死亡識能測量、心理計量及其應用之範域文獻回顧

A Scoping Review of Death Literacy Measurement, Psychometric Evaluation and Applications

本文應用範域文獻回顧方式，探討死亡識能測量工具類型、信效度分布與相關研究現況，依循PRISMA-ScR指引，進行文獻搜尋與篩選，關鍵字使用死亡識能（death literacy）、死亡識能量表（death literacy index），於PubMed、CINAHL、Embase、google scholar與Airiti Library華藝線上圖書館等，中、英文實證資料庫進行檢索，文獻收錄年限設定2020年1月至2026年1月，最終共納入24篇文獻，採取敘事統合（narrative synthesis）分析進行資料萃取，經彙整歸納重點發現，如下：（一）辨識3種已發展的死亡識能測量工具（DLI、DLI-R、DLI-9），合計至少涵蓋7種翻譯語言（繁體中文、簡體中文、日文、瑞典語、土耳其語、荷蘭語與佛蘭芒語）；（二）研究類型以觀察性研究為主（45.8%），大多集中於亞洲地區（62.5%）；研究場域涵蓋社區、學校、網路社群、醫院；研究對象包含一般大眾、醫護人員、學生、病人與照顧者等角色群體；（三）死亡識能測量工具於研究使用時，面臨跨文化適應性的挑戰，未來於開發與施測時，需縝密考量當地社會文化背景、醫療制度與生命末期照護與臨終儀式之差異。建議未來可參考本範域文獻回顧結果，擬定適切本土化之死亡識能測量工具，後續研究可進一步採用縱貫性或介入性研究設計，驗證長期變化趨勢與變數之間的因果關係。

This scoping review aimed to examine the types of death literacy measurement instruments, their psychometric properties, and the current trends in applications. The PRISMA-ScR guidelines was conducted. Searches strategy using the keywords“death literacy”and“death literacy index”across English and Chinese language databases, including PubMed, CINAHL, Embase, Google Scholar, and Airiti Library. The inclusion period was set from January 2020 to January 2026. A total of 24 studies were included. Data were extracted and synthesized using a narrative synthesis approach. The key findings are summarized as follows: (1) Three death literacy measurement instruments were identified, namely the DLI, DLI-R, and DLI-9, which have collectively been translated into at least seven language versions, including Traditional Chinese, Simplified Chinese, Japanese, Swedish, Turkish, Dutch, and Flemish. (2) Observational studies constituted the predominant research design (45.8%), with the majority conducted in Asian regions (62.5%). Study settings included community, educational institutions, online platforms, and hospital contexts. Study populations encompassed of the general public, healthcare professionals, students, patients, and caregivers. (3) The application of death literacy instruments presents notable challenges related to cross-cultural adaptation. Future development and implementation should carefully consider sociocultural contexts, healthcare systems, and variations in end-of-life care practices and death-related rituals. Based on the findings of this review, the development of culturally appropriate and localized death literacy instruments is recommended. Future research should employ longitudinal or interventional designs to further examine long-term trends and causal relationships among variables.