Assessing prioritization of a good death across Brazil, Italy, Japan, and the United States: A psychometric evaluation

Empirically vetted measures capturing individual priorities for a good death are lacking. This study assessed the measurement properties, measurement invariance, and internal consistency reliability of a prospective measure, Prioritization of a Good Death Index. We used data from a probability sample (<i>N</i> = 4,239) of the general public in Brazil (<i>n</i> = 1,233), Italy (<i>n</i> = 1,000), Japan (<i>n</i> = 1,000), and the United States (<i>n</i> = 1,006). We assessed aims through confirmatory factor analysis (CFA), multi-group CFA, and composite reliability, coefficient H, and average variance extracted. CFA results indicated adequate fit for the full sample, <i>χ</i>²(14) = 174.41, <i>p</i><.001 (CFI = .96, TLI = .94, RMSEA = .05, SRMR = .93), and within each country subsample. Multi-group CFA results did not support scalar invariance, indicating differing end-of-life values across country subsamples. Sufficient internal consistency reliability was achieved within each country. These initial results support the use of the Prioritization of a Good Death Index as a valid and reliable measure to assess end-of-life preferences in practice and research.