Development of a Self-assessment Scale for Nurses to Enhance Dialogue Support between Terminally Ill Cancer Patients and Their Families

Abstract

Purpose: This study aimed to examine the reliability and validity of a self-assessment scale for nurses to enhance dialogue support between terminally ill cancer patients and their families.

Methods: Subjects were 1,196 nurses with at least 3 years of clinical experience working at hospitals throughout Japan, and who were involved in the care of terminally ill cancer patients. An online questionnaire was administered, which included 38 items on a self-assessment scale for nurses’ support of dialogue between terminally ill cancer patients and their families. The statistical analysis included exploratory factor analysis, and examination of internal consistency and construct validity.

Results: A total of 370 responses (30.9%) were analyzed. An exploratory factor analysis helped identify four factors (22 items): (1)Assessing patients’ and families’ dialogue needs; (2)Focusing on patients and families for a deeper understanding of them; (3)Engaging with patients and families with respect for each other’s feeling; and (4) Utilizing a team approach for dialogue support. Cronbach’s alpha coefficient was .944 for the total scale and ranged from .797 to .908 for the four factors. The goodness of fit of the model was as follows: GFI = .888, AGFI = .860, CFI = .931, and RMSEA = .063. The known-groups technique was used to examine construct validity. The scale score showed significantly higher scores among groups with experience in a palliative care unit and among certified nurses or certified nurse specialists in oncology nursing. The convergent validity was .819 (p < .01), concurrent validity was .403 (p < .01).

Conclusions: This study’s results suggest that the scale’s validity and reliability were within the permissible range.