{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T08:05:32Z","timestamp":1789977932947,"version":"4.0.1"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":263,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S147895152610340X_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To culturally adapt and validate the Spanish version of the Subjective End-of-Life Health Literacy Scale (S-EOL-HLS) through community-based workshops in Argentina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610340X_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The S-EOL-HLS was translated following the forward\u2013backward method and iteratively refined through community workshops conducted in urban and rural settings. Initial testing took place in 5 workshops (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a057), followed by face validity assessment by an expert panel (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011). Based on this feedback, additional workshops were conducted alongside cognitive interviews, and a subset of participants completed a test\u2013retest assessment. Participants completed the adapted scale and a brief sociodemographic questionnaire. Psychometric evaluation was performed using exploratory factor analysis on the initial sample and confirmatory factor analysis on a second sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0120), together with assessments of internal consistency and construct validity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610340X_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analyses supported a 3-factor structure representing functional, interactive, and critical dimensions of end-of-life health literacy. Factor loadings ranged from 0.57 to 0.91, with items loading primarily on their intended domains. The model demonstrated acceptable\u00a0fit and high internal consistency (Cronbach\u2019s\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u00a0=\u00a00.89). Qualitative feedback from participants and experts improved the clarity and contextual relevance of the Spanish version. While most participants reported ease in understanding technical end-of-life terminology, greater uncertainty was observed for interactive and decision-making items, indicating challenges in applying information to personal treatment choices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152610340X_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>The Spanish S-EOL-HLS demonstrated evidence of content validity, construct validity, and good psychometric performance in an Argentine context. Beyond its measurement properties, the scale also served as a structured prompt for reflection and dialogue in community settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s147895152610340x","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:22:11Z","timestamp":1789975331000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Validation of the Spanish Subjective End-of-Life Health Literacy Scale through community-based workshops in Argentina"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3273-7993","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Meier","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019whta54","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Lausanne"},{"name":"Instituto Pallium Latinoam\u00e9rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-6989","authenticated-orcid":false,"given":"Ver\u00f3nica In\u00e9s","family":"Veloso","sequence":"additional","affiliation":[{"name":"Instituto Pallium Latinoam\u00e9rica"},{"id":[{"id":"https:\/\/ror.org\/0081fs513","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Buenos Aires"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9len","family":"Carballo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0081fs513","id-type":"ROR","asserted-by":"publisher"}],"name":"Universidad de Buenos Aires"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2328-6032","authenticated-orcid":false,"given":"Vilma A.","family":"Tripodoro","sequence":"additional","affiliation":[{"name":"Instituto Pallium Latinoam\u00e9rica"},{"id":[{"id":"https:\/\/ror.org\/02rxc7m23","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Navarra"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"S147895152610340X_ref4","article-title":"Workshops as a relational material research practice: Creating space for shared knowledge","author":"Eidenskog","year":"2024","journal-title":"Sage Journals"},{"key":"S147895152610340X_ref14","doi-asserted-by":"publisher","DOI":"10.17226\/10883"},{"key":"S147895152610340X_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15866"},{"key":"S147895152610340X_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/15.3.259"},{"key":"S147895152610340X_ref20","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15081676"},{"key":"S147895152610340X_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0292367"},{"key":"S147895152610340X_ref9","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"S147895152610340X_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"S147895152610340X_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951523001165"},{"key":"S147895152610340X_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.11.020"},{"key":"S147895152610340X_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/2041-210X.12860"},{"key":"S147895152610340X_ref10","volume-title":"Health Literacy: The Solid Facts. The Solid Facts","author":"Kickbusch","year":"2013"},{"key":"S147895152610340X_ref8","first-page":"e87960","article-title":"Understanding the influence of culture on end-of-life, palliative, and Hospice care: A narrative review","volume":"17","author":"Hira","year":"2025","journal-title":"Cureus"},{"key":"S147895152610340X_ref19","doi-asserted-by":"publisher","DOI":"10.2466\/03.CP.4.10"},{"key":"S147895152610340X_ref21","first-page":"23","article-title":"Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures","volume":"8","author":"Schermelleh-Engel","year":"2003","journal-title":"Methods of Psychological Research"},{"key":"S147895152610340X_ref23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-80"},{"key":"S147895152610340X_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S2212-5671(15)00123-9"},{"key":"S147895152610340X_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14019-6"},{"key":"S147895152610340X_ref3","doi-asserted-by":"publisher","DOI":"10.22329\/amr.v13i2.3019"},{"key":"S147895152610340X_ref15","doi-asserted-by":"publisher","DOI":"10.47368\/ejhc.2022.102"},{"key":"S147895152610340X_ref7","first-page":"215","article-title":"An easy approach to exploratory factor analysis: Marketing perspective","volume":"6","author":"Hadi","year":"2016","journal-title":"Journal of Educational and Social Research"},{"key":"S147895152610340X_ref1","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2020.20351"},{"key":"S147895152610340X_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.42972"},{"key":"S147895152610340X_ref22","doi-asserted-by":"publisher","DOI":"10.12691\/ajams-9-1-2"},{"key":"S147895152610340X_ref24","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.005579"},{"key":"S147895152610340X_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjph-2023-000600"}],"container-title":["Palliative and Supportive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S147895152610340X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:22:13Z","timestamp":1789975333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S147895152610340X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":26,"alternative-id":["S147895152610340X"],"URL":"https:\/\/doi.org\/10.1017\/s147895152610340x","relation":{},"ISSN":["1478-9515","1478-9523"],"issn-type":[{"value":"1478-9515","type":"print"},{"value":"1478-9523","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e231"}}