Psychometric evaluation of the Korean version of the Advance Care Planning Practice Scale among nurses

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This study translated the Advance Care Planning Practice Scale into Korean and evaluated its psychometric properties using a sample of Korean nurses. This was a methodological study. The Advance Care Planning Practice Scale was translated using a forward–backward procedure and expert review. Data were collected from nurses working in hospitals, public health centers, and long-term care facilities in South Korea, who completed a structured online questionnaire. A total of 200 nurses were included in the study. Construct validity was assessed using confirmatory factor analysis with the weighted least squares mean- and variance-adjusted estimator for ordinal data. Convergent validity was examined through the associations with end-of-life care-related knowledge, known-groups validity according to advance care planning education, and discriminant validity through associations with age and educational attainment. Reliability was assessed using Cronbach’s α and intraclass correlation coefficients. The hypothesized single-factor model showed strong factor loadings (0.79–0.86) but mixed model fit (CFI = 0.981, TLI = 0.944, and RMSEA = 0.256 [90% CI: 0.178–0.344]). A modified model allowing the residuals of Items 1 and 3 to correlate showed strong factor loadings (0.72–0.89) and significantly improved fit (Δχ²(1) = 21.55, p < 0.001; CFI = 0.998, TLI = 0.987, and RMSEA = 0.125 [90% CI: 0.019–0.260]), although the RMSEA remained elevated. Advance Care Planning Practice Scale scores showed a weak positive correlation with knowledge ( r = 0.184, p = 0.009). Nurses with advance care planning education experience had higher scores than those without such experience (4.29 vs. 3.42, p = 0.018, Cohen’s d = 0.43), supporting known-groups validity. Nonsignificant associations with age and educational attainment were consistent with the discriminant validity hypothesis. Internal consistency was high (Cronbach’s α = 0.850; composite reliability = 0.854 for the original model and 0.888 for the modified model), and test–retest reliability was moderate (intraclass correlation coefficient = 0.577). The Korean Advance Care Planning Practice Scale may be a useful brief tool for assessing self-reported advance care planning practice among Korean nurses and may support related research and education. However, its single-factor structure remains provisional pending cross-validation in an independent sample, ideally with an extended item set. Further evaluation of its temporal stability is also warranted.