Assessing advance care planning readiness in individuals with kidney failure.

The purpose of this study was to initiate development of an instrument to assess readiness of patients to discuss advance care plans. The first step of the development of the instrument involved the generation of a 49-item pool representative of the grounded theory of personal preservation (Calvin, 2004). The second step was to assess the content validity of the items using both a professional panel of four experts in end-of-life care and a patient panel of five persons currently being treated with hemodialysis in an inpatient setting. The third step was to pilot test the resultant 30-item instrument with another sample of 10 patients on hemodialysis. The instrument showed preliminary evidence of content validity (overall content validity index = 0.90) and internal consistency reliability of the scale (Cronbach's alpha = 0.73).