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Shared Decision-Making in Diabetes Mellitus: Turkish Adaptation and Initial Psychometric Evaluation of the
Merve Toçoğlu1,2, Ayşe Gülsen Ceyhun Peker1, Derya Gökmen3
1Department of Family Medicine, Ankara University School of Medicine, Ankara, Türkiye.
Rationale:
Shared decision-making is a core component of diabetes care and is recommended in current guidelines, yet no brief validated Turkish instrument is available for assessing it in routine practice.
Aims And Objectives:
To adapt the CollaboRATE-5 scale into Turkish and to evaluate its psychometric properties for assessing patients' perceived involvement in shared decision-making.
Method:
This methodological and cross-sectional study was conducted among 200 patients with diabetes mellitus attending the outpatient clinics of the Department of Endocrinology and Metabolism at Ankara University School of Medicine İbn-i Sina Hospital. Adaptation followed standard translation, back-translation, and cultural adaptation procedures. Factor loadings were examined by confirmatory factor analysis, internal consistency by Cronbach's alpha and corrected item-total correlations, and test-retest reliability by intraclass correlation coefficient. Construct validity was assessed by hypothesis testing against the Decisional Conflict Scale.
Results:
The Turkish CollaboRATE-5 demonstrated high internal consistency (Cronbach's alpha = 0.918). Test-retest reliability was assessed in 65 of the 200 participants (ICC = 0.892); those retested had higher baseline scores. Corrected item-total correlation coefficients ranged from 0.776 to 0.866. Standardized factor loadings were high (0.872-0.986), but structural validity could not be independently confirmed in a just-identified three-item model. The mean CollaboRATE total score was 9.51 ± 2.22 (possible range 0-12), and 31.5% of participants achieved the maximum score. CollaboRATE scores showed a moderate-to-high, significant inverse correlation with total Decisional Conflict Scale scores (rs = -0.641, p < 0.001). In exploratory analyses, higher scores were associated with higher educational level, better perceived health status, and male sex (all p < 0.01).
Conclusion:
The Turkish CollaboRATE-5 provides preliminary evidence for reliability and construct validity as a brief measure of perceived shared decision-making in individuals with diabetes mellitus.