered in terms of the theory of planned behaviour. Decision support technologies aim at helping patients making informed treatment choices. Instruments assessing informed choices need to include risk knowledge, attitude (towards therapy) and actual uptake. However, mechanisms by which decision support achieves its goals are poorly understood. Our aim was therefore to develop and validate an instrument modeling the process of multiple sclerosis (MS) patients’ decision making about whether to undergo disease modifying (immuno-)therapies (DMT). METHODS: We constructed a 30-item patient administered questionnaire to access the elaboration of decisions about DMT in MS according to the theory of planned behaviour. MS-patients’ belief composites regarding immunotherapy were classified according to the domains “attitude”, “subjective social norm” and “control beliefs” and within each domain to either “expectations” or “values” yielding 6 sub-domains. A randomized controlled trial (n = 192) evaluating an evidence based educational intervention tested the instrument’s predictive power regarding intention to use immunotherapy and its sensitivity to the intervention. RESULTS: The psychometric properties of the questionnaire were satisfactory (mean item difficulty 62, mean SD 0.9, range 0–3). Responses explain up to 68% of the variability in the intention to use DMT was explained by up to 68% in the total sample. Four weeks after an educational intervention, predictive power was higher in the intervention (IG) compared to the control group (CG) (intention estimate: CG 56% / IG 69%, p = .179; three domains CG 56% / IG 74%, p = .047; six sub-domains CG 64% / IG 78%, p = .073). The IG held more critical beliefs towards immunotherapy (p = .002) and were less willing to comply with social norm (p = .012). CONCLUSIONS: The questionnaire seems to provide a valid way of explaining patients’ inherent decision processes and to be sensitive towards varying levels of elaboration. Similar tools based on the theory of planned behaviour could be applied to other decision making scenarios.
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spelling pubmed-34166662012-08-11 Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation Kasper, Jürgen Köpke, Sascha Fischer, Korbinian Schäffler, Nina Backhus, Imke Solari, Alessandra Heesen, Christoph BMC Med Inform Decis Mak Research Article BACKGROUND: Patients making important medical decisions need to evaluate complex information in the light of their own beliefs, attitudes and priorities. The process can be considered in terms of the theory of planned behaviour. Decision support technologies aim at helping patients making informed treatment choices. Instruments assessing informed choices need to include risk knowledge, attitude (towards therapy) and actual uptake. However, mechanisms by which decision support achieves its goals are poorly understood. Our aim was therefore to develop and validate an instrument modeling the process of multiple sclerosis (MS) patients’ decision making about whether to undergo disease modifying (immuno-)therapies (DMT). METHODS: We constructed a 30-item patient administered questionnaire to access the elaboration of decisions about DMT in MS according to the theory of planned behaviour. MS-patients’ belief composites regarding immunotherapy were classified according to the domains “attitude”, “subjective social norm” and “control beliefs” and within each domain to either “expectations” or “values” yielding 6 sub-domains. A randomized controlled trial (n = 192) evaluating an evidence based educational intervention tested the instrument’s predictive power regarding intention to use immunotherapy and its sensitivity to the intervention. RESULTS: The psychometric properties of the questionnaire were satisfactory (mean item difficulty 62, mean SD 0.9, range 0–3). Responses explain up to 68% of the variability in the intention to use DMT was explained by up to 68% in the total sample. Four weeks after an educational intervention, predictive power was higher in the intervention (IG) compared to the control group (CG) (intention estimate: CG 56% / IG 69%, p = .179; three domains CG 56% / IG 74%, p = .047; six sub-domains CG 64% / IG 78%, p = .073). The IG held more critical beliefs towards immunotherapy (p = .002) and were less willing to comply with social norm (p = .012). CONCLUSIONS: The questionnaire seems to provide a valid way of explaining patients’ inherent decision processes and to be sensitive towards varying levels of elaboration. Similar tools based on the theory of planned behaviour could be applied to other decision making scenarios. BioMed Central 2012-07-02 /pmc/articles/PMC3416666/ /pubmed/22747904 http://dx.doi.org/10.1186/1472-6947-12-60 Text en Copyright ©2012 Kasper et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kasper, Jürgen
Köpke, Sascha
Fischer, Korbinian
Schäffler, Nina
Backhus, Imke
Solari, Alessandra
Heesen, Christoph
Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title_full Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title_fullStr Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title_full_unstemmed Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title_short Applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
title_sort applying the theory of planned behaviour to multiple sclerosis patients’ decisions on disease modifying therapy – questionnaire concept and validation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416666/
https://www.ncbi.nlm.nih.gov/pubmed/22747904
http://dx.doi.org/10.1186/1472-6947-12-60
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