Cultural Adaptation and Validation of the Quality of Dying in Long-Term Care Scale (QoD-LTC) for Spanish Nursing Homes

Puente‐Fernández, Daniel; Jimeno-Ucles, Rosel; Mota-Romero, Emilio; Roldán, Concepción; Froggatt, Katherine; Montoya‐Juárez, Rafael

doi:10.3390/ijerph18105287

Cited by 3 publications

(9 citation statements)

References 41 publications

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“…27 These modifications were also included for the professionals' QoD-LTC validation. 18 In keeping with our hypothesis, the Spanish caregivers' version of the QoD-LTC scale showed the same number of factors and equal factor distribution as the original scale. 22 As in the original scale, the three factors were Personhood, Closure, and Preparatory Task.…”

Section: Discussionsupporting

confidence: 70%

“…In a previous study, the QoD-LTC scale was validated in a Spanish population for nursing home professionals, but not for caregivers. 18 This could be important because caregivers play a determining role in end-of-life care in nursing homes. Although they are not usually the main support in residents' daily life activities, families play a crucial role in end-of-life decisions, especially when residents show cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

“…In a previous study, the QoD‐LTC scale was validated in a Spanish population for nursing home professionals, but not for caregivers 18 . This could be important because caregivers play a determining role in end‐of‐life care in nursing homes.…”

Section: Introductionmentioning

confidence: 99%

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Cultural adaptation and validation of the Quality of Dying in Long‐term Care (QoD‐LTC and QoD‐LTC‐C) scales by caregivers in nursing homes

Puente‐Fernández,

Soto Felipe,

Mota‐Romero

et al. 2023

Psychogeriatrics

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BackgroundThere is a lack of tools that can evaluate quality of dying in nursing homes from the perspective of deceased patients' caregivers. The aim of this study was to adapt and validate the caregivers' versions of the Quality of Dying in Long‐Term Care (QoD‐LTC) and Quality of Dying in Long‐Term Care Complete (QoD‐LTC‐C) scales in the Spanish context.MethodsThis was a cultural adaptation and validation study. The scales were translated from English to Spanish and vice versa, and 13 experts in end‐of‐life care participated in a two‐round Delphi panel. Caregivers of 69 deceased residents from seven nursing homes in southern Spain completed both scales. Reliability, feasibility, and concurrent validity with global quality of dying perception and symptom burden (Edmonton Symptom Assessment Scale), were evaluated.ResultsSpanish caregivers' version of the QoD‐LTC scale showed good internal consistency for the total scale (α = 0.74) and each of its three factors, and good inter‐rater reliability (ICC = 0.50) and test–retest reliability (ICC = 0.81). The Spanish QoD‐LTC‐C scale for caregivers showed good internal consistency for the total scale (α = 0.81) and for its component factors, and good test–retest reliability (ICC = 0.89) and inter‐rater reliability (ICC = 0.66). Both scales correlated with family caregivers' global perception of deceased residents' quality of dying (r = 0.39; r = 0.32), but not with the ESAS score.ConclusionsBoth scales presented an adequate factorial structure, internal consistency, and reliability to assess caregivers' perception of the quality of dying in Spanish nursing homes.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

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Cultural adaptation and validation of the Quality of Dying in Long‐term Care (QoD‐LTC and QoD‐LTC‐C) scales by caregivers in nursing homes

Puente‐Fernández,

Soto Felipe,

Mota‐Romero

et al. 2023

Psychogeriatrics

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“…The scale has acceptable reliability (α = .681) and is correlated with various other scales relating to end-of-life care. A three-factor model was validated using principal components analysis: Quality of care (five items), End-of-life communication by the resident (three items) and End-oflife appearance (three items) (Puente-Fernández et al, 2021).…”

Section: Quantitative Toolsmentioning

confidence: 99%

Quality of dying among elderly people diagnosed with dementia in nursing homes: A mixed methods study

