Cross-cultural adaptation and psychometric testing of the Quality of Dying and Death Questionnaire for the Spanish population

Purpose: Many measurements have been developed to assess the quality of death (QoD). Among these, the Quality of Dying and Death Questionnaire (QODD) is the most widely studied and best validated. Informal carers and health professionals who care for the patient during their last days of life can complete this assessment tool. The aim of the study is to carry out a cross-cultural adaptation and a psychometric analysis of the QODD for the Spanish population. Methods: The translation was performed using a double forward and backward method. An expert panel evaluated the content validity. The questionnaire was tested in a sample of 72 Spanish-speaking adult carers of deceased cancer patients. A psychometric analysis was performed to evaluate internal consistency, divergent criterion-related validity with the Mini-Suffering State Examination (MSSE) and concurrent criterion-related validity with the Palliative Outcome Scale (POS). Results: Some items were deleted and modified to create the Spanish version of the QODD (QODD-ESP-26). The instrument was readable and acceptable. The content validity index was 0.96, suggesting that all items are relevant for the measure of the QoD. This questionnaire showed high internal consistency (Cronbach's a coefficient = 0.88). Divergent validity with MSSE (r = -0.64) and convergent validity with POS (r = -0.61) were also demonstrated. Conclusions: The QODD-ESP-26 is a valid and reliable instrument for the assessment of the QoD of deceased cancer patients that can be used in a clinical and research setting.