The decision making control instrument to assess voluntary consent

Victoria A Miller1, Richard F Ittenbach2, Diana Harris3

  • 1Department of Anesthesiology and Critical Care Medicine, the Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine (VAM)

Insights

Parents can now measure the perceived voluntariness of medical decisions for their children using the new Decision Making Control Instrument (DMCI). This validated tool assesses self-control, absence of control, and others' control in decision-making.

Area of Science:

  • Medical Ethics
  • Psychometrics
  • Clinical Psychology

Background:

  • Ensuring informed and voluntary consent is crucial for medical interventions and research participation.
  • Parental decision-making for critically ill children requires careful consideration of voluntariness.

Purpose of the Study:

  • To develop and validate an instrument measuring parents' perceived voluntariness when making decisions for their seriously ill children.
  • Introduce the Decision Making Control Instrument (DMCI) as a novel tool for assessing perceived control in medical decision-making.

Main Methods:

  • A 28-item experimental form of the DMCI was administered to 219 parents at a tertiary care children's hospital.
  • Exploratory and confirmatory factor analyses were employed to refine the instrument.
  • The study utilized statistical techniques to validate the construct and internal consistency of the DMCI.

Main Results:

  • Factor analysis reduced the instrument to a 9-item scale with three dimensions: Self-Control, Absence of Control, and Others' Control.
  • The 3-factor model demonstrated consistency with the collected data.
  • The DMCI exhibited high internal consistency (0.83 overall, 0.68-0.87 for subscales) and construct validity, correlating with affect, trust, and decision self-efficacy measures.

Conclusions:

  • The Decision Making Control Instrument (DMCI) is a reliable and valid tool for assessing perceived voluntariness in medical decision-making.
  • The DMCI can enhance understanding of treatment and research decision voluntariness in pediatric healthcare settings.
  • This instrument provides valuable insights into the psychological factors influencing parental consent for medical interventions.
Abstract

Related Concept Videos

Decision Making01:20

Decision Making

Decision-making is a fundamental cognitive process that involves evaluating alternatives and selecting among them. This process can range from simple choices, such as deciding what to wear, to complex decisions, like choosing a major in college or a career path. The complexity of the decision often dictates the approach we use, which can be broadly categorized into two types: automatic and controlled decision-making.
Automatic decision-making is fast, intuitive, and relies on gut feelings...
Nurses' Legal Responsibilities I01:27

Nurses' Legal Responsibilities I

In healthcare, informed consent is a crucial process that involves thoroughly communicating medical treatment options to patients, including benefits, risks, potential side effects, and alternatives. This process enables patients to make well-informed decisions about their care, ensuring they understand the implications of their choices before consenting to or refusing treatment.
The legal responsibilities of a nurse regarding informed consent include the following:
Decision Making: Traditional Method01:14

Decision Making: Traditional Method

The process of hypothesis testing based on the traditional method includes calculating the critical value, testing the value of the test statistic using the sample data, and interpreting these values.
First, a specific claim about the population parameter is decided based on the research question and is stated in a simple form. Further, an opposing statement to this claim is also stated. These statements can act as null and alternative hypotheses, out of which a null hypothesis would be a...
Ethics in Research01:56

Ethics in Research

Today, scientists agree that good research is ethical in nature and is guided by a basic respect for human dignity and safety. However, this has not always been the case. Modern researchers must demonstrate that the research they perform is ethically sound.
Controls in Experiments01:13

Controls in Experiments

When conducting an experiment, it is crucial to have control to reduce bias and accurately measure the dependent variables. It also marks the results more reliable. Controls are elements in an experiment that have the same characteristics as the treatment groups but are not affected by the independent variable. By sorting these data into control and experimental conditions, the relationship between the dependent and independent variables can be drawn. A randomized experiment always includes a...
Decision Making: P-value Method01:09

Decision Making: P-value Method

The process of hypothesis testing based on the P-value method includes calculating the P- value using the sample data and interpreting it.
First, a specific claim about the population parameter is proposed. The claim is based on the research question and is stated in a simple form. Further, an opposing statement to the claim  is also stated. These statements can act as null and alternative hypotheses:  a null hypothesis would be a neutral statement while the alternative hypothesis can have a...