Creating the Final Conversations Scale: A Measure of End-of-Life Relational Communication with Terminally Ill Individuals

Abstract

Final conversations (FCs) are defined as the communicative interactions, both verbal and nonverbal, that occur between terminally ill patients and relational partners. In this study, the “Final Conversations Scale” was developed and tested. A total of 152 participants that had engaged in final conversations with individuals that were terminally ill completed the newly developed instrument. Factor analysis produced a five-factor structure, including: messages of spirituality/religion; expressions of love; proactive difficult relationship talk; everyday communication; and talk about illness/death. Participants' perceptions of the relational closeness and difficulty with the deceased significantly influenced the individuals' recalled frequency of FCs messages. Practical and scholarly implications focus on the needs of the family members regarding their communication with terminally ill individuals, as well as directions for future research with the FCs Scale.

KEYWORDS:

• end-of-life communication
• family communication
• final conversations
• relational communication
• scale development
• verbal and nonverbal communication

Notes

Note. There were no split factor loadings that fit split factor criteria (Guerrero et al., 1995), hence these are not reported; factor loadings less than .30 for items that did not load onto a meaningful factor are not included.

Note. All scale means and standard deviations are on a 1–7 scale.

IRB Human Subjects Approval was obtained from the Texas State University Institutional Review Board. The IRB approval number is 2011J1875.

Using a truly random sampling procedure was very difficult with the desired population. In fact, data were collected over a nine-month period, which yielded 226 participant responses (only 152 of those responses were usable for data analysis purposes). Consequently, future research with this population might seek to use alternative sampling procedures—possibly a purposive sampling technique in which hospice centers are contacted directly. The current sample was recruited through word-of-mouth and snowball procedures.

We used the online list-serve CRTNET (i.e., Communication, Research, and Theory Network) to post two calls for eligible participants. CRTNET is comprised of a variety of communication scholars (faculty members) and practitioners (corporate workers, consultants, trainers).

The authors of this manuscript recruited participants by reaching out to family and friends via social media; in particular, Facebook.

The original list of items for the FCs Scale was given to 11 scholars to check for face validity of the items. Specifically, the scholars that helped provide feedback on FCs Scale items included: three health communication scholars; four EOL and palliative care communication scholars; and four interpersonal and relational communication scholars. All of the scholars consulted not only were experts in the field, but were also informed of the FCs qualitative research that inspired the FCs Scale.