Abstract 13088: The Psychometric Properties of the Advance Care Planning Engagement Survey in Cardiovascular Diseases

Abstract

Background: Patients with cardiovascular diseases (CVDs) have high mortality rates, and the progress is uncertain. Advance care planning (ACP) can help these patients and their caregivers prepare for expected or unexpected end-of-life situations effectively. However, the implementation of ACP is suboptimal in this population, resulting in unnecessary suffering of patients and their caregivers and increased health costs. Different versions of the Advance Care Planning Engagement Survey (ACPES) have been used to assess ACP engagement. However, the comprehensive psychometric properties of the ACPES-9 have not been tested in South Korea. Aim: To test the reliability and validity of the ACPES-9 in patients with CVDs. Hypothesis: The reliability of the ACPES-9 is supported by Cronbach’s alpha ≥ .70, and the validity is supported by meeting the cut points of good model fit indices (chi-square test: not significant, CFI ≥ .95, TLI ≥ .95, SRMR < .05, and RMSEA < .07) with factor loadings > .40 in confirmatory factor analysis (CFA) and significant associations of ACP engagement with registration of advance directive (AD) and the intention. Methods: In this cross-sectional study, data on ACP engagement (ACPES-9) and registration of ADs and the intention and sociodemographic characteristics (sample characteristics questionnaire) were collected from 4 hospitals or public health centers (N = 105, mean age: 66.3) between February and March, 2023. Cronbach’s alpha was used to test the reliability. Confirmatory factor analysis and independent t-tests were used to test the validity. Results: Cronbach’s alphas for the total scale and self-efficacy and readiness dimensions were .93, .82, and .97, respectively. In CFA with two factors, all indices of model fit were acceptable: chi-square test = 21.76, p = .151; CFI = .995; TLI = .989; SRMR = .024; RMSEA = .059). All factor loadings were > .65. Patients who registered AD (35.3 vs. 24.3, p < .001) or had the intention (28.9 vs. 20.6, p < .001) had higher scores of the ACPES-9 than their counterparts, respectively. Conclusions: The findings demonstrate that the ACPES-9 was a reliable and valid instrument by supporting the hypothesis. Healthcare providers can use this instrument to assess and manage ACP engagement in patients with CVDs.