Melbourne Decision Making Questionnaire Download !EXCLUSIVE!
Collipal Cabello
Introduction: Decision making (DM) is among the most important abilities for everyday functioning. However, the most widely used measures of DM come from behavioral paradigms, whose ecological validity and standalone use has been criticized in the literature. Though these issues could be addressed by the use of DM questionnaires as a complementary assessment method, no such instruments have been validated for use in Brazilian Portuguese. Therefore, the aim of this study was to conduct the translation and validation of the Melbourne Decision Making Questionnaire (MDMQ) for use in a Brazilian population.
Aims To develop a measure of dentists' anxiety in clinical situations; to establish if dentists' anxiety in clinical situations affected their self-reported clinical decision-making; to establish if occupational stress, as demonstrated by burnout, is associated with anxiety in clinical situations and clinical decision-making; and to explore the relationship between decision-making style and the clinical decisions which are influenced by anxiety.Design Cross-sectional study.Setting Primary Dental Care.Subjects and methods A questionnaire battery [Maslach Burnout Inventory, measuring burnout; Melbourne Decision Making Questionnaire, measuring decision-making style; Dealing with Uncertainty Questionnaire (DUQ), measuring coping with diagnostic uncertainty; and a newly designed Dentists' Anxieties in Clinical Situations Scale, measuring dentists' anxiety (DACSS-R) and change of treatment (DACSS-C)] was distributed to dentists practicing in Nottinghamshire and Lincolnshire. Demographic data were collected and dentists gave examples of anxiety-provoking situations and their responses to them.Main outcome measure Respondents' self-reported anxiety in various clinical situations on a 11-point Likert Scale (DACSS-R) and self-reported changes in clinical procedures (Yes/No; DACSS-C). The DACSS was validated using multiple t-tests and a principal component analysis. Differences in DACSS-R ratings and burnout, decision-making and dealing with uncertainty were explored using Pearson correlations and multiple regression analysis. Qualitative data was subject to a thematic analysis.Results The DACSS-R revealed a four-factor structure and had high internal reliability (Cronbach's α = 0.94). Those with higher DACSS-R scores of anxiety were more likely to report changes in clinical procedures (DACSS-C scores). DACSS-R scores were associated with decision-making self-esteem and style as measured by the MDMQ and all burnout subscales, though not with scores on the DUQ scale.Conclusion Dentists' anxiety in clinical situations does affect the way that dentists work clinically, as assessed using the newly designed and validated DACSS. This anxiety is associated with measures of burnout and decision-making style with implications for training packages for dentists.
Table 4 summarizes the mean and standard deviation of the total and subscale scores of the DMDCQ in the entire sample of participants. When the total score of the questionnaire and the scores of its subscales are higher, higher numbers of individuals make positive decisions and the couple will be more inclined toward donor conception in the future.
Decision-making (DM) is simply choosing among alternatives or defining one's course of action. A depressed individual does not perceive himself as a decision-maker as ruminations reinforce dysfunctional metacognitive beliefs and poor executive functioning. The aim was to study and compare the relationship among DM, metacognition, and executive functioning in those with recurrent depressive disorder (RDD) and in healthy controls (HCs).
Relationships between suicide intention, cognitive styles, and decision making in attempted suicide
Suhruth Reddy1, Dushad Ram2
1 Department of Psychiatry, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India
2 Department of Medicine (Psychiatry), College of Medicine, Shaqra University, Shaqra, Saudi Arabia
Decisions about how to manage bothersome symptoms of chronic illness are complex and influenced by factors related to the patient, their illness, and their environment. Naturalistic decision-making describes decision-making when conditions are dynamically evolving, and the decision maker may be uncertain because the situation is ambiguous and missing information. Contextual factors, including time stress, the perception of high stakes, and input from others may facilitate or complicate decisions about the self-care of symptoms. There is no valid instrument to measure these contextual factors. The purpose of this study was to develop and test a self-report instrument measuring the contextual factors that influence self-care decisions about symptoms.
