Localization of Advance Care Planning directives – assessing a reliable and quality translation

Abstract

Introduction: Advance care planning is an inherent right of individuals to manage their own life and body, enabling them to participate in decisions about their future care according to their wishes. However, there is currently no assessment tool for advance care planning that can determine the extent to which patients have progressed through that care process.

Objectives: To translate the 15-item Advance Care Planning document into Thai language and to evaluate the content validity and reliability of the resulting Thai version.

Method: The research design is a descriptive study and was conducted in two phases. Phase 1 involved translating the original English version of the assessment into Thai language and then back into English using the translation and back-translation technique by a professional translator
from a university language institute. Both translations were conducted independently, and the validity of the content was verified by five qualified experts. Phase 2 assessed the reliability of the translated content with a sample of 30 patients aged 20 years and older with lung cancer. Phase 2 was conducted at a tertiary hospital in Bangkok between July and August 2025. The reliability of the assessment was analyzed using Cronbach’s alpha coefficient.

Results: The findings revealed that the back-translated version was consistent with the original English version. The Thai language version demonstrated good content validity (Content Validity Index = 0.87) and satisfactory internal consistency (Cronbach’s alpha = 0.86). The item–total correlation coefficients ranged from 0.27 to 0.77, which are considered acceptable.

Conclusions: The Thai language version demonstrated good quality and can be used to assess advance care planning among patients receiving palliative care in the Thai context.