Development and validation of the advance care planning practice preference scale for clinical nurses

Aims: The aim of this study was to develop the advance care planning (ACP) practice preference scale and validate its psychometric properties among clinical nurses.Design: An instrument development and validation study was completed in the following three phases: (a) the generation and revision of the item, (b) the preliminary exploration and evaluation of the item and (c) the psychometric evaluation of the scale.Methods: A literature review was conducted to develop the indicator system. A total of 360 clinical nurses (for item analysis) and 688 clinical nurses (for psychometric evaluation) were recruited. The exploratory factor analysis and confirmatory factor analysis were conducted to evaluate the construct validity. The reliability was explored by internal consistency and test-retest reliability. The study was conducted from October 2021 to January 2022.Results: A total of 24 items were finally retained by the item analysis from the initial 78-item pool. In the exploratory factor analysis, the six-factor model explained 79.933% of the total variation. After limiting to three factors, 59.305% of the total variation was explained. Above factor models supported by the confirmatory factor analysis were consistent with the theoretically structure, and the fitting indexes were all satisfactory. Also, the findings showed appropriate internal consistency and test-retest reliability.Conclusions: ACP practice preference scale presents satisfactory psychometric properties among clinical nurses and can be adopted to evaluate the propensity of clinical nurses to practice ACP.Impact: ACP practice preference scale can be adopted to understand the training needs of clinical nurses on ACP clinical practice.Patient or Public Contribution: Clinical nurses participated in the pilot testing and validation of ACP practice preference scale.