Main aim: This study measures quality of palliative care in 181 family members (i.e. spouse, child) to cancer victims with terminal disease one month after the time of death. The literature reveals no agreement in terms of multiple vs. single item instruments, and whether the satisfaction is conceived as one- or multidimensional. Thus, the specific aim was to explore the underlying factor structure and dimensionality of the 20 items of the FAMCARE Scale measuring the degree to which family members are satisfied with the health care received by both the patient and the family with respect to information giving, availability of care, psychological care and physical patient care.
Methods: To examine the dimensionality and the psychometric properties of the FAMCARE items, we performed a factor analysis, a Mokken Scaling Program analysis, and a reliability analysis.
Results: The majority of the family members reported a high level of satisfaction with care that is in accordance with most studies with palliative care. Further, the results showed that 19 out of the 20 items form a strong one-dimensional scale. Since the scale is one-dimensional, the possibility of reducing the number of items should be explored in future research.
Conclusion: Due to the methodological problems in measuring satisfaction with palliative care that our study shares with others, such as social desirability, poor discrimination of levels of satisfaction, and retrospectively collected information, caution is needed in interpreting results from measures of satisfaction with family care. We recommend to measure satisfaction with care one to two months after the death of the patient. One should also explore the possibilities of measuring satisfaction with care prospectively as an integral part of the palliative care program.