Development and psychometric properties of the Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines


instrument development
palliative care
psychometric properties

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Soriano, G. P., Calong Calong, K. A., Martinez, R. C. K., Ito, H., Yasuhara, Y., Abalos, E., & Tanioka, T. (2023). Development and psychometric properties of the Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines. Belitung Nursing Journal, 9(5), 512–519.
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Accepted for publication: 2023-10-09
Peer reviewed: Yes

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Background: Over the years, a few tools and instruments have been developed to assist in the assessment within a palliative care setting. However, many of these tools and instruments do not reflect a person-centered palliative care model.

Objective: This study aims to develop a Person-centered Palliative Care Nursing Instrument (PPCNI) in the Philippines.

Methods: An exhaustive search of the literature was conducted to develop a pool of items for the instrument. The validity of the instrument was evaluated using the content validity index (CVI), while the factor structure was assessed using exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation. Also, the internal reliability was evaluated using Cronbach’s alpha.

Results: EFA yielded three factors: 1) Caring as maintaining person’s dignity (13 items), 2) caring as empowerment of person’s autonomy (14 items), and 3) caring as understanding person’s momentary concerns (10 items). Whereas the internal consistency reliability of these subscales appeared excellent (i.e., 0.95, 0.96, and 0.93, respectively), the Cronbach’s alpha for the overall scale was 0.98. The item-total correlation coefficients were >0.30 for all items, ranging from 0.310 to 0.726.

Conclusion: Findings support a three-factor, 37-item PPCNI that can be used in clinical practice to ensure that nurses provide palliative care based on patient needs and preferences.


Copyright (c) 2023 Gil P. Soriano, Kathyrine A. Calong Calong, Rudolf Cymorr Kirby Martinez, Hirokazu Ito, Yuko Yasuhara, Evalyn Abalos, Tetsuya Tanioka

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Declaration of Conflicting Interest

The authors had no conflict of interest to declare.


We would like to express our deep gratitude to Prof. Ma. Isabelita Rogado for assisting the researchers with data collection and to all Filipino nurses who participated in this survey. Also, we would like to extend our warmest thanks to Professor Emerita Britt-Marie Ternestedt, who has been working on the development of the 6S model since the early 1990s, and to Dr. Jane Österlind and Dr. Ingela Henoch, who developed the 6S model for person-centered palliative care, and who gave us permission to use their theoretical framework.

Authors’ Contributions

All the authors have contributed substantially to the conceptualization, data collection, and interpretation. The final version of the manuscript was read and approved by all authors, who agreed to be accountable for all aspects of the work and ensure that any concerns about the accuracy or integrity of any part of the work are appropriately addressed. All authors drafted the manuscript and critically revised it for intellectual content.

Data Availability

The data presented in this study are available on request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

Declaration of Use of AI in Scientific Writing

Nothing to declare.


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