Measuring Self-Efficacy and Readiness for Advance Care Planning in Chinese Older Adults

Abstract

Context: Self-efficacy and readiness for advance care planning (ACP) is underresearched in the Chinese population given that these are novel concepts in the culture.

Objectives: To translate the self-efficacy and readiness subscales of the ACP Engagement Scale into Chinese using the Brislin's Model and test its psychometric properties in Chinese older adults.

Methods: Content validity and face validity were established based on the views of a group of experts and older adults. Then, a survey was conducted with a convenience sample of 204 community-dwelling older adults. Convergent validity was evaluated using Pearson's correlation coefficients with the SURE test, a decisional conflict scale. The scores between older adults who had hospitalization experience in the previous year and those who did not have were compared to examine discriminant validity.

Results: The findings showed that the Chinese subscales had good internal consistency (Cronbach's α 0.94-0.97) and acceptable one-week test-retest reliability (intraclass correlation coefficient 0.66-0.70). There was a significantly high correlation between the self-efficacy and the readiness subscales (r = 0.809; P < 0.01) and moderate correlation between the two subscales and the SURE test (r = 0.509-0.587; P < 0.01). Discriminant validity was supported by significant differences between older adults who had hospitalization experience in the last year and those who did not have (P < 0.05).

Conclusion: The Chinese readiness and self-efficacy subscales of the ACP Engagement Survey are valid and reliable tools for assessing the preparedness of the Chinese older adults for ACP.

Keywords: Advance care planning; Chinese; psychometric testing; readiness; self-efficacy.