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

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

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.

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.

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).

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.