TRANSLATION AND CULTURAL ADAPTATION OF DEATH ATTITUDE PROFILE REVISED (DAP-R) FOR USE IN BRAZIL

Machado, Raylane da Silva; Oriá, Mônica Oliveira Batista; Fernandes, Márcia Astrês; Gouveia, Márcia Teles de Oliveira; Silva, Grazielle Roberta Freitas da

doi:10.1590/1980-265X-TCE-2018-0238

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ORIGINAL ARTICLE • Texto contexto - enferm. 28 • 2019 • https://doi.org/10.1590/1980-265X-TCE-2018-0238 copy

TRANSLATION AND CULTURAL ADAPTATION OF DEATH ATTITUDE PROFILE REVISED (DAP-R) FOR USE IN BRAZIL

TRADUCCIÓN Y ADAPTACIÓN CULTURAL DE DEATH ATTITUDE PROFILE REVISED (DAP-R) PARA USO EN BRASIL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to perform the translation, cultural adaptation, and content validation of Death Attitude Profile Revised to the Brazilian context.

Method:

a methodological study that comprised the following stages: initial translation, synthesis of these translations, back translation, expert committee and pre-test conducted with 40 nursing students. The cultural adaptation process, which preceded content validation, carried out with three expert judges.

Results:

the Brazilian version of Death Attitude Profile Revised maintained semantic, idiomatic, conceptual and experiential equivalences to the original version. The final content validity coefficient of the scale reached 0.85 for language clarity and theoretical relevance and 0.86 for practical relevance. Regarding the theoretical dimensions, a substantial Kappa mean value among evaluators was obtained (0.709). Data analysis on internal consistency, performed by calculating Cronbach's alpha coefficient, displayed a reliability considered high (α = 0.892).

Conclusion:

it is extremely important to have an instrument adapted to the Brazilian reality that allows for measuring the attitudes towards death from both a positive and negative point of view because, by identifying these attitudes, interventions and training are designed to improve the care process in nursing. Thus, the cultural adaptation process resulted in a reliable adapted version with valid content. However, it is necessary to test the psychometric properties before using in care practice and research.

DESCRIPTORS:
Death; Attitude in front of death; Nursing; Translation; Validation studies

Original	Final Instrument Version, Brazil
Death Attitude Profile Revised (DAP-R)	Perfil de atitudes frente à morte - Revisado (DAP-R).
1. Death is no doubt a grim experience.	1. A morte é sem dúvida uma experiência desagradável.
2. The prospects of my own death arouses anxiety in me.	2. A expectativa da minha própria morte desperta ansiedade em mim.
3. I avoid death thoughts at all costs.	3. Evito pensamentos sobre a morte a todo custo.
4. I believe that I will be in heaven after I die.	4. Acredito que vou para o céu depois que eu morrer.
5. Death will bring an end to all my troubles.	5. A morte trará um fim a todos os meus problemas.
6. Death should be viewed as a natural, undeniable, and unavoidable event.	6. A morte deveria ser vista como um evento natural, inegável e inevitável.
7. I am disturbed by the finality of death.	7. Me incomoda o caráter definitivo da morte.
8. Death is an entrance to a place of ultimate satisfaction.	8. A morte é uma entrada para um lugar de satisfação plena (céu, paraíso).
9. Death provides an escape from this terrible world.	9. A morte proporciona uma fuga deste mundo terrível.
10. Whenever the thought of death enters my mind, I try to push it away.	10. Sempre que o pensamento de morte entra na minha mente, eu tento afastá-lo.
11. Death is deliverance from pain and suffering.	11. A morte é uma libertação da dor e do sofrimento.
12. I always try not to think about death.	12. Eu sempre tento não pensar sobre morte.
13. I believe that heaven will be a much better place than this world.	13. Acredito que o céu será um lugar bem melhor do que este mundo.
14. Death is a natural aspect of life.	14. A morte é um aspecto natural da vida.
15. Death is a union with God and eternal bliss.	15. A morte é uma união com Deus e com a felicidade eterna.
16. Death brings a promise of a new and glorious life.	16. A morte traz a promessa de uma vida nova e gloriosa.
17. I would neither fear death nor welcome it.	17. Não temeria a morte, mas também não a receberia de braços abertos.
18. I have an intense fear of death.	18. Eu tenho um medo intenso da morte.
19. I avoid thinking about death altogether.	19. Eu, de modo geral, evito pensar sobre a morte.
20. The subject of life after death troubles me greatly.	20. O tema da vida após a morte me incomoda muito.
21. The fact that death will mean the end of everything as I know it frightens me.	21. O fato de que a morte significa o fim de tudo que eu conheço, me assusta.
22. I look forward to a reunion with my loved ones after I die.	22. Tenho esperança de me reunir com os meus entes queridos depois que eu morrer.
23. I view death as a relief from earthly suffering.	23. Vejo a morte como um alívio do sofrimento terreno.
24. Death is simply a part of the process of life.	24. A morte é simplesmente parte do processo da vida.
25. I see death as a passage to an eternal and blessed place.	25. Vejo a morte como uma passagem para um lugar eterno e abençoado.
26. I try to have nothing to do with the subject of death.	26. Tento não me envolver com o tema da morte.
27. Death offers a wonderful release of the soul.	27. A morte oferece uma maravilhosa libertação da alma.
28. One thing that gives me comfort in facing death is my belief in the afterlife.	28. Uma das coisas que me conforta ao enfrentar a morte é minha crença em uma vida após a morte.
29. I see death as a relief from the burden of this life.	29. Vejo a morte como um alívio do fardo dessa vida.
30. Death is neither good nor bad.	30. A morte não é boa nem ruim.
31. I look forward to life after death.	31. Espero ansioso pela vida após a morte.
32. The uncertainty of not knowing what happens after death worries me.	32. A incerteza de não saber o que acontece depois da morte me preocupa.

