Frommelt Attitude Toward Care of the Dying Scale Form B: Validation for Spanish health professionals

Abstract

Objective The aim of this study is to culturally adapt and validate the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B) in Spanish health professionals. Method A cultural adaptation and scale validation was carried out to evaluate the validity of appearance, content and construct, reliability and feasibility. The psychometric validation of the FATCOD-B was carried out on a sample of 2,446 Spanish physicians, nurses, psychologists, and social workers and students of these disciplines, between January 2017 and December 2018. This sample was selected by intentional sampling. Descriptive statistics were used to characterize the sample. An exploratory multi-group factor analysis was performed, internal consistency was evaluated by calculating Cronbach's α and stability by test–retest. Results A total of 2,446 people participated in the study, 1,134 students and 1,312 professionals. The exploratory multi-group factor analysis revealed a two-dimensional factor structure, with a total of 17 items retained in the model from the 30 of the original scale. The results showed that this version has adequate reliability (α = 0.79) and for each subscale, and stability (ICC = 0.843, p < 0.001). Significance of results FATCOD has been used with physicians and nurses from different countries. However, no reports have been found in the literature of its use with psychologists and social workers. It is important to have an instrument that allows us to know the attitudes of these professionals since they are all directly involved in the care of patients at the end of their lives and their families. The Spanish version of FATCOD-B has proven to be a reliable and valid instrument for its use in Spanish health professionals while allowing comparisons between disciplines.

Supportive and Palliative Care Attitude for Cancer Patients

“…Attitude, which referred to a force or quality of mind, seemed much more appropriate [6,7]. Traditionally, attitudes have been considered to have three fundamental components: affective (feeling and emotional reaction) behavioral (individual intention that self-concept), and cognitive (beliefs, knowledge, thought, experience) components to the attitude object [6][7][8][9] (as shown Figure 1).…”

“…It is important to have tools that allow us to know the attitudes of health care professionals towards the care of patients who is under Palliative care [9]. Attitudes towards palliative care were defined as feelings, thoughts, attitudes, and comfort level towards care of the patients and their family [5,20] and most of the available tools are in attitude and competence in dealing with death and dying tools that are Frommel's attitudes towards care of the dying (FATCOD-A for nurses, FATCOD-B for students) scale by 1991 [21].…”

“…Attitudes towards palliative care were defined as feelings, thoughts, attitudes, and comfort level towards care of the patients and their family [5,20] and most of the available tools are in attitude and competence in dealing with death and dying tools that are Frommel's attitudes towards care of the dying (FATCOD-A for nurses, FATCOD-B for students) scale by 1991 [21]. FATCOD tool has been used with physicians and nurses form different countries and a few countries' reports have been using for psychologists and social workers [5,9,13,[22][23][24]. This tool is specifically designed for evaluating nurses and has an equal number of positively and negatively worded items and responding rate is 5 point on the Liker scale, ranging from 30 to 150.…”

“…It is necessary for health care professionals to better understand death, accept, and prepare for it with a mature attitude [25,26]. Death attitude profile revised (created by Wong, Reker and Gesser in 1994 [27]) tool is reliable and valid assessment instrument used to identify attitudes about care at the end of life among clinicians [9]. DAP-R reliability values were high and the five domains of attitude towards death i.e., fear of death, death avoidance, natural acceptance, approach acceptance, and escape acceptance, respectively [26,28].…”

“…A health care professional has a more positive attitude to care for these people which is also associated with less fear and avoidance of death, anxiety, and stress [9,[22][23][24].…”