Table 1 Analysis of the importance rating of the first round of items by experts

1

I think the implementation of ACP can reduce the suffering of patients’ diseases.

4.80

0.42

0.09

2

I think the implementation of ACP will help respect patient medical autonomy.

4.90

0.32

0.07

3

I think the implementation of ACP can meet the wishes of the dying elderly.

4.90

0.32

0.07

4

I think the implementation of ACP can reduce the financial pressure on families.

4.40

0.52

0.12

5

I think the implementation of ACP can reduce the burden of decision-making for families.

4.70

0.67

0.14

6

I think the implementation of ACP can facilitate the development of community hospice care.

4.70

0.67

0.14

7

I think the implementation of ACP can save health care resources.

4.70

0.48

0.10

8

I think the implementation of ACP will increase my workload.

4.30

1.06

0.25

9

I think the implementation of ACP would add to my emotional burden.

4.20

1.03

0.25

10

I think the implementation of ACP will lead to disputes between doctors and patients.

4.50

0.06

0.01

11

The positive attitude of the patient towards ACP will motivate me to implement ACP.

4.80

0.63

0.13

12

The positive attitude of the patient’s family towards ACP will motivate me to implement ACP.

4.80

0.63

0.13

13

The help of a community attorney will motivate me to pursue ACP.

4.30

0.82

0.19

14

The support of my supervisors will motivate me to implement ACP.

4.80

0.42

0.09

15

The help of social workers (e.g. volunteers) will motivate me to implement ACP.

4.20

0.79

0.19

16

The help of a psychiatric professional will motivate me to implement ACP.

4.10

0.88

0.22

17

I have good communication skills to have ACP discussions with patients.

4.80

0.42

0.09

18

I have enough patience to support ACP discussions with patients.

4.60

0.70

0.15

19

I have enough responsibility to support ACP discussions with patients.

4.70

0.48

0.10

20

I have expert knowledge of psychological assessment to help me in my ACP discussions with patients.

4.50

0.53

0.12

21

I have enough ACP expertise to have an ACP discussion with my patients.

4.80

0.42

0.09

22

I am qualified to perform ACP.

4.60

0.70

0.15

23

At this stage, ACP has no formal regulations, workflow, relevant legislation, etc. in our country, which will hinder me in implementing ACP.

4.90

0.32

0.07

24

Inadequate community health human resource allocation will hinder my implementation of ACP.

4.70

0.48

0.10

25

Traditional culture (culture of death, culture of filial piety, etc.) will prevent me from implementing ACP.

4.70

0.67

0.14

26

Incentives for health care professionals will facilitate my implementation of ACP.

4.80

0.42

0.09

27

The support of national policy will facilitate my implementation of ACP.

5.00

0.00

0.00

28

The ethics of saving lives would prevent me from implementing ACP.

3.70

1.42

0.38

29

The family doctor contracting policy will facilitate my implementation of ACP.

4.20

0.92

0.22

30

A relaxed and comfortable community healthcare environment will facilitate my implementation of ACP.

4.70

0.67

0.14

31

Community hospitals conduct ACP organizational training sessions to promote my implementation of ACP.

4.60

0.70

0.15

32

A good doctor-patient relationship will facilitate my implementation of ACP.

4.50

0.85

0.19

33

In my future work, I would like to implement ACP in my community.

4.70

0.67

0.14