Development and Psychometric Evaluation of a New Short Version of the Swedish Frommelt Attitudes Toward Care of the Dying Scale

Abstract

Background The Frommelt Attitudes Toward Care of the Dying (FATCOD) is widely used as a measure of attitudes toward care of dying patients. However, poor factor structure and item redundancy have been reported across the literature. Objective A short version of the questionnaire is needed, to facilitate effective assessments of the attitudes of those caring for dying patients. The purpose of this study was to develop a FATCOD–Short Form and to secure its psychometric properties. Interventions/Methods Data gathered from 1000 nurses in previous studies were pooled and reanalyzed. Principal components analysis and confirmatory factor analysis were utilized to assess the factor structure of the FATCOD-30. A Rasch model was used to evaluate the measurement functioning of the scale. Results Of the original 30 items, 9 items of FATCOD were chosen for retention in the short form based on the principal components analysis, floor or ceiling effects, interitem correlations, and item-total correlation. All 9 items had good internal reliability. Both confirmatory factor analysis and Rasch analysis supported the unidimensionality of the FATCOD–Short Form. Conclusions The 9-item FATCOD–Short Form demonstrates evidence of acceptable validity and reliability to identify nurses’ attitudes toward caring for dying persons because of its brevity and comprehensive content. Implications for Practice When changing curricula in nursing education or implementing new procedures in nursing practice, it is important to have valid instruments to evaluate the results of the change. Such instruments should not be too lengthy or complicated. FATCOD–Short Form is a brief and valid instrument that can be easily used.

Shortening the Frommelt Attitude Toward the Care Of the Dying Scale (FATCOD-B): a Brief 9-Item Version for Medical Education and Practice

“…This study examined two revisions of the original 30-item FATCOD in which the scale was reduced to a subset of functioning items [16,17]. Seven items (8,9,11,13,14,26,28) were selected in both studies.…”

“…Seven items (8,9,11,13,14,26,28) were selected in both studies. Five items (3,5,6,7,15) were only retained in the previous study of the authors [16] and 2 items (25,29) were isolated in the study of Browall and colleagues [17]. Considering the results of these two independent revisions, a joint set of 14 items was tested using IRT models (partial credit model (PCM) and rating scale model (RSM) specifications).…”

“…The aim of this study is to propose a definitive reduction of the FATCOD scale by joining together both the Swedish and the Italian contributions [15][16][17][18], as, with the different statistical approaches used and the different samples considered, they yielded similar results. With the aim of preserving the usefulness of the tool and facilitating its application in end-of-life care training, this study offers a path toward a valid and parsimonious synthesis of the previous attempts at scale reduction.…”

Development and validation of the Short Professional Quality of Life Scale based on versions IV and V of the Professional Quality of Life Scale

“…Other short-version studies validated in samples of palliative care professionals and with good psychometric results are discussed in the scientific literature, for example, the Bugen Scale Of Coping With Death [ 40 ] or the Swedish Frommelt Attitudes Toward Care of the Dying Scale [ 44 ]. It is worth highlighting the importance of the availability of brief surveys for use in demanding work contexts such as end-of-life care in order to help protect these staff and not overload them with long questionnaires that further increase their burden and stress.…”

“…However, previous research has shown some controversy regarding differences in professionals’ quality of life in relation to these variables [ 24 , 46 – 59 ], and so future research should examine this possible explanation. Several studies have noted that sex is an important variable because women experience more BO than men [ 43 , 44 ]. However, very few studies have examined sex differences related to CF.…”