为家庭访问护士开发量表，以开始与癌症患者的临终讨论
Developing a Scale for Home-Visit Nurses to Start End-of-life Discussions with Cancer Patients
影响因子:3.50000
分区:医学2区 / 临床神经病学2区 卫生保健与服务2区 医学：内科2区
发表日期:2025 Jan
作者:
Kurumi Asaumi, Masataka Oki, Wataru Ohashi
摘要
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.我们进行了一项初步研究，涉及93位家庭视野护士，并评估了量表的构建效度，一致性和重测的可靠性。最后，使用234名家庭视野护士的样本，我们进行了主要研究，并评估了构造有效性和规模一致性。最初开发了41个项目。初步和初级研究中的地板效应，项目 - 局部相关性，善良和探索性因素分析产生了三因素，16个项目模型。该模型的拟合优度为CFI = 0.94，GFI = 0.90，AGFI = 0.87和RMSEA = 0.06。 Cronbach的整体尺度alpha为0.91。T-Eold的可靠性和有效性是可以接受的，因为这是一个适当的量表，家庭访问的护士可以使用该量表来确定与癌症患者进行寿命终止讨论的时间。但是，需要进一步的研究来检查T-EOLD在国内和国际上的临床效用。
Abstract
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.