Spanish Cross-Cultural Adaptation and Psychometric Properties of the Advance Care Planning Self-Efficacy: A Cross-Sectional Study.

Abstract

<b><i>Background:</i></b> Perceived self-efficacy in advance care planning (ACP) is frequently used to measure the impact of ACP programs for professionals responsible for advanced chronic patients. A validated ACP Self-Efficacy (ACP-SE) scale is not currently available in Spanish. <b><i>Objective:</i></b> To culturally adapt and validate Baughman's ACP-SE scale into Spanish (ACP-SEs). <b><i>Methodology/Design:</i></b> An instrumental study was performed in two phases: (1) cultural adaptation of the ACP-SE scale and (2) psychometric properties measurement. <b><i>Setting/Participants:</i></b> The survey was sent to 5785 professionals: physicians, nurses, psychologists, and social workers, members of scientific associations in the areas of primary care, geriatrics, and palliative care in Catalonia, Spain. <b><i>Results:</i></b> Five hundred thirty-eight questionnaires were obtained, respondents were physicians (69.0%) and nurses (28.4%) and mean age was 47 years (standard deviation [SD] = 10.1). Most were women (79.6%), 68% had >15 years of professional experience, and 80.7% worked in primary care. Internal consistency was high (Cronbach's alpha = 0.95) and showed a unidimensional structure explaining 56.2% of total variance. Mean score was 67.37 (SD = 16.1). Variables associated with greater self-efficacy were previous training (<i>t</i> = -3.23, df = 273.76, <i>p</i> = 0.001), previous participation in ACP processes (<i>t</i> = -6.23, df = 521, <i>p</i> < 0.001), and membership in geriatric or palliative care scientific association (<i>p</i> < 0.001). ACP-SEs positively correlated to other compared scales. <b><i>Conclusion:</i></b> The ACP-SE scale demonstrates adequate psychometric properties. This is the first self-efficacy scale for ACP in Spanish. It should facilitate a better understanding of implementation processes related to ACP programs for professionals involved in caring for patients with advanced diseases.