Bridging the Gap in Mental Health: Developing Specific tools for Advanced Care Planning Assessment

Advanced Care Planning (ACP) is increasingly recognized as a critical component in healthcare,

underscoring the autonomy and dignity of individuals across various health conditions. Its

significance is especially pertinent in mental health, where ACP empowers adults with mental

illnesses to express their future healthcare preferences and directives, thereby ensuring that

their choices are respected during crises when they may lack decision-making capacity. Despite

its importance, there is an absence of instruments specifically designed for ACP assessment in

the realm of mental health. Our study outlines the methodology approach employed in the

development of specific instruments for evaluating ACP-related dimensions in mental health.

The initial phase of our research involved a systematic review of existing literature on the

development or adaptation of ACP assessment tools in diverse health conditions. This

systematic review spanned across five databases: PsycNET, PubMED, Web of Science, Scopus,

and CINAHL, aiming to pinpoint studies focused on the creation, adaptation, and validation of

ACP assessment instruments. Following this, we pinpointed key aspects measured by these

tools and identified items to integrated into a novel instrument tailored for ACP in mental

health.

Out of 1,222 studies, 54 met our inclusion criteria, contributing to a total of 57 instruments.

Predominantly, these instruments assessed knowledge of ACP procedures (36%), attitudes

towards ACP (17%), participation in ACP activities (16%), and self-efficacy regarding ACP (12%).

We reviewed and adapted items, particularly those related to knowledge and attitudes, for

application in the mental health context. This led to the creation of two novel instruments

specifically designed to evaluate attitudes and knowledge about ACP in mental health. These

measurement instruments address aspects previously overlooked in ACP for mental health,

potentially fostering a culture of empowerment and enhancing the overall quality of care

delivered.