{"doi":"10.1371/journal.pone.0282960","title":"Italian cross-cultural adaptation of the Quality of Communication questionnaire and the 4-item advance care planning engagement questionnaire","abstract":"BACKGROUND: Advance care planning (ACP) is influenced by several factors (e.g., patient's readiness to engage, clinician's skills, and the cultural environment). Availability of reliable and valid self-reported measures of the ACP domains is crucial, including cross-cultural equivalence. AIM: To culturally adapt into Italian the 19-item Quality of Communication (QOC) and the 4-item ACP Engagement (4-item ACP-E) questionnaires. METHODS: We translated and culturally adapted the two questionnaires and produced a significant other (SO) version of the QOC (QOC-SO). Each questionnaire was field tested via cognitive interviews with users: nine patients (QOC, 4-item ACP-E) and three SOs (QOC-SO) enrolled at three palliative care services. RESULTS: We made minor changes to 5/19 QOC items, to improve clarity and internal consistency; we changed the response option 'didn't do' into 'not applicable'. Finally, we slightly revised the QOC to adapt it to the paper/electronic format. QOC debriefing revealed that the section on end of life was emotionally challenging for both patients and SOs. We simplified the 4-item ACP-E layout, added a sentence in the introduction, and revised the wording of one item, to improve coherence with the Italian ACP legislation. ACP-E debriefing did not reveal any major issue. CONCLUSIONS: Results were satisfactory in terms of semantic, conceptual and normative equivalence of both questionnaires. Acceptability was satisfactory for the 4-item ACP-E, while findings of the QOC cognitive debriefing informed a major amendment of a pilot trial protocol on ACP in multiple sclerosis (ConCure-SM): use of the interviewer version only, in an adaptive form. Psychometric testing of both questionnaires on a large, independent sample will follow.","journal":"PLoS ONE","year":2023,"id":347582,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8895,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1089451,"name":"Simone Veronese","orcid":"0000-0002-9555-7252","position":1,"is_corresponding":false},{"id":1089452,"name":"Marta Perin","orcid":"0000-0003-4631-7380","position":2,"is_corresponding":false},{"id":1089453,"name":"Marta Cascioli","orcid":"0000-0003-2021-2900","position":3,"is_corresponding":false},{"id":1089454,"name":"Mariangela Farinotti","orcid":"0000-0003-0670-452X","position":4,"is_corresponding":false},{"id":1089455,"name":"Paola Kruger","orcid":"0000-0002-6225-2161","position":5,"is_corresponding":false},{"id":1089456,"name":"Roberta Martina Zagarella","orcid":"0000-0001-8012-2451","position":6,"is_corresponding":false},{"id":373822,"name":"J. Randall Curtis","orcid":"0000-0001-9529-845X","position":7,"is_corresponding":false},{"id":237755,"name":"Rebecca L. Sudore","orcid":"0000-0003-4436-2209","position":8,"is_corresponding":false},{"id":498225,"name":"Elizabeth L. Nielsen","orcid":null,"position":9,"is_corresponding":false},{"id":394313,"name":"Ruth A. Engelberg","orcid":null,"position":10,"is_corresponding":false},{"id":1089457,"name":"Andrea Giordano","orcid":"0000-0003-4466-9788","position":11,"is_corresponding":false},{"id":1089458,"name":"Alessandra Solari","orcid":"0000-0001-9930-7579","position":12,"is_corresponding":false},{"id":1089953,"name":"on behalf of the ConCure-SM project","orcid":null,"position":13,"is_corresponding":false},{"id":1089450,"name":"Ludovica De Panfilis","orcid":"0000-0002-5509-7626","position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T01:12:01.859977Z","pmid":"36952509","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}