Adaptation and validation of the Euthanasia Attitude Scale into Spanish

Abstract

Background: Considering the extensive debate that is currently taking place in Spain regarding euthanasia, it is important to examine the attitude of professionals who perform most of their duties at the bedside of these patients and their families. Objectives: The aim of the present study was to present an adaptation and validation of the Euthanasia Attitude Scale and to evaluate its psychometric properties among a sample of nursing students in Spain. Research design: A cross-sectional study design was conducted. Participants and research context: Non-probabilistic sampling was used to recruit 396 Spanish nursing students. Methods: A self-report questionnaire, including socio-demographic data and the Euthanasia Attitude Scale, were used for data collection. The psychometric properties of the Euthanasia Attitude Scale were assessed, including reliability and validity. Fit indices of the overall model were computed. Ethical considerations: This study was approved by the Hospital Ethical Committee. Students were informed of the aims and procedures and provided written informed consent prior to data collection. Results: The factorial solution comprised four domains and the scale demonstrated adequate internal consistency (Cronbach’s alpha = .878). For the exploratory factor analysis, the Kaiser–Meyer–Olkin index of sampling adequacy was .905 and the Bartlett’s Test of Sphericity was 2972.79 (p < .001). The initial factorial solution revealed four factors with eigenvalues of 6.78 for the first factor, 1.90 for the second one, 1.29 for the third, and 1.10 for the fourth factor. Moreover, there was a significant relationship between religiosity and the domains of the Euthanasia Attitude Scale. Discussion: This study obtained a Cronbach’s alpha coefficient of .88 which is in consonance with the findings reported by other studies whereby none of the items were removed and the initial structure based on four domains was conserved, with a factorial solution that explains 52.79% of the total variance. The displacement of some items of the domain may be explained by certain religious and/or cultural components as, in accordance with other studies, people with firm religious beliefs are more inclined to refuse euthanasia. Conclusion: According to the findings of this study, the Euthanasia Attitude Scale is a reliable and valid instrument to measure the attitudes toward euthanasia in a sample of Spanish nursing students. This Spanish adaptation will be valuable in future studies examining the attitude and implication of nurses, understanding that nurses are key figures in the euthanasia debate.

Validation of the Greek Version of Euthanasia Attitude Scale (EAS) in Greek Medical Doctors

“…The EAS total score was sensitive to years of service, frequency and number of dying patients treated, and need for training on psychological support in end-of-life patients, but not to age and gender. Onieva-Zafra also stated that beliefs of euthanasia can change and vary according to individual education and experience [ 26 ]. The same study that aimed to evaluate EAS scale psychometric properties among a sample of nursing students in Spain performed an exploratory factor analysis and found that the Kaiser–Meyer–Olkin index of sampling adequacy was 0.905 and the Bartlett’s Test of Sphericity was 2972.79 ( p < 0.001).…”

Spanish Version of the Attitude Towards Euthanasia Scale

“…Examples of items are: "if a patient in severe pain requests it, a doctor should remove life support and allow that patient to die" or "it is okay for a doctor to administer enough medicine to a suffering patient to end that patient's life if the doctor thinks that the patient´s pain is too severe". The original factorial structure was composed by four dimension: severe pain [1,3,9], no recovery [4,6], patient request [8,10] and doctor´s authority [4,5,7]. Several items had cross-loaded with several dimension.…”

“…In Spain, as in other countries, the term euthanasia is surrounded by media controversy, colored by social, cultural and, of course, religious factors [4]. Today, there are debates about the legalization of euthanasia around the world, accompanied by a wide variety of political and ideological groups with very diverse voices, ranging from extensive pro-euthanasia campaigns to strong opponents of legalizing euthanasia.…”

“…However, this law was not even voted on in the Spanish Parliament because it was postponed due to the imminent call for general elections. What does exist in Spain is a Law of Patient Autonomy and Rights and Obligations, according to which the patient has the right to decide freely, after receiving adequate information, among the available clinical options", as well as to "refuse treatment, except in the cases determined by law [4].…”

“…Few studies have explored the attitude of health professionals in Spain towards this issue, and in most of these attempts, a tool validated and used in other countries has never been used. Recently Onieva et al have validated the Euthanasia Attitude Scale (EAS) tool in a sample of university nursing students with good psychometric properties [4]. However, we may face different attitudes depending on whether we are talking about active or passive euthanasia, just as there are certain situations where people may be more for or against euthanasia.…”