title: Spanish Validation of the Care Evaluation Scale for Measuring the Quality of Structure and Process of Palliative Care From the Family Perspective.
abstract: BACKGROUND
  A reliable and valid measure of the structure and process of end-of-life care is important for improving the outcomes of care.
  
  
  OBJECTIVE
  This study evaluated the validity and reliability of the Spanish adaptation of a satisfaction tool of the Care Evaluation Scale (CES), which was developed in Japan to evaluate palliative care structure and process from the perspective of family members.
  
  
  METHODS
  Standard forward-backward translation and a pilot test were conducted. A multicenter survey was conducted with the relatives of patients admitted to palliative care units for symptom control. The dimensional structure was assessed using confirmatory factor analyses. Concurrent and discriminant validity were tested by correlation with the SERQVHOS, a Spanish hospital care satisfaction scale and with an 11-point rating scale on satisfaction with care. The reliability of the CES was tested by Cronbach α and by test-retest correlation.
  
  
  RESULTS
  A total of 284 primary caregivers completed the CES, with low missing response rates. The results of the factor analysis suggested a six-factor solution explaining 69% of the total variance. The CES moderately correlated with the SERQVHOS and with the overall satisfaction scale (intraclass correlation coefficients of 0.66 and 0.44, respectively; P = 0.001). Cronbach α was 0.90 overall and ranged from 0.85 to 0.89 for subdomains. Intraclass correlation coefficient was 0.88 (P = 0.001) for test-retest analysis.
  
  
  CONCLUSIONS
  The Spanish CES was found to be a reliable and valid measure of the satisfaction with end-of-life care structure and process from family members' perspectives.
authors.affiliation: Palliative Care Unit, NS La Candelaria University Hospital, Tenerife, Spain. Electronic address: mabenros@gmail.com.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Benitez-Rosario
authors.affiliation: Palliative Care Unit, NS La Candelaria University Hospital, Tenerife, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Caceres-Miranda
authors.affiliation: Support Research Service, Primary Health Care, Tenerife, Spain.
authors.forename: Armando
authors.initials: A
authors.lastname: Aguirre-Jaime
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005163:Factor Analysis, Statistical; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D013030:Spain; D013727:Terminal Care / Q000379:methods; D014175:Translating; D055815:Young Adult
keywords: Family satisfaction; palliative care audit; palliative care satisfaction; quality indicators; quality of care; satisfaction scale