老年人对预先医疗指示的知识、态度和行为意向：问卷的制定和测试。
Knowledge, attitudes, and behavioral intentions of elderly individuals regarding advance care planning: Questionnaire development and testing.
机构信息
School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.
出版信息
PLoS One. 2022 Jul 28;17(7):e0272351. doi: 10.1371/journal.pone.0272351. eCollection 2022.
BACKGROUND
Studies have indicated that the advance care planning knowledge and attitudes of elderly individuals strongly affect their implementation of advance care planning. A measurement with a theoretical base for evaluating elderly individuals' knowledge, attitudes, and behavioral intentions regarding advance care planning is lacking.
OBJECTIVES
To develop a questionnaire and understand elderly individuals' knowledge, attitudes, and behavioral intentions regarding implementing advance care planning.
METHODS
A cross-sectional questionnaire survey was conducted. The content validity index, and statistical methods, including discrimination, factor, and reliability analysis, were adopted for psychometric testing. Descriptive statistics mainly presented data analysis.
RESULTS
401 elderly individuals were recruited from a medical center and one senior activity center. The content validity index was approximately 0.71-0.92 for the developed questionnaires, the Kuder-Richardson formula 20 was 0.84 for advance care planning knowledge, and the Cronbach's alpha was 0.86, 0.94, 0.76, and 0.92 for attitudes, behavioral intentions, influencing factors, and subjective norms, respectively. The average score for advance care planning knowledge for elderly individuals was 4.42, with a correct answer rate of 49.1%. They lacked knowledge of advance care planning-related legislation. The mean score for attitudes and behavioral intentions was 14.32 and 3.48, respectively. Elderly individuals agreed that advance care planning has benefits but were worried about the emotional distress caused by advance care planning discussions. Elderly individuals with positive behavioral intentions tend to implement advance care planning. Spouses, children, doctors, and nurses are significant reference people for elderly individuals.
CONCLUSIONS
The developed questionnaire exhibits good validity and reliability for understanding elderly individuals' knowledge, attitudes, and behavioral intentions concerning advance care planning. Advance care planning materials or decision aids suitable for elderly individuals must be developed to increase their understanding of advance care planning. Additionally, the role of nurses is indispensable in promoting advance care planning among elderly individuals.
背景
研究表明，老年人的预先护理计划知识和态度会强烈影响他们实施预先护理计划。缺乏一种具有理论基础的测量工具来评估老年人对预先护理计划的知识、态度和行为意向。
目的
开发一种问卷，以了解老年人对实施预先护理计划的知识、态度和行为意向。
方法
采用横断面问卷调查法。采用内容效度指数和统计学方法，包括区分度、因子和信度分析进行心理测量学检验。描述性统计主要呈现数据分析。
结果
共招募了 401 名来自一家医疗中心和一个老年人活动中心的老年人。开发问卷的内容效度指数约为 0.71-0.92，预先护理计划知识的 Kuder-Richardson 公式 20 为 0.84，态度、行为意向、影响因素和主观规范的克朗巴哈系数分别为 0.86、0.94、0.76 和 0.92。老年人预先护理计划知识的平均得分为 4.42，正确回答率为 49.1%。他们对与预先护理计划相关的立法知之甚少。态度和行为意向的平均得分为 14.32 和 3.48。老年人认为预先护理计划有好处，但担心预先护理计划讨论带来的情绪困扰。具有积极行为意向的老年人更倾向于实施预先护理计划。配偶、子女、医生和护士是老年人的重要参考人。
结论
开发的问卷具有良好的信度和效度，可用于了解老年人对预先护理计划的知识、态度和行为意向。必须开发适合老年人的预先护理计划材料或决策辅助工具，以提高他们对预先护理计划的理解。此外，护士在促进老年人预先护理计划方面的作用不可或缺。
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