Data from: Measuring Engagement in Advance Care Planning: A Cross-sectional Multi-centre Feasibility Study

Objectives: To assess feasibility, acceptability, and clinical sensibility of a novel survey, the Advance Care Planning (ACP) Engagement Survey in various health care settings.
Setting: A target sample of 50 patients from each of primary care, hospital, cancer care, and dialysis care settings.
Participants: A convenience sample of patients without cognitive impairment who could speak and read English was recruited. Patients 50 years and older were eligible in primary care; patients 80 and older or 55 years and older with clinical markers of advanced chronic disease were recruited in hospital; patients aged 19 and older were recruited in cancer and renal dialysis centres.
Outcomes: We assessed feasibility, acceptability and clinical sensibility of the ACP Engagement Survey using a 6-point scale. The ACP Engagement Survey measures ACP processes (knowledge, contemplation, self-efficacy, readiness) on 5-point Likert scales and actions (yes/no).
Results: 196 patients (38 to 96 years old, 50.5% women) participated. Mean (±standard deviation) time to administer was 48.8 ±19.6 minutes. Mean acceptability scores ranged from 3.2±1.3 in hospital to 4.7±0.9 in primary care and mean relevance ranged from 3.5±1.0 in hospital to 4.9±0.9 in dialysis centres (p values <0.001 for both). The mean process score was 3.1±0.6 and the mean action score was 11.2±5.6 (of a possible 25).
Conclusions:
The ACP Engagement Survey demonstrated feasibility and acceptability in out-patient settings, but was less feasible and acceptable among hospitalized patients due to length. A shorter version may improve feasibility. Engagement in ACP was low to moderate.

研究目标：评估新型调查问卷《预立医疗照护计划（Advance Care Planning，ACP）参与度调查问卷》在各类医疗场景中的可行性、可接受性与临床合理性。
研究场景：计划从基层医疗、住院医疗、癌症诊疗及透析诊疗四类场景中各招募50名患者作为目标样本。
研究对象：采用便利抽样法招募无认知障碍、能够理解并使用英语的患者。其中，基层医疗场景纳入50岁及以上患者；住院医疗场景纳入80岁及以上患者，或55岁及以上且伴有晚期慢性病临床指征的患者；癌症诊疗中心与透析中心则纳入19岁及以上患者。
研究结局：采用6分量表评估该预立医疗照护计划参与度调查问卷的可行性、可接受性与临床合理性。该问卷通过5级李克特（Likert）量表评估预立医疗照护计划相关流程（包括知识水平、思考程度、自我效能、准备状态），并以二分类（是/否）项评估相关行动。
研究结果：共计196名患者参与研究，年龄区间为38至96岁，女性占比50.5%。问卷平均施测时长为48.8±19.6分钟（平均值±标准差）。可接受性平均得分范围为住院场景的3.2±1.3至基层医疗场景的4.7±0.9；临床相关性平均得分范围为住院场景的3.5±1.0至透析中心的4.9±0.9，两项指标的组间比较均具有统计学显著性差异（p<0.001）。预立医疗照护计划流程的平均得分为3.1±0.6，行动项平均得分为11.2±5.6（满分为25分）。
研究结论：预立医疗照护计划参与度调查问卷在门诊场景中展现出良好的可行性与可接受性，但在住院患者群体中因问卷时长过长，可行性与可接受性均有所下降。可通过简化问卷版本提升其临床适用性。本次研究中，预立医疗照护计划的参与度处于低至中等水平。