The decisional conflict scale: Moving from the individual to the dyad level

Decisional conflict is a central determinant of decision making, particularly in the context of uncertainty. It is also one of the most frequently reported outcomes in studies on decision support interventions. Decisional conflict is defined as personal uncertainty about which option to choose. The Decisional Conflict Scale (DCS) is a self-administered questionnaire that was originally designed to assess decisional conflict in patients. The scale has since been adapted to and tested among health professionals, since decisional conflict as seen by doctors, nurses and other healthcare providers has proven useful in evaluating the quality of the shared decision making (SDM) process. In recent years, however, more and more researchers have found that evaluating the perspectives of the patient and the health professional as interdependent members of a dyad, rather than as two autonomous individuals, offers exciting avenues for developing interventions to improve decision making in the clinical setting. For that reason, the SDM community has increasingly turned its attention to a dyadic approach to SDM. In this paper, we briefly review the history of the Dyadic Decisional Conflict Scale (D-DCS), update its psychometrics based on published work, and propose a research agenda for refining it further.