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Confirmatory factor analysis of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD–B) among Italian medical students

Published online by Cambridge University Press:  11 February 2015

Paolo Leombruni ,
Barbara Loera ,
Marco Miniotti ,
Francesca Zizzi ,
Lorys Castelli  and
Riccardo Torta
Paolo Leombruni
Affiliation:
Department of Neuroscience, University of Turin, Turin, Italy
Barbara Loera*
Affiliation:
Department of Psychology, University of Turin, Turin, Italy
Marco Miniotti
Affiliation:
Department of Neuroscience, University of Turin, Turin, Italy
Francesca Zizzi
Affiliation:
Department of Neuroscience, University of Turin, Turin, Italy
Lorys Castelli
Affiliation:
Department of Psychology, University of Turin, Turin, Italy
Riccardo Torta
Affiliation:
Department of Neuroscience, University of Turin, Turin, Italy
*
Address correspondence and reprint requests to: Barbara Loera, Department of Psychology, University of Turin, 8, via Verdi, 10124 Torino, Italy. E-Mail: barbara.loera@unito.it
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Abstract

Objective:

A steady increase in the number of patients requiring end-of-life care has been observed during the last decades. The assessment of healthcare students' attitudes toward end-of-life care is an important step in their curriculum, as it provides information about their disposition to practice palliative medicine. The Frommelt Attitude Toward Care of the Dying Scale (FATCOD–B) was developed to detect such a disposition, but its psychometric properties are yet to be clearly defined.

Method:

A convenience sample of 608 second-year medical students participated in our study in the 2012/2013 and 2013/2014 academic years. All participants completed the FATCOD–B. The sample was randomly divided in two subsamples. In the item analysis, reliability (Cronbach's α), internal consistency (item–total correlations), and an exploratory factor analysis (EFA) were conducted using the first subsample (n = 300). Using the second subsample (n = 308), confirmatory factor analysis (CFA) was performed using the robust ML method in the Lisrel program.

Results:

Reliability for all items was 0.699. Item–total correlations, ranging from 0.03 to 0.39, were weak. EFA identified a two-dimensional orthogonal solution, explaining 20% of total variance. CFA upheld the two-dimensional model, but the loadings on the dimensions and their respective indicators were weak and equal to zero for certain items.

Significance of Results:

The findings of the present study suggest that the FATCOD–B measures a two-dimensional construct and that several items seem in need of revision. Future research oriented toward building a revised version of the scale should pay attention to item ambiguity and take particular care to distinguish among items that concern emotions and beliefs related to end-of-life care, as well as their subjects (e.g., the healthcare provider, the patient, his family).

Keywords

FATCOD–BAttitudes toward the dyingConfirmatory factor analysis (CFA)Item validityMedical students
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 5 , October 2015 , pp. 1391 - 1398
Copyright
Copyright © Cambridge University Press 2015 

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