Reliability and validity of the Korean version of MAPPIN'SDM for patients and healthcare providers

초록

Background Shared decision making (SDM) integrates the expertise of healthcare providers with the values and preferences of patients. The Multifocal Approach to Sharing in Shared Decision-Making (MAPPIN'SDM) based on a six-step SDM model, has shown robust reliability and validity in diverse settings. This study aimed to validate the Korean version (K-MAPPIN'SDM) and assess its applicability in Korean clinical practice. Methods The K-MAPPIN'SDM was developed through a translation and cultural adaptation process including forward translation, synthesis, blind back translation, semantic equivalence review, and multidisciplinary evaluation for accuracy in the Korean context. The instrument was piloted with six physicians and 288 patients involved in SDM. For construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted. Psychometric evaluation included Pearson's correlation, Guttman split-half coefficient, and Cronbach's alpha. Criterion validity was assessed using the 9-Item Shared Decision-Making Questionnaire (SDM-Q-9), SDM-Q-Doc, and Communication Assessment Tool (CAT). Results The final K-MAPPIN'SDM was successfully developed through a scientifically rigorous and culturally sensitive translation and validation process. EFA and CFA supported a one-factor model for both versions of K-MAPPIN'SDM, though model fit was better for the patient version. Internal consistency of the K-MAPPIN'SDM was high (Cronbach's alpha = 0.94 for healthcare provider version; 0.87 for patient version). Guttman coefficients were 0.90 and 0.73, respectively. The provider version correlated strongly with SDM-Q-Doc (r = 0.88, p < .001); the patient version correlated with SDM-Q-9 (r = 0.58, p < 0.001) and CAT (r = 0.47, p < .001). Conclusions The K-MAPPIN'SDM is a psychometrically sound tool for assessing SDM. This scale has the potential to be widely used to assess SDM in Korea. K-MAPPIN'SDM can serve as a tool to assess current state of SDM implementation from diverse perspectives in Korea and provide framework for training healthcare providers in SDM practices.

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