scholarly journals Reliability and Validity of the Traditional Chinese Version of the Advance Care Planning Engagement Survey: A Pilot Evaluation in Taiwanese Outpatients

2021 ◽  
pp. 082585972110512
Author(s):  
Fang-Chun Wei ◽  
Chieh-Kuan Hsu ◽  
Yu-Lin Wu ◽  
Jung-Yu Liao ◽  
Chi-Hsien Huang ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Advance Care Planning ◽  
Medical Center ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Practice Effect ◽  
Chinese Version ◽  
Care Planning ◽  
Advance Care

Objective: The Advance Care Planning Engagement Survey (ACP-ES) has proven effective in evaluating individuals’ engagement in advance care planning (ACP). However, a Traditional Chinese version of ACP-ES (ACPES-TC) has not yet been developed. Therefore, this study aimed to translate and preliminarily validate the ACPES-TC in the Taiwanese context. Material and Methods: A forward and backward translation process was conducted. The translated questionnaire was confirmed by clinical and academic experts. The ACPES-TC was then evaluated for its reliability and validity with participants in the community and from an outpatient clinic in a medical center in Northern Taiwan. The participants comprised healthy people aged 20 to 30 years and patients ≥55 years old, recruited from September 17 to October 28, 2019. Results: Seventy people were recruited, including 20 people aged 20 to 30 years in the community and 50 patients ≥ 55 years old from clinics. The ACPES-TC scores are significantly higher among those of older age, having financial independence, and under long-term medication ( p < .05). The patients’ preference for health-related decision-making is significantly correlated with the ACPES-TC score; the point-biserial correlation coefficient is 0.46 ( p < .001). The discriminant and criterion-related validities are verified. The ACPES-TC demonstrated a good internal consistency (Cronbach's α .97), acceptable one-week test-retest reliability (overall intraclass correlation coefficient 0.86), and low practice effect between the test and retest (Cohen's d .43). Conclusion: The overall reliability and validity of the ACPES-TC are fair, which could be used to evaluate the patients’ engagement in ACP in Taiwan. However, further studies with a full-scale psychometric evaluation are needed.

Psychometric Evaluation of the Nursing Stress Scale (NSS) Among Chinese Nurses in Taiwan

2007 ◽  
Vol 15 (2) ◽  
pp. 133-144 ◽  
Author(s):  
Mei-Hua Lee ◽  
William L. Holzemer ◽  
Julia Faucett
Keyword(s):  
Internal Consistency ◽  
Stress Reduction ◽  
Medical Center ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Internal Consistency Reliability ◽  
Chinese Version ◽  
Stress Scale ◽  
Nursing Stress ◽  
Test Retest Reliability

The purpose of this study was to translate the Nursing Stress Scale (NSS) into Chinese and test its reliability and validity among Chinese nurses in Taiwan. Potential participants were asked to self-administer a Chinese version of the NSS. The agreement estimation was used to determine the equivalence of the meaning between the Chinese and original English versions and was rated by five bilingual nurses as 92% accurate for the 34 items. The test-retest reliability for the NSS at 2 weeks was .71 (p = .022, n = 10). Internal consistency reliability and factor analysis were tested with 770 nurses from 65 inpatient units at a medical center in Taiwan. The internal consistency of the Chinese version of the NSS for an overall coefficient alpha is .91 for the total scale, and ranges from .67 to .79 for the subscales. The Chinese version of the NSS explains 53.77% of the variance in work stressors among Chinese nurses in Taiwan. Overall, the Chinese version of the NSS is internally consistent but may not be stable over 2 weeks. There was adequate evidence of the reliability and validity of the NSS-Chinese as an instrument appropriate to measure work stress among Chinese nurses. The translated NSS could be a useful tool for examining the frequency and major sources of stress experienced by Chinese nurses in hospital settings, and for the development of appropriate interventions for stress reduction.

scholarly journals Measuring advance care planning behavior in Dutch adults: translation, cultural adaptation and validation of the Advance Care Planning Engagement Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Doris van der Smissen ◽  
Agnes van der Heide ◽  
Rebecca L. Sudore ◽  
Judith A. C. Rietjens ◽  
Ida J. Korfage
Keyword(s):  
Chronic Disease ◽  
Construct Validity ◽  
Internal Consistency ◽  
Advance Care Planning ◽  
Content Validity ◽  
Intraclass Correlation ◽  
Criterion Validity ◽  
Care Planning ◽  
Validity And Reliability ◽  
Advance Care