The Self-Care Decisions Inventory is a 27-item self-report instrument that measures the extent to which contextual factors influence decisions about symptoms of chronic illness. The six scales (external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment) reflect naturalistic decision making, have excellent content validity, and demonstrate high multidimensional reliability. Additional testing of the instrument is needed to evaluate clinical utility.
How adults with chronic illness make decisions about what to do when experiencing symptoms is poorly understood. The naturalistic decision making framework may help to explain how such decisions are made. Naturalistic decision making focuses on how people use experience to make decisions and how contextual factors influence this process [2]. The decision maker may experience uncertainty when the situation is ambiguous, the environment is changing, or necessary information is missing. For example, a symptom may be new, or an individual may be unsure what caused the symptom. Decisions may also be influenced by time stress (e.g., symptom changes quickly), the perception that there is much at stake (e.g., symptom is severe), and conflicting input from multiple individuals [2].
First, contextual factors were identified from the literature that are thought to influence self-care decisions. Next, a preliminary list of items was generated. The items described how these contextual factors influence the response to bothersome symptoms based on the foundational work on naturalistic decision making [2] as well as the application of naturalistic decision making to self-care decisions in adults with heart failure [3]. The authors discussed and revised the items as well as the instrument instructions and scoring format until consensus was reached on an initial instrument draft.
Content validity is the degree to which the content of the instrument reflects the construct (i.e., naturalistic decision making) that the instrument was designed to measure [9]. The COSMIN methodology for evaluating content validity defines three properties of content validity (relevance, comprehensiveness, and comprehensibility) and further recommends that both patients and professionals are involved in the validation process [10]. Thus, we evaluated the content validity of the instrument in two ways: (i) A Delphi survey of clinicians and researchers and (ii) Cognitive interviews with adults with chronic illness.
The Delphi technique uses structured questionnaires that are distributed in iterative rounds to a group of experts who remain anonymous to each other throughout the process [11]. For the Delphi survey, we defined experts as (i) Clinicians who routinely help adults make decisions about their chronic illnesses and (ii) Researchers who have published on decision making related to chronic illness in the scientific literature. Experts were identified through a Facebook discussion on the topic of decision-making in self-care, a literature search on decision-making in chronic illness, and the professional networks of the study authors. The Delphi survey was completed electronically using Qualtrics (Provo, UT). Respondents rated the relevance of items to the construct of naturalistic decision making on a 4-point scale (not relevant, somewhat relevant, quite relevant, highly relevant). The comprehensibility of items was rated dichotomously (clear, not clear). Respondents had the opportunity to suggest new items to support comprehensiveness of the instrument and ensure that no facets of the construct were omitted. Finally, respondents provided feedback on the clarity of the proposed instrument instructions and the scoring format.
No measure of the contextual factors influencing decision making as described in the naturalistic decision making framework exists, so we chose to assess convergent validity, the degree to which the new measure is related to other measures of decision-making. We compared each recalibrated Self-Care Decisions Inventory with the Melbourne Decision-Making questionnaire (Melbourne DMQ) domains. The Melbourne DMQ measures four patterns for coping with decisional conflict: vigilance, hypervigilance, buck passing and procrastination [7]. The coping pattern of vigilance involves clarifying objectives, canvassing an array of alternatives, searching for relevant information, assimilating that information, and evaluating alternatives before making a choice. The pattern of hypervigilance involves frantic searching, time pressure, and impulsive choice of a contrived solution. Buck passing is described as an avoidance style associated with defensiveness and dependency. Finally, procrastination is another form of defensive avoidance that involves delaying decision making. Higher scores indicate a preference for that coping pattern and vigilance is negatively correlated with the other patterns. The scale alpha coefficient reliabilities ranged from 0.74 to 0.87 in a sample of 2018 participants from six countries [7]. We hypothesized that each recalibrated scale on the Self-Care Decisions Inventory would be significantly associated with Melbourne DMQ domains. Linear correlations with Bonferroni correction were computed to test these hypotheses.
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