尽管有潜在的好处和临终沟通的愿望，但它很少发生在家庭环境中。亲属在沟通过程中发挥着重要作用；因此，了解他们所面临的困难至关重要。开发和评估亲属版本的临终讨论困难-家庭调查表(DEOLD-FI-r)的因素结构、信度和效度。德国一家医院招募了晚期癌症患者的亲属。探讨了问卷的因素结构。通过 DEOLD-FI-r 与避免癌症沟通、生活质量、痛苦和临终讨论期间经历的困难的措施之间的相关性来检查结构有效性。此外，我们还检查了参与谈话和未参与谈话的人之间的群体差异。大约 111 名亲属完成了调查（平均年龄 55.5 岁，52% 为女性）。 DEOLD-FI-r 的最终版本包含 23 项 (α = .92)。探索性因素分析得出三个因素解释了 74% 的方差。每个因素都描述了临终讨论中潜在沟通障碍的另一个维度：1）自己的情感负担，2）关系和患者相关的困难，3）消极态度。与我们的假设一致的相关性以及那些已经与亲属谈论过生命终结的人报告的沟通困难较少（t（106）= 5.38，P < .001，d = 0.8）支持了构造效度。结果表明，DEOLD-FI-r 是系统评估家庭临终沟通困难的有效且可靠的工具。通过关注亲属，它补充了已经验证的患者版本。版权所有 © 2024 作者。由爱思唯尔公司出版。保留所有权利。

Despite the potential benefits and the desire for end-of-life communication, it rarely occurs in the familial context. Relatives play a significant role in the communication process; thus, it is crucial to understand the difficulties that they face.To develop and evaluate the relatives' version of the Difficulties in End-of-Life Discussions - Family Inventory (DEOLD-FI-r) regarding its factor structure, reliability and validity.Relatives of patients with advanced cancer were recruited in a German hospital. The factor structure of the questionnaire was explored. Construct validity was examined through correlations between the DEOLD-FI-r and measures of avoidance of cancer communication, quality of life, distress, and experienced difficulty during end-of-life discussions. Additionally, we examined the group difference between those who had and had not engaged in the conversation.About 111 relatives completed the survey (mean age 55.5 years, 52% female). The final version of the DEOLD-FI-r contained 23 items (α = .92). The exploratory factor analysis resulted in three factors explaining 74% of the variance. Each factor described another dimension of potential communication barriers in end-of-life discussions: 1) Own emotional burden, 2) Relational and patient-related difficulties, 3) Negative attitudes. Construct validity was supported by correlations consistent with our hypotheses and less reported communication difficulty by those who had already talked about the end-of-life with their relative (t(106) = 5.38, P < .001, d = 0.8).The results indicate that the DEOLD-FI-r is a valid and reliable instrument for the systematic assessment of difficulties in family end-of-life communication. By focusing on relatives, it complements the already validated patient-version.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.