Assessment of the quality of end-of-life care: translation and validation of the German version of the “Care of the Dying Evaluation” (CODE-GER) - a questionnaire for bereaved relatives

Background International studies indicate deficits in end-of-life care that can lead to distress for patients and their next-of-kin. The aim of the study was to translate and validate the “Care of the Dying Evaluation” (CODE) into German (CODE-GER). Methods Translation according to EORTC (European Organisation for Research and Treatment of Cancer) guidelines was followed by data collection to evaluate psychometric properties of CODE-GER. Participants were next-of-kin of patients who had died an expected death in two hospitals. They were invited to participate at least eight, but not later than 16 weeks after the patient’s death. To calculate construct validity, the Palliative care Outcome Scale (POS) was assessed. Difficulty and perceived strain of answering the questionnaire were assessed by a numeric scale (0–10). Results Out of 1137 next-of-kin eligible, 317 completed the questionnaire (response rate: 27.9%). Data from 237 main sample participants, 38 interraters and 55 next-of-kin who participated for repeated measurement were analysed. Overall internal consistency, α = 0.86, interrater reliability, ICC (1) = 0.79, and retest-reliability, ICC (1, 2) = 0.85, were good. Convergent validity between POS and CODE-GER, r = −.46, was satisfactory. A principal component analysis with varimax rotation showed a 7-factor solution. Difficulty, M = 2.2; SD ± 2.4, and perceived strain, M = 4.1; SD ± 3.0, of completing the questionnaire were rather low. Conclusion The results from the present study confirm CODE-GER as a reliable and valid instrument to assess the quality of care of the dying person. More over our study adds value to the original questionnaire by proposing a deepened analysis of obtained data. The development of seven subscales increases its potential for further surveys and research. Trial registration This study was registered retrospectively on the 25th of January 2018 at the German Clinical Trials Register (DRKS00013916).

Cultural and Organisational Diversity Evaluation (CODE)

Purpose – This paper aims to present the Cultural and Organisational Diversity Evaluation (CODE) model and its subsequent electronic tool, aiming to assess the cultural fit of global partners. Design/methodology/approach – The study is a longitudinal study for gaining profound insights into cultural differences and for increasing understanding of human dynamics influencing the success of global relationships. A multi-method including overlapping qualitative and quantitative research methodology was used comprising interviews, observations and questionnaires. Findings – Incorporating cultural knowledge and understanding of the specific context of the partners in global transactions was found to bring added value to global partners. The results of the pilot studies suggest that increased appreciation and awareness of cultural diversity in global transactions are important factors for achieving harmonised distributed collaboration. Such awareness, also called cultural intelligence, can be reached by using a customised assessment tool that evaluates the particularities of the partners. Research limitations/implications – The conceptual CODE model has so far only been piloted in a few cases in a longitudinal study and is not a commercial tool. Practical implications – Raising awareness of cultural concerns is important for organisations that are involved in global transactions to improve communication, mutual understanding and effectivity. The CODE assesses the cultural fit of partners in a global context. Social implications – Organisations involved in global transactions would benefit from understanding the culture of partners for improved effectiveness. Originality/value – The CODE model, an instrument for assessing the fit between organisational and national culture, is a novel model developed by the authors.