Perceived self-efficacy on advance care planning in Latin America: ACP-SEs Latam validation

Advance Care Planning is a fundamental process in palliative and person-centered care, as it promotes clinical decisions that align with patients' values and preferences. However, in Latin America no regionally validated instruments were available to measure professional self-efficacy in this domain although a locally validated Argentinian version is available.

The objective of this study was to conduct a multicenter cross-cultural validation of the Perceived Self-Efficacy in Advance Care Planning Scale (ACP-SEsAR) among Latin American healthcare professionals, ensuring its cultural relevance and psychometric robustness.

An exploratory instrumental study was carried out with 685 healthcare professionals from 18 Spanish-speaking Latin American countries. Linguistic and cultural adaptation followed the International Test Commission guidelines. Twenty-one experts from 12 countries evaluated item clarity, coherence, sufficiency, and relevance using the Content Validity Coefficient (CVC). Reliability and construct validity were analyzed using Cronbach's alpha, McDonald's omega, and exploratory and confirmatory factor analyses.

The analyses demonstrated the scale's strength and consistency in the Latin American context. The expert panel showed excellent agreement (CVC = 0.895). The scale exhibited high internal consistency (α = 0.974; ω = 0.93) and a solid unidimensional structure (KMO = 0.91; CFI = 0.96; RMSEA = 0.048).

The Latin American version, termed ACP-SEs Latam, demonstrated excellent validity, reliability, and cultural adequacy, consolidating its role as an essential tool for strengthening professional training, evaluating interventions, and informing person-centered health policies.