title: Development the Care Evaluation Scale Version 2.0: a modified version of a measure for bereaved family members to evaluate the structure and process of palliative care for cancer patient.
abstract: BACKGROUND
  The Care Evaluation Scale (CES1.0) was designed to allow bereaved family members to evaluate the structure and process of care, but has been associated with a high frequency of misresponses. The objective of this study was to develop a modified version of CES1.0 (CES2.0) that would eliminate misresponses while maintaining good reliability and validity.
  
  
  METHODS
  We conducted a cross-sectional questionnaire survey by mail in October 2013. The participants were bereaved family members of patients who died from cancer in seven institutions in Japan. All family members were asked to complete CES2.0, the short form CES1.0, items on overall care satisfaction, the Family Satisfaction with Advanced Cancer Care (FAMCARE) Scale, the Patient Health Questionnaire-9 (PHQ-9) and the Brief Grief Questionnaire (BGQ). To examine test-retest reliability, all participants were asked to complete a second CES2.0.
  
  
  RESULTS
  Of 596 questionnaires sent, 461 (77%) were returned and 393 (66%) were analyzed. In the short form CES1.0, 17.1% of the responses were identified as misresponses. No misresponses were found in CES2.0. We identified 10 CES2.0 subscales similar to those in CES1.0 using exploratory factor analysis. Cronbach's alpha was 0.96, and the intraclass correlation coefficient was 0.83. Correlations were found between CES2.0 and overall satisfaction (r = 0.83) and FAMCARE (r = 0.58). In addition, total CES2.0 scores were negatively correlated with the PHQ-9 (r = -0.22) and BGQ (r = -0.10).
  
  
  CONCLUSIONS
  These results suggest that CES2.0 eliminated misresponses associated with CES1.0 while maintaining good reliability and validity and greatly improving test-retest reliability.
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan. miyasita-tky@umin.net.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan.
authors.forename: Maho
authors.initials: M
authors.lastname: Aoyama
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan.
authors.forename: Misato
authors.initials: M
authors.lastname: Nakahata
authors.affiliation: Aiwa Hospital, Nagano, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Palliative Care and Pain Clinic, Matsue City Hospital, Matsue, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Medical Oncology, Kansai Electric Power Hospital, Osaka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yanagihara
authors.affiliation: Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Hamamatsu, Japan.
authors.forename: Akemi
authors.initials: A
authors.lastname: Shirado
authors.affiliation: Department of Palliative Medicine, Oita City Medical Association's Almeida Memorial Hospital, Oita, Japan.|Wata Clinic, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Shutoh
authors.affiliation: Department of Pharmacy, Ashiya Municipal Hospital, Ashiya, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Okamoto
authors.affiliation: Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hamano
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Miyamoto
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan.
authors.forename: Saki
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8575, Sendai, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sato
authors.affiliation: Institute of Academic Initiatives, & Graduate School of Human Sciences, Osaka University, Osaka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara Hospital, Shizuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
mesh_terms: D000328:Adult; D000368:Aged; D001601:Bereavement; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005260:Female; D006117:Grief; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000592:standards*; D010549:Personal Satisfaction; D015397:Program Evaluation; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards; D055815:Young Adult
keywords: Bereavement; Neoplasms; Palliative care; Quality of care; Questionnaires