Development of a Scale to Assess Physician Advance Care Planning Self-Efficacy.
*Self Efficacy; Adult; advance care planning; Advance Care Planning; Advance Care Planning/*organization & administration; Attitude of Health Personnel; Attitudes; Chronic Disease; Communication; Cross Sectional Studies; Cross-Sectional Studies; end-of-life care; Exploratory Research; family medicine; Family/*psychology; Female; Health Knowledge; Human; Humans; Instrument Construction; Instrument Validation; Male; Middle Aged; Physician-Patient Relations; Physicians; Physicians – Psychosocial Factors; Practice; Reliability and Validity; scale development; Scales; self-efficacy; Self-Efficacy – Evaluation; Surveys and Questionnaires/*standards; Terminal Care/psychology; Validation Studies
BACKGROUND: Although patients prefer that physicians initiate advance care planning (ACP) conversations, few physicians regularly do so. Physicians may be reluctant to initiate ACP conversations because they lack self-efficacy in their skills. Yet, no validated scale on self-efficacy for ACP exists. Our objective was to develop a scale that measures physicians' ACP self-efficacy (ACP-SE) and to investigate the validity of the tool. METHODS: Electronic questionnaires were administered to a random sample of family medicine physicians (n = 188). Exploratory factor analysis was performed to determine whether the scale was multidimensional. An initial assessment of the scale's validity was also conducted. RESULTS: The exploratory factor analysis indicated that a single factor was appropriate using all 17 items. A single, unidimensional scale was created by averaging the 17 items, yielding good internal consistency (Cronbach alpha = 0.95). The average scale score was 3.94 (standard deviation = 0.71) on a scale from 1 to 5. The scale was moderately correlated with a global single-item measure of self-efficacy for ACP ( r = .79, P \textless .001), and the scale differentiated between physician groups based on how much ACP they were doing, how recently they had an ACP conversation, formal training on ACP, and knowledge of ACP. In a multivariate analysis, the ACP-SE scale was a strong predictor of the percentage of patients with chronic life-limiting diseases with whom the physician discussed ACP. CONCLUSION: The final ACP-SE scale included 17 items and demonstrated high internal consistency.
Baughman Kristin R; Ludwick Ruth; Fischbein Rebecca; McCormick Kenelm; Meeker James; Hewit Mike; Drost Jennifer; Kropp Denise
The American journal of hospice & palliative care
2017
2017-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1049909115625612" target="_blank" rel="noreferrer noopener">10.1177/1049909115625612</a>
Do elder emergency department patients and their informants agree about the elder's functioning?
*Activities of Daily Living; *Attitude to Health; *Geriatric Assessment; *Health Status; *Self-Assessment; Aged; Bias; Cross-Sectional Studies; Emergency Service; Emergency Treatment/*methods/standards; Family/*psychology; Female; Hospital; Humans; Inpatients/*psychology; Interviews as Topic/*standards; Male; Medical History Taking/*methods/standards; Mental Health; Quality of Life; Surveys and Questionnaires/*standards
OBJECTIVE: To compare elder patients' and their informants' ratings of the elder's physical and mental function measured by a standard instrument, the Medical Outcomes Study Short Form 12 (SF-12). METHODS: This was a randomized, cross-sectional study conducted at a university-affiliated community teaching hospital emergency department (census 65,000/year). Patients \textgreater69 years old, arriving on weekdays between 10 AM and 7 PM, able to engage in English conversation, and consenting to participate were eligible. Patients too ill to participate were excluded. Informants were people who accompanied and knew the patient. Elder patients were randomized 1:1 to receive an interview or questionnaire version of the SF-12. The questionnaire was read to people unable to read. Two trained medical students administered the instrument. The SF-12 algorithm was used to calculate physical (PCS) and mental (MCS) component scores. Oral and written versions were compared using analysis of variance. The PCS and MCS scores between patient-informant pairs were compared with a matched t-test. Alpha was 0.05. RESULTS: One hundred six patients and 55 informants were enrolled. The patients' average (+/-SD) age was 77 +/- 5 years; 59 (56%; 95% CI = 46% to 65%) were women. There was no significant difference for mode of administration in PCS (p = 0.53) or MCS (p = 0.14) scores. Patients rated themselves higher on physical function than did their proxies. There was a 4.1 (95% CI = 99 to 7.2) point difference between patients' and their proxies' physical component scores (p = 0.01). Scores on the mental component were quite similar. The mean difference between patients and proxies was 0.49 (95% CI = 3.17 to 4.16). The half point higher rating by patients was not statistically significant (p = 0.79). CONCLUSIONS: Elders' self-ratings of physical function were higher than those of proxies who knew them. There was no difference in mental function ratings between patients and their proxies. Switching from informants' to patients' reports in evaluating elders' physical function in longitudinal studies may introduce error.
Gerson L W; Blanda M; Dhingra P; Davis J M; Diaz S R
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
2001
2001-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1111/j.1553-2712.2001.tb00191.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2001.tb00191.x</a>
A multi-dimensional measure of vocational identity status.
*Career Choice; *Employment; Female; Humans; Male; Ohio; Psychometrics; Surveys and Questionnaires/*standards; Young Adult
Establishing a worker identity is among the most central aspects of the transition from adolescence to adulthood. Despite its importance, few measures with acceptable psychometric and conceptual characteristics exist to assess vocational identity statuses. This study reports the development and evaluation of the Vocational Identity Status Assessment (VISA), which is derived from established conceptual models and includes career exploration, commitment, and reconsideration dimensions. Results show that the VISA exhibited metric invariance across a high school and university sample. Cluster analyses demonstrated that the VISA consistently resolved six identity statuses across the two samples, supporting the previously established achieved, moratorium, foreclosed, and diffused statuses along with two additional statuses termed searching moratorium and undifferentiated. The identity statuses predicted differences in participants' work valences and well-being with the achieved and diffused statuses respectively exhibiting the most and least favorable characteristics. Implications, limitations, and suggestions for future research based upon these findings are offered.
Porfeli Erik J; Lee Bora; Vondracek Fred W; Weigold Ingrid K
Journal of Adolescence
2011
2011-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.adolescence.2011.02.001" target="_blank" rel="noreferrer noopener">10.1016/j.adolescence.2011.02.001</a>