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

AbstractEnd-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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Hospital end-of-life care: families’ free-text notes

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-00239 ◽

2020 ◽

pp. bmjspcare-2020-00239

Author(s):

Sandra Kurkowski ◽

Johannes Radon ◽

Annika R Vogt ◽

Martin Weber ◽

Stephanie Stiel ◽

...

Keyword(s):

Palliative Care ◽

Quality Of Care ◽

End Of Life ◽

End Of Life Care ◽

Qualitative Content Analysis ◽

Free Text ◽

Life Care ◽

Quality Aspects ◽

Care Of The Dying

BackgroundPalliative care strives to improve quality of life for patients with incurable diseases. This approach includes adequate support of the patients’ loved ones. Consequently, loved ones have personal experiences of providing end-of-life care for their next. This is a resource for information and may help to investigate the loved ones’ perspectives on need for improvements.AimTo identify further quality aspects considered important by loved ones to improve the quality of care at the end of life as an addition to quantitative results from the Care of the Dying Evaluation for the German-speaking area (CODE-GER) questionnaire.DesignWithin the validation study of the questionnaire ‘Care of the Dying Evaluation’ (CODETM) GER, loved ones were asked to comment (free text) in parallel on each item of the CODE-GER. These free-text notes were analysed with the qualitative content analysis method by Philipp Mayring.Setting/participantsLoved ones of patients (n=237), who had died an expected death in two university hospitals (palliative and non-palliative care units) during the period from April 2016 to March 2017.Results993 relevant paragraphs were extracted out of 1261 free-text notes. For loved ones, important aspects of quality of care are information/communication, respect of the patient’s and/or loved one’s will, involvement in decision-making at the end of life (patient’s volition) and having the possibility to say goodbye.ConclusionsIt is important for loved ones to be taken seriously in their sorrows, to be informed, that the caregivers respect the patients’ will and to be emotionally supported.Trial registration numberThis study was registered at the German Clinical Trials Register (DRKS00013916).

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Learning outcomes from an end of life care training programme

Primary Health Care ◽

10.7748/phc.26.3.25.s31 ◽

2016 ◽

Vol 26 (3) ◽

pp. 25-28

Author(s):

Emma Vincent

Keyword(s):

End Of Life ◽

Learning Outcomes ◽

End Of Life Care ◽

Training Programme ◽

Life Care ◽

Care Training

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Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives

BMJ Open ◽

10.1136/bmjopen-2020-037466 ◽

2020 ◽

Vol 10 (8) ◽

pp. e037466

Author(s):

Patricia Harasym ◽

Sarah Brisbin ◽

Misha Afzaal ◽

Aynharan Sinnarajah ◽

Lorraine Venturato ◽

...

Keyword(s):

Palliative Care ◽

End Of Life ◽

End Of Life Care ◽

Long Term Care ◽

Symptom Assessment ◽

Assessment Tools ◽

Life Care ◽

Community Based ◽

Term Care

ObjectiveThe COVID-19 pandemic has highlighted ongoing challenges to optimal supportive end-of-life care for adults living in long-term care (LTC) facilities. A supportive end-of-life care approach emphasises family involvement, optimal symptom control, multidisciplinary team collaboration and death and bereavement support services for residents and families. Community-based and palliative care specialist physicians who visit residents in LTC facilities play an important role in supportive end-of-life care. Yet, perspectives, experiences and perceptions of these physicians remain unknown. The objective of this study was to explore barriers and facilitators to optimal supportive end-of-life palliative care in LTC through the experiences and perceptions of community-based and palliative specialist physicians who visit LTC facilities.DesignQualitative study using semi-structured interviews, basic qualitative description and directed content analysis using the COM-B (capability, opportunity, motivation - behaviour) theoretical framework.SettingResidential long-term care.Participants23 physicians who visit LTC facilities from across Alberta, Canada, including both in urban and rural settings of whom 18 were community-based physicians and 5 were specialist palliative care physicians.ResultsMotivation barriers include families’ lack of frailty knowledge, unrealistic expectations and emotional reactions to grief and uncertainty. Capability barriers include lack of symptom assessment tools, as well as palliative care knowledge, training and mentorship. Physical and social design barriers include lack of dedicated spaces for death and bereavement, inadequate staff, and mental health and spiritual services of insufficient scope for the population.ConclusionFindings reveal that validating families’ concerns, having appropriate symptom assessment tools, providing mentorship in palliative care and adapting the physical and social environment to support dying and grieving with dignity facilitates supportive, end-of-life care within LTC.

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Frommelt Attitudes Toward Care of the Dying Scale Form B

OMEGA - Journal of Death and Dying ◽

10.1177/0030222815568944 ◽

2015 ◽

Vol 70 (3) ◽

pp. 227-250 ◽

Cited By ~ 13

Author(s):

Chiara Mastroianni ◽

Michela Piredda ◽

Chiara Taboga ◽

Fiorino Mirabella ◽

Elisabetta Marfoli ◽

...

Keyword(s):

Nursing Students ◽

End Of Life ◽

Internal Consistency ◽

End Of Life Care ◽

Intraclass Correlation ◽

Italian Population ◽

Life Care ◽

Validity And Reliability ◽

Convenience Sample ◽

Care Of The Dying

Nurses' attitudes toward caring for dying patients have an impact on the quality of the care provided. Education can improve knowledge and attitudes toward end-of-life care. No validated tool that measures such attitudes is available for Italian nursing students. The aim of this study was to translate the Frommelt Attitudes Toward Care of the Dying Scale (FATCOD) Form B from English into Italian and to establish its validity and reliability within an Italian population of students. A two-stage design was used. Stage 1 adapted the original version of the tool and tested it for content validity through a multistep process. Stage 2 tested its psychometric properties by analyzing internal consistency, test–retest reliability, and construct validity. The convenience sample consisted of 465 nursing students from all the universities of one Italian region. Measures of stability showed a very good overall (0.87) intraclass correlation coefficient (ICC). The discriminating capacity of the scale was adequate with good values of asymmetry and kurtosis for most of the items. Good internal consistency was found. The six factors derived from the factor analysis are the following: Fear/Malaise, Communication, Relationship, Care of the family, Family as Caring, and Active Care. FATCOD Form B-I is a valid, reliable, and acceptable tool for evaluation of attitudes toward end-of-life care in Italian students. It measures six specific dimensions that should be highlighted during health care student education and training.

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