家访护士发现确定与癌症患者发起临终讨论的适当时间具有挑战性。本研究旨在开发临终讨论时机 (T-EOLD) 量表来帮助家访护士确定与癌症患者启动临终讨论的适当时间，并测试其可靠性和有效性。量表项目是根据从访谈、文献综述和专家小组讨论中提取的定性数据制定的。我们对 93 名家访护士进行了初步研究，评估了量表的结构效度、一致性和重测信度。最后，我们以234名家访护士为样本，进行了初步研究，评估了结构效度和量表一致性。初步制定了41个项目。初步研究和初步研究中的下限效应、项目总相关性、良好-较差和探索性因素分析产生了三因素、16 项模型。该模型的拟合优度为 CFI = 0.94、GFI = 0.90、AGFI = 0.87 和 RMSEA = 0.06。总体量表的 Cronbach α 值为 0.91。T-EOLD 的信度和效度是可以接受的，因为它是家访护士可以用来确定与癌症患者开始临终讨论的时间的适当量表。然而，还需要进一步研究来检验 T-EOLD 在国内和国际上的临床实用性。版权所有 © 2024 美国临终关怀和姑息医学学会。由爱思唯尔公司出版。保留所有权利。

Home-visit nurses find it challenging to determine the appropriate time to initiate end-of-life discussions with cancer patients.This study aimed to develop the Timing of End-of-Life Discussions (T-EOLD) scale to help home-visit nurses determine the appropriate time to initiate end-of-life discussions with cancer patients and to test its reliability and validity.The scale items were developed based on qualitative data extracted from interviews, literature reviews, and expert panel discussions. We conducted a preliminary study involving 93 home-visit nurses and evaluated the construct validity, consistency, and test-retest reliability of the scale. Finally, using a sample of 234 home-visit nurses, we conducted the primary study and assessed the construct validity and scale consistency.A total of 41 items were initially developed. Floor effect, item-total correlation, good-poor, and exploratory factor analysis in the preliminary and primary studies yielded a three-factor, 16-item model. The model's goodness-of-fit was CFI = 0.94, GFI = 0.90, AGFI = 0.87, and RMSEA = 0.06. Cronbach's alpha for the overall scale was 0.91.The reliability and validity of the T-EOLD is acceptable, as it is an appropriate scale that home-visit nurses can use to determine the time to initiate end-of-life discussions with cancer patients. However, further study is required to examine T-EOLD's clinical utility, both nationally and internationally.Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.