Preliminary Bereaved Family Satisfaction Questionnaire for Hospice Care: A Mixed-Methods Feasibility and Acceptability Study.

PURPOSE: This study aimed to develop a preliminary hospice bereaved-family satisfaction questionnaire that captures families' experiences and is comprehensible to respondents and to assess its feasibility and acceptability. METHODS: An exploratory sequential mixed-methods design guided by the COSMIN framework was used. In-depth interviews were conducted with bereaved family members (n=12) to identify key areas for evaluation. A draft item pool was developed by integrating these areas with existing experience-assessment tools and refined through two Delphi rounds with hospice experts (n=20) and a comprehensibility review. A multi-institutional pilot survey assessed feasibility (completion time and item-level missing data) and preliminary measurement properties (item distributions and internal consistency). RESULTS: Qualitative analysis identified four overarching categories choice of hospice and palliative care services; experience with hospice and palliative care (satisfaction and unmet needs); end-of-life preparation and post-bereavement experience; and experience with previous satisfaction surveys. In the second Delphi round, all items met the content-validity threshold (CVR ≥0.42) for importance and appropriateness. Service-specific questionnaires comprised 25 items each for inpatient and home hospices and 23 items for consultative hospices. Item-level missingness was low, the mean completion time ranged from 10~12 minutes, and the inpatient version showed high internal consistency (Cronbach's α=0.95). CONCLUSION: The questionnaire demonstrated acceptable content validity and feasibility in the Korean hospice context. A large-scale validation of the factor structure, criterion validity, and other measurement properties is required before nationwide use in quality monitoring and policy evaluation.