Development and Validation of a Scale for Measuring Spousal End-of-Life Communication

Currently there are no instruments measuring communication about end-of-life (EOL) issues in families not involved in palliative care. The purpose of the study was the development and initial validation of a new quantitative instrument, the Marital End-of-Life Communication Scale (MELCS), to measure EOL communication in married/partnered adults. After initial item development and validation in married/partnered adults (age 45 years old and older, N=101), six items, scored by 5-point Likert-type response options, were chosen for the final version of the scale. Factor analyses confirmed the theorized single-factor structure. The MELCS demonstrated excellent reliability (CR=0.892) as well as good content, convergent (AVE=0.587), discriminant, construct, and criterion-related validity. In addition, the scale was invariant across age, gender, and level of death anxiety. Analyses of the nomological network showed that marital EOL communication positively related with general marital communication (R=0.53), and negatively related with death anxiety (R=–0.47) and self-rated health status (R=–0.44).