Alaina J Brown1, Megan Johnson Shen, Diana Urbauer, Jolyn Taylor, Patricia A Parker, Cindy Carmack, Lauren Prescott, Carly Rosemore, Elizabeth Kolawole, Charlotte Sun, Lois Ramondetta, Diane C Bodurka. 1. *Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN; †Department of Medicine, Weill Cornell, New York, NY; Departments of ‡Biostatistics, and §Gynecologic Oncology and Reproductive Medicine; The University of Texas MD Anderson Cancer Center; Houston, TX; ∥Department of Behavioral Science; Memorial Sloan Kettering Cancer Center; New York, NY; and Departments of ¶Behavioral Science, and #Clinical Education, The University of Texas MD Anderson Cancer Center; Houston, TX.
Abstract
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed. In step II, the revised scale was administered to a new sample of patients to assess scale reliability and validity. An exploratory factor analysis determined if the scale loaded onto unique factors. In step III, the revised scale was administered to a third sample of patients, and a confirmatory factor analysis was conducted to test the factor structure proposed in step II. Associations between ACPRS score and completion of advance directives were evaluated. RESULTS: Based on patients' responses, the original ACPRS used in step I was modified to the ACPRS used in step II. The final 8-item ACPRS is a valid, reliable (Cronbach α = 0.81) scale and has 2 primary factors. Women with medical power of attorney documents and living wills had higher ACPRS total scores than those who did not have these advance directives (P = 0.0030). Women with do-not-resuscitate (DNR) orders had higher ACPRS total scores than women without DNRs (P = 0.0176). CONCLUSIONS: The ACPRS is a valid and reliable 8-item scale that assesses the readiness of gynecologic oncology patients to discuss advance care planning issues.
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed. In step II, the revised scale was administered to a new sample of patients to assess scale reliability and validity. An exploratory factor analysis determined if the scale loaded onto unique factors. In step III, the revised scale was administered to a third sample of patients, and a confirmatory factor analysis was conducted to test the factor structure proposed in step II. Associations between ACPRS score and completion of advance directives were evaluated. RESULTS: Based on patients' responses, the original ACPRS used in step I was modified to the ACPRS used in step II. The final 8-item ACPRS is a valid, reliable (Cronbach α = 0.81) scale and has 2 primary factors. Women with medical power of attorney documents and living wills had higher ACPRS total scores than those who did not have these advance directives (P = 0.0030). Women with do-not-resuscitate (DNR) orders had higher ACPRS total scores than women without DNRs (P = 0.0176). CONCLUSIONS: The ACPRS is a valid and reliable 8-item scale that assesses the readiness of gynecologic oncology patients to discuss advance care planning issues.
Authors: Teresa P Díaz-Montes; Megan K Johnson; Robert L Giuntoli; Alaina J Brown Journal: Am J Hosp Palliat Care Date: 2012-04-24 Impact factor: 2.500
Authors: Alexi A Wright; Jennifer W Mack; Patricia A Kritek; Tracy A Balboni; Anthony F Massaro; Ursula A Matulonis; Susan D Block; Holly G Prigerson Journal: Cancer Date: 2010-10-01 Impact factor: 6.860
Authors: Daren K Heyland; Peter Dodek; Graeme Rocker; Dianne Groll; Amiram Gafni; Deb Pichora; Sam Shortt; Joan Tranmer; Neil Lazar; Jim Kutsogiannis; Miu Lam Journal: CMAJ Date: 2006-02-28 Impact factor: 8.262
Authors: Jennifer W Mack; Angel Cronin; Nancy L Keating; Nathan Taback; Haiden A Huskamp; Jennifer L Malin; Craig C Earle; Jane C Weeks Journal: J Clin Oncol Date: 2012-11-13 Impact factor: 44.544
Authors: Thomas J Smith; Sarah Temin; Erin R Alesi; Amy P Abernethy; Tracy A Balboni; Ethan M Basch; Betty R Ferrell; Matt Loscalzo; Diane E Meier; Judith A Paice; Jeffrey M Peppercorn; Mark Somerfield; Ellen Stovall; Jamie H Von Roenn Journal: J Clin Oncol Date: 2012-02-06 Impact factor: 44.544
Authors: Sarah P Huepenbecker; Sophia Lewis; Mark C Valentine; Marguerite L Palisoul; Premal H Thaker; Andrea R Hagemann; Carolyn K McCourt; Katherine C Fuh; Matthew A Powell; David G Mutch; Lindsay M Kuroki Journal: Gynecol Oncol Rep Date: 2022-08-05