The development of a scale to assess attitudes to advance statements

A review of 32 articles appeared to suggest that a general sense of perceived control was related to favourable outcome. Control over symptoms, illness and treatment might all have beneficial effects for psychological adjustment and well being. The evidence is less consistent for general and specific health locus of control beliefs, although there is some evidence to suggest mediational and moderational roles. Perceived control was concluded to be an important variable for understanding the relationship between physical illness and adjustment or distress.;Research aim: to develop an acceptable, valid and reliable scale that could be used to assess attitudes to Advance Statements with people aged over 50 years old.;Method: Scale items were developed from a qualitative analysis of the literature. An initial scale of 40-items was piloted with 46 participants. Following feedback from the pilot sample and a focus group, the scale was amended. The responses from 180 participants were used to analyse the internal consistency of the scale. Principal components analysis (using varimax rotation) was used to determine the component structure and identify items for removal.;Results: A two-factor 28-item scale was produced, which had a coefficient alpha of 0.862 and split-half reliability of 0.890, suggesting the scale to be reliable.;Discussion: The scale has a number of potential clinical and research applications. However, further work is needed to establish psychometric properties and generalisability.