Validation of Toolkit After-Death Bereaved Family Member Interview

Area of Science:

• Healthcare Quality
• Psychometrics
• End-of-Life Care

Background:

• Assessing end-of-life care quality from the family's perspective is crucial for patient-centered medical care.
• Existing tools may not fully capture the nuances of family member experiences after a patient's death.
• The Toolkit After-Death Bereaved Family Member Interview was developed to address this gap.

Purpose of the Study:

• To evaluate the reliability and validity of the Toolkit After-Death Bereaved Family Member Interview.
• To measure the quality of end-of-life care through the unique perspective of bereaved family members.
• To identify actionable areas for healthcare providers to improve care quality.

Main Methods:

• A retrospective telephone survey was conducted with 156 family members 3-6 months post-death.
• Data were collected from participants across outpatient hospice, nursing home, and hospital settings.
• Statistical analyses included Cronbach's alpha, item-to-total correlations, item-to-item correlations, and factor analysis.

Main Results:

• Seven of the eight proposed problem scores/scales demonstrated acceptable psychometric properties (Cronbach's alpha 0.58-0.87).
• Most domains showed moderate correlations with overall satisfaction (0.44-0.52), except for closure and advance care planning.
• Family members receiving hospice services reported fewer problems and higher quality of care ratings.

Conclusions:

• The Toolkit After-Death Bereaved Family Member Interview shows promise as a reliable and valid measure of end-of-life care quality.
• The instrument can provide valuable, actionable information for quality improvement initiatives.
• Further refinement is needed for the 'closure' domain to enhance its correlation with overall satisfaction.