Promoting advance care planning as health behavior change: development of scales to assess Decisional Balance, Medical and Religious Beliefs, and Processes of Change.
Promoting advance care planning as health behavior change: development of scales to assess Decisional Balance, Medical and Religious Beliefs, and Processes of Change.
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DOI：
10.1016/j.pec.2011.04.035
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发表时间：
2012-01
影响因子：
3.5
通讯作者：
Iannone L
中科院分区：
文献类型：
--
作者：
Fried TR;Redding CA;Robbins ML;Paiva A;O'Leary JR;Iannone L
研究行为改变的跨理论模型（TTM）的关键结构，并将其应用于提前护理计划（ACP），研究这些措施之间的关联是否复制了TTM所假设的关系。采用顺序量表开发技术，根据304名年龄≥65岁的人的回答，开发决策平衡（行为改变的利弊）、ACP价值观/信仰（阻碍参与的宗教信仰和医学误解）、改变过程（促进参与的行为和认知过程）的测量方法。每个量表/子量表的条目显示出高因子负荷（>.5）和良好至优异的内部一致性（Cronbach α 0.76 - 0.93）。方差分析（MANOVA）对六种行为的赞成、反对、ACP价值观/信念和POC分量表按变化阶段进行评分的结果显著，Wilks的λ= .555 -。809年,η2 = .068 -。178，所有模型的p≤0.001。TTM的核心构念用于ACP的测量具有较高的信度和效度。这些构式与行为改变阶段之间的横截面关系支持使用ttm量身定制的干预措施来改变参与ACP的利弊观念，并促进使用某些改变过程来促进老年人参与ACP。
To develop measures representing key constructs of the Transtheoretical Model (TTM) of behavior change as applied to advance care planning (ACP) and to examine whether associations between these measures replicate the relationships posited by the TTM. Sequential scale development techniques were used to develop measures for Decisional Balance (Pros and Cons of behavior change), ACP Values/Beliefs (religious beliefs and medical misconceptions serving as barriers to participation), Processes of Change (behavioral and cognitive processes used to foster participation) based on responses of 304 persons age ≥ 65 years. Items for each scale/subscale demonstrated high factor loading (> .5) and good to excellent internal consistency (Cronbach α .76–.93). Results of MANOVA examining scores on the Pros, Cons, ACP Values/Beliefs, and POC subscales by stage of change for each of the six behaviors were significant, Wilks' λ= .555–.809, η2=.068–.178, p ≤ .001 for all models. Core constructs of the TTM as applied to ACP can be measured with high reliability and validity. Cross-sectional relationships between these constructs and stage of behavior change support the use of TTM-tailored interventions to change perceptions of the pros and cons of participation in ACP and promote the use of certain processes of change in order to promote older persons' engagement in ACP.
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