Construction and content validation of an Advance Directive Document form for advance care planning in Colombia: a Delphi study

Introduction: The advance directive document (ADD) is intended to align medical care and treatment with the person's goals and preferences in clinical scenarios where they are unable to communicate and decide. It is a priority to promote the creation of the ADD in patients with serious illnesses as part of the advance care planning (ACP) process. Objective: To construct and validate the content of an ADD form with an interdisciplinary approach. Methods: Qualitative study using the Delphi technique. The study comprised three iterative rounds of online surveys involving healthcare professionals and professors from the country. In round 1, panelists evaluated the components of the sample form and suggested new ones. In round 2, they assessed their level of agreement with the components suggested in round 1. In round 3, using the results from round 2, the final ADD form was developed. Results: A structured ADD form was developed, containing ethical, clinical, and legal criteria. Conclusions: A structured ADD form with high-quality content is presented for completion and formalization in the framework of a deliberative process exclusively between the doctor and the patient. It is available for partial or total adoption by patients, doctors, healthcare institutions, and palliative care services throughout Colombia.