Wang Haojie, Zhang Weiqing, Wang Kun, Song Jielu, Cao Yabing, Wei Zhihua
The Second Clinical Medical School of Zhengzhou University, Zhengzhou City, Henan Province, China.
Nanjing University Medical School, Affiliated Nanjing Drum Tower Hospital, Nangjing City, Jiangsu, China.
Int J Older People Nurs. 2025 May;20(3):e70025. doi: 10.1111/opn.70025.
Subjective end-of-life health literacy investigates individuals' abilities in knowledge, communication and decision-making related to health during the end-of-life stage. This study aims to culturally adapt the Subjective End-of-Life Health Literacy Scale (S-EOL-HLS) for a Chinese context, including reliability and validity assessments among older adult community populations.
We translated, back-translated and cross-culturally adapted the English version (S-EOL-HLS) using Brislin's translation model. Subsequently, a survey was conducted among older adults in the community to assess the scale's reliability.
The content validity index for each item ranged from 0.714 to 1.000, with a total scale index of 0.928. Exploratory factor analysis identified three main factors with eigenvalues ≥ 1, contributing to a cumulative variance of 67.131%. Confirmatory factor analysis demonstrated that all fit indices met the required criteria, resulting in a Cronbach's α coefficient of 0.945. The half-split reliability was 0.956, and test-retest reliability reached 0.905. Validity evaluation using the HLS-EU-Q16 demonstrated a positive correlation with the scores of the Chinese End-of-Life Health Literacy Scale (r = 0.821, p < 0.001).
The Chinese version of the S-EOL-HLS exhibits strong reliability and validity among older individuals. It is suitable for evaluating end-of-life health literacy within the Chinese cultural context.
主观临终健康素养研究个体在临终阶段与健康相关的知识、沟通和决策能力。本研究旨在对主观临终健康素养量表（S-EOL-HLS）进行文化调适，以适用于中国背景，包括对老年社区人群进行信效度评估。
我们采用布里斯林翻译模型对英文版本（S-EOL-HLS）进行翻译、回译和跨文化调适。随后，对社区老年人进行调查以评估该量表的信度。
各条目内容效度指数范围为0.714至1.000，总量表指数为0.928。探索性因子分析确定了三个特征值≥1的主要因子，累计方差贡献率为67.131%。验证性因子分析表明所有拟合指数均符合要求标准，Cronbach's α系数为0.945。分半信度为0.956，重测信度达到0.905。使用HLS-EU-Q16进行效度评估显示与中国临终健康素养量表得分呈正相关（r = 0.821，p < 0.001）。
中文版S-EOL-HLS在老年人中表现出较强的信度和效度。它适用于在中国文化背景下评估临终健康素养。
