Abstract

Objectives

Evidence on the validity of the French version of the Decisional Conflict Scale (DCS) remains limited, especially among people living with chronic noncancer pain in Canada. This study examined the measurement properties of the French 16-item DCS and assessed its cross-cultural measurement invariance in this population.

Methods

We conducted a secondary analysis of a pan-Canadian cross-sectional online survey following the Consensus-Based Standards for the Selection of Health Measurement Instruments guidance. We evaluated score distribution, including ceiling and floor effects. We assessed readability, internal consistency, structural validity of a hypothesized 5-factor model, and convergent and discriminant validities. We tested measurement invariance between the French and English versions.

Results

We analyzed data from 270 French-speaking Canadians (mean age = 51; 60% male; 54.8% with less than a university diploma; and 70.4% with limited health literacy). The French DCS showed good readability (Flesch-Kincaid Grade Level: 5.6), no ceiling or floor effects for the total score, and high internal consistency (ω = 0.95). The 5-factor structure was supported (CFI = 0.98). Convergent validity was confirmed (AVE: 0.61-0.72), but discriminant validity was poor (AVE and 71.3% with limited health literacy).

Conclusions

The French 16-item DCS has acceptable measurement properties and cross-cultural measurement invariance in people living with chronic noncancer pain. Further research is necessary to enhance its validity, possibly by reexamining its factor structure.