Development and Validation of the Readiness for End-of-Life Conversations (REOLC) Scale

Abstract

Background: Engaging in end-of-life care considerations is beneficial when the time is right. The purpose of this study is to provide a valid instrument to assess peoples readiness for end-of-life conversations before they are initiated.Materials and Methods: A community sample was recruited in study one for exploratory factor analysis of a 13-item questionnaire. In study two, psychometric properties were analyzed with structural equation modeling in a population affected by cancer. Convergent and discriminant validity were assessed with questionnaires measuring distress, depression, anxiety, fear of progression, and distress of death and dying.Results: In study one (N = 349) exploratory factor analysis resulted in three subscales readiness (α = 0.84), communication (α = 0.76), and values (α = 0.56) with a possible common factor (α = 0.84) for a community sample. In study two (N = 84) the three-factor solution with 13 items was not supported for cancer patients. Factor structure was adapted to 12 items with one common factor readiness (α = 0.87). Model fit was good: χ2(50) = 59.18, p>0.05 (Satorra-Bentler-correction = 1.27), with χ2/df = 1.184, rRMSEA = 0.053 (90%-CI[0.000;0.100]), and rSRMR = 0.072. Convergent validity was supported by moderate correlations to trait gratitude, ratings of readiness to provide a living will or talk with family about the end of life. Divergent validity was supported by no or small correlation with distress, depression, general and death anxiety and fear of progression, respectively.Conclusions: Results support usage of the REOLC Scale in different settings with adapted factor structure. The questionnaire is interpreted as valid and reliable instrument to assess objective readiness for end-of-life conversations.

The trajectory of prognostic cognition in patients with advanced cancer: is the traditional advance care planning approach desirable for patients?

“…Readiness for end-of-life discussions can be defined as a change in health behaviour ( 56 ) when participating in each component of end-of-life discussions ( 57 ). Although readiness for end-of-life discussions has no formal definition, it includes readiness to engage in end-of-life thoughts, barriers and facilitators of end-of-life conversations ( 58 ).…”

Matters of Life and Death: An Experimental Study Investigating Psychological Interventions to Encourage the Readiness for End-of-Life Conversations

“…"Thinking about the end of life is part of life" or "For me it makes sense to talk about death and the dying process with my family/friends"). For the validation and psychometric evaluation of the Readiness for End-of-Life Conversations scale, see Berlin et al [43]. The items were rated on a 6-point Likert scale from 0 "do not agree at all" to 5 "fully agree" (online suppl.…”

Applying the community readiness model to identify and address inequity in end-of-life care in South Asian communities

“…Whilst previous work has explored community readiness in relation to end-of-life care, 9 , 10 this is the first study to utilise the model to explore readiness in South Asian communities to engage in end-of-life care services and it adds to the current literature that explores the end-of-life and palliative care for people of South Asian heritage. 11 , 12 In comparison to previous literature (that focused on understanding the perspectives of South Asian individuals 12 and providing suitable community-based culturally appropriate end-of-life care 11 ), this study focuses on exploring the way in which South Asian communities view new end-of-life services.…”