Currently submitted to: JMIR Nursing
Date Submitted: Sep 4, 2026
Open Peer Review Period: Sep 8, 2026 - Nov 3, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development of a Digital Health Tool: Validation of the Good Death Inventory in Taiwan: A Cross-sectional study
ABSTRACT
Background:
In Taiwanese culture, the concept of a “good death” refers to a peaceful and fulfilled process at the end of life, encompassing physical, psychological, spiritual, and social well-being. However, the lack of culturally appropriate quantitative and digital tools to assess good death remains a major challenge. This study aimed to develop and validate a Taiwan-specific version of the Good Death Inventory (GDI) and establish a corresponding digital health tool.
Objective:
The objectives of this study were to (1) obtain permission from the author of the original questionnaire in Japan to translate the original GDI into Traditional Chinese, (2) examine the reliability and validity of the locally adapted version of the GDI in Taiwanese cultural contexts, and (3) develop a digitalized version of the instrument for clinical use.
Methods:
A cross-sectional design was adopted, and the study was conducted in three phases. In Phases I and II, the original GDI, authorized by Morita and colleagues in Japan, was translated into Traditional Chinese and validated through expert review and pilot testing. The instrument contains 18 domains and 54 items rated on a 7-point Likert scale (1 = “strongly disagree” to 7 = “strongly agree”). In Phase III, the Digital Health Tool of Good Death was developed by nursing informatics specialists through specification analysis, workflow design, and prototype construction.
Results:
Content validity was evaluated by four clinical experts, yielding Content Validity Index values of .94 in the first round and .97 in the second. Internal consistency reliability was tested with 30 clinical nurses, demonstrating a Cronbach’s alpha of .957.
Conclusions:
The locally adapted version of the Good Death Inventory showed strong reliability and validity (≥ .95) and was successfully adapted into a Traditional Chinese version suitable for Taiwan’s cultural context. This digital tool enhances accessibility and usability in smart hospitals and can serve as an effective quantitative assessment instrument for end-of-life care, supporting early planning and intervention for patients and families.
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