OBJECTIVES

: With an increasing number of available options for the treatment of migraine, a patient-individualized approach is required. There is a need to understand the effect of shared decision-making (SDM) as part of a successful therapeutic relationship clinician-patient. The Decisional Conflict Scale (DCS) measures the patients' state of uncertainty during health-related decision-making. We aimed to translate and adapt the DCS into Spanish from Spain for its use with migraine patients.

METHODS

: The translation and cross-cultural adaptation of the original DCS (English) was performed following ISPOR recommended steps: 1) preparation; 2) two independent forward translations, 3) reconciliation; 4) one back translation, 5) harmonization and 6) cognitive debriefing. For cognitive debriefing and content validation, pilot testing was carried out with a small group of migraine patients.

RESULTS

The harmonized Spanish version of the DCS was pilot tested with a sample of 17 patients from two headache outpatient clinics who were unfamiliar with the instrument. Mean age of the respondents 38.8 (SD 11) years; 88% female; mean time since migraine diagnosis 17.2 (SD 12.2) years. Mean time to complete the questionnaire was 2.4 (SD 1.1) minutes; 82.4% of patients considered that the DCS had an adequate length, rating it as “short”, “simple,” and “easy to answer”. During interviews, patients reported that most of the items were highly understandable, and response options were appropriate. However, changes were required in the wording of one of them. After this modification, 76.9% of participants understood better the modified item. More than 80% of patients stated that all the items were highly relevant to assess their decisional conflict.

CONCLUSIONS

: The cognitive debriefing process ensures that the translated and adapted version was easy to understand for this population. The Spanish version of the DCS can be a useful instrument to evaluate decisional conflict in migraine patients.