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Developing a Measure of End-of-Life Care Nursing Knowledge for Japanese Geriatric Nurses

Okumura-Hiroshige, Akemi MSN, RN, PHN; Fukahori, Hiroki PhD, RN, PHN; Yoshioka, Sachiko MSN, RN, CNS; Nishiyama, Midori MSN, RN, CNS; Takamichi, Kaori MSN, RN, CNS; Kuwata, Miyoko MSN, RN, CNS

Journal of Hospice & Palliative Nursing: August 2019 - Volume 21 - Issue 4 - p E1–E9
doi: 10.1097/NJH.0000000000000532
Online-Only Article

This study developed an end-of-life (EOL) care nursing knowledge scale for Japanese geriatric nurses (ELNKS-JG) to measure nurse knowledge of EOL care for older adults. It also was used to evaluate the quality of The End-of-Life Nursing Education Consortium–Japan Geriatric. Participants were 1168 nurses employed in 32 institutions across Japan. The items of our measure were developed to cover 8 important topics: principles of EOL care for older adults; pain management; symptom management; ethics of care; cultural and spiritual considerations; communication; loss, grief, and bereavement; and caring for final days. The measure included 51 items with an overall Cronbach α coefficient of 0.87 and an intraclass correlation coefficient of 0.81. Our measure, the ELNKS-JG, was confirmed to have good internal consistency, test-retest reliability, content validity, and known-groups validity. This scale’s items included knowledge about noncancerous diseases, physical changes due to aging, family care, and multidisciplinary collaboration. The ELNKS-JG comprehensively measures a nurse’s knowledge of EOL care for older adults in any EOL setting. Furthermore, this scale can evaluate educational programs aimed at improving care quality and encouraging related activities in facilities that provide EOL care.

Akemi Okumura-Hiroshige, MSN, RN, PHN, is PhD candidate, Department of System Management in Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Japan.

Hiroki Fukahori, PhD, RN, PHN, is professor, Division of Gerontological Nursing, Faculty of Nursing and Medical Care, KEIO University, Kanagawa, Japan.

Sachiko Yoshioka, MSN, RN, CNS, is associate director of Nursing, Matsue City Hospital, Shimane, Japan.

Midori Nishiyama, MSN, RN, CNS, is associate director of Nursing, Arima Onsen Hospital, Hyogo, Japan.

Kaori Takamichi, MSN, RN, CNS, is ward nurse manager, National Hospital Organization Iou Hospital, Ishikawa, Japan.

Miyoko Kuwata, MSN, RN, CNS, is director, Division of Nursing Care Development, Oume Keiyu Hospital, Tokyo, Japan.

Address correspondence to Akemi Okumura-Hiroshige, MSN, RN, PHN, 1-5-45 Yushima Bunkyo-ku, Tokyo 133-8510, Japan (

This study was supported by a research grant on hospice palliative care from the Sasakawa Memorial Health Foundation (no. 2014A-14).

The authors have no conflicts of interest to disclose.

Online date: March 20, 2019

© 2019 by The Hospice and Palliative Nurses Association.