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Rochester Participatory Decision-Making Scale (RPAD): Reliability and Validity

¹ Department of Family Medicine, University of Rochester Medical Center: Rochester Center to Improve Communication in Health Care, Rochester, NY
² Department of Psychiatry, University of Rochester Medical Center, Rochester, NY
³ University of California at Davis, Calif
⁴ Department of Community and Preventive Medicine, University of Rochester, Rochester, NY

CORRESPONDING AUTHOR: Cleveland G. Shields, PhD, 1381 South Avenue, Rochester, NY 14620-2830, Cleveland_Shields{at}URMC.Rochester.edu

PURPOSE We wanted develop a reliable and valid objective measure of patient-physician collaborative decision making, the Rochester Participatory Decision-Making Scale (RPAD).

METHODS Based on an informed decision-making model, the RPAD assesses physician behavior that encourages patient participation in decision making. Data were from a study of physician-patient communication of 100 primary care physicians. Physician encounters with 2 standardized patients each were audio recorded, resulting in 193 useable recordings. Transcribed recordings were coded both with RPAD and the Measure of Patient-Centered Communication (MPCC), which includes a related construct, Finding Common Ground. Two sets of dependent variables were derived from (1) surveys of the standardized patients and (2) surveys of 50 patients of each physician, who assessed their perceptions of the physician-patient relationship.

RESULTS The RPAD was coded reliably (intraclass correlation coefficient [ICC] = 0.72). RPAD correlated with Finding Common Ground (r = 0.19, P <.01) and with the survey measures of standardized patient’s perceptions of the physician-patient relationship (r = 0.32 – 0.36 [P <.005]) but less with the patient survey measures (r = 0.06 to 0.07 [P <.005]). Multivariate, hierarchical analyses suggested that the RPAD made a more robust contribution to explaining variance in standardized patient perceptions than did the MPCC Finding Common Ground.

CONCLUSIONS The RPAD shows promise as a reliable, valid, and easy-to-code objective measure of participatory decision making.

Key Words: Physician-patient relations • medical decision making • informatics

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