Refining the Frommelt Attitude Toward the Care of the Dying Scale (FATCOD–B) for medical students: A confirmatory factor analysis and Rasch validation study

Loera, Barbara; Molinengo, Giorgia; Miniotti, Marco; Leombruni, Paolo

doi:10.1017/s147895151700030x

Cited by 12 publications

(32 citation statements)

References 33 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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End-of-life care training has gaps in helping students to develop attitudes toward caring for the dying. Valid and reliable assessment tools are essential in building effective educational programmes. The Frommelt Attitude Toward the Care Of the Dying scale (FATCOD-B) is widely used to measure the level of comfort/discomfort in caring for the dying and to test the effectiveness of end-of-life care training. However, its psychometric properties have been questioned and different proposals for refinement and shortening have been put forward. The aim of this study is to get to a definitive reduction of the FATCOD-B through a valid and parsimonious synthesis of the previous attempts at scale revision. Data were gathered from a sample of 220 medical students. The item response theory approach was used in this study. Of the 14 items selected from two previous proposals for scale revision, 3 had a weak correlation with the whole scale and were deleted. The resulting 11-item version had good fit indices and withstood a more general and parsimonious specification (rating scale model). This solution was further shortened to 9 items by deleting 2 of 3 items at the same level of difficulty. The final 9-item version was invariant for gender, level of religiosity and amount of experience with dying persons, free from redundant items and able to scale and discriminate the respondents.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…The DIF approach within the framework of the Rasch measurement model offered a sophisticated way of confirming that incarcerated individuals and community participants responded in the same manner to all DES-II items. Our study shows the great value of Rasch analysis, which provides detailed item-level analysis and adds refinement to traditional psychometric methods [56][57][58].…”

Section: Discussionmentioning

confidence: 99%

Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study

et al. 2020

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Background: The Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale. Methods: Data were obtained on a sample composed by 320 Italian participants (122 inmates and 198 communitydwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants' level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power. Results: Three items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale. Conclusions: Results provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct.

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“…To the best of our knowledge, there is only one study that has appraised the psychometric properties of the FATCOD within the framework of Rasch analysis. 22 Using Rasch models has several advantages over CTT; in Rasch models, item statistics are not sample-dependent, weights responses are not equal in Rasch models, and reliability and standard error of measurement are not constant. 32 Therefore, a Rasch model was applied to the FATCOD to better understand the relationship between a person's ability and an item's difficulty.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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Refining the Frommelt Attitude Toward the Care of the Dying Scale (FATCOD–B) for medical students: A confirmatory factor analysis and Rasch validation study

Abstract: Our results suggest that the FATCOD-B measures a two-dimensional construct and that only its first dimension is a robust measurement tool for use in medical education to evaluate undergraduates' attitudes about caring for the dying.

Cited by 12 publications

References 33 publications

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

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

Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study

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

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