{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T06:48:04Z","timestamp":1775890084586,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To develop and validate the End\u2010of\u2010Life Care Assessment Tool for Dementia (EoLC\u2010ATD).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A methodological study with multiple phases.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Five sub\u2010studies comprising: a review of 90 validated dementia measures to compile an item bank of advanced dementia symptoms; focus groups with registered nurses on advanced dementia symptom identification and relevance of item bank inclusions; Delphi surveys with dementia experts seeking consensus on the EoLC\u2010ATD constructs and items; pilot testing of the EoLC\u2010ATD; and field testing of the EoLC\u2010ATD in persons with dementia.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The item\u2010bank included 180 symptoms, most of which focus group nurses (\n n<\/jats:italic>\n \u2009=\u200917) identified as occurring in advanced dementia. Delphi surveys with dementia experts (\n n<\/jats:italic>\n \u2009=\u200931) achieved 70% consensus for 25 of 26 EoLC\u2010ATD items. Pilot testing of the EoLC\u2010ATD by two nurses in eight persons with dementia showed good agreement for six constructs (Cohen's Kappa 0.856\u20130.927) and 26 items (Cronbach's alpha 77.0). An \u2018other sympto\u2019 item was included following RN recommendation. The 27\u2010item EoLC\u2010ATD field tested by 17 nurses in persons with dementia (\n n<\/jats:italic>\n \u2009=\u2009113) accurately identified advanced dementia symptoms (Cronbach's alpha 77.0,\n p<\/jats:italic>\n \u2009<\u20090.001). Mortality at 180\u2009days after baseline EoLC\u2010ATD was significant (\n p<\/jats:italic>\n \u2009<\u20090.001, area under the ROC curve\n p<\/jats:italic>\n \u2009=\u20090.769).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The EoLC\u2010ATD accurately and reliably identified symptoms of advanced dementia.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n The EoLC\u2010ATD provides registered nurses with a single measure of advanced dementia symptoms that will help in identifying symptom\u2010responsive palliative care requirements.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n The EoLC\u2010ATD will address the current lack of a validated dementia symptom measure for use by aged care home registered nurses to identify unique palliative and end\u2010of\u2010life care needs according to presenting symptoms in persons living with advanced dementia.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n STROBE Statement for cohort and mixed methods studies.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n An eight\u2010member Expert Advisory Group, which provided guidance and advice throughout the study, was composed of three carers of persons living with dementia, two dementia care clinicians, a dementia care clinical educator, and two dementia clinician researchers.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.70129","type":"journal-article","created":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T09:58:27Z","timestamp":1754474307000},"page":"5430-5443","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Validation of the End\u2010of\u2010Life Assessment Tool for Advanced Dementia: A Multi Method Study"],"prefix":"10.1111","volume":"82","author":[{"given":"Carolyn","family":"Bourke","sequence":"first","affiliation":[{"name":"Health\/UARC University of Technology Sydney Ultimo New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-3804","authenticated-orcid":false,"given":"Lynn","family":"Chenoweth","sequence":"additional","affiliation":[{"name":"Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry UNSW Medicine and Health Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0592-3838","authenticated-orcid":false,"given":"Ekavi","family":"Georgousopoulou","sequence":"additional","affiliation":[{"name":"The University of Notre Dame Australia Darlinghurst New South Wales Australia"},{"name":"ACT Health Phillip Australian Capital Territory Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0349-4248","authenticated-orcid":false,"given":"Anna","family":"Williams","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Faculty of Health University of Technology Sydney Sydney New South Wales Australia"},{"name":"School of Nursing and Midwifery & Translational Health Research Institute (THRI) Western Sydney University New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"issue":"4","key":"e_1_2_11_2_1","first-page":"1","article-title":"The Australia\u2010Modified Karnofsky Performance Status (AKPS) Scale: A Revised Scale for Contemporary Palliative Care Clinical Practice","volume":"12","author":"Abernethy A. 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