Psychometric Properties of The Thai Version of the Nurses’ Intention to Participate in Advance Care Planning Instrument

Authors

  • Apiradee Pimsen College of Medicine, National Cheng Kung University, Taiwan.
  • Chung-Ying Lin College of Medicine, National Cheng Kung University, Taiwan.
  • Virapun Wirojratana Faculty of Nursing, Mahidol University, Thailand.
  • Bih-Ching Shu College of Medicine, National Cheng Kung University, Taiwan.

DOI:

https://doi.org/10.60099/prijnr.2023.262874

Keywords:

Advance care planning, Attitudes, Intention, Knowledge, Nursing, Psychometric testing, Reliability, Theory of Planned Behavior, Validity

Abstract

        Advance care planning is an essential process in healthcare that necessitates active participation from all involved professionals, particularly nurses. However, in Thailand, nurse involvement in ACP is limited. Assessment of nurses’ intention to participate in
advance care planning is necessary to organize training courses to improve their participation in this critical event. However, there is no tool to evaluate Thai nurses’ intention to participate in Advance care planning. Thus, we selected the Health Professionals’ Experience and Attitudes Questionnaire on Advance Care Planning to culturally adapt and validate it in the Thai context. We achieved this through a five-step process: (1) standard translation procedures, including forward translation, reconciliation, and back-translation; (2) item refinement through an expert panel; (3) conducting content validity and cognitive interviews; and (4) confirmation of the first culturally adapted tool by the expert panel on the factors. The panel of experts suggested adding the knowledge dimension and changing the name to the Nurses’ Intention to Participate in Advance Care Planning and (5) The Thai version was tested for validity and reliability using confirmatory factor analysis, average variance extracted, and the Fornell–Larcker criteria matrix, Cronbach’s α, and composite reliability.
        The final version achieved from testing with 260 registered nurses from a teaching hospital in Bangkok is comprised of 20 items distributed across five key dimensions, namely ‘intention,’ ‘attitude,’ ‘subjective norm,’ ‘perceived behavioral control,’ and ‘knowledge,’ demonstrating an excellent model fit, strong composite reliability, and robust internal consistency. This newly adapted tool is a resource for policymakers and nurse educators designing targeted training courses to enhance nurses’ competency in advance care planning. However, before this tool is widely implemented, it would be beneficial to test it further across diverse groups of nursing professionals.

References

Rietjens JA, Sudore RL, Connolly M, et al. Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. Lancet Oncol. 2017;18(9):e543-51. doi: 10.1016/S1470-2045(17)30582-X.

Dupont C, De Vleminck A, Deliens L, Gilissen J. Advance care planning in Belgium. ZEFQ. 2023 Jun 28. doi: 10. 1016/j.zefq.2023.05.003.

Ikander T, Raunkiær M, Hansen O, Dieperink K. Nurses’ involvement in end-of-life discussions with incurable cancer patients and family caregivers: an integrative review. Palliat Support Care. 2022;20(4):570-81. doi: 10.1017/S1478951521000596.

de Campos AP, Polifroni EC. Development of a standardized simulation: advance care planning conversations for nurses. Nurs Res. 2023;72(1):74-80. doi: 10.1097/ NNR.0000000000000625.

Shepherd J, Waller A, Sanson-Fisher R, Clark K, Ball J. Knowledge of, and participation in, advance care planning: a cross-sectional study of acute and critical care nurses’ perceptions. Int J Nurs Stud. 2018;86:74-81. doi: 10.1016/ j.ijnurstu.2018.06.005.

Rietze L, Heale R, Roles S, Hill L. Identifying the factors associated with Canadian registered nurses’ engagement in advance care planning. J Hosp Palliat Nurs. 2018; 20(3):230-6. doi: 10.1097/njh.0000000000000423.

Beck ER, McIlfatrick S, Hasson F, Leavey G. Nursing home manager’s knowledge, attitudes and beliefs about advance care planning for people with dementia in long‐term care settings: a cross‐sectional survey. J Clin Nurs. 2017; 26(17-18):2633-45. doi: 10.1111/jocn.13690.

Boddy J, Chenoweth L, McLennan V, Daly M. It’s just too hard! Australian health care practitioner intentions on barriers to advance care planning. Aust J Prim Health. 2013;19(1):38-45. doi: 10.1071/PY11070.

van Lummel EV, Meijer Y, Tjan DH, van Delden JJ. Barriers and facilitators for healthcare professionals to the implementation of Multidisciplinary Timely Undertaken Advance Care Planning conversations at the outpatient clinic (the MUTUAL intervention): a sequential exploratory mixed-methods study. BMC Palliat Care. 2023;22(1):24. doi: 10.1186/s12904-023-01139-y.

Martina D, Lin C-P, Kristanti MS, et al. Advanced care planning in Asia: a systematic narrative review of healthcare professionals’ knowledge, attitude, and experience. J Am Med Dir Assoc. 2021;22(2):349.e1-349.e28. doi: 10.1016/j.jamda. 2020.12.018.

Ottoboni G, Chattat R, Camedda C, Galletti M, Macripò S, Mariani E, et al. Nursing home staff members’ knowledge, experience and attitudes regarding advance care planning: a cross-sectional study involving 12 Italian nursing homes. Aging Clin Exp Res. 2019;31(11):1675-83. doi:10. 1007/s40520-018-01110-5.

Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ. 2010;340: c1345. doi:10.1136/bmj.c1345.

Pimsen A, Kao CY, Hsu ST, Shu BC. The effect of advance care planning intervention on hospitalization among nursing home residents: a systematic review and meta-analysis. J Am Med Dir Assoc. 2022;23(9):1448-60.e1.

