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Validation of a culturally adapted Swedish-language version of the Death Literacy Index

Johansson, Therese (författare)
Karolinska Institutet,Karolinska Institute,King's College London
Olsson, Åsa (författare)
Karolinska Institutet,Karolinska Institute,Lund University,Lunds universitet,Nationella forskarskolan om åldrande och hälsa,Forskargrupper vid Lunds universitet,National Graduate School on Ageing and Health,Lund University Research Groups
Tishelman, Carol (författare)
Karolinska Institutet,Karolinska Institute,Vrije Universiteit Brussel (VUB),Stockholms läns sjukvårdsområde
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Noonan, Kerrie (författare)
La Trobe University,Western Sydney University
Leonard, Rosemary (författare)
Western Sydney University
Eriksson, Lars E. (författare)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital,City University of London
Goliath, Ida (författare)
Karolinska Institutet,Karolinska Institute,Stockholm Gerontology Research Center
Cohen, Joachim (författare)
Vrije Universiteit Brussel (VUB)
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 (creator_code:org_t)
2023
2023
Engelska.
Ingår i: PLoS ONE. - 1932-6203. ; 18:11 November
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • The death literacy index (DLI) was developed in Australia to measure death literacy, a set of experience-based knowledge needed to understand and act on end-of-life (EOL) care options but has not yet been validated outside its original context. The aim of this study was to develop a culturally adapted Swedish-language version of the DLI, the DLI-S, and assess sources of evidence for its validity in a Swedish context. The study involved a multi-step process of translation and cultural adaptation and two validation phases: examining first content and response process validity through expert review (n = 10) and cognitive interviews (n = 10); and second, internal structure validity of DLI-S data collected from an online cross-sectional survey (n = 503). The psychometric evaluation involved analysis of descriptive statistics on item and scale-level, internal consistency and test-retest reliability, and confirmatory factor analysis. During translation and adaptation, changes were made to adjust items to the Swedish context. Additional adjustments were made following findings from the expert review and cognitive interviews. The content validity index exceeded recommended thresholds (S-CVIAve = 0.926). The psychometric evaluation provided support for DLI-S’ validity. The hypothesized six-factor model showed good fit (χ2 = 1107.631 p<0.001, CFI = 0.993, TLI = 0.993, RMSEA = 0.064, SRMR = 0.054). High internal consistency reliability was demonstrated for the overall scale (Cronbach’s α = 0.94) and each sub-scale (α 0.81–0.92). Test-retest reliability was acceptable, ICC ranging between 0.66–0.85. Through a comprehensive assessment of several sources of evidence, we show that the DLI-S demonstrates satisfactory validity and acceptability to measure death literacy in the Swedish context. There are, however, indications that the sub-scales measuring community capacity perform worse in comparison to other sca and may function differently in Sweden than in the original context. The DLI-S has potential to contribute to research on community-based EOL interventions.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)

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