Psychometric Evaluation and Cultural Adaptation of the Shared Decision‐Making Questionnaire for Chinese Adult Child Caregivers of People With Dementia
Huanran Liu, Vivian Weiqun Lou, Peiyi Lu, You YinObjectives
Adult children are primary caregivers in dementia care. While relationship‐centered care highlights shared decision‐making (SDM) between caregivers and people with dementia (PwD), existing SDM tools often overlook the perspective of adult‐child caregivers in nonclinical home‐based care context, creating a gap in understanding how families make care arrangements decisions. Therefore, this study aimed to culturally adapt and validate SDM‐Q‐Doc (renamed as SDM‐Q‐C) for use among Chinese adult‐child caregivers of PwD.
Methods
We established a pilot study with 7 caregivers to establish face validity and conducted Delphi study with 9 experts to assess content validity, followed by a quantitative survey to examine psychometric validation. In the survey, 142 adult‐child caregivers completed SDM‐Q‐C, the Modified version of Control Preferences Scale in post‐decision (CPS post ), and Decision Regret Scale (DRS). We assessed internal consistency through reliability analysis and structural validity through principal component analysis and confirmatory factor analysis. Construct validity was evaluated by the average variance extracted (AVE) and correlations with CPS post and DRS.
Results
Based on feedback from the pilot study regarding the comprehensibility of the initial translated version (Version I), a revised Version II was developed and subsequently evaluated through the Delphi study. Following expert consensus, Version III was finalized for survey administration and underwent psychometric validation, ultimately resulting in the refined 4‐item SDM‐Q‐C as the final instrument (Version IV). SDM‐Q‐C had excellent internal consistency (Cronbach’s alpha = 0.907). It demonstrated a single structure (78.42% variance explained) with an excellent model fit ( χ 2 = 1.426, df = 1, p = 0.232; CFI = 0.999, TLI = 0.994; RMSEA = 0.053, SRMR = 0.008). It had satisfactory convergent validity (AVE = 0.687 > 0.5) and discriminant validity (√AVE = 0.829 was larger than correlation with DRS, r = 0.056, p > 0.05).
Conclusions
SDM‐Q‐C was the first validated scale assessing SDM in Chinese adult‐child caregivers of PwD, with satisfactory psychometric properties. Future research could cross‐validate it and test its cross‐cultural applicability in diverse populations.
Practice Implications
The SDM‐Q‐C scale can be used in community and home‐based care practice to assess and improve SDM between adult‐child caregivers and their parents with dementia. This tool enables practitioners to identify communication challenges and provide targeted support for family‐centered care planning.