Psychometric Evaluation of the Chinese Version of Decisional Conflict Scale in Chinese Young Women Making HPV Vaccination Decisions

Figures & data

Table 1 Demographic Characteristics of Participants (N=107 Young Women)

	n	%*
Marital status
Single	102	95.3
Married/Cohabited	3	2.8
Educational level
Secondary or below	12	11.2
Tertiary or above	93	86.9
No religious affiliation	78	72.9
Family income (monthly)
< $10,000	10	9.3
$10,000 - $20,000	29	27.1
$20,000 - $30,000	28	26.2
$30,000 - $40,000	9	8.4
>$40,000	28	26.2
Ever heard of HPV vaccine	96	89.7

Note: *Unaccounted percentage is missing data.

Table 2 Goodness-of-Fit Indices of Confirmatory Factor Analyses of the DCS

	χ^2	d.f.	P	RMSEA (90% CI)	CFI	TLI	SRMR
Original 5-factor DCS-16
Correlated model	177.62	94	<0.001	0.09 (0.07, 0.11)	0.91	0.88	0.10
Hierarchical model	255.86	99	<0.001	0.12 (0.11, 0.14)	0.83	0.79	0.15
Extracted 3-factor DCS-13
Correlated model	136.17	62	<0.001	0.11 (0.08, 0.13)	0.89	0.87	0.08
Hierarchical model	136.17	62	<0.001	0.11 (0.08, 0.13)	0.89	0.87	0.08
Original 4-factor DCS-10 (3 responses)
Correlated model	49.51	29	0.01	0.08 (0.04, 0.12)	0.95	0.92	0.07
Hierarchical model	68.69	31	<0.001	0.11 (0.07, 0.14)	0.90	0.86	0.09

Notes: CFI and TLI values ≥0.90, RMSEA values ≤0.10 with 90% confidence interval, and SRMR values ≤0.08 suggest acceptable model fit.

Abbreviations: DCS, decisional conflict scale; d.f., degree of freedom; CFI, comparative fit index; RMSEA (90% CI), root mean square error of approximation with 90% confidence interval; TLI, the Tucker-Lewis Index; SRMR, standardized root mean square residual.

Table 3 Exploratory Factor Analysis of Decisional Conflict Scale (DCS; Principal Components Analysis, Oblimin Rotation)

		Factor			Communality
		1	2	3
1	Do you know which options are available to you? (I)	–	0.77	–	0.56
2	Do you know the benefits of each option? (I)	–	0.94	–	0.82
3	Do you know the risks and side effects of each option? (I)	–	0.90	–	0.78
4	Are you clear about which benefits matter most to you? (V)	–	0.83	–	0.69
5	Are you clear about which risks and side effects matter most to you? (V)	–	0.85	–	0.76
6	Are you clear about which is more important to you (the benefits OR the risks and side effects)? (V)	–	0.69	–	0.63
7	Do you have enough support from others to make a choice? (S)	–	–	0.67	0.59
8	Are you choosing without pressure from others? (S)	–	–	0.83	0.64
11	Do you feel sure about what to choose? (U)	0.77	–	–	0.79
12	Is it easy for you to make the decision? (U)	0.56	–	–	0.62
14	Does your decision show what is important to you? (E)	0.95	–	–	0.78
15	Do you expect to stick with your decision? (E)	0.92	–	–	0.78
16	Are you satisfied with your decision? (E)	0.89	–	–	0.86

Notes: Adapted from O’Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25–30.⁸

Abbreviations: I, Informed subscale; V, Values clarity subscale; S, Support subscale; U, Uncertainty subscale; E, Effective decision subscale (according to the original 5-factors scale).

Table 4 Reliability of Decisional Conflict Scale (DCS)

	Cronbach’s Alpha	Items from Original DCS-16
Original 5-factor 16-item DCS (DCS-16)	0.92	1–16
Informed subscale	0.89	1, 2, 3
Values Clarity subscale	0.86	4, 5, 6
Support subscale	0.66	7, 8, 9
Uncertainty subscale	0.83	10, 11, 12
Effective Decision subscale	0.85	13, 14, 15, 16
Extracted 3-factor 13-item DCS (DCS-13)	0.88	1–8, 11, 12, 14–16
Factor 1 (Uncertainty & Effective Decision)	0.91	11, 12, 14, 15, 16
Factor 2 (Informed & Values Clarity)	0.91	1–6
Factor 3 (Support)	0.51	7, 8
Original 4-factor 10-item DCS (DCS-10, 3 responses)	0.86	1–5, 7–11
Informed	0.86	1, 2, 3
Values Clarity	0.78	4, 5
Support	0.64	7, 8, 9
Uncertainty	0.77	10, 11

Table 5 Correlation Matrix for Construct Validity

	Knowledge About HPV Vaccination
Original 5-factor DCS-16	−0.299**
Informed subscale	−0.124
Values Clarity subscale	−0.208*
Support subscale	−0.185
Uncertainty subscale	−0.301**
Effective Decision subscale	−0.293**
Extracted 3-factor DCS-13	−0.299**
Factor 1 (Uncertainty & Effective Decision)	−0.301**
Factor 2 (Informed & Values Clarity)	−0.180
Factor 3 (Support)	−0.173
Original 4-factor DCS-10 (3 responses)	−0.243*
Informed subscale	−0.103
Values Clarity subscale	−0.211*
Support subscale	−0.177
Uncertainty subscale	−0.288**

Note: *p<0.05, **p<0.01.

Table 6 Summary of Known-Groups Comparisons

	Certainty of Decision	Mean Scores	Standard Deviation	n	P value
Original 5-factor DCS-16	Certain	37.5	18.6	71	0.002
	Uncertain	50.2	20.3	33
Informed subscale	Certain	51.7	28.1	74	0.408
	Uncertain	56.6	28.0	33
Values Clarity subscale	Certain	45.1	27.0	73	0.100
	Uncertain	54.6	27.6	33
Support subscale	Certain	34.9	21.6	74	0.023
	Uncertain	46.2	27.0	33
Uncertainty subscale	Certain	30.7	21.8	72	<0.001
	Uncertain	51.8	27.2	33
Effective Decision subscale	Certain	30.6	20.0	74	0.005
	Uncertain	44.1	26.9	33
Extracted 3-factor DCS-13	Certain	37.7	17.7	72	0.001
	Uncertain	50.6	19.4	33
Factor 1 (Uncertainty & Effective Decision)	Certain	28.6	19.8	73	<0.001
	Uncertain	46.8	25.4	33
Factor 2 (Informed & Values Clarity)	Certain	48.4	25.9	73	0.185
	Uncertain	55.6	24.8	33
Factor 3 (Support)	Certain	30.9	23.6	74	0.007
	Uncertain	45.5	28.6	33
Original 4-factor DCS-10 (3 responses)	Certain	36.5	25.1	72	0.011
	Uncertain	50.6	27.7	33
Informed subscale	Certain	48.9	36.2	74	0.342
	Uncertain	56.1	35.3	33
Values Clarity subscale	Certain	42.1	34.8	73	0.105
	Uncertain	54.6	39.3	33
Support subscale	Certain	31.1	27.2	74	0.034
	Uncertain	47.0	37.6	33
Uncertainty subscale	Certain	22.3	28.1	73	0.006
	Uncertain	43.9	39.0	33

O’Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995;15(1):25–30. doi:10.1177/0272989X9501500105

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