Measuring advance care planning behavior in Dutch adults: translation, cultural adaptation and validation of the Advance Care Planning Engagement Survey

• Published in: BMC medical research methodology 2021-09, Vol.21 (1), p.1-194, Article 194
• Main Authors: van der Smissen, Doris, van der Heide, Agnes, Sudore, Rebecca L, Rietjens, Judith A. C, Korfage, Ida J
• Format: Article
• Language: English
• Subjects: Adults; Advance care planning; Advance directives; Age; Analysis; Behavior change; Behavior modification; Behavioral assessment; Care and treatment; Chronic diseases; Chronic illnesses; COVID-19; Diagnosis; Disease; Dutch; Health aspects; Health behavior; Hypotheses; Measurement; Medical research; Methods; Patient outcomes; Patient reported outcome measure; Practice guidelines (Medicine); Psychological aspects; Social aspects; Translation; Translations and translating; Validation; Validation studies; Validity; Web portals
• ISSN: 1471-2288; 1471-2288
• DOI: 10.1186/s12874-021-01389-5

Background 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. Methods Following validation guidelines, we tested content validity, internal consistency, reproducibility, construct validity, interpretability and criterion validity among persons with and without chronic disease. Results Forward-backward translation indicated the need of only minor adaptations. Two hundred thirty-two persons completed baseline and retest surveys; 121 were aged [greater than or equai to]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). Conclusions 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. Keywords: Advance care planning, Behavior change, Patient reported outcome measure, Translation, Dutch, Validation, Chronic disease