Department of Nursing, Changwon National University, C.P.O. Box 51140, Changwon, Korea.
Department of Emergency Medical Services, Daejeon University, Daejeon, Korea.
Health Qual Life Outcomes. 2022 Mar 24;20(1):48. doi: 10.1186/s12955-022-01952-8.
End-of-life care decision-making has become important to support dignity and quality of life for patients who are facing death in Korea, along with the enactment of the Life-Sustaining Treatment Act in 2018. However, it seems that the concepts and policies related to the law are not yet familiar to health care providers or the general public. This unfamiliarity can hinder efficient end-of-life care discussions. Therefore, the purpose of this study was to propose a valid and reliable tool to explore the level of understanding of concepts and attributes related to end-of-life care decisions.
This is a mixed-methods study design. A relevant law and literature analysis, expert consultation, cognitive interviews of 10 adults, and cross-sectional survey for psychometric tests using data from 238 clinical nurses were performed to update a tool developed before the life-sustaining treatment Act was enacted in Korea.
29 items of the draft version were polished in terms of literacy, total length, and scoring method via cognitive interviews and finalized into 21 items through psychometric tests and expert consultations. The 21 items conformed to the Rasch unidimensional paramenters.
A tool to identify the level of understanding of concepts related to end-of-life care decisions was proposed through a rather rigorous process to ensure feasibility and validity/reliability. We recommend the proposed tool to apply to the adult population and nurses for evaluation and educational purposes.
自 2018 年韩国颁布《维持生命治疗法》以来，临终关怀决策对于面临死亡的患者的尊严和生活质量变得尤为重要。然而，医疗保健提供者或公众似乎对与该法律相关的概念和政策并不熟悉。这种不熟悉可能会阻碍有效的临终关怀讨论。因此，本研究旨在提出一种有效且可靠的工具，以探讨与临终关怀决策相关的概念和属性的理解水平。
这是一项混合方法研究设计。通过对相关法律和文献的分析、专家咨询、对 10 名成年人的认知访谈以及对 238 名临床护士进行的心理测量测试数据的横断面调查，对韩国颁布《维持生命治疗法》之前开发的工具进行了更新。
通过认知访谈，对草稿版本的 29 个项目进行了文化素养、总长度和评分方法的润色，并通过心理测量测试和专家咨询最终确定为 21 个项目。这 21 个项目符合 Rasch 单维参数。
通过相当严格的流程提出了一种识别与临终关怀决策相关的概念理解水平的工具，以确保可行性和有效性/可靠性。我们建议将该工具应用于成年人群体和护士，以进行评估和教育目的。
