Decisional Conflict Scale
The decisional conflict scale (DCS) measures personal perceptions of:
- uncertainty in choosing options;
- modifiable factors contributing to uncertainty such as feeling uninformed, unclear about personal values and unsupported in decision making; and
- effective decision making (in full version) such as feeling the choice is informed, values-based, likely to be implemented and expressing satisfaction with the choice.
The User Manual describes the properties, scoring and directions for administration for each of the DCS versions. The 4 versions are listed below along with links to available translations.
- Traditional DCS: 16 statements, 5 response categories.
Available in: English, French, Danish, Simplified Chinese, Spanish (Chile), German, Japanese, Italian, Malay, Brazilian Portuguese, Spanish (Spain), Swedish, Hebrew. - Question Format DCS: 16 questions, 5 response categories.
Available in: Traditional Chinese. - Low Literacy DCS: 10 questions, 3 response categories.
Available in: English, Spanish (Chile), Spanish (US). - SURE Test for clinical practice: 4 items, 2 response categories.
Available in: English, French, Traditional Chinese, Japanese.
You may use any of these measurement tools without requesting permission. These tools are protected by copyright but are freely available for you to use, provided you: a) cite the reference in any questionnaires or publications; b) do not charge for or profit from them; and c) do not alter them except for adding a specific condition/decision as necessary.
Important Citations
- O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995 Jan-Mar;15(1):25-30.
- Légaré F, Kearing S, Clay K, Gagnon S, D'Amours D, Rousseau M, O'Connor AM. Are you SURE? Assessing patient decisional conflict with a 4-item screening test. Can Fam Physician. 2010 Aug;56(8):e308-14.
- Linder SK, Swank PR, Vernon SW, Mullen PD, Morgan RO, Volk RJ. Validity of a low literacy version of the Decisional Conflict Scale. Patient Educ Couns. 2011 Dec;85(3):521-4. doi: 10.1016/j.pec.2010.12.012. Epub 2011 Feb 5.
- Légaré F, Leblanc A, Robitaille H, Turcotte S. The decisional conflict scale: moving from the individual to the dyad level. Z Evid Fortbild Qual Gesundhwes. 2012;106(4):247-52. Epub 2012 Mar 28.
- Ferron Parayre A, Labrecque M, Rousseau M, Turcotte S, Légaré F. Validation of SURE, a Four-Item Clinical Checklist for Detecting Decisional Conflict in Patients. Med Decis Making. 2014 Jan;34(1):54-62. doi: 10.1177/0272989X13491463. Epub 2013 Jun 17.
- Turcotte S, Guerrier M, Labrecque M, Robitaille H, Rivest LP, Hess B, Légaré F. Dyadic validity of the Decisional Conflict Scale: common patient/physician measures of patient uncertainty were identified. J Clin Epidemiol. 2015 Aug;68(8):920-7. doi: 10.1016/j.jclinepi.2015.03.005. Epub 2015 Mar 21.
- Pecanac KE, Brown RL, Steingrub J, Anderson W, Matthay MA, White DB. A psychometric study of the decisional conflict scale in surrogate decision makers. Patient Educ Couns. 2018 Nov;101(11):1957-1965. doi: 10.1016/j.pec.2018.07.006. Epub 2018 Jul 7.
- Garvelink MM, Boland L, Klein K, Nguyen DV, Menear M, Bekker HL, Eden KB, LeBlanc A, O’Connor A, Stacey D, Légaré F. Decisional Conflict Scale Use over 20 Years: The Anniversary Review. Medical Decision Making. 2019;39(4):301-314. doi:10.1177/0272989X19851345
- Garvelink MM, Boland L, Klein K, Nguyen DV, Menear M, Bekker HL, Eden KB, LeBlanc A, O’Connor A, Stacey D, Légaré F. Decisional Conflict Scale Findings among Patients and Surrogates Making Health Decisions: Part II of an Anniversary Review. Medical Decision Making. 2019;39(4):316-327. doi:10.1177/0272989X19851346
- Brodney S, Fowler FJ Jr, Barry MJ, Chang Y, Sepucha K. Comparison of Three Measures of Shared Decision Making: SDM Process_4, CollaboRATE, and SURE Scales. Med Decis Making. 2019 Jun 21. doi: 10.1177/0272989X19855951. [Epub ahead of print]
- Pozzar RA, Berry DL, Hong F. Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer. BMC Med Inform Decis Mak. 2019 Jul 4;19(1):124. doi: 10.1186/s12911-019-0853-5.
- Boland L, Légaré F, McIsaac DI, Graham ID, Monica T, Decary S, Stacey D. SURE Test Accuracy for Decisional Conflict Screening among Parents Making Decisions for Their Child. Med Decis Making. 2019 Nov 15. doi: 10.1177/0272989X19884541.
- Antunes CMTB, Bampi LNDS, Filho FMDA, Hua FY. Adaptation and cross-cultural validation of the Decisional Conflict Scale for use in Brazil. Revista Eletrônica Acervo Saúde (REAS). 2021. 13(12), 1-9. doi: 10.25248/REAS.e9136.2021.
- Guerrero-Peral ÁL, Porta-Etessam J, Rodríguez-Vico J, Núñez M, Ciudad A, Díaz-Cerezo S, Garí-Peris C, Pérez-Sádaba FJ, Lizán L, Santos-Lasaosa S. Adaptation and validation of the Spanish version of the Decisional Conflict Scale in people with migraine in Spain. Patient Prefer Adherence. 2022 Dec 15;16:3291-3302. doi: 10.2147/PPA.S384333. eCollection 2022.
Last modified: 2023-11-15.
