Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
Department of Fundamental Nursing, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Palliat Support Care. 2021 Jun;19(3):341-347. doi: 10.1017/S1478951520001108.
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.
支持医疗保健专业人员开展预先医疗照护计划（ACP）的重要性已得到全球认可，使用适当的工具评估结果（如人们对 ACP 的理解和准备情况）至关重要。因此，我们开发了一种评估 ACP 进展的国际量表——预先医疗照护计划参与度调查（ACP Engagement Survey）的日语版（包括 15 项、9 项和 4 项），并对其有效性和可靠性进行了检验。
我们将 ACP Engagement Survey 翻译成日语，然后进行回译和文化适应性调整，最后由原始版本的作者进行了审核。同时，我们在一项针对患有慢性病的老年人的在线调查中，收集了基本人口统计学信息和 ACP 相关经验的外部标准数据。我们计算了克朗巴赫α系数以评估其内部一致性，并在三天后进行了重测以计算组内相关系数（ICC）。
共有 200 名应答者（平均年龄 70 岁，9.5%为女性）纳入分析。没有任何一个条目出现满分现象，但有几个条目出现了接近满分的情况。该量表的因子结构与原始版本相同，均为 2 个因子结构，且累积贡献率均较高。克朗巴赫α系数分别为 0.94（15 项版本）、0.91（9 项版本）和 0.95（4 项版本），ICC 分别为 0.88（15 项版本）、0.9（9 项版本）和 0.84（4 项版本）。
日语版 ACP Engagement Survey 的内部一致性和重测信度均非常可靠。结合条目分析的结果，我们可以得出结论，日语版 ACP Engagement Survey 具有足够的可靠性，可用于干预性研究，并且具有可接受的内容效度、结构效度和效标关联效度。
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