University of Hertfordshire


  • Maria Remedios Sanchez-Garcia
  • Jose Antonio Gutiérrez-Romero
  • Manuel Fernández-Alcántara
  • Cesar Hueso-Montoro
  • Claire Goodman
  • Rafael Montoya-Juarez
View graph of relations
Original languageEnglish
Pages (from-to)6-12
Number of pages7
JournalApplied Nursing Research
Early online date5 Jul 2017
Publication statusPublished - 1 Oct 2017


Quality end-of-life care is a central issue in nursing homes, requiring the assessment of individual and family needs by health professionals. Although previous instruments have been developed, they usually rely on family reports and have been adapted from other clinical contexts (hospital or primary care). It is important to consider how health care professionals working in nursing homes perceive what is necessary to achieve quality end-of-life care.
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.


This document is the accepted manuscript version of the following article: Maria Remedios Sánchez-GarcÍa, Jose Antonio Gutiérrez-Romero, Manuel Fernández Alcántara, César Hueso-Montoro, Claire Goodman, and Rafael Montoya-Juárez, ‘End of life care in nursing homes in Spain: Exploratory analysis and evidences of validity of a new scale’, Applied Nursing Research, Vol. 37: 6-12, October 2017. Under embargo until 5 July 2018. The final, definite version is available online at DOI:

ID: 12096866