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Title: Validation of the Chinese version of the care evaluation scale for measuring the quality of structure and process of end-of-life care from the perspective of bereaved family
Authors: Zhao, J
You, L
Tao, H
Wong, FKY 
Issue Date: 2021
Source: BMC palliative care, 2021, v. 20, 85
Abstract: BACKGROUND: Assessing the quality of structure and process of end-of-life care can help improve outcomes. There was currently no valid tool for this purpose in Mainland China. The aim of this study is to validate the Chinese version of the Care Evaluation Scale (CES).
METHODS: From January to December 2017, a cross-sectional online survey was conducted among bereaved family members of cancer patients from 10 medical institutes. The reliability of the CES was assessed with Cronbach's α, and structural validity was evaluated by confirmatory factor analysis. Concurrent validity was tested by examining the correlation between the CES total score and overall satisfaction with end-of-life care, quality of dying and death, and quality of life.
RESULTS: A total of 305 valid responses were analyzed. The average CES score was 70.7 ± 16.4, and the Cronbach's α of the CES was 0.967 (range: 0.802-0.927 for the 10 domains). The fit indices for the 10-factor model of CES were good(root-mean-square error of approximation, 0.047; comparative fit index, 0.952; Tucker-Lewis index, 0.946; standardized root mean square residual, 0.053). The CES total score was highly correlated with overall satisfaction with medical care (r = 0.775, P < 0.01), and moderately correlated with patients' quality of life (r = 0.579, P < 0.01) and quality of dying and death (r = 0.570, P < 0.01). In addition, few associations between CES total score and demographic characteristics, except for the family members' age.
CONCLUSIONS: The Chinese version of the CES is a reliable and valid tool to evaluate the quality of structure and process of end-of-life care for patients with cancer from the perspective of bereaved family in Mainland China.
Keywords: Bereaved family
Cancer
Care Evaluation Scale
End-of-life care
Structure and process
Validation
Publisher: BioMed Central
Journal: BMC palliative care 
ISSN: 1472-684X
DOI: 10.1186/s12904-021-00777-4
Rights: © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
The following publication Zhao, J., You, L., Tao, H. et al. Validation of the Chinese version of the Care Evaluation Scale for measuring the quality of structure and process of end-of-life care from the perspective of bereaved family. BMC Palliat Care 20, 85 (2021) is available at https://doi.org/10.1186/s12904-021-00777-4
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