Development of the End-of-Life Care Nursing Attitude Scale for Japanese Geriatrics

Abstract

This study aimed to develop an end-of-life (EOL) care nursing attitude scale for Japanese geriatric nurses (ELNAS-JG). The items of the ELNAS-JG were developed to cover important topics related to EOL care (eg, motivation for providing EOL care, pain and symptom management, and decision-making support care for older adults). Participants were 1663 nurses employed in 32 institutions across Japan. Of these, 1298 participants were analyzed. An exploratory factor analysis of the 26 scale items revealed a 3-factor solution describing the concepts of responsibility, willingness, and confidence: responsibility and willingness were captured in factor 1 (16 items), and confidence was split into factor 2 (6 items) and factor 3 (4 items) to capture individual and collaborative behaviors. The overall Cronbach α coefficient for the 26 items was 0.95, and the intraclass correlation coefficient was 0.83. Overall, the ELNAS-JG was confirmed to have good internal consistency, test-retest reliability, content validity, known-groups validity, and construct validity. It can comprehensively measure nurses' attitudes toward EOL care for older adults in any EOL setting. Furthermore, this scale can be used to evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.

Preliminary Effect and Acceptability of an Intervention to Improve End-of-Life Care in Long-Term-Care Facilities: A Feasibility Study

“…The ELNAS-JG consists of 26 items rated on a 5-point Likert scale, from “1 = strongly disagree” to “5 = strongly agree”; higher scores indicate more positive attitudes toward end-of-life care. The validity and reliability (Cronbach’s α = 0.96) of the ELNAS-JG were confirmed in a previous study [ 40 ]. Reliability was also confirmed using data from the present study (e.g., α ranged from 0.95 to 0.97 for various time points).…”

“…Attitude toward end-of-life care . Staff’s attitude toward end-of-life care for older adults was measured using an end-of-life care nursing attitude scale for Japanese geriatric nurses (ELNAS-JG), which measures attitudes toward end-of-life care for older adults in any end-of-life setting [ 40 ]. The ELNAS-JG consists of 26 items rated on a 5-point Likert scale, from “1 = strongly disagree” to “5 = strongly agree”; higher scores indicate more positive attitudes toward end-of-life care.…”

Effect of an end‐of‐life gerontological nursing education programme on the attitudes and knowledge of clinical nurses: A non‐randomised controlled trial

“…The original ELNAS‐JG includes 26 items rating nurses’ attitudes for EOL care on a 5‐point Likert scale from 1 (“strongly disagree”) to 5 (“strongly agree”) with total score from 26 to 130; higher scores indicate better attitudes about EOL care (Cronbach's α = 0.95, intraclass correlation coefficient = 0.83). This scale has good internal consistency, test–retest reliability, content validity, known‐groups validity and construct validity (Okumura‐Hiroshige et al, ). The Cronbach's α was 0.96.…”

“…Specialised education can improve nurses’ advanced assessment and care skills; poor education hinders appropriate EOL nursing care (Anstey, Powell, Coles, Hale, & Gould, ; Teixeira et al, ). Palliative care is lacking in nursing curricula (Paice et al, ); 75% of nurses working in Japanese EOL facilities for older adults reported never receiving EOL care education (Okumura‐Hiroshige et al, ). Previous studies on EOL care focused on specialised EOL care education, mainly for cancer (Bakitas et al, ; Bridges, Lucas, Wiseman, & Griffiths, ), advanced chronic diseases (Phongtankuel et al, ), and advanced dementia (Raymond et al, ).…”