Speakers
Abstract
Advance care planning (ACP) is increasingly recognized as a vital component in medical care due to its emphasis on individuals’ autonomy and dignity across diverse health conditions, including mental health. Prior research has produced numerous measurement instruments to assess ACP-related aspects, with attitudes towards ACP remaining the most frequently measured construct. However, existing tools are not tailored to the context of mental health. Therefore, this study aimed to develop a Spanish-language scale assessing attitudes towards ACP for mental health and gather content-based validity evidence incorporating mental health service users’ perspectives.
Guided by the Theory of Planned Behavior, preliminary items were drafted to align with four theoretical domains measured using a 5-point Likert scale: attitudes towards ACP, subjective norms, perceived behavioral control, and intention to engage in ACP. Three rounds of review and refinement were conducted by four researchers, one of whom was a mental health service user. This process yielded an initial pool of 42 items for further analysis. The readability of the items was assessed using a readability tool. The 37 items that met the readability criteria were then evaluated for relevance and clarity by an expert panel via Qualtrics. Content validity indices were computed, including item-level (I-CVI) and scale-level (S-CVI). Values were considered adequate if ≥ .78 for I-CVI and ≥ .90 for S-CVI.
Readability scores ranged from 61.99 to 102.83, indicating that the language used in the instrument is generally accessible. Feedback was received from 13 experts (81.25% participation rate), including 4 users. I-CVI scores ranged from .69 to 1 for relevance, with three items considered candidates for revision or deletion, and from .77 to 1 for clarity, with two items prompting revision or deletion. S-CVI scores were .93 and .94 for relevance and clarity, respectively, indicating excellent content validity. Based on these results, the Advance Care Planning Attitudes Scale for Mental Health is proposed.
This scale incorporates the mental health service users' perspective from its development to its content validation and addresses the gap in attitudes assessment regarding ACP in mental health. By understanding these attitudes, more effective interventions can be designed to make the implementation of ACP a reality, empowering individuals to take an active role in shaping their future care.
| Author | Zhang, C., Barrios, M., Samprieto, H., Guilera, G. |
|---|---|
| Affiliation | Development and Content Validation of the Advance Care Planning Attitudes Scale foMental Health: Incorporating Mental Health Service Users’ Perspectives |
| Keywords | Scale Development; Content Validation |
