Good death inventory: a measure for evaluating good death from the bereaved family member's perspective

The aim of this study was to develop a measure for evaluating good death from the bereaved family member's perspective, and to examine the validity and reliability of the assessment. A cross-sectional anonymous questionnaire was administered to bereaved family members of cancer patients who had died in a regional cancer center from September 2004 to February 2006. We measured the Good Death Inventory (GDI), Care Evaluation Scale, and an overall care satisfaction scale. A retest was conducted one month after sending the questionnaire. Of the 344 questionnaires sent to bereaved family members, 189 responses were analyzed (57%). A factor analysis of the responses to the GDI identified 10 core domains: "environmental comfort," "life completion," "dying in a favorite place," "maintaining hope and pleasure," "independence," "physical and psychological comfort," "good relationship with medical staff," "not being a burden to others," "good relationship with family," and "being respected as an individual." Eight optional domains also were identified: "religious and spiritual comfort," "receiving enough treatment," "control over the future," "feeling that one's life is worth living," "unawareness of death," "pride and beauty," "natural death," and "preparation for death." The GDI had sufficient concurrent validity with the Care Evaluation Scale and overall care satisfaction, sufficient internal consistency (alpha=0.74-0.95), and acceptable test-retest reliability (ICC=0.38-0.72). Finally, we developed a short version of the GDI. The GDI is a valid scale to measure end-of-life care comprehensive outcomes from the bereaved family member's perspective in Japan.