Reliability and Validity of the Traditional Chinese Version of the Advance Care Planning Engagement Survey: A Pilot Evaluation in Taiwanese Outpatients

Fang Chun Wei, Chieh Kuan Hsu, Yu Lin Wu, Jung Yu Liao, Chi Hsien Huang, Chao Agnes Hsiung, Sang Ju Yu, Cheng Pei Lin, Ping Jen Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objective: The Advance Care Planning Engagement Survey (ACP-ES) has proven effective in evaluating individuals’ engagement in advance care planning (ACP). However, a Traditional Chinese version of ACP-ES (ACPES-TC) has not yet been developed. Therefore, this study aimed to translate and preliminarily validate the ACPES-TC in the Taiwanese context. Material and Methods: A forward and backward translation process was conducted. The translated questionnaire was confirmed by clinical and academic experts. The ACPES-TC was then evaluated for its reliability and validity with participants in the community and from an outpatient clinic in a medical center in Northern Taiwan. The participants comprised healthy people aged 20 to 30 years and patients ≥55 years old, recruited from September 17 to October 28, 2019. Results: Seventy people were recruited, including 20 people aged 20 to 30 years in the community and 50 patients ≥ 55 years old from clinics. The ACPES-TC scores are significantly higher among those of older age, having financial independence, and under long-term medication (p <.05). The patients’ preference for health-related decision-making is significantly correlated with the ACPES-TC score; the point-biserial correlation coefficient is 0.46 (p <.001). The discriminant and criterion-related validities are verified. The ACPES-TC demonstrated a good internal consistency (Cronbach's α.97), acceptable one-week test-retest reliability (overall intraclass correlation coefficient 0.86), and low practice effect between the test and retest (Cohen's d.43). Conclusion: The overall reliability and validity of the ACPES-TC are fair, which could be used to evaluate the patients’ engagement in ACP in Taiwan. However, further studies with a full-scale psychometric evaluation are needed.

Original languageEnglish
Pages (from-to)273-279
Number of pages7
JournalJournal of Palliative Care
Issue number3
Publication statusPublished - 2022 Jul
Externally publishedYes


  • Taiwan
  • advance care planning
  • cross-cultural
  • patients’ autonomy
  • patients’ right to autonomy act
  • reliability
  • survey development
  • validity

ASJC Scopus subject areas

  • General Medicine


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