{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:03:12Z","timestamp":1787018592655,"version":"build-2736575974"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008572","name":"University of Ottawa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008572","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Omega (Westport)"],"abstract":"<jats:p>Programs providing end-of-life education require a standardized tool to identify knowledge gaps and evaluate programming. The aims of this mixed methods study was to examine the perceived clinical utility of the Death Literacy Index (DLI) in the Canadian context. An online survey and focus groups captured quantitative and qualitative data from end-of-life care stakeholders. The survey included the DLI and a measure of clinical utility. Participants rated the DLI positively on a 5-point Likert scale: acceptability (4.3), relevance (3.9), and usefulness (4.1). Qualitative findings supported these ratings and highlighted areas for improvement, including simpler language and more inclusive cultural and spiritual content. Ratings for usefulness reflected the index\u2019s potential for initiating end-of-life discussions and program evaluation, though participants noted it may need more specificity to capture nuanced understandings of death literacy. Overall, the findings suggest the DLI requires further refinement and validation to enhance its applicability in the Canadian context.<\/jats:p>","DOI":"10.1177\/00302228251359371","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:06:58Z","timestamp":1753880818000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Utility of the Death Literacy Index in Canada: A Mixed-Methods Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5926-8160","authenticated-orcid":false,"given":"Charmaine","family":"Holland","sequence":"first","affiliation":[{"name":"University of Ottawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1344-0948","authenticated-orcid":false,"given":"Christine J.","family":"McPherson","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Busing","sequence":"additional","affiliation":[{"name":"University of Ottawa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Bruy\u00e8re Research Institute,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2011-000068"},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijintrel.2013.09.005"},{"key":"e_1_3_7_4_1","volume-title":"Supply, distribution and migration of physicians in Canada, 2022","author":"Canadian Institute for Health Information","year":"2023","unstructured":"Canadian Institute for Health Information. (2023). Supply, distribution and migration of physicians in Canada, 2022. CIHI."},{"key":"e_1_3_7_5_1","volume-title":"Advance care planning in Canada","author":"Canadian Hospice Palliative Care Association","year":"2020","unstructured":"Canadian Hospice Palliative Care Association. (2020). Advance care planning in Canada. https:\/\/www.advancecareplanning.ca\/"},{"key":"e_1_3_7_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1140475"},{"key":"e_1_3_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0008417416648446"},{"key":"e_1_3_7_8_1","volume-title":"Internet, phone, mail, and mixed-mode surveys: The tailored design method","author":"Dillman D. A.","year":"2009","unstructured":"Dillman D. A., Smyth J. D., Christian L. M. (2009). Internet, phone, mail, and mixed-mode surveys: The tailored design method (4th ed.). Wiley.","edition":"4"},{"key":"e_1_3_7_9_1","volume-title":"Medical Assistance in Dying (MAiD)","author":"Government of Canada","year":"2024","unstructured":"Government of Canada. (2024). Medical Assistance in Dying (MAiD). https:\/\/www.canada.ca\/en\/health-canada\/services\/medical-assistance-dying.html"},{"key":"e_1_3_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-022-01032-0"},{"key":"e_1_3_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0295141"},{"key":"e_1_3_7_12_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315232058"},{"issue":"3","key":"e_1_3_7_13_1","first-page":"409","article-title":"The influence of sociocultural factors on death, dying, and end-of-life care","volume":"2","author":"Koenig H. G.","year":"1995","unstructured":"Koenig H. G., Gates-Williams J. (1995). The influence of sociocultural factors on death, dying, and end-of-life care. Journal of Palliative Medicine, 2(3), 409\u2013417. https:\/\/doi.org\/10.1089\/jpm.1995.2.409","journal-title":"Journal of Palliative Medicine"},{"key":"e_1_3_7_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481187.2021.1894268"},{"key":"e_1_3_7_15_1","volume-title":"Death Literacy Index: A Report on its Development and Implementation","author":"Leonard R.","year":"2020","unstructured":"Leonard R., Noonan K., Horsfall D., Psychogios H., Kelly M., Rosenberg J., Rumbold B., Grindrod A., Read N., Rahn A. (2020). Death Literacy Index: A Report on its Development and Implementation. Sydney: Western Sydney University. https:\/\/doi.org\/10.26183\/5eb8d3adb20b0."},{"key":"e_1_3_7_16_1","article-title":"Clinical utility","author":"Moorthie S.","year":"2021","unstructured":"Moorthie S., Harris J. (2021). Clinical utility. Genomics England. https:\/\/www.phgfoundation.org\/report\/clinical-utility","journal-title":"Genomics England"},{"key":"e_1_3_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/09699260.2015.1103498"},{"key":"e_1_3_7_18_1","first-page":"263235242412748","article-title":"Advancing death literacy: Revision and short format of the DLI","volume":"18","author":"Noonan K.","year":"2024","unstructured":"Noonan K., Leonard R., Horsfall D., Rosenberg J. P. (2024). Advancing death literacy: Revision and short format of the DLI. Palliative Care and Social Practice, 18, 26323524241274806. https:\/\/doi.org\/10.1177\/26323524241274806","journal-title":"Palliative Care and Social Practice"},{"key":"e_1_3_7_19_1","doi-asserted-by":"publisher","DOI":"10.29333\/ejeph\/8218"},{"key":"e_1_3_7_20_1","article-title":"Validity and reliability of the Turkish version of the death literacy index","author":"Semerci V.","year":"2022","unstructured":"Semerci V., S\u00f6nmez Sari E., Seven A. (2022). Validity and reliability of the Turkish version of the death literacy index. OMEGA - Journal of Death and Dying. Advance Online Publication. https:\/\/doi.org\/10.1177\/00302228221144672","journal-title":"OMEGA - Journal of Death and Dying"},{"issue":"23","key":"e_1_3_7_21_1","first-page":"17","article-title":"Multiculturalism and the Aboriginal peoples in Canada","volume":"47","author":"Srikanth H.","year":"2012","unstructured":"Srikanth H. (2012). Multiculturalism and the Aboriginal peoples in Canada. Economic and Political Weekly, 47(23), 17\u201321.","journal-title":"Economic and Political Weekly"},{"key":"e_1_3_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw102"},{"key":"e_1_3_7_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/00302228251319478"},{"key":"e_1_3_7_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2012.0262"}],"container-title":["OMEGA - Journal of Death and Dying"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00302228251359371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00302228251359371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00302228251359371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:11:31Z","timestamp":1777630291000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00302228251359371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":23,"alternative-id":["10.1177\/00302228251359371"],"URL":"https:\/\/doi.org\/10.1177\/00302228251359371","relation":{},"ISSN":["0030-2228","1541-3764"],"issn-type":[{"value":"0030-2228","type":"print"},{"value":"1541-3764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"article-number":"00302228251359371"}}