Development of an end-of-life care management scale for assessing the care of older adults who wish to spend the end-of-life period at home

Abstract

Aim: To develop an end-of-life care management scale to assess care for older adults who wish to remain at home, and examine its reliability and validity. Methods: An item pool was created based on a literature review, and the 46-item, tentative version of end-of-life care management scale was developed. Next, a cross-sectional survey was conducted with 2583 care managers using a self-reported questionnaire. An exploratory factor analysis was used to evaluate the scale's internal consistency using Cronbach's alpha. Intra-rater reliability was evaluated using the correlation with a repeat test. Construct validity and criterion-related validity were determined using a confirmatory factor analysis, and correlations between this scale and previous scales, respectively. Results: Valid responses were obtained from 477 care managers. Exploratory factor analyses identified 23 items from four factors: “further the teamwork to realize the individual's wishes,” “rapid care planning that anticipates changes in the situation,” “support to family members preparing for end-of-life care at home” and “support to become familiar with the older adult's views of life, death and suffering.” Cronbach's alpha was 0.819 for the entire scale and ≥0.709 for each factor. The intraclass correlation coefficient of the test–retest ranged from 0.756 to 0.863. The correlation coefficients between the previous scales and the entire scale ranged from 0.569 to 0.795 (P < 0.001). Conclusions: The scale showed acceptable internal consistency and concurrent validity. Care managers' use of this scale might improve quality of care management and fulfil older adults' wishes to remain at home during the end-of-life period. Geriatr Gerontol Int 2023; 23: 131–140.