title: Validation of the Quality of Dying-Hospice Scale.
abstract: BACKGROUND
  Measuring the quality of dying (QOD) experience is important for hospice providers. However, few instruments exist that assess one's QOD; and those that do have not been well validated in hospice.
  
  
  OBJECTIVE
  This study tested the properties of the QOD-Hospice Scale (QOD-Hospice) to provide preliminary validation data on internal consistency, inter-rater reliability, convergent validity, and factorability in a hospice setting. Additionally, results of the factor analysis were used to create a brief version of the measure.
  
  
  METHODS
  Bereaved informal caregivers who had provided care for a hospice patient were recruited from a large nonprofit hospice. Participants completed post-death surveys, which included the QOD-Hospice and other study measures. Convergent validity was tested by exploring hypothesized associations with related instruments measuring negative emotional states (Depression Anxiety Stress Scale-21), emotional grief (Texas Revised Inventory of Grief-2), social support (Lubben Social Network Scale-6), and a single-item measure of satisfaction with hospice care.
  
  
  RESULTS
  A total of 70 caregivers participated in the survey (40 primary and 30 secondary caregivers), most of whom were female (67%) and white (81%). The QOD-Hospice produced an alpha of 0.86, an intraclass correlation of 0.49 between caregivers of the same decedent, and was correlated with all measures testing convergent validity (P<0.05; in the hypothesized direction) and most, but not all, subscales. An exploratory factor analysis elicited two factors, Preparation (seven items) and Security (six items), which were combined to create a 13-item version of the scale, the QOD-Hospice-Short Form.
  
  
  CONCLUSIONS
  Although further testing of the QOD-Hospice measures is needed, preliminary evidence suggests that the instruments are reliable and valid for use in hospice.
authors: University of Maryland, Baltimore, Maryland, USA. Electronic address: jcagle@ssw.umaryland.edu.
authors: John G
authors: JG
authors: Cagle
authors: Florida State University, Tallahassee, Florida, USA.
authors: Jean C
authors: JC
authors: Munn
authors: University of Maryland, Baltimore, Maryland, USA.
authors: Seokho
authors: S
authors: Hong
authors: Florida State University, Panama City, Florida, USA.
authors: Maggie
authors: M
authors: Clifford
authors: University of North Carolina, Chapel Hill, North Carolina, USA.
authors: Sheryl
authors: S
authors: Zimmerman
mesh_terms: D000368:Aged; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003643:Death; D005163:Factor Analysis, Statistical; D005260:Female; D017051:Hospice Care; D006738:Hospices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Hospice; end of life; good death; palliative care; psychometrics; quality