Development of a"MITORI"Care Scale to Evaluate Nursing Care for Patients with Endstage Cancer and Their Families

Abstract

Objectives：To develop a " MITORI"Care Scale that evaluates nursing care for patients with end-stage cancer and their families and to examine its reliability and validity.M ethods：The original" M ITORI"Care Scale was developed based on a descriptive study and a comprehensive review of the literature. A revised 49 -item version was developed based an examination of the content validity of the original scale. Subsequently, the revised questionnaire was distributed to 5 6 2registered nurses employed at 4general hospitals in Japan.Results：Exploratory factor analysis by principal factor analysis with promax rotation was conducted. The following five factors comprised of 22 items were finally extracted：" Care facilitating death without regret,"" Spiritual care,"" Assurance of palliative care,"" Supporting decision making with appropriate information,"and " Arrangement of available care."A confirmatory factor analysis was conducted by analyzing covariance structures and the hypothesized statistical model was found to fit the actual data. The reliability of the scale was confirmed by a Cronbachʼ s alpha internal consistency reliability coefficient of 0.9 1( 0.6 7-0. 83 for subscales) and a test-retest reliability coefficient of 0.7 4. The criterion-related validity was confirmed by interventions using Family Support and Dying Care, the Scale of the Professional Autonomy in Nursing, and the Satisfaction Scale of Hospice Nurses in Providing End-of-Life Care. Furthermore, the construct validity was confirmed by the known-group technique.Conclusion：The above findings indicate that the " M ITORI"Care Scale is sufficiently valid to improve the quality of nursing care for patients with end-stage cancer and their families.

Associations with the Japanese Population's Preferences for the Place of End-of-Life Care and Their Need for Receiving Health Care Services

“…[7][8][9] Our questionnaire also inquired about their need for receiving health care services when they decide a preferred place of end-of-life care. It was developed by the authors based on a systematic literature review, [10][11][12][13][14] including the literature related to health care service need. [15][16][17] We assumed three hypothetical domains: (1) the need for receiving health care services in a highly supported environment; (2) the need for using health care services in home care settings; and (3) the need for consulting health care professionals and instructing how to care, when the participants decide their preferred place of care during the end-of-life stage.…”

Factors and Structural Model Related to End-of-Life Nursing Care in General Ward in Japan

“…All path coefficients are statistically significant ( p < .01). End-of-life nursing care was measured by MITORI care scale (Yoshioka et al 19 ). Observed variables of gray boxes are subscales of MITORI care scale.…”

Development and Validity of the Nursing Care Scale and Nurse’s Difficulty Scale in Caring for Dying Patients With Cancer and Their Families in General Hospitals in Japan

“…Therefore, “symptom management” and “reassessment of current treatment and nursing care” should be considered to be specific domains. Existing instruments in Japan, the MITORI Care Scale22 and PCDS,23 contain some items regarding respect for the patient and family members. However, those items do not evaluate nursing care or the nurse’s difficulty right before and after death.…”

“…The authors used the MITORI Care Scale (in Japanese) to examine concurrent validity of the NCD. The MITORI Care Scale consists of 22 representative items that measure nursing care practice throughout the end-of-life phase, not focusing on dying and after death, and has confirmed validity and reliability for patients with cancer 22…”