Psychometric Properties of The Thai Version of the Nurses’ Intention to Participate in Advance Care Planning Instrument

Abstract

Advance care planning is an essential process in healthcare that necessitates active participation from all involved professionals, particularly nurses. However, in Thailand, nurse involvement in ACP is limited. Assessment of nurses’ intention to participate in advance care planning is necessary to organize training courses to improve their participation in this critical event. However, there is no tool to evaluate Thai nurses’ intention to participate in Advance care planning. Thus, we selected the Health Professionals’ Experience and Attitudes Questionnaire on Advance Care Planning to culturally adapt and validate it in the Thai context. We achieved this through a five-step process: (1) standard translation procedures, including forward translation, reconciliation, and back-translation; (2) item refinement through an expert panel; (3) conducting content validity and cognitive interviews; and (4) confirmation of the first culturally adapted tool by the expert panel on the factors. The panel of experts suggested adding the knowledge dimension and changing the name to the Nurses’ Intention to Participate in Advance Care Planning and (5) The Thai version was tested for validity and reliability using confirmatory factor analysis, average variance extracted, and the Fornell–Larcker criteria matrix, Cronbach’s α, and composite reliability. The final version achieved from testing with 260 registered nurses from a teaching hospital in Bangkok is comprised of 20 items distributed across five key dimensions, namely ‘intention,’ ‘attitude,’ ‘subjective norm,’ ‘perceived behavioral control,’ and ‘knowledge,’ demonstrating an excellent model fit, strong composite reliability, and robust internal consistency. This newly adapted tool is a resource for policymakers and nurse educators designing targeted training courses to enhance nurses’ competency in advance care planning. However, before this tool is widely implemented, it would be beneficial to test it further across diverse groups of nursing professionals.