Dimension Mean ± Standard Deviation)	Alpha coefficient DAP-R (Wong, Reker and Gesser, 199412. Wong P, Reker G, Gesser G. Death attitude profile revised: a multidimensional measure of attitude toward death. In: Neimeyer RA, editor. Death anxiety handbook: research, instrumentation, and application. Washington (US): Taylor & Francis;1994.)	Pre-test Alpha Coefficient DAP-R (Machado, 20163. Machado RS, Lima LAA, Silva GRF, Monteiro CFS, Rocha SS. Finitude and death in Western society: a reflection focusing on health professional. Cul Cuid [Internet]. 2016 [cited 2018 Jan 12];20(45):91-7. Available from: https://dx.doi.org/10.14198/cuid.2016.45.10 https://dx.doi.org/10.14198/cuid.2016.45... )
Fear of Death (4.23±1.29)*	α = 0.86	α = 0.80
Death Avoidance (3.93±1.65)*	α = 0.88	α = 0.91
Neutral Acceptance (5.55±0.83)*	α = 0.65	α = 0.60
Approach Acceptance (4.33±1.20)*	α = 0.97	α = 0.87
Escape Acceptance (4.06±1.50)*	α = 0.84	α = 0.86

Scale items	Final content validity coefficient			Mean Kappa
Scale items	LC†	PP‡	TR§	Mean Kappa
Fear of Death				0.658*
1. Death is no doubt a grim experience.	0.96	0.96	0.96
2. The prospects of my own death arouses anxiety in me.	0.96	0.96	0.96
7. I am disturbed by the finality of death.	0.96	0.96	0.89
18. I have an intense fear of death.	0.96	0.96	0.96
20. The subject of life after death troubles me greatly.	0.83	0.83	0.83
21. The fact that death will mean the end of everything as I know it frightens me.	0.96	0.96	0.96
32. A incerteza de não saber o que acontece depois da morte me preocupa.	0.96	0.96	0.96
Death Avoidance				0.571*
3. I avoid death thoughts at all costs.	0.89	0.89	0.89
10. Whenever the thought of death enters my mind, I try to push it away.	0.89	0.89	0.89
12. I always try not to think about death.	0.82	0.76	0.76
19. I avoid thinking about death altogether.	0.89	0.89	0.96
26. I try to have nothing to do with the subject of death.	0.96	0.89	0.83
Neutral Acceptance				0.733*
6. Death should be viewed as a natural, undeniable, and unavoidable event.	0.96	0.96	0.96
14. Death is a natural aspect of life.	0.89	0.96	0.96
17. I would neither fear death nor welcome it.	0.83	0.89	0.76
24. Death is simply a part of the process of life.	0.89	0.83	0.82
30. Death is neither good nor bad.	0.83	0.83	0.76
Approach Acceptance				0.794*
4. I believe that I will be in heaven after I die.	0.89	0.76	0.89
8. Death is an entrance to a place of ultimate satisfaction.	0.76	0.89	0.89
13. I believe that heaven will be a much better place than this world.	0.89	0.76	0.89
15. Death is a union with God and eternal bliss.	0.76	0.76	0.76
16. Death brings a promise of a new and glorious life.	0.76	0.83	0.76
22. I look forward to a reunion with my loved ones after I die.	0.96	0.96	0.89
25. I see death as a passage to an eternal and blessed place.	0.89	0.89	0.83
27. Death offers a wonderful release of the soul.	0.76	0.83	0.83
28. One thing that gives me comfort in facing death is my belief in the afterlife.	0.89	0.89	0.83
31. I look forward to life after death.	0.83	0.89	0.89
Escape Acceptance				0.756*
5. Death will bring an end to all my troubles.	0.96	0.96	0.96
9. Death provides an escape from this terrible world.	0.96	0.96	0.96
11. Death is deliverance from pain and suffering.	0.96	0.96	0.96
23. I view death as a relief from earthly suffering.	0.96	0.96	0.96
29. I see death as a relief from the burden of this life.	0.96	0.96	0.96
Total	0.85	0.86	0.85

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDENCE AUTHOR
Raylane da Silva Machado raylane.s.machado@gmail.com