Abstract Background Advance care planning (ACP) enables people to define, discuss, and record preferences for treatment and care. Measures of ACP behavior are lacking in the Netherlands. We aimed to translate, culturally adapt and validate the 34-item ACP Engagement Survey into Dutch. Methods Following validation guidelines, we tested content validity, internal consistency, reproducibility, construct validity, interpretability and criterion validity among persons with and without chronic disease. Results Forward-backward translation indicated the need of only minor adaptations. Two hundred thirty-two persons completed baseline and retest surveys; 121 were aged ≥60 years. Persons with chronic disease (n = 151) considered the survey more valuable than those without (66 vs. 59, p < 0.001, scale of 20–100), indicating good content validity. Internal consistency (Cronbach’s alpha: 0.97) and reproducibility (intraclass correlation: 0.88) were good. Total ACP Engagement was higher among persons with chronic disease than those without (2.9 vs. 2.4, p < 0.01, scale of 1 to 5), indicating good psychometric support for construct validity and interpretability. Positive correlations of the ACP Engagement Survey and the General Self-Efficacy survey indicated good criterion validity (p < 0.05). Conclusions This study provided good psychometric support for the validity and reliability of the Dutch 34-item ACP Engagement Survey. This instrument can be used to assess involvement in ACP in adults with and without chronic disease.

Advance Care Planning Engagement Survey--Chinese Version

2020 ◽  
Author(s):  
Li Liu ◽  
Ya-Yi Zhao ◽  
Li-Hui Zhang ◽  
Helen Yue-Lai Chan
Keyword(s):  
Advance Care Planning ◽  
Chinese Version ◽  
Care Planning ◽  
Advance Care

“It’s about the conversation”: A multidisciplinary intervention to support advance-care planning.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 111-111 ◽  
Author(s):  
Finly Zachariah ◽  
Linda Klein ◽  
Nancy Clifton-Hawkins ◽  
Becky Andrews ◽  
Andrea McQueary ◽  
...  
Keyword(s):  
End Of Life ◽  
Advance Care Planning ◽  
Advance Directive ◽  
Medical Center ◽  
Care Planning ◽  
Innovative Strategies ◽  
Resource Center ◽  
Family Resource ◽  
Advance Care ◽  
Surrogate Decision

111 Background: A recent California Healthcare Foundation study found that 60% of Californians highly valued “making sure their families are not burdened by tough decisions about their care." However, less than 50% have communicated their end-of-life wishes to their surrogate decision maker. 82% say it is important to have end-of-life wishes in writing, but only 23% say they have done so. At City of Hope National Cancer Medical Center (COH) the advance directive (AD) completion rate is less than 15%. The Department of Supportive Care Medicine Sheri & Les Biller Patient and Family Resource Center (BRC) is leading development of innovative strategies to foster Advance Care Planning (ACP) communication and documentation. Methods: A multi-specialty physician and interdisciplinary team assembled and designed a social media advertised 4-hour interactive event that was held in the BRC. Over 40 staff and volunteers facilitated individualized ACP conversations with the “Go Wish” cards, private consultations with social workers, showed novel COH ACP videos, provided multi-lingual ACP literature and advance directive documents available for completion with Notary support on-site. Results: Over 300 people attended, including patients, caregivers and COH staff. Forty-seven advance directives were completed (24 by patient/caregivers, 23 by COH staff). Twenty-nine Go Wish games were facilitated (2 in Spanish). Of the 52 attendees who completed exit evaluations, 44% were patients, 31% staff, and 11% were caregivers. Respondents reported that the event increased their comfort and likelihood of having conversations about ACP with others. Importantly, 38 of the 52 surveyed, did not have an AD prior to attending the event. Of those 38 attendees, 18 of them completed an AD at the event (or 47%). Conclusions: Advanced care planning is an all too often avoided conversation that results in increased distress of patients, families and providers. By proactively designing opportunities for facilitated conversations in dynamic and public arenas, fear and stigmas are diffused and the true focus and intent of discovering what people wish so the medical team, surrogates and family can ensure their values are honored and met become possible.

Engaging staff in advance care planning during National Healthcare Decisions Week at a major cancer hospital.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 19-19
Author(s):  
Lindsay Emanuel ◽  
Gayle Ito-Hamerling ◽  
Nicole Boutros ◽  
Finly Zachariah
Keyword(s):  
General Education ◽  
Advance Care Planning ◽  
Advance Directive ◽  
Administrative Support ◽  
Medical Center ◽  
Care Planning ◽  
National Healthcare ◽  
National Medical ◽  
Personal Ads ◽  
Advance Care

19 Background: In a 2014 study of US adults, “lack of awareness” was the most commonly reported reason for not having an advance directive (AD). Medical staff have opportunities to increase AD awareness for patients at key touchpoints in the cancer treatment trajectory. At City of Hope National Medical Center (COH), the Department of Supportive Care Medicine with administrative support and significant institutional collaboration created a patient-and-staff-centric Advance Care Planning program and marketing awareness campaign titled “Plan Today for Tomorrow.” Methods: Efforts were made to increase staff comfortability with and personal completion of ADs. General education was provided through staff in-services, medical grand rounds, and new employee orientation, all with opportunities to complete personal ADs. In addition, education and training were provided to staff at key patient touchpoints, including new patient services and the pre-anesthesia testing clinic. Most recently, during the 2017 National Healthcare Decisions Week, one day was tailored specifically to increasing the number of staff who have completed their own advance directive. A five dollar Starbucks incentive was made available for non-physician staff who completed their own AD. Free notary services and AD support were made available at multiple locations on the main COH campus and satellites clinics. Results: On the day dedicated to staff outreach and completion of personal ADs during the COH 2017 National Healthcare Decisions week, 109 staff members completed their own AD. Staff participants reported increased comfort with the AD conversation, relief of personal burden by completing AD, increased understanding of the document and the importance of completion, and a sense of “practicing what they preach” to patients. Conclusions: Targeted efforts to engage staff in advance care planning can be successful. Nominal incentives may be helpful to attract staff to explore advance care planning personally. Further work is needed to embed advance care planning and advance directive completion in the culture of healthcare institutions.

