Connaissances et attitudes des infirmiers libéraux face à la douleur en fin de vie

Cross-validity of the end-of-life care management scale via a cross-sectional study

AIM

To examine the cross-validity of the end-of-life care management scale (EOLCM scale).

METHOD

This cross-sectional study used a self-report questionnaire. Participants were care managers who had not participated in a previous study that developed the EOLCM scale. The survey items included participants' demographic information, the EOLCM scale, the number of end-of-life (EOL) cases managed in the last three years, and two concurrent scales, namely the Multidisciplinary Cooperation Behavior Scale for Medical and Nursing Professionals in Home Care and the "MITORI" Care Scale to Evaluate Nursing Care for Patients with End-Stage Cancer and Their Families. "MITORI" means providing care near the dying person. Internal consistency of the EOLCM scale was assessed via Cronbach's alpha. The model's goodness-of-fit was assessed via a confirmatory factor analysis (CFA). Construct validity was determined using the correlation coefficients between the scores of the EOLCM scale and concurrent scales, and the number of EOL cases managed in the last three years.

RESULTS

Valid responses were received from 501 care managers. Cronbach's αs were 0.824 and >0.709 for the entire scale and each factor, respectively. The model fit indices for the CFA were goodness-of-fit index = 0.916, adjusted goodness-of-fit index = 0.892, comparative fit index = 0.947, and root mean square error of approximation = 0.053. Correlation coefficients between the concurrent scales and the EOLCM scale, and between the number of EOL cases and the EOLCM scale ranged from 0.623 to 0.817 (P < 0.001) and from 0.103 to 0.244 (P < 0.001), respectively.

CONCLUSION

The EOLCM scale showed acceptable cross-validity. Further studies are required to examine its cross-cultural and predictive validities. Geriatr Gerontol Int 2024; 24: 48-52.

End-of-life care management for older adults at home by multidisciplinary professionals in Japan

Background

Population aging is a global phenomenon, and there is an urgent need to establish community-based integrated care systems for a sustainable society. In particular, the needs of home-dwelling older adults are multifaceted, encompassing areas such as medical care, nursing care, and welfare. Therefore, it is necessary to implement comprehensive care management that utilizes social resources suitable for diverse needs. This study aims to comprehensively describe care management practices by various professionals for home-dwelling older adults in the end-of-life (EOL) period.

Methods

This study adopted a qualitative analysis method using conventional content analysis. We conducted semi-structured interviews of 20 multidisciplinary professionals from February to March 2020.

Results

Multidisciplinary professionals ensured continuity of care by implementing care management as necessary when providing care to older adults who desired to stay at home until the end. Seven categories of EOL care management practices for home-dwelling older adults by multidisciplinary professionals were generated: (1) support to enable discharge to home; (2) decision-making support that captures the intention of the older adult without missing opportunities; (3) building a team system to realize the desired life and EOL; (4) family support for the entirety of the EOL period, (5) symptom control aimed at the realization of wishes; (6) emotional support for acceptance of the EOL period; (7) spiritual support.

Conclusions

Multidisciplinary professionals, including care managers, collaborating in a mutually complementary manner by sharing a comprehensive understanding of care management might prevent knowledge fragmentation and ensure that older adults receive home-based EOL care.