Description

The Schedule of Attitudes toward Hastened Death (SAHD-20) is a self-report psychometric instrument designed to assess desire for hastened death among patients with severe or life-threatening illnesses. The scale consists of 20 items and was developed by Rosenfeld and colleagues to provide a structured assessment of patients’ attitudes and wishes related to hastened death.

The instrument has been used particularly in oncology and palliative care settings, where the evaluation of desire for hastened death can contribute to a broader understanding of patients’ psychological distress and supportive care needs.

Purpose

The main purpose of the SAHD-20 is to quantitatively assess a patient’s desire for hastened death in the context of serious illness. According to the source material, the questionnaire is primarily administered to patients with life-threatening conditions, such as cancer.

Its use can support research examining the relationship between desire for hastened death and factors such as psychological distress, disease burden, quality of life, and palliative care needs.

Structure and Scoring

The SAHD-20 contains 20 statements, answered using a True/False response format. The total score ranges from 0 to 20, with higher scores indicating a stronger desire for hastened death.

According to the original material, a score of ≥7 indicates a high level of desire for hastened death, while a score of ≥11 reflects a particularly elevated level. These values should be interpreted within the clinical and research context and should not be considered independent diagnostic criteria.

Validity

The SAHD-20 has been examined in populations of patients with advanced cancer and has demonstrated satisfactory evidence of validity. The provided material specifically refers to the study by Mystakidou et al. (2004), which evaluated the validity of the instrument among terminally ill cancer patients.

Reliability

The instrument has demonstrated very good internal consistency, with a reported Cronbach’s alpha of 0.89, supporting its reliability as a measure of desire for hastened death.

Applications

The SAHD-20 can be used in research related to palliative care, psycho-oncology, quality of life, psychological distress, and advanced illness. It provides a standardized way to investigate the intensity of desire for hastened death and the factors potentially associated with it.

Because of the sensitive nature of the construct, results should be interpreted with particular care and within a broader clinical and psychosocial assessment rather than in isolation.

References

Rosenfeld, B., Breitbart, W., Galietta, M., Kaim, M., Funesti-Esch, J., Pessin, H., et al. (2000). The Schedule of Attitudes toward Hastened Death: Measuring desire for death in terminally ill cancer patients. Cancer, 88(12), 2868–2875.

Mystakidou, K., Rosenfeld, B., Parpa, E., Tsilika, E., Katsouda, E., Galanos, A., & Vlahos, L. (2004). The Schedule of Attitudes toward Hastened Death: Validation analysis in terminally ill cancer patients. Palliative & Supportive Care, 2(4), 395–402.

Masterson, M. P., Slivjak, E., Jankauskaite, G., Breitbart, W., Pessin, H., Schofield, E., et al. (2018). Beyond the bucket list: Unfinished business among advanced cancer patients. Psycho-Oncology, 27(11), 2573–2580.