{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:05:46Z","timestamp":1784693146421,"version":"3.55.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003803","name":"university of hong kong","doi-asserted-by":"publisher","award":["006027001"],"award-info":[{"award-number":["006027001"]}],"id":[{"id":"10.13039\/501100003803","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Effective advance care planning depends on clinician-patient communication quality. However, ACP-CAT, the only validated observer-rated instrument, remains untested in real-world clinical encounters and non-Western contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Validating ACP-CAT in assessing clinician-patient communication quality with advanced cancer and chronic kidney disease in Hong Kong, comparing against patient and family ratings of clinician communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Cross-sectional study of adult patients with advanced cancer or chronic kidney disease from five hospitals and one hospice service. Two independent raters evaluated audiotaped advance care planning conversations using ACP-CAT, while patients and family members assessed communication quality using the Chinese Quality of Communication Questionnaire (C-QOC). We assessed the psychometric properties, including interrater reliability, convergent and discriminant validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>One hundred and thirty-seven advance care planning conversations involving 84 cancer patients, 53 renal patients, 107 family members, and 20 clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      ACP-CAT demonstrated high interrater reliability (mean Gwet\u2019s AC1\u2009=\u20090.81; 88.6% agreement). Convergent validity was demonstrated through significant correlations between ACP-CAT total score and patient-rated C-QOC End-of-life planning subscale (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.29,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01), family-rated C-QOC summary score (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.27,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and family-rated C-QOC End-of-life planning subscale (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2009=\u20090.34,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Discriminant validity was supported by absence of correlations with patients\u2019 self-rated health status and information or decision-making preferences (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Clinicians frequently explored patients\u2019 fears and health goals, but rarely discussed nonmedical priorities, valued activities, or surrogate decision makers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ACP-CAT demonstrates strong concurrent validity with patient- and family-rated measures and ecological validity in real clinical settings. These findings support its reliability for assessing advance care planning communication quality across diverse cultural contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163251394892","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T02:56:16Z","timestamp":1768964176000},"page":"228-252","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Bringing patients and family onboard: Validation of advance care planning communication assessment tool (ACP-CAT) with patient and family perspectives"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-3929","authenticated-orcid":false,"given":"Steven T. W.","family":"Chu","sequence":"first","affiliation":[{"name":"Division of Geriatrics, Queen Mary Hospital, School of Clinical Medicine, The University of Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-4654","authenticated-orcid":false,"given":"Helen Y. L.","family":"Chan","sequence":"additional","affiliation":[{"name":"The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy W. T.","family":"Chen","sequence":"additional","affiliation":[{"name":"Haven of Hope Sister Annie Skau Holistic Care Centre, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie O. 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