Care of the dying evaluation (CODE) questionnaire: psychometric appraisal for application in Persian-speaking populations

Geriatr Nurs. 2026 Mar:68:103774. doi: 10.1016/j.gerinurse.2025.103774. Epub 2025 Dec 22.

Abstract

Objectives: To appraise the psychometric properties of the CODE-P1 for its application to assess quality of end-stage care among Iranian patients.

Method: A forward/backward translation procedure was performed to prepare a preliminary draft of CODE-P and its face and content validity were tested by an experts' panel. The CODE-P was completed in this cross-sectional study by 280 bereaved family members in several hospitals in Ardabil, Iran. Construct validity, internal consistency and reliability were checked.

Results: CODE-P had good face and content validity (mean impact score = 4.01 and CVI = 0.92). EFA identified five factors which worked well in terms of construct validity (factor loadings range from 0.31 to 0.84) and internal consistency (Cronbach's Alpha = 0.91).

Conclusion: The findings supported psychometric properties of the CODE-P for assessing end-stage care quality in Persian-speaking patients. Its application for end-of-life care quality assessment could provide a base for planning evidence-informed interventions.

Keywords: Bereavement; End of life care; Hospital care; Palliative care; Psychometric; Questionnaire.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Bereavement
  • Cross-Sectional Studies
  • Female
  • Health Services Research
  • Humans
  • Iran / ethnology
  • Male
  • Middle Aged
  • Middle Eastern People* / ethnology
  • Middle Eastern People* / psychology
  • Psychometrics* / instrumentation
  • Quality Assurance, Health Care* / methods
  • Quality Assurance, Health Care* / standards
  • Reproducibility of Results
  • Surveys and Questionnaires* / standards
  • Terminal Care* / psychology
  • Terminal Care* / standards
  • Young Adult

Supplementary concepts

  • Iranian people