1.Research on the standardization of living will model texts based on the Delphi method
Hongjun CHEN ; Wenyue DONG ; Jialin FU ; Xuanyun WANG ; Dingyi WANG ; Yue WANG
Chinese Medical Ethics 2025;38(4):512-521
ObjectiveTo develop a standardized living will manual suitable for promotion in China, combining existing literature and the current implementation status of living will both domestically and internationally as well as the characteristics of modern medicine. MethodsA pool of manual entries was constructed through hospital interviews and literature retrieval. A Delphi method expert correspondence was conducted to modify and supplement the manual entry settings. The results of the correspondence were statistically analyzed to verify the reliability and scientific validity of the manual and the correspondence. ResultsThis study constructed a pool of manual entries by conducting interviews in four hospitals in Beijing and retrieving and including 155 pieces of literature,and developed a preliminary version of the manual with a total of 40 entries in four sections, namely medicine, psychology, society, and farewell. The manual items were revised through two rounds of the Delphi method correspondence with a total of 88 experts. The expert response rates in the two rounds of the correspondence questionnaires were 100% and 90%, respectively; the expert authority coefficients were 0.84 and 0.865, respectively; and Kcndall W was 0.141 and 0.077, respectively. In terms of the reliability test, the Cronbach’s α coefficients of the two rounds of correspondence were 0.941 and 0.969, respectively, and the Guttman coefficients were 0.862 and 0.857, respectively. As for the validity test, the Pearson correlation coefficient for 39 entries was R>0.4 in the first round of correspondence, and for 41 entries was R>0.4 in the second round of correspondence; a total of 20 entries in the first round of correspondence had an I-CVI ≥ 0.780, and the scale’s S-CVI was 0.786; a total of 31 entries in the second round of correspondence had an I-CVI ≥ 0.780, and the scale’s S-CVI was 0.846. Meanwhile, this study developed a legal instrument section of the manual including personal information, effective time, modification and revocation, witnesses, and other contents by reviewing relevant laws and regulations both domestically and internationally. ConclusionThe standardized living will manual is comprehensive, reliable, and scientific, which makes it suitable for promotion and further improvement.