Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, Rotterdam, CA, The Netherlands.
Division of Geriatrics, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA.
BMC Med Res Methodol. 2021 Sep 25;21(1):194. doi: 10.1186/s12874-021-01389-5.
Advance 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.
Following validation guidelines, we tested content validity, internal consistency, reproducibility, construct validity, interpretability and criterion validity among persons with and without chronic disease.
Forward-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).
This 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.
预先医疗照护计划（ACP）使人们能够确定、讨论和记录对治疗和护理的偏好。荷兰缺乏 ACP 行为的衡量标准。我们旨在将 34 项 ACP 参与调查翻译成荷兰语，并进行文化适应性验证。
根据验证指南，我们在患有和不患有慢性疾病的人群中测试了内容有效性、内部一致性、可重复性、结构有效性、可解释性和标准有效性。
向前向后翻译表明只需要进行微小的调整。232 人完成了基线和复测调查；121 人年龄≥60 岁。患有慢性疾病的人（n=151）认为该调查比没有患有慢性疾病的人更有价值（66 对 59，p<0.001，20-100 分制），表明具有良好的内容有效性。内部一致性（Cronbach's alpha：0.97）和可重复性（组内相关系数：0.88）良好。患有慢性疾病的人比没有患有慢性疾病的人在 ACP 参与度上更高（2.9 对 2.4，p<0.01，1-5 分制），表明结构有效性和可解释性具有良好的心理计量学支持。ACP 参与调查和一般自我效能感调查的正相关表明具有良好的标准有效性（p<0.05）。
本研究为荷兰 34 项 ACP 参与调查的有效性和可靠性提供了良好的心理计量学支持。该工具可用于评估患有和不患有慢性疾病的成年人参与 ACP 的情况。
