Abstract:

Objective To develop a scale for assessing the decision-making participation of elderly patients in end-of-life hospice care and evaluate its reliability and validity，with the aim of providing a reliable tool for assessing the level of decision-making participation in end-of-life hospice care for elderly patients. Methods Based on the theory of planned behavior framework，a draft of the scale was developed through literature review，Delphi expert consultation，and a pilot survey. Using convenience sampling，a survey was conducted from February to May 2025，selecting 503 elderly patients in end-of-life stages from 4 tertiary general hospitals and a cancer specialty hospital in Urumqi. The reliability and validity of the scale were tested. Results 522 questionnaires were sent out，and 503 valid questionnaires were recovered，with an effective questionnaire recovery rate of 96.36%. Exploratory factor analysis extracted 5 common factors，with a cumulative variance contribution rate of 82.107%. Confirmatory factor analysis showed that the model fit well. The item level content validity index was 0.950~1.000，and the scale level content validity index was 0.992. The Cronbach’s alpha coefficient was 0.948，and the split-half reliability coefficient was 0.865. The correlation coefficients between the total score of the questionnaire and the score of the calibration instrument were 0.599，respectively. The final formal scale consisted of 29 items in 5 dimensions：behavioral attitude，subjective norm，perceived behavioral control，behavioral intention and behavior. Conclusion The Hospice Care Decision-Making Participation Scale for Terminally Ill Elderly Patients has good reliability and validity，and can be used as an evaluation tool for hospice decision-making participation of terminally elderly patients.

Key words: Aged, End-Stage, Hospice Care, Decision-Making Participation, Scale, Reliability, Validity, Nursing Care

摘要：

目的 编制老年终末期患者安宁疗护决策参与量表，并检验其信效度，旨在为评估老年终末期患者安宁疗护决策参与度提供可靠的评估工具。方法 以计划行为理论为基础，通过文献检索、专家函询及预调查形成量表初稿。采用便利抽样法，于2025年2—5月选取乌鲁木齐市4所三级甲等综合医院或肿瘤专科医院收治的老年终末期患者进行调查，检验量表的信效度。结果 发放问卷522份，回收有效问卷503份，有效问卷回收率为96.36%。经探索性因子分析提取5个公因子，累计方差贡献率为82.107%。验证性因子分析结果显示，模型拟合度较好。量表条目水平的内容效度指数为0.950~1.000，量表水平的内容效度指数为0.992；量表总的Cronbach’s α系数为0.948，折半信度为0.865。以安宁疗护决策意愿量表作为效标工具，量表的效标关联效度为0.599（P<0.01）。最终形成的正式量表包括行为态度、主观规范、知觉行为控制、行为意向与行为5个维度，共29个条目。结论 老年终末期患者安宁疗护决策参与量表具有较好的信效度，可作为该类患者安宁疗护决策参与度的评估工具。

关键词: 老年人, 终末期, 安宁疗护, 决策参与, 量表, 信度, 效度, 护理