Abstract
The importance of supporting advance care planning (ACP) by healthcare professionals is recognized worldwide, and assessing the outcomes, such as people's understanding and readiness for ACP, using an appropriate instrument is essential. We, therefore, developed a Japanese version of the Advance Care Planning Engagement Survey (ACP Engagement Survey; 15 items, 9 items, and 4 items), an international scale for assessing the progress of the ACP, and examined its validity and reliability. The ACP Engagement Survey was translated into Japanese, back-translated, and culturally adapted, and the final version was reviewed by the author of the original version. Data on basic demographic information and ACP-related experiences were simultaneously collected as external criteria in an online survey of older adults with chronic diseases. The Cronbach's alpha was calculated to assess its internal consistency, and a retest was performed three days later to calculate the intra-class correlation coefficients (ICCs). A total of 200 respondents (mean age 70; 9.5% female) were included in the analysis. None of the items showed a ceiling effect, but several items did exhibit a floor effect. The factor structure was the same 2-factor structure as the original version, and both factors exhibited a high cumulative contribution rate. The Cronbach's alphas were 0.94 (15-item version), 0.91 (9-item version), and 0.95 (4-item version), and ICCs were of 0.88 (15-item version), 0.9 (9-item version), and 0.84 (4-item version). The Japanese version of the ACP Engagement Survey was confirmed to have very good reliability regarding both internal consistency and test-retest reliability. Together with the result of the item analysis, we can conclude that the Japanese version of the ACP Engagement Survey is sufficiently reliable to be utilized in interventional studies, and it has acceptable content validity, construct validity, and criterion-related validity.
Highlights
Advance care planning (ACP), which involves patients and their surrogate decision-makers discussing the patient’s end-of-life care with healthcare professionals, has gained importance with recent advances in medical technology and the social background, and its effectiveness has been validated worldwide (Weathers et al, 2016; Jimenez et al, 2018)
The results showed that those who completed advance directives (AD) were not always able to receive the care they had specified in the AD
The results showed that it has high internal consistency and high construct validity
Summary
Advance care planning (ACP), which involves patients and their surrogate decision-makers discussing the patient’s end-of-life care with healthcare professionals, has gained importance with recent advances in medical technology and the social background, and its effectiveness has been validated worldwide (Weathers et al, 2016; Jimenez et al, 2018). Studies have shown that ACP can help individuals receive the desired medical care and health support, improve patient–physician communication, and increase the patient’s and family’s satisfaction with the end-of-life care (Meeker and Jezewski, 2005; Detering et al, 2010; Murray and Butow, 2010; Ke et al, 2015; Martin et al, 2016). Merely completing an AD can make it difficult for proxy decision-makers to respond appropriately when circumstances change (The SUPPORT Project). It is important to share the process of discussing future goals and expectations based on the patient’s values with their family and/or close friends (Connors et al, 1995; Collins et al, 2006)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
