Validating care and treatment scenarios for measuring decisional conflict regarding future care preferences among older adults

Craig Sinclair; Ling Yeoh; Ava Karusoo-Musumeci; Kirsten A Auret; Josephine M Clayton; Michelle Hilgeman; Elizabeth Halcomb; Ron Sinclair; Angelita Martini; Anne Meller; Rebecca Walton; Li Wei; Tiet-Hanh Dao-Tran; Susan Kurrle; Tracy Comans

doi:10.1111/hex.14010

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Validating care and treatment scenarios for measuring decisional conflict regarding future care preferences among older adults

Journal article

Open access

Peer reviewed

Validating care and treatment scenarios for measuring decisional conflict regarding future care preferences among older adults

Craig Sinclair, Ling Yeoh, Ava Karusoo-Musumeci, Kirsten A Auret, Josephine M Clayton, Michelle Hilgeman, Elizabeth Halcomb, Ron Sinclair, Angelita Martini, Anne Meller, …

Health expectations : an international journal of public participation in health care and health policy, Vol.27(2), e14010

2024

DOI: https://doi.org/10.1111/hex.14010

PMCID: PMC10918722

PMID: 38450803

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Abstract

Advance Care Planning

Aged

Anxiety

Humans

Research Design

Research Personnel

Objective Decisional conflict is used increasingly as an outcome measure in advance care planning (ACP) studies. When the Decisional Conflict Scale (DCS) is used in anticipatory decision-making contexts, the scale is typically tethered to hypothetical scenarios. This study reports preliminary validation data for hypothetical scenarios relating to life-sustaining treatments and care utilisation to inform their broader use in ACP studies. Methods Three hypothetical scenarios were developed by a panel of multidisciplinary researchers, clinicians and community representatives. A convenience sample of 262 older adults were surveyed. Analyses investigated comprehensibility, missing data properties, sample norms, structural, convergent and discriminant validity. Results Response characteristics suggested that two of the scenarios had adequate comprehensibility and response spread. Missing response rates were unrelated to demographic characteristics. Predicted associations between DCS scores and anxiety (r's = .31–.37, p < .001), and ACP engagement (r's = −.41 to −.37, p < .001) indicated convergent validity. Conclusion A substantial proportion of older adults reported clinically significant levels of decisional conflict when responding to a range of hypothetical scenarios about care or treatment. Two scenarios showed acceptable comprehensibility and response characteristics. A third scenario may be suitable following further refinement. Patient or Public Contribution The scenarios tested here were designed in collaboration with a community representative and were further piloted with two groups of community members with relevant lived experiences; four people with life-limiting conditions and five current or former care partners.

Details

Title: Validating care and treatment scenarios for measuring decisional conflict regarding future care preferences among older adults
Authors/Creators: Craig Sinclair - UNSW Sydney
Ling Yeoh - UNSW Sydney
Ava Karusoo-Musumeci - Neuroscience Research Australia
Kirsten A Auret - The University of Western Australia
Josephine M Clayton - The University of Sydney
Michelle Hilgeman - Tuscaloosa VA Medical Center
Elizabeth Halcomb - University of Wollongong
Ron Sinclair - The University of Adelaide
Angelita Martini - The University of Western Australia
Anne Meller - South Eastern Sydney Local Health District
Rebecca Walton - Brightwater Group, Perth, Western Australia, Australia
Li Wei - Murdoch University
Tiet-Hanh Dao-Tran - Centre for Health Services Research, University of Queensland, Brisbane, Queensland, Australia
Susan Kurrle - Northern Sydney Local Health District
Tracy Comans - The University of Queensland
Publication Details: Health expectations : an international journal of public participation in health care and health policy, Vol.27(2), e14010
Publisher: John Wiley & Sons Ltd.
Grant note: GNT2006283 / National Health and Medical Research Council
Identifiers: 991005648387407891
Murdoch Affiliation: School of Nursing
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.112 Palliative Care; 1.112.237 End-of-Life Care
Web Of Science research areas: Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health
ESI research areas: Social Sciences, general