scholarly journals Prevalence of Geriatric Syndromes and the Need for Hospice Care in Older Patients of the Emergency Department: A Study in an Asian Medical Center

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ya-Ting Ke ◽  
An-Chi Peng ◽  
Yi-Min Shu ◽  
Min-Hsien Chung ◽  
Kang-Ting Tsai ◽  
...  
Keyword(s):  
Emergency Department ◽  
Sleep Disturbance ◽  
Advance Care Planning ◽  
Hospice Care ◽  
Medical Center ◽  
Care Planning ◽  
Geriatric Syndromes ◽  
Family Meeting ◽  
Advance Care ◽  
Nutrition Problem

Background. The prevalence of geriatric syndromes and the need for hospice care in the emergency department (ED) in Asian populations remain unclear. This study was conducted to fill the data gap. Methods. Using a newly developed emergency geriatric assessment (EGA), we investigated the prevalence of geriatric syndromes and the need for hospice care in older ED patients of a tertiary medical center between September 1, 2016, and January 31, 2017. Results. We recruited a total of 693 patients with a mean age of 78.0 years (standard deviation 8.2 years), comprising 46.6% of females. According to age subgroups, 37.4% of patients were aged 65–74 years, 37.4% were aged 75–84 years, and 25.2% were aged ≥85 years. The prevalence rates of geriatric syndromes were as follows: delirium (11.4%), depression (23.4%), dementia (43.1%), deterioration of activities of daily living (ADL) for <1 year (29.4%), vision impairment (22.2%), hearing impairment (23.8%), sleep disturbance (13.1%), any fall in <1 year (21.8%), polypharmacy (28.7%), pain (35.1%), pressure ulcer (5.6%), incontinence or retention (29.6%), indwelling device or physical restrain (21.6%), nutrition problem (35.7%), frequent use of medical resources (50.1%), lack of advance care planning (84.0%), caregiver problem (4.6%), socioeconomic problem (5.5%), and need for family meeting (6.2%). The need for hospice care was 11.9%. Most geriatric syndromes increased with advancing age except depression, sleep disturbance, polypharmacy, pain, nutrition problem, lack of advance care planning, caregiver problem, and socioeconomic problem. Conclusion. Geriatric syndromes and the need for hospice care were common in the older ED patients. Further studies about subsequent intervention for improving geriatric care are needed.

scholarly journals Capturing what matters: A retrospective observational study of advance care planning documentation at an academic medical center during the COVID-19 pandemic

2021 ◽  
pp. 026921632110659
Author(s):  
Fangdi Sun ◽  
Raphaela Lipinsky DeGette ◽  
Elizabeth C Cummings ◽  
Lisa X Deng ◽  
Karen A Hauser ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Medical Center ◽  
Cohort Analysis ◽  
Academic Medical Center ◽  
Care Planning ◽  
Code Status ◽  
Palliative Care Consultation ◽  
Advance Care ◽  
Care Consultation

Background: Advance care planning allows patients to share their preferences for medical care with the aim of ensuring goal-concordant care in times of serious illness. The morbidity and mortality of the COVID-19 pandemic has increased the importance and public visibility of advance care planning. However, little is known about the frequency and quality of advance care planning documentation during the pandemic. Aim: This study examined the frequency, quality, and predictors of advance care planning documentation among hospitalized medical patients with and without COVID-19. Design: This retrospective cohort analysis used multivariate logistic regression to identify factors associated with advance care planning documentation. Setting/participants: This study included all adult patients tested for COVID-19 and admitted to a tertiary medical center in San Francisco, CA during March 2020. Results: Among 262 patients, 31 (11.8%) tested positive and 231 (88.2%) tested negative for SARS-CoV-2. The rate of advance care planning documentation was 38.7% in patients with COVID-19 and 46.8% in patients without COVID-19 ( p = 0.45). Documentation consistently addressed code status (100% and 94.4% for COVID-positive and COVID-negative, respectively), but less often named a surrogate decision maker, discussed prognosis, or elaborated on other wishes for care. Palliative care consultation was associated with increased advance care planning documentation (OR: 6.93, p = 0.004). Conclusion: This study found low rates of advance care planning documentation for patients both with and without COVID-19 during an evolving global pandemic. Advance care planning documentation was associated with palliative care consultation, highlighting the importance of such consultation to ensure timely, patient-centered advance care planning.

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