Abstract
BackgroundAssessing the quality of structure and process of end-of-life care can help improve outcomes. There was currently no valid tool for this purpose in Mainland China. The aim of this study is to validate the Chinese version of the Care Evaluation Scale (CES).MethodsFrom January to December 2017, a cross-sectional online survey was conducted among bereaved family members of cancer patients from 10 medical institutes. The reliability of the CES was assessed with Cronbach’s α, and structural validity was evaluated by confirmatory factor analysis. Concurrent validity was tested by examining the correlation between the CES total score and overall satisfaction with end-of-life care, quality of dying and death, and quality of life.ResultsA total of 305 valid responses were analyzed. The average CES score was 70.7 ± 16.4, and the Cronbach’s α of the CES was 0.967 (range: 0.802–0.927 for the 10 domains). The fit indices for the 10-factor model of CES were good(root-mean-square error of approximation, 0.047; comparative fit index, 0.952; Tucker–Lewis index, 0.946; standardized root mean square residual, 0.053). The CES total score was highly correlated with overall satisfaction with medical care (r = 0.775, P < 0.01), and moderately correlated with patients’ quality of life (r = 0.579, P < 0.01) and quality of dying and death (r = 0.570, P < 0.01). In addition, few associations between CES total score and demographic characteristics, except for the family members’ age.Conclusions The Chinese version of the CES is a reliable and valid tool to evaluate the quality of structure and process of end-of-life care for patients with cancer from the perspective of bereaved family in Mainland China.
Highlights
Assessing the quality of structure and process of end-of-life care can help improve outcomes
In this study, we evaluated the psychometric properties of the Chinese version of the Care Evaluation Scale (CES) to measure quality of structure and process of end-of-life care from the prospective of bereaved family members of cancer patients in Mainland China
In conclusion, evaluation of the quality of care provided to dying patients are essential for making improvements to be made in the field of health service of end-of-life care
Summary
Assessing the quality of structure and process of end-of-life care can help improve outcomes. Valid, and clinically manageable measurement tools for evaluating the quality of care provided to dying patients are essential for improvements to be made [3]. Such tools should cover the experiences of patients and their families, as both should be the focus of high-quality end-of-life care [4]. Family members are an important source of information and several studies have proven that it is feasible and valid to evaluate the outcomes of end-of-life care from the perspective of bereaved families [5,6,7]
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