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Validation of the Spanish Subjective End-of-Life Health Literacy Scale through community-based workshops in Argentina.

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Title: Validation of the Spanish Subjective End-of-Life Health Literacy Scale through community-based workshops in Argentina.
Authors: Meier C; Faculty of Business and Economics (HEC), University of Lausanne, and Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne (HEC), Lausanne, Switzerland.; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina., Veloso VI; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina.; Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina., Carballo B; Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina., Tripodoro VA; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina.; ATLANTES Global Observatory of Palliative Care, University of Navarra, Navarra, Spain.
Source: Palliative & supportive care [Palliat Support Care] 2026 Sep 21; Vol. 24, pp. e231. Date of Electronic Publication: 2026 Sep 21.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Cambridge University Press Country of Publication: England NLM ID: 101232529 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-9523 (Electronic) Linking ISSN: 14789515 NLM ISO Abbreviation: Palliat Support Care Subsets: MEDLINE
Imprint Name(s): Original Publication: Cambridge : Cambridge University Press, c2003-
MeSH Terms: Health Literacy*/standards , Health Literacy*/methods , Health Literacy*/statistics & numerical data , Psychometrics*/instrumentation , Psychometrics*/methods , Psychometrics*/standards , Terminal Care*/methods , Terminal Care*/standards , Terminal Care*/psychology, Education/methods ; Humans ; Argentina ; Surveys and Questionnaires ; Female ; Reproducibility of Results ; Male ; Middle Aged ; Aged ; Adult ; Translating
Abstract: Objectives: 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.
Methods: The S-EOL-HLS was translated following the forward-backward method and iteratively refined through community workshops conducted in urban and rural settings. Initial testing took place in 5 workshops (n = 57), followed by face validity assessment by an expert panel (n = 11). Based on this feedback, additional workshops were conducted alongside cognitive interviews, and a subset of participants completed a test-retest 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 = 120), together with assessments of internal consistency and construct validity.
Results: 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 fit and high internal consistency (Cronbach's α = 0.89). 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.
Significance of Results: 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.
Contributed Indexing: Keywords: Argentina; End-of-life health literacy; Spanish-speaking populations; community-based workshops; cultural adaptation; palliative care; scale validation
Entry Date(s): Date Created: 20260921 Date Completed: 20260921 Latest Revision: 20260921
Update Code: 20260921
DOI: 10.1017/S147895152610340X
PMID: 42764784
Database: MEDLINE
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  Data: Validation of the Spanish Subjective End-of-Life Health Literacy Scale through community-based workshops in Argentina.
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  Data: <searchLink fieldCode="AU" term="%22Meier+C%22">Meier C</searchLink>; Faculty of Business and Economics (HEC), University of Lausanne, and Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne (HEC), Lausanne, Switzerland.; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina.<br /><searchLink fieldCode="AU" term="%22Veloso+VI%22">Veloso VI</searchLink>; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina.; Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina.<br /><searchLink fieldCode="AU" term="%22Carballo+B%22">Carballo B</searchLink>; Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Buenos Aires, Argentina.<br /><searchLink fieldCode="AU" term="%22Tripodoro+VA%22">Tripodoro VA</searchLink>; Instituto Pallium Latinoamérica, Ciudad de Buenos Aires, Argentina.; ATLANTES Global Observatory of Palliative Care, University of Navarra, Navarra, Spain.
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  Data: <searchLink fieldCode="JN" term="%22101232529%22">Palliative & supportive care</searchLink> [Palliat Support Care] 2026 Sep 21; Vol. 24, pp. e231. <i>Date of Electronic Publication: </i>2026 Sep 21.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Cambridge+University+Press%22">Cambridge University Press </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>101232529 <i>Publication Model: </i>Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1478-9523 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2214789515%22">14789515 </searchLink><i>NLM ISO Abbreviation: </i>Palliat Support Care <i>Subsets: </i>MEDLINE
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  Data: <i>Original Publication</i>: Cambridge : Cambridge University Press, c2003-
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  Data: <searchLink fieldCode="MM" term="%22Health+Literacy%22">Health Literacy*</searchLink>/<searchLink fieldCode="MM" term="%22Health+Literacy+standards%22">standards</searchLink> <br /><searchLink fieldCode="MM" term="%22Health+Literacy%22">Health Literacy*</searchLink>/<searchLink fieldCode="MM" term="%22Health+Literacy+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Health+Literacy%22">Health Literacy*</searchLink>/<searchLink fieldCode="MM" term="%22Health+Literacy+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Psychometrics%22">Psychometrics*</searchLink>/<searchLink fieldCode="MM" term="%22Psychometrics+instrumentation%22">instrumentation</searchLink> <br /><searchLink fieldCode="MM" term="%22Psychometrics%22">Psychometrics*</searchLink>/<searchLink fieldCode="MM" term="%22Psychometrics+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Psychometrics%22">Psychometrics*</searchLink>/<searchLink fieldCode="MM" term="%22Psychometrics+standards%22">standards</searchLink> <br /><searchLink fieldCode="MM" term="%22Terminal+Care%22">Terminal Care*</searchLink>/<searchLink fieldCode="MM" term="%22Terminal+Care+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Terminal+Care%22">Terminal Care*</searchLink>/<searchLink fieldCode="MM" term="%22Terminal+Care+standards%22">standards</searchLink> <br /><searchLink fieldCode="MM" term="%22Terminal+Care%22">Terminal Care*</searchLink>/<searchLink fieldCode="MM" term="%22Terminal+Care+psychology%22">psychology</searchLink><br /><searchLink fieldCode="MH" term="%22Education%22">Education</searchLink>/<searchLink fieldCode="MH" term="%22Education+methods%22">methods</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Argentina%22">Argentina</searchLink> ; <searchLink fieldCode="MH" term="%22Surveys+and+Questionnaires%22">Surveys and Questionnaires</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Reproducibility+of+Results%22">Reproducibility of Results</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Translating%22">Translating</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives: 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.<br />Methods: The S-EOL-HLS was translated following the forward-backward method and iteratively refined through community workshops conducted in urban and rural settings. Initial testing took place in 5 workshops (n = 57), followed by face validity assessment by an expert panel (n = 11). Based on this feedback, additional workshops were conducted alongside cognitive interviews, and a subset of participants completed a test-retest 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 = 120), together with assessments of internal consistency and construct validity.<br />Results: 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 fit and high internal consistency (Cronbach's α = 0.89). 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.<br />Significance of Results: 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.
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  Data: <i>Keywords: </i>Argentina; End-of-life health literacy; Spanish-speaking populations; community-based workshops; cultural adaptation; palliative care; scale validation
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  Data: <i>Date Created: </i>20260921 <i>Date Completed: </i>20260921 <i>Latest Revision: </i>20260921
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  Data: 10.1017/S147895152610340X
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  Data: 42764784
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42764784
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