# Polish translation, cross-cultural adaptation, and psychometric evaluation of the Frommelt Attitude Toward Care of the Dying Scale — Form A (FATCOD-A) among nurses

## TL;DR

This study translated and validated a tool to assess Polish nurses' attitudes toward caring for dying patients, finding it reliable and two-dimensional.

## Contribution

The study provides a culturally adapted and psychometrically validated Polish version of the FATCOD-A scale for assessing nurses' attitudes toward end-of-life care.

## Key findings

- The Polish version of FATCOD-A has a two-factorial structure and adequate internal consistency (α = 0.820).
- Nurses' attitudes correlate with gender, age, workplace, work experience, and education.
- The final scale consists of 30 items and is recommended for further validation.

## Abstract

Nurses’ attitudes towards death, dying patients and End-of-Life care have a great significance for the quality of provided care. Various factors influence nurses’ attitudes towards death. Negative attitudes or ineffective ways of coping with stress caused by patient’s death can lead to severe implications, such as job burnout or avoidance and hostility toward dying patients. Therefore, evaluation of nurses’ attitudes towards caring for terminally ill is essential for providing good and suitable palliative care.

The aim of the study was to validate and culturally adapt the Frommelt Attitude Toward Care of the Dying Scale Form A. Research was conducted among 283 polish nurses with the use of questionnaire translated by two independent certified interpreters. Polish version of the tool was accepted by the author of the scale - K. H. M. Frommelt. The reliability of the scale was calculated using Cronbach’s Alpha coefficient. The validity analysis was determined by assessing the correlation between sociodemographic data and the results of the scale. Factor analysis was performed using the principal component analysis and Varimax rotation method.

The analysis revealed two-factorial structure of the tool. Internal consistency of the scale calculated with the Cronbach’s Alpha coefficient showed adequate reliability of the entire scale (α = 0,820) and its factors (α = 0.808 and α = 0.757 respectively). The final version of the Polish scale consists of 30 items. Also, the study revealed correlation between nurses’ attitude and gender, age, workplace, work experience and education.

This preliminary study demonstrated good internal consistency and a two-dimensional structure of Polish version of FATCOD A, and the results suggest that further validation work should be performed. It is important to expand the database of tools designed to conduct research among nurses and this study provides another instrument that can be used for this purpose.

The online version contains supplementary material available at 10.1186/s12912-025-03994-x.