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

Doris van der Smissen*, Agnes van der Heide, Rebecca L. Sudore, Judith A.C. Rietjens, Ida J. Korfage

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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.

Original languageEnglish
Article number194
Number of pages8
JournalBMC Medical Research Methodology
Issue number1
Publication statusPublished - 25 Sept 2021

Bibliographical note

This work was supported by the Netherlands Organisation for Health Research and Development [grant number: 80–84400–98-356]. Dr. Sudore is funded in part by the National Institute on Aging, National Institutes of Health (grant number: K24AG054415). The funding sources had no involvement in the study design, collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the article for publication.

Publisher Copyright:
© 2021, The Author(s).


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