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Research Paper
- Development of an end-of-life care competency scale for nurses in long-term care hospitals: a psychometric validation study
- Sookyeon Son, Mi-Kyeong Jeon
- J Korean Acad Nurs 2025;55(4):598-612. Published online November 27, 2025
- DOI: https://doi.org/10.4040/jkan.25113
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Abstract
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ePub - Purpose
This study aimed to develop a scale to measure end-of-life care (EOLC) competency among nurses working in long-term care hospitals and to evaluate its validity and reliability.
Methods
Preliminary items were developed based on attributes and indicators identified through a conceptual analysis of EOLC competency. The initial version of the scale was refined through expert content validity assessment, item revision, and a pilot test. The main survey was conducted among 460 nurses in long-term care hospitals, and 409 valid responses were analyzed after excluding 51 incomplete or invalid cases. Data were analyzed using software-assisted item analysis, exploratory and confirmatory factor analyses, and assessments of convergent, discriminant, and criterion-related validity, as well as reliability testing.
Results
The initial 55 items were reduced to a final set of 30 items across seven dimensions. Model fit indices indicated good construct validity (χ²/degrees of freedom=1.91, standardized root mean square residual=.06, root mean square error of approximation=.07, Tucker-Lewis index=.90, comparative fit index=.91), with a total explained variance of 70.2%. The scale demonstrated strong criterion-related validity (r=.76, p<.001), high internal consistency (Cronbach’s α=.95; McDonald’s ω=.95), acceptable test–retest reliability (r=.56, p<.001), and an intraclass correlation coefficient of .72 (95% confidence interval, .51–.84; p<.001).
Conclusion
The developed scale is a valid and reliable instrument for assessing EOLC competency among nurses in long-term care hospitals. It can be effectively utilized for educational assessment, training evaluation, and the measurement of program effectiveness in end-of-life care.
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