Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Mennonite College of Nursing

First Advisor

Kim S. Astroth


This dissertation is a report of a three-phase quantitative research study that included the development and testing of an instrument to examine the perceptions of nephrology nurses toward advance care planning for persons with chronic kidney disease. Phase 1 began with the identification of the dimensions of advance care planning and creation of an item pool for the instrument. The instrument was distributed to five content experts for evaluation and comments of inclusiveness to measure perceptions toward advance care planning. In Phase 2 the item pool was pilot tested in a convenience sample of 50 nephrology nurses. Exploratory factor analysis using principal component analysis determined four factors that accounted for the variation among the latent variable of advance care planning. The 30-item instrument explained 64% of model variance and had strong internal reliability consistency for the scale and each subscale. In Phase 3 the instrument was tested in a convenience sample of 230 nephrology nurses contacted primarily via mailed postcards or professional networking sites with the web address to access the survey. Confirmatory factor analysis supported the four distinct dimensions of the newly developed instrument to measure nephrology nurse perceptions toward advance care planning. Construct validity of the NephRN Perceptions toward Advance Care Planning instrument was determined through correlation analysis with the Concerns about Dying scale and the Attitude toward Patient Advocacy scale. The final 12-item NephRN Perceptions toward Advance Care Planning instrument had strong internal reliability consistency.


Imported from ProQuest Haras_ilstu_0092E_10099.pdf


Page Count


Included in

Nursing Commons