Patients' perceptions of their clinical interactions: development of the multidimensional desire for control scales

Interventions oriented toward enhancing patient-provider communication will benefit from having a satisfactory measure of patients’ desires for control in clinical interactions. Findings from two studies are reported describing the development and validation of the Multidimensional Desire for Control (MDC) Scales. A total of 160 patients with non-insulin-dependent diabetes (NIDDM) participated in the first study, which was designed to develop and validate a measure of patients‘ desires for control. Factor analysis yielded three subscales reflecting patients’ desires for: (i) personal, (ii) clinician, and (ii) shared control in the interaction. Alphas for the three subscales were high (α 0.75–0.86). Correlations with other measures of control were suggestive of good construct validity. The second investigation involves a replication study verifying the factorial composition and validity of the scales. An independent sample of 109 patients with NIDDM participated in this study. Findings support the reliability of the subscales (α0.75–0.81). Furthermore, patients‘ desires for control were significantly associated with patient satisfaction, with desire for personal control negatively related to patient satisfaction (r = –0.30, –0.41, affective and behavioural dimensions, respectively) and desire for clinician control positively related to satisfaction (r = 0.44, 0.28, 0.31, affective, behavioral, and cognitive dimensions, respectively).