Abstract
BackgroundAdvance care planning (ACP) enables people to define, discuss, and record preferences for treatment and care. Measures of ACP behavior are lacking in the Netherlands. We aimed to translate, culturally adapt and validate the 34-item ACP Engagement Survey into Dutch.MethodsFollowing validation guidelines, we tested content validity, internal consistency, reproducibility, construct validity, interpretability and criterion validity among persons with and without chronic disease.ResultsForward-backward translation indicated the need of only minor adaptations. Two hundred thirty-two persons completed baseline and retest surveys; 121 were aged ≥60 years. Persons with chronic disease (n = 151) considered the survey more valuable than those without (66 vs. 59, p < 0.001, scale of 20–100), indicating good content validity. Internal consistency (Cronbach’s alpha: 0.97) and reproducibility (intraclass correlation: 0.88) were good. Total ACP Engagement was higher among persons with chronic disease than those without (2.9 vs. 2.4, p < 0.01, scale of 1 to 5), indicating good psychometric support for construct validity and interpretability. Positive correlations of the ACP Engagement Survey and the General Self-Efficacy survey indicated good criterion validity (p < 0.05).ConclusionsThis study provided good psychometric support for the validity and reliability of the Dutch 34-item ACP Engagement Survey. This instrument can be used to assess involvement in ACP in adults with and without chronic disease.
Highlights
Advance care planning (ACP) enables people to define, discuss, and record preferences for treatment and care
Validation Content validity We examined whether participants thought all important topics related to ACP were covered and whether topics were missing
Translation from English into Dutch To culturally adapt the survey to the Dutch context, some adaptations were made
Summary
Advance care planning (ACP) enables people to define, discuss, and record preferences for treatment and care. The Advance Care Planning (ACP) Engagement Survey, developed in the United States, is such an instrument. The survey, of which versions exist with 82, 55, 34, 15, 9 and 4 items, evaluates the effects of the entire ACP process [4, 5]. This is important because the focus of ACP has evolved from a sole focus of documenting preferences in an advance directive, to being an ongoing behavior change process in which individuals consider, discuss and record goals, values and preferences for treatment and care [1, 4]. Instruments to measure ACP behavior are lacking in the Netherlands
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