Confirmatory factor analysis of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-B) among Italian medical students
Confirmatory factor analysis of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD-B) among Italian medical students
复制标题
DOI：
10.1017/s1478951515000139
复制
发表时间：
2015-10-01
影响因子：
2.2
通讯作者：
Torta, Riccardo
中科院分区：
文献类型：
--
作者：
Leombruni, Paolo;Loera, Barbara;Torta, Riccardo
目的：在过去的几十年里，观察到需要临终关怀的患者数量稳步增加。评估保健学生对临终关怀的态度是他们课程的重要一步，因为它提供了关于他们倾向于实践姑息医学的信息。Frommelt临终关怀态度量表（FATCOD-B）是为了检测这种倾向而开发的，但其心理测量特性尚未明确定义。方法：选取2012/2013学年和2013/2014学年608名医二学生作为方便样本。所有参与者都完成了FATCOD-B。样本被随机分为两个子样本。在项目分析中，使用第一个子样本（n = 300）进行信度（Cronbach's alpha）、内部一致性（项目-总相关性）和探索性因子分析（EFA）。使用第二个子样本（n = 308），在Lisrel程序中使用稳健ML方法进行验证性因子分析（CFA）。结果：各条目的信度为0.699。项目总量相关性较弱，范围在0.03到0.39之间。EFA确定了一个二维正交解决方案，解释了总方差的20%。CFA支持二维模型，但维度及其各自指标的负荷较弱，某些项目的负荷为零。结果的意义：本研究的结果表明，FATCOD-B测量的是一个二维结构，并且有几个项目似乎需要修改。未来的研究方向是建立一个修订版的量表，应注意项目的模糊性，并特别注意区分与临终关怀有关的情绪和信念的项目，以及他们的主体（例如，医疗保健提供者，病人，他的家人）。
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 alpha), 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).