Development and psychometric testing of the Advance Care Planning Decision Balance Scale for Family Members of Patients with Advanced Cancer
10.3760/cma.j.cn115682-20250309-01152
- VernacularTitle:晚期癌症患者家属预立医疗照护计划参与决策平衡量表编制与信效度检验
- Author:
Aihong WU
1
;
Xiaoqing LUO
1
;
Xiuni GAN
1
;
Qian WU
1
;
Xuelan XIA
1
;
Lingjie ZHANG
1
;
Min ZHENG
1
Author Information
1. 重庆医科大学附属第二医院呼吸与危重症医学科，重庆 400010
- Publication Type:Journal Article
- Keywords:
Neoplasms;
Advance care planning;
Decisional balance;
Advanced cancer;
Family members;
Scale development;
Reliability and validity
- From:
Chinese Journal of Modern Nursing
2025;31(30):4114-4120
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To develop a culturally adapted Advance Care Planning (ACP) Decision Balance Scale for Family Members of Patients with Advanced Cancer in China, and to test its reliability and validity.Methods:Based on the transtheoretical model-decisional balance framework, the item pool was established through literature analysis, qualitative interviews, and research team discussions. After expert panel meetings and semantic debugging pre-surveys among family members of patients with advanced cancer, item screening was conducted to form the pilot scale. From October to December 2024, the scale was administered to 310 family members of inpatients with advanced cancer in five Class Ⅲ Grade A hospitals in Chongqing. SPSS and AMOS software were used for item analysis and reliability and validity testing, and the final formal scale was developed.Results:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer consisted of 2 dimensions, perceived cost of choice and perceived benefit of choice, with a total of 12 items. The Cronbach's α coefficient of the scale was 0.875, the split-half reliability was 0.905, and the test-retest reliability was 0.856. The item-level content validity index ranged from 0.880 to 1.000, and the scale-level content validity index was 0.980. Exploratory factor analysis extracted 2 common factors, with a cumulative variance contribution rate of 65.365%. Confirmatory factor analysis showed χ 2/ df=1.743, and the model fit indices met the requirements. The scale also demonstrated good convergent validity and discriminant validity. Conclusions:The ACP Decision Balance Scale for Family Members of Patients with Advanced Cancer developed in this study demonstrated good reliability and validity. It can be used as a tool to assess the level of ACP decision-making participation of family members of patients with advanced cancer, and to systematically, comprehensively, and effectively evaluate, collect, and analyze their behavioral intentions and barriers regarding ACP decision-making.
