Institutional members access full text with Ovid®

Share this article on:

The Swedish Version of the Frommelt Attitude Toward Care of the Dying Scale: Aspects of Validity and Factors Influencing Nurses’ and Nursing Students’ Attitudes

Henoch, Ingela PhD; Browall, Maria PhD; Melin-Johansson, Christina PhD; Danielson, Ella PhD; Udo, Camilla MSc; Johansson Sundler, Annelie PhD; Björk, Maria PhD; Ek, Kristina PhD; Hammarlund, Kina PhD; Bergh, Ingrid PhD; Strang, Susann PhD

doi: 10.1097/NCC.0b013e318279106b
Articles: Online Only

Background: Nurses’ attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

Objectives: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

Methods: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

Results: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α’s. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

Conclusions: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses’ attitudes toward caring for dying patients.

Implication for Practice: Care culture might influence nurses’ attitudes toward caring for dying patients; the benefits of education need to be explored.

Author Affiliations: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg (Drs Henoch, Strang, and Danielson); Department of Neurobiology, Division of Nursing, Care Science and Society, Karolinska Institutet, Stockholm (Dr Browall); School of Life Sciences, University of Skövde (Drs Browall, Johansson Sundler, Björk, Ek, Hammarlund, and Bergh); Department of Health Sciences, Mid Sweden University, Östersund (Drs Melin-Johansson and Danielson and Mrs Udo); and Angered Local Hospital, Gothenburg (Dr Strang), Sweden.

Funding for this project has been received from the Royal Society of Arts and Sciences in Gothenburg and Adlerbert Research Foundation, Wilhelm and Martina Lundgren’s Fund, and Assar Gabrielsson’s Fund.

The authors have no conflicts of interest to disclose.

Correspondence: Ingela Henoch, PhD, Sahlgrenska Academy, University of Gothenburg, Institute of Health and Caring Sciences, Box 457, SE-405 30 Gothenburg, Sweden (

Accepted for publication October 12, 2012.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins