Factor structure investigation of perceived facilitators and barriers in end-of-life care among Korean nurses

Aim: The aim of this study was to assess the validity and reliability of the Korean version of a questionnaire assessing facilitators/barriers in end-of-life care that was originally developed for nurses in the USA. Methods: Back-translation was undertaken to produce the Korean version. A principal component analysis with varimax rotation and Cronbach's alpha was used to test factorial validity and reliability, respectively. Results: The analysis examined data from 383 nurses in a tertiary hospital in Korea. For end-of-life care facilitators, five factors accounted for 59% of the total variance. The factors were labeled "family preparedness", "support for nurses", "nurse-patient relationship", "transition after death", and "decision-making". Six factors, explaining 59% of the variance, were extracted for end-of-life care barriers. These factors were "misunderstanding patient's will", "preoccupied nursing workload", "lack of institutional support", "dealing with family's maladaptive coping", "visiting hours", and "communication about patient's status with family members". Cronbach's alpha was 0.89 for the 23 facilitator items and 0.90 for the 24 barrier items. Conclusion: Overall, the findings demonstrate that the questionnaire has measurement properties in a sample of Korean nurses. Further studies are needed with different populations to reflect end-of-life care in various clinical settings.