Milintangkul U. National policy on palliative care in Thailand. National Health Commission Office [Internet]. 2017 Dec [cited 2023 Apr 1]. Available from: https://en.national health.or.th/knowledge-base/national-policy-palliative-care-thailand-dr-ugrid-milintangkul-m-d-m-p-h-advisor-national-health-commission-office-nhco-sept-17-2015/

Nilmanat K. Palliative care in Thailand: development and challenges. Can Oncol Nurs J. 2016;26(3):262-4.

Kajornkijaroen A, Srinonprasert V, Kornbongkotmart S, Praditsuwan R. Difference is opinion regarding end-of-life between older patients and their family, a Thai perspective. BMJ Support Palliat Care. 2011;1(1):65-109. doi:10. 1136/bmjspcare-2011-000053.106.

Hsieh CC, Huang HP, Tung TH, Chen IC, Beaton RD, Jane SW. The exploration of the knowledge, attitudes and practice behaviors of advanced care planning and its related predictors among Taiwanese nurses. BMC Palliat Care. 2019;18(1):99. doi:10.1186/s12904-019-0483-9.

Chan HY, Kwok AO, Yuen K, Au DK, Yuen JK. Association between training experience and readiness for advance care planning among healthcare professionals: a cross-sectional study. BMC Med Educ. 2020;20(1):451. doi:10.1186/ s12909-020-02347-3.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211. doi:10.1016/0749- 5978(91)90020-T.

Ludwick R, Baughman KR, Jarjoura D, Kropp DJ. CE: Original research: advance care planning: an exploration of the beliefs, self-efficacy, education, and practices of RNs and LPNs. Am J Nurs. 2018;118(12):26-32. doi:10.1097/01.NAJ.0000549664.43827.ce.

Pan HH, Wu LF, Chang LF, Hung YC, Lin C, Ho CL. Effects dispositional resilience and self-efficacy on practice in advanced care planning of terminally ill patients among Taiwanese nurses: a study using path modeling. Int J Environ Res Public Health.2021;18(3):1236. doi:10.3390/ijerph18031236.

Kermel Schiffman I, Werner P. Willingness of family caregivers of people with dementia to undertake Advance Care Planning: examining an extended model of the Theory of Planned Behavior. Dementia (London). 2021;20(3): 1044-57. doi:10.1177/1471301220922761.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24): 3186-91. doi:10.1097/00007632-200012150-00014.

He J, van de Vijver F. Bias and equivalence in cross-cultural research. Online Read Psychol Cult. 2(2). doi:10. 9707/ 2307-0919.111.

Welkenhuysen-Gybels J, Billiet J, Cambré B. Adjustment for acquiescence in the assessment of the construct equivalence of Likert-type score items. J Cross-Cult Psychol. 2003;34(6): 702-22. doi:10.1177/00220 22103257070.

Polit DF, Beck CT. Nursing research: principles and methods. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2020. ISBN:1975110641.

Soper DS. A-Priori Sample Size Calculator for Structural Equation Models [Software]. Available from: https:// www.danielsoper.com/statcalc

Kline RB. Principles and practice of structural equation modeling (4th ed.). New York, NY: Guilford Publications. ISBN 978-1-4625-2336-8.

Ding L, Velicer WF, Harlow LL. Effects of estimation methods, number of indicators per factor, and improper solutions on structural equation modeling fit indices. Struct Equ Modeling. 1995;2(2):119-43. doi:10.1080/107 05519509540000.

Anderson JC, Gerbing DW. Structural equation modeling in practice: a review and recommended two-step approach. Psychol Bull. 103(3), 411-23. doi:10.1037/0033-2909. 103.3.411.

Taylor EJ, Li AH. Healthcare chaplains’ perspectives on nurse–chaplain collaboration: an online survey. J Relig Health. 2020;59(2):625-38. doi:10.1007/s10943-019-00974-5.

Pheunpha P, Bowarnkittiwong S. Value-added models for improving university school effectiveness in Thailand. AFBE Journal. 2016;9(2):89-103.

Baruch Y, Holtom BC. Survey response rate levels and trends in organizational research. Hum Relat. 2008;61(8): 1139-60. doi:10.1177/0018726 708094863.

Rosseel Y. Lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48(2):1-36. doi:10.18637/jss.v048.i02.

Marsh, H.W., Hau, K.-T., & Wen, Z. In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Struct Equ Modeling. 2004;11(3):320-41. doi:10.1207/s15328007sem1103_2.

Farrell AM, Rudd JM. Factor analysis and discriminant validity: a brief review of some practical issues. In: Tojib D, editor, Australia-New Zealand Marketing Academy Conference. Australia-New Zealand Marketing Academy; 2009. ISBN: 1-86308-158-5.

Powell DA, Schafer WD. The robustness of the likelihood ratio chi-square test for structural equation models: a meta-analysis. J Educ Behav Stat. 2001;26(1):105–32. doi: 10.3102/10769986026001105.

Comrey AL, Lee HB. A first course in factor analysis. 2nd ed. Psychology Press eBooks; 2013. Available from: https:// doi.org/10.4324/9781315827506

Conner M. Extending not retiring the theory of planned behavior: a commentary on Sniehotta, Presseau and Araújo-Soares. Health Psychol Rev. 2015;9(2):141-5. doi:10.1080/17437199. 2014.899060.

Downloads

Published

2023-09-28

How to Cite

1.
Pimsen A, Chung-Ying Lin, Wirojratana V, Shu B-C. Psychometric Properties of The Thai Version of the Nurses’ Intention to Participate in Advance Care Planning Instrument. PRIJNR [Internet]. 2023 Sep. 28 [cited 2024 Dec. 22];27(4):781-97. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/262874

Issue

Section

Original paper

Categories