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Qual Life Res. 2017 Jan;26(1):235-239. doi: 10.1007/s11136-016-1409-0. Epub 2016 Sep 26.

Development of a short form of the Spanish schedule of attitudes toward hastened death in a palliative care population.

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Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain.
Public Health Unit, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain.
Centre d'Atenció Primària Les Corts. Transverse Group for Research in Primary Care, IDIBAPS, Barcelona, Spain.
Escola Universitària d'Infermeria Gimbernat, Autonomous University of Barcelona, Barcelona, Spain.
Department of Psychology, Fordham University, Bronx, NY, USA.
Department of Palliative Medicine, University Hospital of Cologne, Cologne, Germany.
School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Josep Trueta s/n, 08195, Sant Cugat del Vallès, Barcelona, Spain.



The schedule of attitudes toward hastened death (SAHD) is widely used to assess the wish to hasten death (WTHD) among patients with life-threatening conditions. A short form of the SAHD would increase its clinical applicability in this population.


Rasch analysis of data from 101 Spanish palliative inpatients. Item reduction involved selecting items with a high discrimination index (point-biserials ≥0.70), removing items with inadequate fit statistics, and assessing unidimensionality and local dependency. We examined the test probability function to establish an empirical risk score for suffering a WTHD and tested convergence between the original and the reduced set of items.


A set of five items met all quality criteria. In this sample, 20.8 % of participants had a higher risk of a WTHD (p > 50 %) at a score of 3. Correlation analysis confirmed convergent validity between the original and reduced forms. Concurrent validity was confirmed by the similar correlations shown by both versions of the SAHD (5 and 20 items) with other measures.


This 5-item Spanish form of the SAHD could be a suitable alternative to the full instrument. The cut-off score derived from the Rasch analysis may be able to detect patients at risk of a WTHD.


Desire to die; Desire to hasten death; End-of-life care; End-of-life decisions; Instrument; Item response theory; Measurement; Palliative care; Wish to hasten death

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Conflict of interest statement

Compliance with ethical standards Conflicts of interest The authors declare no conflict of interest. Ethical approval All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Clinical Research Ethics Committee and the Healthcare Ethics Committee of Bellvitge University Hospital (Barcelona). Informed consent Informed consent was obtained from all individual participants included in the study.

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