Miyashita Mitsunori, Morita Tatsuya, Sato Kazuki, Hirai Kei, Shima Yasuo, Uchitomi Yosuke
Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
J Pain Symptom Manage. 2008 May;35(5):486-98. doi: 10.1016/j.jpainsymman.2007.07.009. Epub 2008 Mar 20.
The aim of this study was to develop a measure for evaluating good death from the bereaved family member's perspective, and to examine the validity and reliability of the assessment. A cross-sectional anonymous questionnaire was administered to bereaved family members of cancer patients who had died in a regional cancer center from September 2004 to February 2006. We measured the Good Death Inventory (GDI), Care Evaluation Scale, and an overall care satisfaction scale. A retest was conducted one month after sending the questionnaire. Of the 344 questionnaires sent to bereaved family members, 189 responses were analyzed (57%). A factor analysis of the responses to the GDI identified 10 core domains: "environmental comfort," "life completion," "dying in a favorite place," "maintaining hope and pleasure," "independence," "physical and psychological comfort," "good relationship with medical staff," "not being a burden to others," "good relationship with family," and "being respected as an individual." Eight optional domains also were identified: "religious and spiritual comfort," "receiving enough treatment," "control over the future," "feeling that one's life is worth living," "unawareness of death," "pride and beauty," "natural death," and "preparation for death." The GDI had sufficient concurrent validity with the Care Evaluation Scale and overall care satisfaction, sufficient internal consistency (alpha=0.74-0.95), and acceptable test-retest reliability (ICC=0.38-0.72). Finally, we developed a short version of the GDI. The GDI is a valid scale to measure end-of-life care comprehensive outcomes from the bereaved family member's perspective in Japan.
本研究的目的是从丧亲家庭成员的角度开发一种评估善终的方法,并检验该评估的有效性和可靠性。对2004年9月至2006年2月在某地区癌症中心去世的癌症患者的丧亲家庭成员进行了一项横断面匿名问卷调查。我们测量了善终量表(GDI)、护理评估量表和总体护理满意度量表。在发送问卷一个月后进行了重测。在向丧亲家庭成员发送的344份问卷中,分析了189份回复(57%)。对GDI回复的因子分析确定了10个核心领域:“环境舒适”、“生命圆满”、“在喜爱的地方离世”、“保持希望和愉悦”、“独立”、“身心舒适”、“与医护人员的良好关系”、“不给他人造成负担”、“与家人的良好关系”以及“作为个体受到尊重”。还确定了8个可选领域:“宗教和精神慰藉”、“接受足够的治疗”、“掌控未来”、“感觉自己的生命有价值”、“对死亡无意识”、“自豪与美好”、“自然死亡”以及“为死亡做准备”。GDI与护理评估量表和总体护理满意度具有足够的同时效度,具有足够的内部一致性(α=0.74 - 0.95),以及可接受的重测信度(ICC=0.38 - 0.72)。最后,我们开发了GDI的简短版本。GDI是从日本丧亲家庭成员的角度衡量临终护理综合结果的有效量表。