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Background and aim of the work: Nursing education plays a key role in preparing future nurses to deal with dying patients, which represents one of the most emotionally involving aspect of nursing. The aims of the study were to explore nursing students’ attitudes towards care of dying patients in three different European contexts and to analyze the variables that can influence them. Methods: We conducted an international multicenter cross-sectional study. We administered the Frommelt Attitude Toward Care of the Dying Scale form B (FATCOD-B) and a demographic form to 569 students, enrolled in three Nursing Programmes in different countries (Italy, Spain and United Kingdom), who accepted to participate in the study. The data were analyzed using SPSS software version 26.0. Results: Median total FATCOD-B scores indicated intermediate levels of students’ attitudes towards care for dying patients, with a statistically significant difference among the three student groups. The median total FATCOD-B scores did not statistically significantly change in students with different age, gender, year of study, religious beliefs, nursing education on palliative care, previous experiences of dying patient care and personal grieving. Conclusions: In our study, nursing students feel partially prepared in caring for dying patients and their attitudes do not change as the course of study progresses. No selected variables had an impact on students’ attitudes towards palliative care. Since nurses play a vital role in ensuring the quality of care, education on end-of-life care should be offered as a core part of undergraduate nursing programs. (www.actabiomedica.it)

The thesis aims to map the current state of preparedness of students of non-physician medical disciplines for meeting with the care for dying patients and death. On the basis of the set objective the following hypotheses were formed: H1: At the chosen disciplines, the preparedness of the students for meeting with the care for dying patients and death differs. H2: With age of the students, the preparedness of the students for meeting with the care for dying patients and death differs. H3: With the length of the practice of the students, the preparedness of the students for meeting with the care for dying patients and death differs. H4: At undergraduate and postgraduate study of nurses, the preparedness of the students for meeting with the care for dying patients and death differs. H5: On the basis of previous experience with terminally ill patient, the preparedness of the students for meeting with the care for dying patients and death differs. In the empirical part of the thesis was used the method of quantitative research using survey which was distributed among the students of the chosen disciplines at Faculty of Health and Social Sciences, University of South Bohemia in České Budějovice. The research connected with the thesis was realized within solution of the team grant project of Grant Agency of University of South Bohemia in České Budějovice - Utilization of Measuring Tools in Nursing (058/2018/S). The survey had two parts. Non-standardized part was focused on finding out of the basic identification data of respondents, information connected with approach and experience of the students with dying and with death not only of patients, with teaching of the palliative care within preparation of students at Faculty of Health and Social Sciences, University of South Bohemia in České Budějovice. The second part of the survey was made up of standardized tool "Frommelt Attitude Toward Care of the Dying Scale (FATCOD-B)" containing 42 questions. The gathered filled in surveys were after optical inspection entered into the program SASD. In it and also in the program SPSS were then conducted subsequent data analysis with utilization of the first and the second level of sorting. During the research it was confirmed that at the chosen disciplines, with age and with the length of practice the preparedness of students for meeting with the care for dying and death differs. On the contrary it was not confirmed that the preparedness of the students for meeting with the care for dying patients and death at undergraduate and postgraduate study of nurses and on the basis of previous experience with terminally ill patient would differ. The results of the research reveal weaknesses in the preparedness of the students for meeting with the care for dying patients and death especially in the area of practical application of obtained theoretical knowledge. The students in survey expressed that they are afraid, feel anxious and do not know how to communicate in caring for the dying and dead. To these and other problems we react in the thesis output in the form of the university subject that should help to improve their preparedness.

Objective:A steady increase in the number of patients requiring end-of-life care has been observed during the last decades. The assessment of healthcare students' attitudes toward end-of-life care is an important step in their curriculum, as it provides information about their disposition to practice palliative medicine. The Frommelt Attitude Toward Care of the Dying Scale (FATCOD–B) was developed to detect such a disposition, but its psychometric properties are yet to be clearly defined.Method:A convenience sample of 608 second-year medical students participated in our study in the 2012/2013 and 2013/2014 academic years. All participants completed the FATCOD–B. The sample was randomly divided in two subsamples. In the item analysis, reliability (Cronbach's α), internal consistency (item–total correlations), and an exploratory factor analysis (EFA) were conducted using the first subsample (n= 300). Using the second subsample (n= 308), confirmatory factor analysis (CFA) was performed using the robust ML method in the Lisrel program.Results:Reliability for all items was 0.699. Item–total correlations, ranging from 0.03 to 0.39, were weak. EFA identified a two-dimensional orthogonal solution, explaining 20% of total variance. CFA upheld the two-dimensional model, but the loadings on the dimensions and their respective indicators were weak and equal to zero for certain items.Significance of Results:The findings of the present study suggest that the FATCOD–B measures a two-dimensional construct and that several items seem in need of revision. Future research oriented toward building a revised version of the scale should pay attention to item ambiguity and take particular care to distinguish among items that concern emotions and beliefs related to end-of-life care, as well as their subjects (e.g., the healthcare provider, the patient, his family).

Objective:Given the increasing number of patients requiring palliative care and the need for more professionals who are able to provide care for the dying comfortably, assessment of medical attitudes toward end-of-life care is becoming a key aspect of medical education. The present study aimed to establish whether the Frommelt Attitude Toward the Care Of the Dying, Form B (FATCOD–B) meets current psychometric standards of validity for an assessment tool in medical education.Method:The participants were 200 undergraduate medical students. Since in a previous study the FATCOD–B was found to have a weak structure due to poor item validity, a refined version was proposed and tested in the present study. Confirmatory factor analysis and the Rasch model were employed to assess its dimensionality and psychometric properties.Results:The construct measured by the FATCOD–B continues to be misspecified. The tool has a two-dimensional structure. The first is well-structured and demonstrates appreciable measurement and discriminant capabilities. The second has low validity because its measurement capabilities are based on weakly correlated items.Significance of results:Our results suggest that the FATCOD–B measures a two-dimensional construct and that only its first dimension is a robust measurement tool for use in medical education to evaluate undergraduates' attitudes about caring for the dying.