Reliability and Validity Assessments of the Subjective End‐Of‐Life Health Literacy Scale in Community Older Adults
Haojie Wang, Weiqing Zhang, Kun Wang, Jielu Song, Yabing Cao, Zhihua WeiABSTRACT
Background
Subjective end‐of‐life health literacy investigates individuals' abilities in knowledge, communication and decision‐making related to health during the end‐of‐life stage. This study aims to culturally adapt the Subjective End‐of‐Life Health Literacy Scale (S‐EOL‐HLS) for a Chinese context, including reliability and validity assessments among older adult community populations.
Methods
We translated, back‐translated and cross‐culturally adapted the English version (S‐EOL‐HLS) using Brislin's translation model. Subsequently, a survey was conducted among older adults in the community to assess the scale's reliability.
Results
The content validity index for each item ranged from 0.714 to 1.000, with a total scale index of 0.928. Exploratory factor analysis identified three main factors with eigenvalues ≥ 1, contributing to a cumulative variance of 67.131%. Confirmatory factor analysis demonstrated that all fit indices met the required criteria, resulting in a Cronbach's α coefficient of 0.945. The half‐split reliability was 0.956, and test–retest reliability reached 0.905. Validity evaluation using the HLS‐EU‐Q16 demonstrated a positive correlation with the scores of the Chinese End‐of‐Life Health Literacy Scale (r = 0.821, p < 0.001).
Conclusion
The Chinese version of the S‐EOL‐HLS exhibits strong reliability and validity among older individuals. It is suitable for evaluating end‐of‐life health literacy within the Chinese cultural context.