Development, Translation, and Validation of the Japanese Quality of Dying and Death Questionnaire for Families of ICU Patients.

BACKGROUND AND AIM

Intensive care unit (ICU) mortality rates are notably high. Several studies outside Japan indicate that the Quality of Death and Dying (QODD) in ICUs is often rated lower compared with settings such as hospices or specialized palliative care units. However, there are no tools to directly evaluate QODD in ICUs that are appropriate to Japanese culture and medicine. Consequently, no study has been conducted in Japanese ICU settings. This study aimed to develop a Japanese version of the QODD Questionnaire 3.2A (ICU-QODD) and to evaluate its reliability and validity.

METHODS

The ICU-QODD was translated into Japanese following the guidelines for translation, adaptation, and validation of instruments. A pilot test involving an expert panel and family members of 40 ICU survivors helped establish the content validity index (CVI). Further testing with 59 bereaved family members evaluated validity through convergent and known groups analyses, while reliability was assessed through internal consistency and test-retest methods.

RESULTS

The pilot test confirmed the face and content validity of the Japanese ICU-QODD. Following revisions, all items achieved a CVI of 0.78 or higher, with an average scale-level CVI exceeding 0.90. One item with low CVI was excluded, resulting in a finalized 24-item version. The ICU-QODD demonstrated strong construct validity, with significant domain correlations to the total score. Known-groups analysis revealed lower QODD scores for patients admitted from the ward p=0.03). Internal consistency and reliability were robust, with the intraclass correlation coefficient generally above 0.7 (range: 0.705-0.964, p<0.001).

CONCLUSIONS

The Japanese version of the ICU-QODD translated in this study demonstrates satisfactory validity and reliability, making it suitable for clinical use in Japan, and adapted to the country's medical, cultural, and linguistic context.