It is necessary to improve communication among nursing homes professionals, families, patients and other health workers.

In this study, the objective was to develop an instrument to assess quality of end-of-life care in the context of Spanish care homes. A 24 item scale Nursing Home End of Life Care Scale (NHEOLC) was developed through a systematic evaluation of existing tools combined with an iterative process of consultation with group experts in end of life care in long term care settings. A total of 307 health care professionals agreed to participate in the study and completed the scale. The scale was grouped in six dimensions: physical, psychological aspects and spiritual aspects of care, family care, bereavement, and patient/family preferences management. The results suggest an adequate factorial structure of the scale and good internal consistency for the total score and the subscales. In addition, the results showed significant differences depending on the size of the nursing home, the category of health professionals, and their own perceptions of his work regarding end-of-life care.Keywords: quality of end-of life; nursing homes; instrument; palliative care; health professionals.

PURPOSETo develop and pilot the DD‐14 scale, a 14‐indicator scale based on the Nursing Outcome Classification “Dignified life closure” (1307).METHODSSixteen experts selected 14 indicators for Spanish populations. Six care home nurses piloted the scale in 50 terminal patients without cognitive impairment. Factorial and reliability analyses were performed and correlations were determined with dependency, symptomatology, and palliative care quality.FINDINGSDD‐14 demonstrated high reliability (α = 0.916) and a stable factorial structure. It was not influenced by sex, age, or disease and correlated positively with the Barthel index (r = .622; p = .00) and negatively with the Palliative Outcome Scale (r = −.542;p = .00).CONCLUSIONSDD‐14 is a useful scale for evaluating end‐of‐life dignity.IMPLICATIONS FOR NURSING PRACTICEThis instrument could be useful in planning nursing interventions.