Background: Considering the extensive debate that is currently taking place in Spain regarding euthanasia, it is important to examine the attitude of professionals who perform most of their duties at the bedside of these patients and their families.
Objectives: The aim of the present study was to present an adaptation and validation of the Euthanasia Attitude Scale and to evaluate its psychometric properties among a sample of nursing students in Spain.
Research design: A cross-sectional study design was conducted.
Participants and research context: Non-probabilistic sampling was used to recruit 396 Spanish nursing students.
Methods: A self-report questionnaire, including socio-demographic data and the Euthanasia Attitude Scale, were used for data collection. The psychometric properties of the Euthanasia Attitude Scale were assessed, including reliability and validity. Fit indices of the overall model were computed.
Ethical considerations: This study was approved by the Hospital Ethical Committee. Students were informed of the aims and procedures and provided written informed consent prior to data collection.
Results: The factorial solution comprised four domains and the scale demonstrated adequate internal consistency (Cronbach's alpha = .878). For the exploratory factor analysis, the Kaiser-Meyer-Olkin index of sampling adequacy was .905 and the Bartlett's Test of Sphericity was 2972.79 (p < .001). The initial factorial solution revealed four factors with eigenvalues of 6.78 for the first factor, 1.90 for the second one, 1.29 for the third, and 1.10 for the fourth factor. Moreover, there was a significant relationship between religiosity and the domains of the Euthanasia Attitude Scale.
Discussion: This study obtained a Cronbach's alpha coefficient of .88 which is in consonance with the findings reported by other studies whereby none of the items were removed and the initial structure based on four domains was conserved, with a factorial solution that explains 52.79% of the total variance. The displacement of some items of the domain may be explained by certain religious and/or cultural components as, in accordance with other studies, people with firm religious beliefs are more inclined to refuse euthanasia.
Conclusion: According to the findings of this study, the Euthanasia Attitude Scale is a reliable and valid instrument to measure the attitudes toward euthanasia in a sample of Spanish nursing students. This Spanish adaptation will be valuable in future studies examining the attitude and implication of nurses, understanding that nurses are key figures in the euthanasia debate.
Keywords: Clinical ethics; euthanasia; instrument validation; professional ethics; psychometric properties; religiosity.