Development, Validity, and Reliability of Three Instruments to Assess Holistic Care from Different Perspectives

Chun-Kai Fang,1– 4 Shih-Hsuan Pi,5 In-Fun Li6,7 1Hospice and Palliative Care Center and Department of Psychiatry, MacKay Memorial Hospital, New Taipei, Taiwan; 2Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; 3Department of...

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Bibliographic Details
Main Authors: Fang CK, Pi SH, Li IF
Format: Article
Language:English
Published: Dove Medical Press 2025-06-01
Series:Journal of Multidisciplinary Healthcare
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Online Access:https://www.dovepress.com/development-validity-and-reliability-of-three-instruments-to-assess-ho-peer-reviewed-fulltext-article-JMDH
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Summary:Chun-Kai Fang,1– 4 Shih-Hsuan Pi,5 In-Fun Li6,7 1Hospice and Palliative Care Center and Department of Psychiatry, MacKay Memorial Hospital, New Taipei, Taiwan; 2Department of Thanatology and Health Counseling, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; 3Department of Death Care Service, MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan; 4Institute of Long-Term Care, MacKay Medical College, New Taipei, Taiwan; 5Department of Medical Research, MacKay Memorial Hospital, New Taipei, Taiwan; 6Center of Long-term Care, MacKay Memorial Hospital, Taipei, Taiwan; 7Department of Nursing, MacKay Medical College, New Taipei, TaiwanCorrespondence: Chun-Kai Fang, Hospice and Palliative Care Center, MacKay Memorial Hospital, New Taipei, Taiwan, Email chunkai.fang0415@gmail.comBackground: Holistic care emphasizes an integrated approach addressing physical, psychological, social, and spiritual needs, yet validated assessment tools from diverse perspectives remain limited.Aim: To develop and validate three holistic care assessment tools: the Holistic Care Quality Assessment Scale – Patient (HCQAS-P), Family (HCQAS-F), and the Holistic Care Knowledge Assessment Scale (HCKAS) for professionals.Methods: A mixed-methods design included qualitative interviews and a cross-sectional survey at two Taiwanese hospitals. Psychometric analyses were conducted on responses from 1,017 participants: 321 patients, 298 family members, and 398 professionals.Results: Qualitative findings identified five core holistic care themes. A total of 1,017 participants completed the quantitative study, including patients (n = 321), family members (n = 298), and healthcare professionals (n = 398). HCQAS-P and HCQAS-F showed high internal consistency (Cronbach’s α > 0.92); HCKAS revealed a four-factor structure (institutional, competence, effectiveness, cost). Holistic care quality positively correlated with shared decision-making (γ = 0.542) and good death perceptions (γ = 0.250), and negatively with demoralization (γ = − 0.246) and distress (γ = − 0.184). Providers scored lowest in spiritual and social care.Conclusion: The validated tools offer a comprehensive assessment framework for holistic care. Findings highlight the value of shared decision-making and the need to strengthen training in non-physical care aspects.Keywords: holistic care, patient-centered care, shared decision-making, interdisciplinary collaboration, assessment scale
ISSN:1178-2390