This Article Full Text (PDF) All Versions of this Article: 0272989X08317014v1 28/6/899    most recent References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kremer, H. Articles by Ironson, G. Search for Related Content PubMed PubMed Citation Articles by Kremer, H. Articles by Ironson, G. Social Bookmarking                         What's this?

Measuring the Involvement of People with HIV in Treatment Decision Making Using the Control Preferences Scale

Department of Psychology, University of Miami, Coral Gables, h.kremer@ miami.edu

Gail Ironson, MD, PhD

Department of Psychology, University of Miami, Coral Gables

Objectives. Since 1983, HIV patients have been advocating for participatory decision making. This study measures the involvement that HIV-positive people perceive in treatment decision making. A secondary objective is to assess the validity of the instrument used to examine decisional roles, the Control Preferences Scale (CPS). Method. The authors interviewed 79 HIV-positive people, a sub-sample of a study on long survival with HIV, diverse with respect to ethnicity, age, gender, and sexual orientation. They compared the self- and researcher-rated decisional roles of participants on the CPS. They also assessed how well the CPS corresponds with Charles's paternalistic, shared- and informed-choice models of decision making about treatment based on decisional roles and information exchange. Results. Most participants (75%) perceived collaborative/active involvement in decision making. Agreement (Kendall's tau-b) between self- and researcher-rated decisional roles on the CPS was 0.82, whereas agreement between self-ratings on the CPS and researcher ratings on Charles's classification was 0.60. Charles's classification was difficult if participants had chosen not to take their prescribed medication without being adequately informed about the risky consequences of this decision. Conclusions. In this study, HIV-positive people perceived a high level of involvement in decision making. Reliability and convergent validity of the CPS was high. Charles's classification was problematic because decisional roles and information exchange are distinct dimensions. Some people make risky treatment decisions on their own without being adequately informed. The CPS is a useful instrument to measure decisional role perceptions of HIV-positive people but needs to be complemented by an instrument measuring treatment knowledge.

Key Words: decision-making • HIV • antiretroviral treatment • control perception • patient involvement • validity.

This version was published on November 1, 2008

Medical Decision Making, Vol. 28, No. 6, 899-908 (2008)
DOI: 10.1177/0272989X08317014


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?