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The process included forward translation, reconciled single translation, back translation, translation review, cognitive interviews (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), and psychometric validation using a nationally representative online sample of 2500 Japanese adults aged 20\u201379 years. Participants completed an online survey, with a subsample (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009300) completing a retest after 4 weeks. Confirmatory factor analysis (CFA), internal consistency, construct validity, and test\u2013retest reliability were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The DLI\u2010J demonstrated excellent psychometric properties. CFA supported the six\u2010factor structure of the DLI\u2010J (Tucker\u2013Lewis index [TLI]\u2009=\u20090.940, comparative fit index [CFI]\u2009=\u20090.947, standardized root mean square residual [SRMR]\u2009=\u20090.048, and root mean square error of approximation [RMSEA]\u2009=\u20090.063) and the two\u2010factor structure of the DLI\u2010J\u20109 (TLI\u2009=\u20090.945, CFI\u2009=\u20090.960, SRMR\u2009=\u20090.042, and RMSEA\u2009=\u20090.069). Internal consistency was excellent for the total DLI\u2010J scale (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.959) and all subscales (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.870\u20130.959). Convergent validity was supported by positive correlations with death competency, whereas discriminant validity was confirmed by negligible correlations with loneliness. Known\u2010groups validity was established, with higher scores among bereaved individuals and end\u2010of\u2010life care professionals. The test\u2013retest reliability was moderate to good (intraclass correlation coefficient [ICC]\u2009=\u20090.515\u20130.819). The overall DLI\u2010J mean score was 3.82 (standard deviation = 1.91), lower than international benchmarks. Floor effects were observed in the hands\u2010on care, accessing help, and community support subscales.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The DLI\u2010J and DLI\u2010J\u20109 are psychometrically robust instruments for assessing death literacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pcn5.70258","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T13:18:17Z","timestamp":1765113497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of the Japanese version of the Death Literacy Index (DLI\u2010J) and its short form (DLI\u2010J\u20109)"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1327-5022","authenticated-orcid":false,"given":"Kenjiro","family":"Kawaguchi","sequence":"first","affiliation":[{"name":"Center for Preventive Medical Sciences Chiba University Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaku","family":"Kurotori","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine Hokkaido University Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu\u2010Ru","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Preventive Medical Sciences Chiba University Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Graduate School of Medicine Hokkaido University Sapporo Japan"},{"name":"Division of Infectious Disease Prevention and Control, Department of Infectious Disease Prevention and Control, Public Health Bureau, Ministry of Health Labour and Welfare Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Sunohara","sequence":"additional","affiliation":[{"name":"Department of Public Health, Graduate School of Medicine Hokkaido University Sapporo Japan"},{"name":"Clinical Training Center Hokkaido University Hospital Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Wakasa","sequence":"additional","affiliation":[{"name":"Department of Public Health, Graduate School of Medicine Hokkaido University Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ho","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Health The Ohio State University Wexner Medical Center Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine Hokkaido University Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirobumi","family":"Takenouchi","sequence":"additional","affiliation":[{"name":"Organization for Designing Future Society, Faculty of Agriculture, and Graduate School of Science and Technology Shizuoka University Shizuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Shimazono","sequence":"additional","affiliation":[{"name":"Institute of Regional Planning Taisho University Kita\u2010ku Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsunori","family":"Kondo","sequence":"additional","affiliation":[{"name":"Center for Preventive Medical Sciences Chiba University Chiba Japan"},{"name":"Research Department Institute for Health Economics and Policy Minato\u2010ku Japan"},{"name":"Center for Social Common Capital Beyond 2050, Institutional Advance and Communications Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etsuko","family":"Tadaka","sequence":"additional","affiliation":[{"name":"Department of Community and Public Health Nursing, Faculty of Health Sciences Hokkaido University Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiko","family":"Tamakoshi","sequence":"additional","affiliation":[{"name":"Department of Public Health, Faculty of Medicine Hokkaido University Sapporo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Nakagomi","sequence":"additional","affiliation":[{"name":"Center for Preventive Medical Sciences Chiba University Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Global atlas of palliative care","author":"Worldwide Hospice Palliative Care Alliance; 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