Puente‐Fernández

Peña

Soto‐Felipe

et al. 2022

Psychiatric Ment Health Nurs

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Accessible Summary What is known on the subject Nurses working at nursing homes can play a pivotal role in mental health as a high proportion of residents diagnosed with dementia are in these facilities. Many institutionalized residents diagnosed with dementia develop clinical complications and symptoms that reduce the quality of dying. A mixed‐methods approach can help nurses with the difficult task of assessing the quality of dying among these residents and identify inconsistencies that cannot be found using scales alone, but no studies were found in this topic. What the paper adds to existing knowledge Through the Quality of dying in Long‐Term Care Scale (QoD‐LTC), nurses described symptom management, quality of care, and end‐of‐life appearance as adequate and end‐of‐life communication as lacking. Generally speaking, the scores on the scale were consistent with the data from semi‐structured interviews conducted with nurses. In the semi‐structured interviews, some of the concepts on the scale, including ‘dignity’, ‘holistic’ care, ‘good relationships with healthcare professionals’, and ‘a peaceful death’, are complex and not fully incorporated into nurses' practice in nursing homes when assessing residents diagnosed with dementia. This could be improved by using the SENSES Model or person‐centred care frameworks. What are the implications for practice? There is evidence of shortcomings among professionals in the correct use of concepts linked to psychological wellbeing, communication, therapeutic relationship, safety and participation, preservation of dignity, decision‐making, and resident autonomy, which can be addressed using specific theoretical approaches developed in the field of mental health nursing. Abstract IntroductionThe complex nature of end‐of‐life assessment of individuals diagnosed with dementia would benefit from a mixed‐methods approach that simultaneously assess the perception and response of nurses to standardized tools. Aim/QuestionTo examine nursing professionals' perceptions of the quality of dying among residents diagnosed with dementia using the Quality of Dying in Long‐Term Care settings (QoD‐LTC) questionnaire and to identify consistencies and inconsistencies in their narratives. MethodMixed‐methods study using concurrent triangulation with data integration for results and interpretation. Nurses from eight nursing homes assessed 117 residents diagnosed with dementia who died in the previous 3 months using the QoD‐LTC scale. After informed consent was obtained (nurses/caregivers), 17 semi‐structured scale‐based interviews were conducted. ResultsSymptom management, quality of care, and end‐of‐life appearance were found to be adequate, while end‐of‐life communication was deemed insufficient. The qualitative and quantitative data were consistent for most of the items on the QoD‐LTC. DiscussionConcepts such as dignity, holistic care, good relationships, and peaceful death are complex and not fully incorporated into professional practice. Implications for PracticeThe results high...

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“…However, few instruments exist that assess the quality of one's dying process in Spain. This study uses the new FDM proposed to validate the design of a new Spanish version of the "Quality of Dying in Long-Term Care" (QoD-LTC) [25], one of the most widely used scales to assess the quality of dying in long-term care facilities.…”

Section: Survey Outcomes (Results)mentioning

confidence: 99%

A Fuzzy Delphi Consensus Methodology Based on a Fuzzy Ranking

Hierro

Sánchez²,

Puente‐Fernández

et al. 2021

Mathematics

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Delphi multi-round survey is a procedure that has been widely and successfully used to aggregate experts’ opinions about some previously established statements or questions. Such opinions are usually expressed as real numbers and some commentaries. The evolution of the consensus can be shown by an increase in the agreement percentages, and a decrease in the number of comments made. A consensus is reached when this percentage exceeds a certain previously set threshold. If this threshold has not been reached, the moderator modifies the questionnaire according to the comments he/she has collected, and the following round begins. In this paper, a new fuzzy Delphi method is introduced. On the one hand, the experts’ subjective judgments are collected as fuzzy numbers, enriching the approach. On the other hand, such opinions are collected through a computerized application that is able to interpret the experts’ opinions as fuzzy numbers. Finally, we employ a recently introduced fuzzy ranking methodology, satisfying many properties according to human intuition, in order to determine whether the expert’s fuzzy opinion is favorable enough (comparing with a fixed fuzzy number that indicates Agree or Strongly Agree). A cross-cultural validation was performed to illustrate the applicability of the proposed method. The proposed approach is simple for two reasons: it does not need a defuzzification step of the experts’ answers, and it can consider a wide range of fuzzy numbers not only triangular or trapezoidal fuzzy numbers.

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Cultural Adaptation and Validation of the Quality of Dying in Long-Term Care Scale (QoD-LTC) for Spanish Nursing Homes

Cited by 3 publications

References 41 publications

Cultural adaptation and validation of the Quality of Dying in Long‐term Care (QoD‐LTC and QoD‐LTC‐C) scales by caregivers in nursing homes

Cultural adaptation and validation of the Quality of Dying in Long‐term Care (QoD‐LTC and QoD‐LTC‐C) scales by caregivers in nursing homes

Quality of dying among elderly people diagnosed with dementia in nursing homes: A mixed methods study

A Fuzzy Delphi Consensus Methodology Based on a Fuzzy Ranking

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