34th International Conference on Oncology Nursing and Cancer Care
Singapore City, singapore
Mackay Medical College,Taiwan
Title: Development and cross-cultural validation of the advance care planning knowledge index (ACPKI)
Biography: Yvonne Hsiung
Two cross-cultural studies were conducted to develop and validate a measure, Advance Care Planning Knowledge Index (ACPKI). Specific aims were to assess prior illness experiences and medical information gained to affect end-of-life decision-making. Through item development and refinement, the original scale was reduced from a 32-item ACP knowledge and experience scale among Chinese-American immigrants residing in greater Chicago area (n=211). With satisfactory content validity, internal consistencies of ACP experience (6 items, α = .67) and ACP knowledge (7 items, α = .84), the exploratory factor analysis (EFA) discovered 2 factors. Overseas Chinese scored high on the ACPKI were found highly positively correlated with socioeconomic status, American acculturation, attitudes toward life-sustaining treatment, and palliative care usage. Further cross-cultural EFA and confirmatory factor analysis yielded the same 2-factor structure among hospitalized Taiwanese patients from various areas (n =508). However, in this Taiwanese sample, 3 items related to self-illness and 3 items of self-rated understanding of ACP were suggestively removed from each subscale for better internal consistencies (α = .69 and .84, respectively) and a better model fit (.92). An individual’s knowledge construct specifically related to life-sustaining treatment, advance directives documents, and the communicative process of ACP appeared to be two dimensional (AVE= 67.33, AGFI= .998). We created a data-driven and efficient tool, the 7-item ACPKI with sound psychometric properties. Future research is necessary to replicate studies for temporal stability across heterogeneous samples and structure confirmation. The potential usefulness of the index as outcome measures for ACP intervention programs is discussed.