A translated Korean version of the Advance Care Planning Practice Scale demonstrated preliminary psychometric validity and internal consistency in a sample of nurses, according to findings from a methodological study published in BMC Palliative Care. The research team evaluated the tool to determine whether it can reliably measure self-reported advance care planning behaviors across diverse clinical environments in South Korea.
To adapt the measurement instrument, the researchers implemented a forward–backward translation procedure complemented by expert review. Data were gathered through a structured online questionnaire completed by 200 nurses practicing in South Korean hospitals, public health centers, and long-term care facilities, providing an empirical basis for testing the scale’s measurement structure.
Construct validity was examined through confirmatory factor analysis applying the weighted least squares mean- and variance-adjusted estimator for ordinal data. The hypothesized single-factor specification yielded strong standardized factor loadings between 0.79 and 0.86, alongside mixed fit indices including a comparative fit index of 0.981, a Tucker–Lewis index of 0.944, and a root mean square error of approximation of 0.256 with a 90 percent confidence interval from 0.178 to 0.344. A modified structural model that permitted correlated residuals between Items 1 and 3 produced factor loadings spanning 0.72 to 0.89 and a statistically significant improvement in model fit (delta chi-square = 21.55 with 1 degree of freedom, p < 0.001; CFI = 0.998; TLI = 0.987), though the RMSEA remained somewhat elevated at 0.125 (90 percent confidence interval: 0.019 to 0.260).
The evaluation also examined convergent validity and known-groups comparisons to assess the practical coherence of the instrument. Scores on the Advance Care Planning Practice Scale demonstrated a weak positive correlation with end-of-life care-related knowledge (r = 0.184, p = 0.009). Furthermore, known-groups validity was supported by significant score differences based on training background, as nurses who had completed advance care planning education achieved higher average scores than those without prior training (4.29 versus 3.42, p = 0.018, Cohen’s d = 0.43).
Discriminant validity was supported by nonsignificant associations between scale scores and participant characteristics, specifically age and educational attainment. Reliability assessments revealed high internal consistency, reflected in a Cronbach’s alpha of 0.850 and composite reliability values of 0.854 for the initial single-factor model and 0.888 for the modified model. Test–retest reliability evaluated across repeated administrations yielded a moderate intraclass correlation coefficient of 0.577.
The authors concluded that the Korean Advance Care Planning Practice Scale functions as a potentially valuable brief instrument for assessing self-reported advance care planning practices and supporting relevant nursing education and research. However, the researchers emphasized that the single-factor structure remains provisional until verified through cross-validation in independent cohorts, preferably using an expanded item set, while additional research is needed to more fully determine its temporal stability.
Subject of Research: Psychometric evaluation of the Korean Advance Care Planning Practice Scale
Article Title: Psychometric evaluation of the Korean version of the Advance Care Planning Practice Scale among nurses
Article References: KIM, J., KO, H., CHO, K., YANG, J., BAEK, S. Y., KIM, M. Y., & AN, M. (2026). Psychometric evaluation of the Korean version of the Advance Care Planning Practice Scale among nurses. BMC Palliative Care. https://doi.org/10.1186/s12904-026-02370-z
Image Credits: AI Generated
DOI: 10.1186/s12904-026-02370-z
Keywords: advance care planning, Advance Care Planning Practice Scale, nursing practice, psychometric evaluation, construct validity, confirmatory factor analysis, internal consistency, test-retest reliability, known-groups validity, discriminant validity, convergent validity, palliative care, end-of-life care, methodological research, South Korea, Cronbach's alpha
News Source: Ophelia Keating. (November 10, 2026). Korean Advance Care Planning Practice Scale Shows Initial Validity Among Nurses. Scienmag.
