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Death Preparedness Scale for Advanced Cancer Patients: Instrument Development and Psychometric Properties
Xi Zhang1,2, Xiaoli Wei3, Meizhen Zhao1
1Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Psycho-Oncology
|April 11, 2025
Summary
A new scale comprehensively assesses death preparedness in advanced cancer patients. This validated tool helps healthcare professionals provide targeted interventions to improve end-of-life care quality.
Area of Science:
- Palliative Care
- Oncology
- Psychometrics
Background:
- Death preparedness is vital for advanced cancer patients' quality of death.
- Existing measurement tools lack comprehensiveness and validated reliability/validity.
- A specific, validated tool is needed for advanced cancer patients.
Purpose of the Study:
- To develop and validate a comprehensive measurement tool for death preparedness.
- To assess the reliability and validity of the new scale.
Main Methods:
- Exploratory mixed-methods approach (qualitative and quantitative stages).
- Grounded theory and literature review for scale construction.
- Delphi method for content validity; psychometric testing on 753 patients using item analysis, EFA, and CFA.
Main Results:
- A 22-item, 4-dimensional scale: Death awareness, Emotional response, Hospice program, Reflexive care.
- The four dimensions explain 64.010% of the total variance.
- Confirmatory factor analysis confirmed a good fit for the 4-factor model; Cronbach's alpha was 0.991.
Conclusions:
- The developed scale demonstrates strong reliability and validity for assessing death preparedness.
- It enables comprehensive assessment of advanced cancer patients' death preparedness.
- Subscale scoring facilitates targeted interventions to enhance patient quality of life and death.
