Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers

Lauren Van Scoy, Andrew G. Day, Michelle Howard, Rebecca Sudore, Daren K. Heyland

Research output: Contribution to journalArticle

Abstract

Context: Although measures that assess patient engagement in the advance care planning (ACP) process exist, there are no validated tools to assess surrogate decision makers' (SDMs') role in ACP. Objectives: The objective of this study was to adapt and begin to validate a patient-oriented questionnaire for use with SDMs of patients with chronic illness. Methods: Questions from the 55-item patient-oriented ACP engagement survey were adapted for SDMs and assessed for face validity. The resultant 47-item questionnaire was administered to 65 SDMs of patients with chronic illness. Responses were assessed and items were flagged for removal based on item redundancy, nonresponses, and ceiling effects. A preliminary exploratory factor analysis was performed, internal consistency was assessed, and domains were constructed based on findings. Results: The 47-item questionnaire was administered to 65 participants (mean age 51.8; 81% female; 96% Caucasian). Seventeen items were removed owing to redundancy (r > 0.80), and 13 items lacking face validity were removed. In a preliminary exploratory factor analysis of the resultant 17-item questionnaire, a three-factor solution was deemed most statistically and conceptually sound. Items were organized into domains: 1) serving as an SDM (seven items); 2) contemplation (four items); 3) readiness (six items). Internal consistency for each domain was high (Cronbach alpha 0.90–0.91). Conclusion: The 17-item ACP engagement survey for SDMs (ACP-17-SDM) is a conceptually sound and reliable questionnaire adaptation of the original ACP engagement survey. This questionnaire may be used by researchers in parallel with the patient-oriented ACP engagement survey to more fully understand the impact of ACP interventions on SDMs. Larger studies are needed to more closely examine construct validity.

Original languageEnglish (US)
Pages (from-to)980-988.e9
JournalJournal of Pain and Symptom Management
Volume57
Issue number5
DOIs
StatePublished - May 1 2019

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Advance Care Planning
Reproducibility of Results
Statistical Factor Analysis
Chronic Disease
Surveys and Questionnaires
Patient Participation
SDM

All Science Journal Classification (ASJC) codes

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Van Scoy, Lauren ; Day, Andrew G. ; Howard, Michelle ; Sudore, Rebecca ; Heyland, Daren K. / Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers. In: Journal of Pain and Symptom Management. 2019 ; Vol. 57, No. 5. pp. 980-988.e9.
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abstract = "Context: Although measures that assess patient engagement in the advance care planning (ACP) process exist, there are no validated tools to assess surrogate decision makers' (SDMs') role in ACP. Objectives: The objective of this study was to adapt and begin to validate a patient-oriented questionnaire for use with SDMs of patients with chronic illness. Methods: Questions from the 55-item patient-oriented ACP engagement survey were adapted for SDMs and assessed for face validity. The resultant 47-item questionnaire was administered to 65 SDMs of patients with chronic illness. Responses were assessed and items were flagged for removal based on item redundancy, nonresponses, and ceiling effects. A preliminary exploratory factor analysis was performed, internal consistency was assessed, and domains were constructed based on findings. Results: The 47-item questionnaire was administered to 65 participants (mean age 51.8; 81{\%} female; 96{\%} Caucasian). Seventeen items were removed owing to redundancy (r > 0.80), and 13 items lacking face validity were removed. In a preliminary exploratory factor analysis of the resultant 17-item questionnaire, a three-factor solution was deemed most statistically and conceptually sound. Items were organized into domains: 1) serving as an SDM (seven items); 2) contemplation (four items); 3) readiness (six items). Internal consistency for each domain was high (Cronbach alpha 0.90–0.91). Conclusion: The 17-item ACP engagement survey for SDMs (ACP-17-SDM) is a conceptually sound and reliable questionnaire adaptation of the original ACP engagement survey. This questionnaire may be used by researchers in parallel with the patient-oriented ACP engagement survey to more fully understand the impact of ACP interventions on SDMs. Larger studies are needed to more closely examine construct validity.",
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Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers. / Van Scoy, Lauren; Day, Andrew G.; Howard, Michelle; Sudore, Rebecca; Heyland, Daren K.

In: Journal of Pain and Symptom Management, Vol. 57, No. 5, 01.05.2019, p. 980-988.e9.

Research output: Contribution to journalArticle

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AU - Day, Andrew G.

AU - Howard, Michelle

AU - Sudore, Rebecca

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