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Oral narrative assessments are important for diagnosis of language disorders in school-age children so scoring needs to be reliable and consistent. This study explored the impact of training on the variability of story grammar scores in children's oral narrative assessments scored by multiple raters. Fifty-one speech pathologists and 19 final-year speech pathology students attended training workshops on oral narrative assessment scoring and analysis. Participants scored two oral narratives prompted by two different story stimuli and produced by two children of differing ages. Demographic information, story grammar scores and a confidence survey were collected pre- and post-training. The total story grammar score changed significantly for one of the two oral narratives. A significant effect was observed for rater years of experience and the change in total story grammar scores post training, with undergraduate students showing the greatest change. Two story grammar elements, character and attempt, changed significantly for both stories, with an overall trend of increased element scores post-training. Confidence ratings also increased post-training. Findings indicated that training via an interactive workshop can reduce rater variability when using researcher-developed narrative scoring systems.

Objective: Decisional conflict is used increasingly as an outcome measure in advance care planning (ACP) studies. When the Decisional Conflict Scale (DCS) is used in anticipatory decision‐making contexts, the scale is typically tethered to hypothetical scenarios. This study reports preliminary validation data for hypothetical scenarios relating to life‐sustaining treatments and care utilisation to inform their broader use in ACP studies. Methods: Three hypothetical scenarios were developed by a panel of multidisciplinary researchers, clinicians and community representatives. A convenience sample of 262 older adults were surveyed. Analyses investigated comprehensibility, missing data properties, sample norms, structural, convergent and discriminant validity. Results: Response characteristics suggested that two of the scenarios had adequate comprehensibility and response spread. Missing response rates were unrelated to demographic characteristics. Predicted associations between DCS scores and anxiety (r's =.31–.37, p <.001), and ACP engagement (r's = −.41 to −.37, p <.001) indicated convergent validity. Conclusion: A substantial proportion of older adults reported clinically significant levels of decisional conflict when responding to a range of hypothetical scenarios about care or treatment. Two scenarios showed acceptable comprehensibility and response characteristics. A third scenario may be suitable following further refinement. Patient or Public Contribution: The scenarios tested here were designed in collaboration with a community representative and were further piloted with two groups of community members with relevant lived experiences; four people with life‐limiting conditions and five current or former care partners. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To explore the associations between depression, anxiety, decisional conflict and advance care planning engagement and the potential mediating role of decisional conflict in the associations between depression, anxiety and advance care planning among community‐dwelling older adults.A cross‐sectional study was conducted with 262 community‐dwelling older Australians across metropolitan, regional and rural communities between August and October 2022.Validated self‐reported questions were used to collect data on anxiety, depression (Hospital Anxiety and Depression Scale), decisional conflict (Decisional Conflict Scale), advance care planning engagement (Advance Care Planning Engagement Survey) and covariates (demographic characteristics, health literacy [Health Literacy Screening Questions]), overall health status (Short form 36). Data analysis included descriptive statistics, bivariate association analysis, general linear modelling and path analysis.Anxiety and decisional conflict were directly associated with advance care planning engagement even after controlling for potential effects of demographic characteristics, health literacy and overall health status. The model, including age, gender, country of birth, language spoken at home, education, overall health status, anxiety, depression, decisional conflict and interaction between anxiety and decisional conflict, explained 24.3% of the variance in their advance care planning engagement. Decisional conflict mediated the association between anxiety and advance care planning engagement.Increased anxiety and decisional conflict were associated with reduced advance care planning engagement directly, even among community‐dwelling older adults with higher levels of education and health literacy. Increased anxiety was associated with reduced advance care planning engagement indirectly via increased decisional conflict. Healthcare professionals should assess community‐dwelling older adults' anxiety and implement interventions to manage their anxiety and decisional conflict, as these may facilitate their engagement in advance care planning.Understanding factors associated with advance care planning engagement among community‐dwelling older adults may inform strategies facilitating their future engagement in advance care planning. Findings from this study may be used as evidence for future implementation to facilitate the engagement of community‐dwelling older adults in advance care planning.The STROBE statement checklist was used as a guide to writing the manuscript.The study was advertised publicly through social media (e.g. Twitter and Facebook) and newsletters (e.g. Advance Care Planning Australia, Centre for Volunteering, Palliative Care Australia and a large home care service provider with approximately 7000 older clients receiving support or services) to recruit participants. People aged 65 years and older living independently in the Australian community who could communicate in English were invited to participate and answer the questionnaire. [ABSTRACT FROM AUTHOR]