Attitudes towards death and dying among intensive care professionals: A cross-sectional design evaluating culture-related differential item functioning of the frommelt attitudes toward care of the dying instrument

Hanan HamdanAlshehri; Axel Wolf; Joakim Öhlén; Richard Sawatzky; Sepideh Olausson

doi:10.1016/j.heliyon.2023.e18864

Attitudes towards death and dying among intensive care professionals: A cross-sectional design evaluating culture-related differential item functioning of the frommelt attitudes toward care of the dying instrument

Heliyon. 2023 Aug 6;9(8):e18864. doi: 10.1016/j.heliyon.2023.e18864. eCollection 2023 Aug.

Authors

Hanan HamdanAlshehri^{1

2}, Axel Wolf^{2

3

4}, Joakim Öhlén^{2

5

6}, Richard Sawatzky⁷, Sepideh Olausson²

Affiliations

¹ Princess Nourah bint Abdulrahman University, Medical and Surgical Department College of Nursing, Riyadh, Saudi Arabia.
² Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Vastra Gotland, Sweden.
³ Sahlgrenska University Hospital/Ostra, Department of Anaesthesiology and Intensive Care Medicine, Gothenburg, Sweden.
⁴ Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
⁵ University of Gothenburg Centre for Person-Centred Care, University of Gothenburg, Sweden.
⁶ Palliative Centre, Region Vastra Gotaland Sahlgrenska University Hospital, Gothenburg, Sweden.
⁷ Trinity Western University, Canada.

Abstract

Objective: The objective is to examine whether one of the most used instruments for measuring attitudes towards caring for dying patients, the Frommelt Attitude Toward Care of the Dying (FATCOD-B) instrument, has the same meaning across different societal contexts, as exemplified by Swedish and Saudi Arabian intensive care professionals.

Methods: A cross-sectional design used the 30-item FATCOD-B questionnaire. It was distributed to intensive care professionals from Sweden and Saudi Arabia, generating a total sample of 227 participants. Ordinal logistic regression models were used to examine the differential item functioning (DIF) for each item.

Results: Up to 12 of the 30 items were found to have significant DIF values related to: (a) Swedish and Saudi Arabian intensive care professionals, (b) Swedish and Saudi Arabian registered nurses (RNs), (c) RNs' levels of experience and (d) RNs and other intensive care professionals in Saudi Arabia.

Conclusions: The results indicate that FATCOD should be used cautiously when comparing attitudes towards death and dying across different societal and healthcare contexts.

Keywords: Attitude scale; Death and dying; Differential item functioning; Intensive care; Ordinal logistic regression; Palliative care.