Assessing the internal consistency and temporal stability of advance directives generated by an interactive, online...

Area of Science:

• Health Informatics
• Medical Ethics
• Patient Decision Aids

Background:

• Advance directives (ADs) are crucial for patient autonomy in healthcare.
• Online tools can facilitate the creation of ADs, but their reliability needs evaluation.

Purpose of the Study:

• To assess the internal consistency and temporal stability of ADs created using an interactive online program.
• To determine the reliability of AD components over time.

Main Methods:

• 33 participants completed the online AD program across three sessions, spaced two weeks apart.
• Agreement rates for 'General Wishes' and test-retest correlations for 'Specific Wish for Treatment' were analyzed.

Main Results:

• 'General Wishes' demonstrated high temporal stability (94% identical responses).
• 'Specific Wish for Treatment' showed moderate stability (average ρ=0.59-0.75), with lower stability than 'General Wishes'.
• Internal consistency across all time points and scenarios was high (Cronbach's α > 0.90).

Conclusions:

• Online ADs exhibit good temporal stability, particularly for general preferences.
• Specific treatment preferences show moderate stability, suggesting potential for refinement.
• The online program effectively generates reliable advance directives.