Noonan Kerrie, Grindrod Andrea, Shrestha Sumina, Lee Sora, Leonard Rosemary, Johansson Therese
Public Health Palliative Care Unit, La Trobe University, Bundoora Campus, Melbourne, VIC 3000, Australia.
Western NSW Local Health District, Dubbo, Australia.
Palliat Care Soc Pract. 2024 Sep 17;18:26323524241274806. doi: 10.1177/26323524241274806. eCollection 2024.
Since the development of the Death Literacy Index (DLI) in 2019 in Australia, subsequent internationally validated versions have prompted rewording and refinement of the original survey questions. Use of the DLI in the community has also resulted in requests for a short format.
To examine and report on the psychometric properties of a revised version of the DLI-R and develop a short format DLI-9.
A cross-sectional national survey was conducted for the validation of the revised DLI.
The DLI items were revised by the research team using the international literature. DLI data were collected from a representative online non-probability panel of 1202 Australian adults, based on age, gender, and geographical location. Confirmatory factor analysis (CFA) was conducted to ensure the revised version (DLI-R) was consistent with the original. To develop a short format version of the DLI (DLI-9), items were first removed based on face validity, followed by an exploratory factor analysis (EFA) and CFA. The internal reliability of the DLI-R and the DLI-9 was assessed using Cronbach's alpha. The intraclass correlation coefficient was calculated to examine the inter-rater reliability between the DLI-R and DLI-9.
Twenty-four questions in the DLI were reworded for clarity. A CFA on the 29 items of this modified version of the DLI indicated a good model fit (Tucker-Lewis Index (TLI): 0.93; Comparative Fit Index (CFI): 0.93; root mean square of approximation (RMSEA): 0.06; standardized root mean residual (SRMR): 0.06), with six latent variables and an underlying latent variable "death literacy." For the DLI-9, an EFA identified a nine-item, two-factor structure model (DLI-9). A subsequent CFA in a separate sample demonstrated a good model fit for the DLI-9 (TLI: 0.92; CFI: 0.94; RMSEA: 0.089; SRMR: 0.07). Excellent inter-rater reliability (0.98) was observed between DLI-9 and DLI-R. Cronbach's alpha coefficients for DLI-R scales and subscales and the DLI-9 all exceeded 0.8, indicating high internal consistency.
The DLI-R and the DLI-9 were found to have acceptable psychometric properties. The development of a shorter version of the DLI provides a valid measure of overall death literacy.
自2019年澳大利亚开发死亡素养指数（DLI）以来，随后经过国际验证的版本促使对原始调查问卷问题进行了重新措辞和完善。在社区中使用DLI也引发了对简短版本的需求。
检验并报告修订版DLI-R的心理测量特性，并开发一个简短版的DLI-9。
进行了一项全国性横断面调查，以验证修订后的DLI。
研究团队利用国际文献对DLI项目进行了修订。基于年龄、性别和地理位置，从1202名澳大利亚成年人的代表性在线非概率样本中收集DLI数据。进行验证性因素分析（CFA）以确保修订版（DLI-R）与原始版本一致。为了开发DLI的简短版（DLI-9），首先基于表面效度删除项目，随后进行探索性因素分析（EFA）和CFA。使用克朗巴哈系数评估DLI-R和DLI-9的内部信度。计算组内相关系数以检验DLI-R和DLI-9之间的评分者间信度。
对DLI中的24个问题进行了重新措辞以使其更清晰。对该修订版DLI的29个项目进行的CFA表明模型拟合良好（塔克-刘易斯指数（TLI）：0.93；比较拟合指数（CFI）：0.93；近似均方根（RMSEA）：0.06；标准化均方根残差（SRMR）：0.06），有六个潜在变量和一个潜在变量“死亡素养”。对于DLI-9，EFA确定了一个九项、两因素结构模型（DLI-9）。随后在另一个样本中进行的CFA表明DLI-9模型拟合良好（TLI：0.92；CFI：0.94；RMSEA：0.089；SRMR：0.07）。在DLI-9和DLI-R之间观察到了出色的评分者间信度（0.98）。DLI-R量表、子量表和DLI-9的克朗巴哈系数均超过0.8，表明内部一致性高。
发现DLI-R和DLI-9具有可接受的心理测量特性。开发DLI的较短版本为总体死亡素养提供了一种有效的测量方法。
